Cutting Medicaid could hurt those trying to live independently | Opinion
Ian Bott, who is on the autism spectrum and has schizoaffective disorder, has competed in the Special Olympics many times, has a bachelor’s degree from Boise State University and served two terms on the governor’s Developmental Disabilities Council and on the board of the State Independent Living Council.
Ian can attribute a lot of that success to Medicaid, which helps pay for medications, therapy, dental visits as well help with laundry, cooking and transportation.
But perhaps most importantly, Medicaid has allowed Ian to live independently.
Ian, who lives in an apartment in Boise’s North End, can go to the coffee shop and the gym, do yoga, volunteer and work.
“Without Medicaid services, I would be a danger to myself and others, and I wouldn’t be able to live alone and would probably go back to a group home or go to jail and lose my independence I have worked so hard to gain,” Ian wrote in a letter to the editor to the Idaho Statesman. “I would lose my suicidal thoughts-free streak most likely and I wouldn’t be able to do as much in the community.”
The Idaho Legislature on March 23 passed nearly $22 million in cuts to Medicaid provider reimbursement rates for residential habilitation services. Gov. Brad Little on Thursday signed the bill.
It’s unclear exactly how much of an impact this might have on people like Ian, who lives in self-directed care. Others, like Katie Hodges, whom I profiled a few weeks ago and who bravely testified before a Senate committee in March, receive more intensive, round-the-clock care and could see their services diminished.
Ian wants to make others aware of the harm that cuts could have on others.
“I think what I’m more worried about, with the cuts going through, is people who are in need of 24/7 care, or who need care most of the time from a partner, from somebody who is working with them, not getting the help they need, and potentially passing away,” Ian told me in an interview. “Part of my advocacy, my motto is to speak up for those who can’t speak up for themselves. It’s not for me, it’s more for the people who need the help that Medicaid offers that I do this kind of work.”
When interviewed by the Idaho Statesman in 2009, Ian said, “I hope to be able to live on my own someday — my ultimate goal.”
Ian has achieved that goal.
Ian has lived in different environments, including group homes and “supported independent living.” Today, Ian is living in “self-directed care,” which Medicaid helps pay for.
In self direction, money is set aside to use as needed. In Ian’s case, it’s $55,000 a year.
Compare that with the cost of 24/7 care, which can cost $800 a day, or a group setting such as the Southwest Idaho Treatment Center, which costs $2,000 a day.
It’s a good investment to help people like Ian become independent, contributing members of society.
Medicaid covers the cost of paying people who help Ian with activities of daily living, such as transportation, grocery shopping, medical appointments, cleaning the apartment, organization and household management, as well as social integration, such as going with Ian to coffee shops and helping navigate social situations (voice volume, personal space, appropriate behavior in public).
“I think that I work better living by myself,” Ian said. “Living in residential habilitation or an independent care facility wouldn’t allow me to, and I think that I’m happier here. I think that if I was to go back to an independent care facility, I would resent it, because I worked so hard to get past that.”
Ian’s mom, Susan Pohl, told me that getting Ian, who uses the pronouns they and them, into self-directed independent living has been a Godsend.
“Living on their own enables them, makes them feel like a regular person, like a real person, you know, somebody who is independent and a bonafide adult,” she told me in a phone interview. “When we finally were able to get them into a place by themself, they blossomed.”
Scott McIntosh is the opinion editor of the Idaho Statesman. You can email him at smcintosh@idahostatesman.com or call him at 208-377-6202. Sign up for the free weekly email newsletter The Idaho Way.
