Our mission is to empower adults with disabilities through vocational and social opportunities, and to guide them toward realizing their goals and dreams.
Think About Us When You Vote on the State's Budget—It Is Good Policy and Good for Our Economy!
Founded in 1964, Merrick, Inc., (Merrick) was one of the first Day Training and Habilitation (DT&H) providers in Minnesota and is licensed by the State as an Adult Day Services (ADS), DT&H and Supported Employment Services (SES) provider; and is enrolled in the Ticket-To-Work (TTW) employment network. Merrick is dedicated to serving adults with developmental disabilities by providing supports that offer meaningful vocational options, enhance personal skills, empower choice making abilities, and expand participation in the community. Most of the clients in our program have a primary diagnosis of mental retardation and a number are non-ambulatory, sight impaired/blind, hearing impaired/deaf, non-verbal, or have special dietary concerns (e.g. G-Tubes, dietary restrictions, modified diets, etc.). In addition, many clients have secondary diagnoses that include autism, cerebral palsy, epilepsy, mental illness, seizure disorders, and other related conditions. Approximately 60% of the clients live in a group home with 35% living with a family member and 5% living independently.
The primary focus of Merrick's program is to provide training and work opportunities for adults with developmental disabilities through integrated vocational, social, and habilitation programming as well as supporting transportation. Services include employer-based work through contacts and relationships with businesses in the community or through facility-based production of work outsourced to Merrick; job coaching and related vocational support and counseling; and a full range of occupational and other therapies. Merrick works with over 75 local businesses and community organizations to provide workforce solutions for those organizations and also has a tradition of developing its own social enterprises to create meaningful employment suitable to the preferences and abilities of clients at Merrick. Through meaningful employment and other programming, Merrick fosters greater independence, community integration, health, and safety for the clients served. Merrick is governed by an 18 person Board of Trustees, including business and community leaders, human service professionals, and family advocates. Merrick employs over 150 staff members. Over 90% of Trustees and staff and 100% of the clients at Merrick live in Minnesota, pay taxes in Minnesota, and are eligible to vote in Minnesota.
Protect Core Services for Vulnerable Citizens with Disabilities
We urge you not to cut reimbursement rates for day services for adults with developmental disabilities. Since 2003, reimbursement rates have not kept pace with the actual cost of delivering these programs. Based on a 2009 report by ARRM, disability service provider rates increased only 8% over the previous ten years while cumulative inflation for the same time period was almost 20%. More specifically, Merrick received no rate increase in 2004 or 2010, and suffered rate cuts of 1% in 2003 and 2.58% in 2009. In addition, Merrick is open at least 250 days a year, but is only reimbursed for 244 days per year resulting in over $30,000 in unbillable services in 2010. In the past few years, Merrick has cut staff, reduced training, frozen salaries, and diligently looked for other ways to generate program revenue. We cannot continue to absorb significant rate cuts, increases in licensing fees, the cost of background checks, and still attract and retain qualified staff to deliver high quality services. Even with charitable gambling and donor support, Merrick has limited means at these rates to increase alternative sources of funding to foster new job creation and sustain, much less enhance and innovate program support for our clients.
Why should programs for adults with developmental disabilities be "held harmless" as stated by Speaker of the House Kurt Zeller in a December 11 interview with the Pioneer Press? Because that is what the public wants and because these programs work! A 2007 survey by the Governor's Council on Developmental Disabilities found that 80% of Minnesotans acknowledge that we are all better off when we provide the support necessary to help people live to their potential. At Merrick, we receive client and other stakeholder satisfaction scores of over 97% for program and transportation services. Aggregate client wages have increased annually each year for the last 7 seven years and are now more than double client wages earned in 2004.
Our Services Fuel The Local Economy
In 2010, Merrick worked with a local economist, Dr. C. Ford Runge, from the University of Minnesota to assess the economic impact of the State's investment in Merrick's program (a study reviewed by a panel of peers including State Economist Tom Stinson). As stated in the report - besides the dividends of work, wages, transportation, and supervision to clients, other dividends include: "wages to program staff; avoided costs of residential supervision; taxes paid by clients and staff; and state revenue from charitable gambling activities. In addition, many of these programs seek to leverage state support by seeking grants supplementing state taxpayer dollars. Finally, the companies that employ people with disabilities through contracts with such programs do so both because of their civic concern and because it makes good business sense. In sum, public investments in day service programs for people with developmental disabilities produces nearly $3.00 of economic benefit for every $1.00 spent. These benefits actually help to reduce and offset the actual, unavoidable cost of the 24-hour long term care for persons with developmental disabilities. Apart from any humanitarian concern for the less fortunate, government cuts to such programs are penny-wise and dollar-foolish".
Look for Cost Savings in Service Reform
Legislators often ask for solutions other than rate cuts to help reduce government spending and close the budget gap. Merrick urges legislators to look for cost savings for the State and the provider community through regulatory reform. Opportunities include:
Reduce Administrative Burden: As permitted by Medicaid, reimburse at weekly or daily rates not hourly as recommended by DHS. Services are not delivered hourly and the administrative burden to invoice on that basis is too high. Additionally, budget neutral, as it applies to the new rate frameworks, should be by each of the 31 services to maintain stability within the system and compliance with state and federal Medicaid regulations.
Reform case management: As discussed in the February 2011 Report to the Legislature, client choice of case managers is restricted in Minnesota and the cost exorbitantly high. By defining service expectations and restructuring rates to be in-line with comparable services, not only can the State save nearly $40 million dollars annually, but clients will have a genuine choice in selecting this critical advocate in coordinating their service plan.
Preserve CCSA: A vital resource to families that choose to have their adult children with disabilities reside at home, this funding source promotes integration in the community at a much lower cost than Medicaid services.
Reduce liability limits: While the economy has suffered and rates have declined, state liability limits have been raised from $300,000 to $1.5 million. This limit is often used in government contracts with private sector. The limit should be lowered to $1 million, extended to providers working on behalf of the state, and be reset every five years based on the highest COLA in that time period.
Reduce Regulations: Amend MN Statute 309.53 so that non-profits file a certified annual audit according to the following schedule: total revenues under $1 million – no audit required; total revenues of $1 to $5 million – financial reviews every year with a certified audit every 6 years; total revenues of $5 to 10 million - financial reviews every year with a certified audit every 3 years; and total revenues over $10 million – certified audit every year.
Close State Operated Services: As the METO lawsuit demonstrates, there is an inherent conflict of interest in both monitoring and managing human service programs. This aside, State operated services cost substantially more than their private, non profit provider peers and do not produce better outcomes.
Reduce Bureaucratic Spending: At a time when recipient budgets and provider rates are being cut, DHS is requesting an additional 4 FTEs in their biennium budget. There is too much redundancy in the current system and DHS reform seems to always result in sameness at an ever increasing cost that takes funding away from recipient services. It is time for a legislative audit to bring bureaucratic spending back in line with core values and services.
What makes a program worth administering, a service worth receiving, or a price worth paying is the achievement of outcomes that show persons with disabilities and society as a whole are better off for the services having been provided. Come visit us to see first-hand why clients choose Merrick and the community is better off for the services having been delivered. For more information, to schedule a tour, or to request a copy of the economic impact study, contact John Wayne Barker, Executive Director, Merrick, Inc., email@example.com or 651.789.6209.