Colorado disability rights activists (ADAPT) prevent budget cuts to Medicaid Home-Health Services, 2002

On July 5-18, 2002, between 11 and 22 members of Colorado ADAPT (Americans for Attendant Policies Today) held a constant vigil outside of the state Human Services Building in Denver in order to protest the state Health Care Policy Finance (HCPF) committee making any cuts, caps, or changes to the community long-term care policy in Colorado Medicaid. Their goal was to put pressure on HCPF in order to enforce the promises that HCPF had previously made to ADAPT about not cutting Medicaid funds and services.

At noon on Friday, July 5, about 170 people from various Home Health Agencies and disability rights organizations held a rally for “no cuts, no caps, and no changes. This was in response to a meeting ADAPT had held with Karen Reinertson, Colorado’s Medicaid Director, earlier that day, at which Reinertson had informed them that Home Health Agencies were being cut by 5%, and that enrollment in Colorado’s Home and Community Based Waiver program would be frozen, effective as of July 1. After the rally, ADAPT members began holding an enforcement vigil in order to ensure that HCPF would not endanger Colorado’s compliance with the Olmstead decision, that HCPF would uphold their promises, and to support the ADAPT members who would be meeting with HCPF officers during the week.

ADAPT members held their vigil through the night, withstanding water from the automatic sprinkler system at 1:00 am followed by strong rain at 5:00 am. They had built a “sidewalk city,” without any tents or other forms of shelter, near the front door of the Human Services Building, in which they planned to stay until the HCPF or state legislature retracted the cuts, caps, and changes to funding for home alternatives to nursing homes.

On Monday, July 8, state employees returning to work were greeted by the 20 ADAPT activists who had been camped outside of the Human Services Building all weekend. Reinertson came out to meet with the protestors holding vigil in the afternoon, but would not commit to retracting the cuts to home health funding. The vigil as well as more meetings continued on Tuesday, when it became clear that the state government was being heavily influenced by ADAPT’s protests.

On Wednesday, Colorado Human Services employees began to get annoyed with the ADAPT activists, resorting to verbal violence and shutting off the electrical power and water supply that ADAPT was using. Eventually the power was turned back on so that the ADAPT members who were using electric wheelchairs could recharge their batteries. At 10:00 am that day, HCPF officials held a meeting with ADAPT at which they said that the state was considering retracting the cap that they had placed on home-health services. The officials then presented a more consumer-directed service proposal, Senate Bill 27. This meeting went far to boost the activists’ morale, who were preparing for a heavy thunderstorm, including a strong hailstorm, which hit at 5:00 that evening.

ADAPT stayed put through the night, much to the amazement of state employees who watched from the inner doorway of the building as the advocates sang and continued to hold their vigil in the downpour. The meetings continued on Thursday, July 11, with a proposal from Reinertson of no caps, only 2.5% cuts, and the instatement of a differentials system, through which a higher rate would be paid for attendant services performed before 8:00 am and after 4:00 pm, thereby rewarding agencies that are “serious about meeting consumers’ real-world needs.” However, while ADAPT was in support of the differentials system because it would help direct Medicaid reimbursements, they felt strongly that is would be possible to instate such a program without cutting the current home-health funds.

On Friday at 9:00 am, a public hearing on the cuts made by HCPF was held at the Jefferson County Government Building. Some of the ADAPT advocates attended the hearing, while others stayed behind to keep the vigil at the Human Services Building. The hearing produced a lot of discussion, but no results. After the meeting, Senate Majority Leader Bill Thiebout stopped by ADAPT’s “sidewalk city” in order to offer his support, and to announce that he had filed a lawsuit against Governor Bill Owens over the state budget cuts, which he said were made without legislative approval.

The advocates continued their vigil through a second weekend, during which they made plans to become more demanding with Reinertson on Monday by reintroducing their demands and asking for a written response as well as an exclusive meeting between HCPF and ADAPT. ADAPT felt as though Reinertson had developed a condescending and patronizing attitude towards them, and that she was only talking to the Directors of the Home Health Agencies instead of directly to ADAPT members, around whom the whole issue really revolved.

On the next Monday, ADAPT collectively walked out of the meeting with HCPF after Gary Schneider, the HCPF long-term care director, said that their would be no caps and no changes to the home and community based services, but that the home health budget cut would have to be instated. ADAPT also sent Reinertson a letter on Monday reminding her that it was necessary to meet the demands of ADAPT rather than negotiate with the Home Health Agencies.

On the morning of Tuesday, July 16, an impromptu meeting was held at the “sidewalk city” between ADAPT, Home Health Agency directors, Karen Reinertson, Gary Schneider, and David Bolin, the Executive Director of the Center for People with Disabilities. During the meeting, the Home Health Agencies proposed the possibility that they could find other ways to cut the 5% from their budgets without affecting attendant services. They proposed cutting their Occupational and Physical Therapy in-home treatment budgets by placing limits on the number of Medicaid-funded visits allowed, and only for one year after an injury.

The vigil continued through Wednesday, and on Thursday, July 18, the HCPF committee finally agreed to ADAPT’s demands, canceling all of the cuts, caps, and changes they had made to home-health services on July 1. Reinertson congratulated ADAPT on their successful and well-organized campaign, and at 1:30 pm ADAPT held a press conference to announce their victory and conclude their campaign.