Last week, Oregon lawmakers discussed legislative proposals that would establish a system that would pay parents to care for their children with intellectual and developmental disabilities.
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Members of the Oregon Senate Interim Committee on Human Services, Mental Health, and Recovery discussed two legislative concepts during a meeting on Friday. Sen. Tim Knopp (R-Bend) introduced Legislative Concept (LC) 656 to the committee, which aims to extend financial support for parents of disabled children that was offered during the COVID-19 pandemic.
“Parents with disabled kids struggled a lot during the pandemic,” Knopp said. “Part of that was driven by the lack of caregivers and the ability to get caregivers, even if they were available.”
The federal government partially paid for the parents of disabled kids to take care of their kids during the pandemic. And Knopp said he was contacted by constituents requesting that he support legislation that would provide an opportunity for these benefits to continue in some way.
“The reasons they wanted this to continue were the fact that they saw significant benefit of kids being overall healthier, happier, more integrated in their communities, and staying out of institutional living situations and the hospital,” Knopp said. “They recognized that kids actually did better when parents were being paid to care for these kids.”
LC 656 would remove a prohibition against parents serving as paid caregivers or personal support workers to their minor children, Knopp said. It would allow children who have severe needs to qualify for in-home support care from parents, offer parents the same type of training as personal support workers get, and retain the decision-making authority of paid parents when it comes to their minor child’s support needs.
LC 656 would also create a transition program so that when a child turns 18 they can work with their parents to best prepare for any change in services and roles, Knopp said.
Sen. Sara Gelser Blouin (D-Corvallis) introduced LC 1256 to the committee. She said she conducted some research to determine whether it was best for the state to establish a paid-parent caregiver program as part of Oregon’s Medicaid plan or to attempt to acquire a waiver.
“If something is part of the state Medicaid plan, it becomes an entitlement for everyone,” Gelser Blouin said. “You can’t dial back or refine if anyone else becomes eligible for that service in that service category. There aren’t any cost controls for that. So I wanted to try to figure out what that would cost. A waiver can give you access to those same services, but within that waiver, you can provide some levers to be able to control cost over time.”
Gelser Blouin said that 12,409 children under 18 are currently eligible for intellectual and developmental eligibility services. Of that group, only about 4,776 use in-home services, she said.
According to the Oregon Department of Human Services’ Office of Developmental Disabilities Services, the cost for provider in-home services per case for a child was about $3,843 per month in 2021. The cost per case increased to $6,106 per month for paid parents who provided care, primarily due to a higher number of hours worked by parents, Gelser Blouin said.
Looking at current participation numbers for those eligible who are using in-home services, those who are eligible but not using any services, and projected increases in users, the state’s general fund costs for services would increase by about $157 million if a paid-parent program was implemented as a Medicaid plan, Gelser Blouin said.
Due to the high cost of a Medicaid plan, LC 1256 proposes to establish a paid-parent program through the state applying for a waiver.
“And because it’s a waiver, we can identify the population,” Gelser Blouin said.
The state would be able to categorize kids into service level tiers based on age.
“It will more closely match the service need to a kid’s age in a more refined way,” Gelser Blouin said. “Rather than choosing the number of hours a child needs, this goes more to the intensity. There are children who would leapfrog to the highest tier because of behavioral needs or because of medical needs.”
The number of hours parents could be paid for in caring for children would be capped at 60 hours a week per household. That could mean one parent being paid for 40 hours, while the other is paid for 20, or any other combination that would bring the household’s total hours to 60.