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Wednesday, June 7, 2017

Trump budget will devastate children with disabilities

“Trump Budget Guts Medicaid, Disability Programs” read the headline from Disability Scoop, the news service that covers children and adults with developmental disabilities, which accurately and without hyperbole summed up the full budget submitted to Congress by President Donald Trump’s administration.

In its unrealistic desire to simultaneously cut taxes for the rich, increase defense spending and make no changes or reforms of any kind to Medicare and Social Security, the Trump administration’s budget eviscerates multiple programs that help Americans with disabilities. Nowhere is that more evident than when  looking at the federal government programs that currently help low-income children younger than 18 who have developmental disabilities such as autism, cerebral palsy, intellectual disability and severe epilepsy.

Let’s take a hypothetical example — a child named Bobby, age 10, who was diagnosed with autism and an anxiety disorder at age 3. Bobby was born into a low-income household in Los Angeles and has two younger siblings. In California, he would likely qualify for assistance from the state’s Regional Centers, which provide care coordination and funding for vital services throughout a person’s lifetime. Paid largely by Medicaid waiver programs, the Regional Centers can pay for behavioral and social skills training for Bobby, as well as respite for his parents (typically the primary caregivers).

Once he entered the local public school system at age 5, Bobby would most likely be eligible for special education, which is based on each student having an Individual Education Plan that creates educational goals and outcomes, put together by a team of teachers, other professionals such as a speech therapist, and Bobby’s parents.

Although Bobby is very strong academically, he has trouble self-regulating his body, and is given to erratic mood swings, especially when his schedule changes or there is a substitute aide who accompanies him to mainstream classes. The only topic he really cares about is Disney movies, many of which he has memorized in their entirety. Because he doesn’t answer any non-Disney questions and has some strange mannerisms, the other children don’t play with him and he usually is alone at recess.

He sees a child psychologist to treat his anxiety, as well as a pediatrician, both paid by Medicaid.

Bobby’s mom is a high school graduate with health issues related to her being a breast cancer survivor, and she has never been employed at anything other than minimum-wage jobs. His dad works in construction on a gig basis, with some months good and others very bad.

The annual household income is at 110 percent of the federal poverty guidelines, so the family qualifies for Bobby to receive Supplemental Security Income (SSI). This provides a monthly cash amount of $735 that helps to pay for the family’s rent of $2,000 a month for a modest two-bedroom apartment.

How would the proposed Trump budget cuts impact Bobby and his family? Because of Medicaid cuts, Bobby probably would see a reduction in his social skills therapy paid by the Regional Centers, and if his psychologist won’t accept reduced payments, then Bobby will no longer have access to mental health services.

SSI and Social Security Disability Insurance are slated for 10 percent cuts in the Trump budget, so that means less money for monthly rent. And the family already has been told that its rent is due to go up by another $50 a month. If Dad can’t get more construction work, it will be that much harder to make ends meet.

With the proposed special education cuts, Bobby could lose his one-to-one aide and be told that he should get by using “natural supports,” meaning same-age peers (this happened to my family).

Meanwhile, President Trump’s youngest son, Barron, age 11, is set to attend private St. Andrew’s Episcopal School in Maryland in the fall. St. Andrew’s is a coeducational college preparatory school founded in 1978 and carries a hefty annual tuition of $40,000.

Its website says that its programs “are designed to serve students of varied interests and abilities capable of achievement in a challenging academic environment.” According to the Washington Post, “St. Andrew’s is known for its small classes, pioneering use of brain-based research to help students of all abilities to succeed and for providing extra support for students who need it.” In short, this is the perfect school environment for someone who is academically strong but may need help in other areas.

But not everyone can afford to send their child to a school with the very best programs and services that would meet the needs of children on the spectrum. The larger question is whether it is moral for the president to deny that to Americans like Bobby. 

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