Medicaid changes forcing two people with autism out of a group home

Published: Jan. 5, 2018 at 4:13 PM CST
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Dalton has been living at a group home in Cedar Rapids for more than three years. He lives there with another individual named Kevin. They both have autism.

Andy’s mother, Lisa McKiney says he’s made a lot of progress there with the individual one on one care he receives.

She says, “He's just strived from there. He's talking in complete sentences, he's not drooling out the side of his mouth, and he's not highly medicated. They got rid of some medicine."

Once again his life is changing forever because he will have to find a new home, and his parents say he doesn't do well with change.

McKiney says, "Everybody else has their moments but Dalton's are escalated to the tenth degree. But these folks here make it so he's safe here, he knows what to do here."

Dalton and Kevin have also become best friends. Kevin calls Daulton’s parents “mom and dad.” Dalton‘s father Timothy Mumma says, "Kevin's parents are dead. His sister is not well off. And that kid ain't got a chance. He ain't got a chance. If this house goes he's institutionalized for the rest of his life. "

Neither parent can afford to quit their jobs--and they're not physically capable of taking care of Kevin and Dalton. McKiney says, "I'm fighting for the guys, I'm fighting for them, I'm fighting for REM to get what they deserve. The boys deserve this. They're human. That's all I can say."

REM Iowa runs the house that they stay in. In a statement, they told KCRG-TV9:

“Since the implementation of Managed Care for Medicaid recipients of Home and Community-Based Services (HCBS) in April 2016, REM Iowa has not been reimbursed at a rate that supports the individual service needs of the gentlemen in this program. We have attempted to work with the state and the MCOs for nearly two years while continuing to provide the 1:1 staffing support levels that are required according to the authorized service plans established for the gentlemen supported by this program. The rate that we are receiving for services only covers approximately 40 percent of the cost of these services. No provider could continue to sustain losses of this nature indefinitely.

Further complicating the situation, effective December 1, 2017, the state moved to a tiered rate system that relies exclusively on the Supports Intensity Scale (SIS). That tool does not adequately capture the needs of many of the individuals served in home and community-based services and, as a result, is placing individuals in rate tiers that will not cover the cost of the services they are receiving.

We are committed to ensuring as seamless a transition as possible for the people served in this program, and we stand ready to assist in any manner. Despite the unfortunate closure of this program, REM Iowa remains committed to serving the residents of Iowa for many years to come.”

A GoFundMe page has been created for Dalton and Kevin.