Medicaid changes may make disabled quit jobs

Those at sheltered workshops could face a choice between work and health care.

When more Medicaid cuts go in effect on Aug. 28, sheltered workshop employees could have a tough decision to make.

The Missouri Association of Sheltered Workshop Managers has expressed concern in recent weeks that the cuts may force workers to choose between continuing working with no medical benefits or quitting so they can have the medical care they need.

Missouri sheltered workshops are not-for-profit industries that employ about 8,000 people with disabilities. The workshops are funded largely through contracts for their services in the private sector, but they can receive as much as 24 percent of their operating costs from government funds and private grants, donations and contributions.

The workshops provide employment for disabled people who might not be able to get and keep jobs otherwise, but those workers also need medical care for their disabilities and don't make over minimum wage, said Hillary Schmittzehe, director of the Cape Girardeau Community Sheltered Workshop.

The workshop in Cape Girardeau employs 85 people with a satellite shop in Fruitland that employs 60 and one in Marble Hill, Mo., that employs about 55.

The local workshops package materials for their customers and recycle materials.

"It is a concern, because some of them will quit now and they'll be better off not working than if they were working," Schmittzehe said.

One of the Medicaid programs being cut is the Medical Assistance for Workers with Disabilities, which helps disabled workers pay for medical care. Now those workers will have to bring in wages at 85 percent of the federal poverty level to receive benefits. That level is currently set at $9,570 for an individual and $12,830 for a family of two.

If they make more than 85 percent of the level, they would have to spend any income over that amount on medical expenses to get benefits.

Randy Hylton, legislative chairman for the MASWM, has asked the Medicaid Reform Commission to repeal the new standards, saying that 2,000 workshop employees could be forced to either quit or lose their medical benefits. Hylton said many workshop employees would have to spend $200 to $400 each month out of pocket to reach the spend-down level.

Workers who quit the workshops could probably receive assistance from other programs, said Hylton, but that would cost the state more money because workshops generate most of their operating funds themselves.

According to his estimates, Hylton said state funds spent on an individual in a workshop currently total about $13 a day, but for a developmentally disabled individual not employed by a workshop that expenditure can reach $50 per day.

If a sufficient amount of employees quit, said MASWM president Stan Shurmantine, that could force some smaller workshops out of business.

"The minimum requirement is 15 employees per shop," said Shurmantine. "Some shops in rural areas have 30 or fewer employees. If they drop below 15 they could lose their certification."

A reduced work force could also affect the productivity of the shops, making it harder if not impossible to meet contracts, said Shurmantine.

But one of the biggest problems lies with incorporating the disabled into society. Workshop managers say the workshops give disabled people a feeling of being a productive part of society instead of feeling isolated.

"They have, number one, contact with other people, people they can identify with," said Schmitteze. "That helps them emotionally and physically. And the ability to get a paycheck helps in the same way."

For many of the developmentally disabled, the workshops are the only environment they can work in, since they are dealt with by special personnel and work beside others with similar conditions.

MASWM is asking Gov. Matt Blunt to call a special session to change the requirements. However, Blunt's office said the action will not be on the special legislative session, a start date for which is still undetermined.

msanders@semissourian.com

335-6611, extension 182