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The following are testimonies from ASD to the Joint Finance
Committee
about Adult Services for individuals with autism in Delaware in March of 2002.
John Fisher-Gray Lydia
Fisher-Gray Robert
Padgett Artie Kempner
Joanne Smythe Charlene
Triplett Karen Bashkow
Marie-Anne Aghazadian
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Dover, 7 March 2002
Testimony of John Fisher Gray, President of the Autism Society
of Delaware,
Before the Joint Finance Committee of the General Assembly of Delaware
Mr. DiPinto, Mr. Vaughn, Members of the Committee:
Thank you for the opportunity to testify today. My name is John Fisher Gray. I am a citizen of Delaware residing in Senator Blevins’ and Representative Hudson’s districts. Two of my three children are here with me today. Lydia, our eldest child is 11 and in the sixth grade; she will offer her testimony in a few minutes. Ian is 10 and a student at the Delaware Autism Program in Newark. I am also the president of the Autism Society of Delaware, and it is chiefly in that capacity that I appear before you today.
I am here to ask for your help, not for myself, not for my son, but for people with disabilities, including autism, who are 11 years older than he. These people will reach their 21st birthdays during the next fiscal year and therefore be graduated from special education programs throughout the State. Many need support services to live somewhat independent, more meaningful lives. Without these services, many will be relegated to life in an institution or will be forced to live at home. I needn’t tell you that life in an institution is not a desirable option when there are alternatives. It is also contrary to the U.S. Supreme Court’s Olmstead decision. Life at home can create physical, emotional, and financial burdens for parents, especially as they age. Without adequate funding in the budget, we can expect that some parents will be compelled to give up their jobs so they can stay at home and care for their now adult family member with a disability. Yet despite this real need, the Governor’s budget does not include any funding for support services for people leaving special education programs this year.
In the coming fiscal year, five young adults will be graduated from the Delaware Autism Program. It is for them especially, but also for other graduates with disabilities, that I ask you to appropriate money in this budget to fund these necessary services. I make this request on behalf of the over 500 members of the Autism Society of Delaware, who reside in virtually every legislative district in our State.
We recognize that the State’s revenues are down and that any money you appropriate for adults with special needs will likely have to come from other parts of the budget. We also acknowledge that when times are tough, there is an attraction to across-the-board budget cuts. Still, we submit that the impact on these people and their families if they do not receive services is much greater than the impact if, say, repaving a road is delayed by a year. For that reason, we ask you to make the more difficult choices that the Governor’s budget chose to avoid.
Based on information we have received from the Division of Developmental Disabilities Services (the "Division"), the Autism Society of Delaware believes three areas for which the Division is responsible must be adequately funded to ensure delivery of necessary services. These three areas are the Special Populations Program (also known as the Post-21 Program), community programs for special school graduates, and emergency residential services. If each is not adequately funded, the Division will be forced to shift resources from one area to another. There will also be a domino effect on other, older adults already receiving services from the Division as funds budgeted for them are diverted to provide services for new entrants into these programs.
Adult Special Populations (Post-21) Program
Four of the five people to be graduated from the Delaware Autism Program are requesting services from the Division. Three of those are requesting residential services in the Adult Special Populations program. The Division also expects seven other people to require services in this program. They are "rare or complex" students as defined in 14 Delaware Code § 3124, who are currently in private, special education placements. The people who would be served by the Adult Special Populations program have challenging and even extreme behaviors, which have so far required special placements. They will obviously continue to need special services as adults. If they are not served in the Adult Special Populations program, they might be served—though not as well—in the Division’s regular community and vocational programs. But there is no money in the budget for those programs either. Perhaps their parents will try to care for them at home without assistance. Perhaps they will be placed in an institution. Perhaps the Division will be forced to provide services to them on an emergency basis, although that program also receives no funds under the Governor’s budget.
Most people in the Adult Special Populations program are eligible for Medicaid. For those people, federal Medicaid funds cover half of the cost of care, but only if the State pays its half. With the anticipated Medicaid funds and assuming an even split between residential and day services, we estimate Delaware’s cost to provide services to ten people to be approximately $420,000.
Special School Graduates
The Division expects that one of the five Delaware Autism Program graduates will receive community services with the broader pool of special education graduates. The Division also anticipates that 58 people in Delaware will be leaving special education programs this year. Our federal and state governments have invested considerable resources in their education. The Individuals with Disabilities Education Act ("IDEA") contemplates a smooth transition from educational to adult services, including mandatory transition planning in which supports for students leaving the special education system are affirmatively identified.
These students are able and ready to work so long as they receive adequate support such as job coaches. They have received vocational training in their schools with the goal of securing gainful employment. Historically, the State has provided the necessary services to support these people but, again, there is no funding in the Governor’s budget.
We know from experience that graduating with a job is the single greatest predictor of future independence and success for students leaving the Delaware Autism Program. We assume the same is true for graduates from other special education programs. Without needed support and the reinforcement that a job supplies, graduates rapidly lose their vocational skills. Unfortunately, once this occurs, they rarely receive the extra retraining and motivation they require to regain lost skills. It would be a tragedy to let these people graduate from their special education programs and not provide vocational support and day programs for them.
Many of the people in these programs are also eligible for the 50% Medicaid match. Assuming that about half of the graduates from special education programs will need services from the Division, we estimate the cost of providing these services to be approximately $925,000.
Emergency Residential Services
It is our understanding that the Division typically provides emergency residential services to approximately 35 people each year. These people are classified on the Division’s "Registry" as Level 1–Urgent. They typically have suddenly lost a place to live or are subject to abuse, neglect, or unhealthy living conditions. Obviously, the Division must help these people but, again, the Governor’s budget contains no funds for these known, recurrent, required services. Without funding in this category, the Division will have to divert other funds to pay for these services. We do not have adequate information to provide an estimate of the costs for these services. The Division can supply that information.
Please Fund Needed Services
It should be clear from my testimony that the Autism Society of Delaware is asking you to fund necessary services for adults in our State with many special needs, not just autism. Still, let me conclude by speaking about that community with which I am most familiar. The students graduating from the Delaware Autism Program have been supported over their years there by scores of teachers, administrators, paraprofessionals, bus drivers, aides, custodians, secretaries, speech-language pathologists, vocational specialists, parents, grandparents, aunts, uncles, siblings, and friends. They have worked together over days, months, and years to teach these students eye contact, dressing, toileting, self-care, basic greetings, other communication skills—some use only the Picture Exchange Communication System—number and letter recognition, sorting, and other vocational skills. All of these people have invested their time, energy, and part of themselves in these students. They have struggled with them and rejoiced in their triumphs. All of this was done to teach them the skills to be as independent and self-sufficient as they possibly could be.
Now these students are on the verge of graduating. They can continue to succeed if they receive the necessary support services as adults. Please don’t let all of their hard work and that of their supporters go to waste. Please let government fulfill its highest and best purpose of helping those least able to help themselves. Please fund the services these people need.
Respectfully submitted,
John Fisher Gray
President
Telephone (302) 996-6174
How Many People with Autism Live in Delaware?
It is difficult to say with precision how many Delawareans have autism. Johns Hopkins University, working with the support of the Delaware Department of Education and the Delaware Department of Health and Social Services, has begun a study funded by the U.S. Centers for Disease Control and Prevention ("CDC") that will give us the best possible estimate of autism prevalence in Delaware children. They will use the same methodology developed by the CDC in estimating autism prevalence in metropolitan Atlanta (discussed below). Until we have the results of that study, which are some years away, we can only extrapolate from other figures.
We know there are about 345 pupils in Delaware between the ages of 3 and 21 with the educational classification of autism. These numbers likely exclude a number of children meeting the diagnostic criteria for an autism spectrum disorder.
Until recently, the generally accepted view was that approximately 1 in 500 people in the United States have autism. More recently, the CDC reported that the prevalence of autism in metropolitan Atlanta is 34 per 10,000 people. The CDC web site also states, "
Studies done in Europe and Asia since 1985 indicate that there may be as many as 2 to 6 per 1000 children who have one of the autism spectrum disorders."Clusters of autism have been reported in New Jersey and California with prevalence rates as high as 1 in 150 and 1 in 132.
If we apply these rates to Delaware’s population, estimated by the 2000 census at 783,600 people, the range of people with autism in Delaware is:
|
Prevalence Rate |
Delawareans with Autism |
|
1 in 500 |
1600 |
|
34 in 10,000 |
2700 |
|
6 per 1000 |
4700 |
|
1 in 150 |
5230 |
|
1 in 132 |
6000 |
Of this range of estimates, at this time we feel that 34 in 10,000 is likely the most valid, yielding approximately 2700 people in Delaware with autism.
What is Autism? Click here to learn more about autism.
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Testimony
of Lydia Fisher Gray
Before the Joint Finance Committee
Of the General Assembly of Delaware
7 March 2002
I don’t think it is fair for parents to have to support their children by themselves their whole lives. I know that I’m going off to college and getting a job to support myself. But what about my brother? He won’t be able to get a job to take care of himself, and it will be left up to my parents. It costs about $100,000 a year to put your child in a group home, and I know for a fact that most families cannot afford that. Some parents could have their child stay and live with them, but they can’t do that without some sort of daycare program or employment support. Even then, they can’t have a child at home forever.
Everyone needs to be independent in one way or another, whether it is living alone or even just learning how to button your own shirt. If the group homes and support were already provided, it would help both the parents and the child. The parents wouldn’t have to pay for housing and special care, and at the same time the child would be learning independence and other important values. I know my brother’s class has only gotten to buttoning their own shirts. When the time comes for them to go out on their own, they are going to need help. I am here today to ask you for the funding for that help which many people need. I am only in sixth grade but I already know that it is your job to help, so please do.
Thank you.
Lydia Fisher Gray
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March 7, 2002
My name is Robert Padgett and I live at 808 Evergreen Road in Magnolia,
Delaware. I'm 14 years old and my brother, Lucas, is autistic. Lucas is 11 and
has trouble talking and thinking. He works very hard trying to understand
everyday life.
I'm starting to think about what college I want to go to, and what I want to be
when I grow up. I might want to go to Annapolis and be a Naval Aviator. But what
if my brother doesn't have any help getting a job or a place to live when he
grows up? Then once my parents are gone, I'll have to be home with my brother
all the time. It's hard enough just to think about my future, let alone what my
future will be like if there's no help for Lucas when he's grown up.
I'm very proud of my brother. Doctors said he'd never speak, but he does. He
also ties his shoes, uses a calculator to add, and is learning to cook food in a
microwave oven. Thanks to the Delaware Autism Program he's learning to function
in a world he doesn't understand.
Please don't let all his hard work be for nothing.
Please do the right thing and provide the money to help adults like Lucas find
jobs and have lives.
Please give me the chance to have a job and a life, too.
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My name is Artie Kempner, and this is the fourth year in a row that I have testified before this committee. I have three young sons who are 8, 7, and 5. My 7 year old, Ethan, has autism and attends the Delaware Autism Program in Newark. You may remember that last year Ethan joined me in these chambers during testimony – he was the cute guy on my shoulders!
Because of the wonderful D-A-P program, Ethan is now able to do things that would have been impossible 20 years ago with the educational services that were available. D-A-P has taught Ethan how to speak, how to use a computer, how to ride a bike, and mot importantly teaches Ethan how to help himself.
This past January, we took a family ski vacation to Vermont and put all the boys in ski camp, including Ethan. With the help of a 20-year old counselor – who had no real training in autism, Ethan learned to ski independently. The greatest family moment that my wife Marcy and I have had was for all five of us to come down the mountain together. If you could have seen Ethan’s face as he was shushing down that mountain you would know why the services he receives are so well worth it.
I have come here the last fours years to encourage, prod and push this committee to take our adult service programs to a higher level. Studies have proven that our adults with autism and special needs can continue to learn and continue to grow as people. I’m not going to tell you that this doesn’t come without a cost and is not a challenge. The bottom line is that if we put a more comprehensive service program in place, and give this population a chance, the costs will go down.
I will use the vocational program at the DAP as an example of how a well-run program can make such a distinct difference. The Delaware Autism Program graduates over 70% of its students with a job placement. That compares with the national average of fewer than 25%. These adults with autism becoming earning members of our community and in many cases hold down jobs that typical workers do not want to fill.
We can replicate this success at the adult services level if we appropriate the proper funding. Presently the majority of staff working with adults makes at or just above minimum wage. If we are to build a program that will be successful, we have to increase these wages. If we increase the wages we will see the standards of the programs increase. We are in a vicious cycle that revolves around low pay, insufficient training and high turnover.
It is time to make a commitment to this community. It is time to allocate the funds that will help service providers hire experienced and trained professionals to develop comprehensive programs. It is time to look forward and do the right thing. This pas January, my son Ethan skied down a mountain, all by himself. But before he could accomplish that feat, he had to climb the challenging mountain that is autism. He could NOT have done that without a great deal of help. So help our adults climb and conquer their mountain.
Sincerely,
Artie Kempner
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March 7, 2002
Honorable Senator Vaughn, Representative Di Pinto and distinguished members of the Joint Finance Committee:
My name is Joanne Smythe. I am the mother of seven children. Although raising seven children is no easy task, my two youngest children have presented the greatest difficulties for my family and me. My son Bobby, twenty-two, who has both a mental illness and developmental disability is receiving services through the DDDS Adult Special Population Program.
This year, my daughter Susan, twenty-one, who has autism, will be graduating from the Delaware Autism Program (DAP). Susie has been in the Autism Program since she was two and a half years old. Susan presents many challenges. In addition to having autism, she also has self-abusive behaviors that could result in severe injuries if not addressed. Susie needs constant care, supervision, and support. She sleeps less than five hours a night and can’t ever be left unattended.
A few years ago, the staff at the Autism Program suggested we place Susie in their residential program, not only because it became increasingly difficult for me and my husband to care for her, but also because they felt that the very structured setting of the DAP would give her the opportunities to learn the independence skills she needed to succeed as an adult.
Over the years, Susie has acquired basic independence and vocational skills and with the appropriate supports she can live and maintain a job in the community. She worked hard at becoming who she is today, and we are very proud of her.
However, they key to Susie’s success is support, by professionals who are trained to help her manage her behaviors, and who can continue to teach her to care for herself. I can’t do that. Susie is too complex and demanding for one person or one family. Many years ago, she probably would have been place in an institution. I am thankful that she was able to attend a good school program and live at home with us for as long as she has.
But, If Susie were to return to live with us, we wouldn’t survive the strain she puts on us. Whenever Susie comes hoe, I can’t leave the house and have to spend every waking hour by her side. It’s too much to ask of one person, to provide that kind of intense care every day. Furthermore, Susie needs a very structured environment that is impossible to create in our home.
Please understand, we are not planning on giving Susie up, all I am asking is that we be given a chance to continue the life we have with her right now, where she can live in a group home, continue learning and be safe. Her family and I will continue to be an important part of her life just as we are now.
Fore just one minute, I am asking you to think of Susie a your child, and of me as yourselves. Wouldn’t you want me to reexamine my priorities, and make sure that when I make a decision on how state dollars are spent, that the lives of people like Susie rank higher than roads, new court houses or state slogans?
Thank you for listening, and thank you for doing what you believe is right for Susie and my family.
Respectfully,
Joanne Smythe
March 4, 2002
Dear Mr. & Mrs. Smythe
I am writing in response to your request for an assessment of your daughter Susan’s need for residential placement once she attains adult status. As you well know Susan initially came to our residence at the Delaware Autism Program as an emergency placement. At that time she displayed a number of inappropriate and maladaptive behaviors including severe self-abuse and self-injury, temper tantrums and non-compliance, as well as acute sleeping and eating disorders. During he course of her educational program Susan has since made tremendous progress. Not only has she eliminated all but the last vestiges of the original presenting behaviors, but she has also mastered many of the skills necessary for successful daily living and for participation in normal domestic and community activities. These gains, however, must be regarded as somewhat fragile. There is considerable evidence that, should the supportive context and trained staff currently in place be reduced or eliminated, Susan would almost certainly regress. In the event that adult services, including residential placement, are unavailable I can say with great certainty that Susan will eventually revert to her former patterns of behavior; the only relevant question would concern how rapidly such deterioration might occur. In view of the potential harm to Susan’s educational attainments and to her personal well-being, I urge you to do all within your capacity to secure appropriate placement and services for Susan as she reaches adulthood. In closing I would like to say that Susan has grown into a fine young woman with great potential for a satisfying and productive life. I wish her and all of your family the best of luck in the future. Please let me know if I can be of any further assistance.
Sincerely,
Mark J. Murphy
Residential Program Advisor
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Dear Distinguished Members of the Joint Finance Committee;
I am writing about an issue of great concern to me and to my family. This issue directly affects the welfare of my son Brian.
Brian has a disability that has an impact on every aspect of his life and the lives of his family. Brian has autism. As a parent, I anticipate the time when Brian will be an adult. In light of the current lack of funding for adult services, that anticipation is partly clouded with fear.
During Brian’s education, the teachers spend much time telling me that the skills learned in school will ensure a brighter future for children with autism. At 21 years of age, Brian will leave the educational setting. Brian will continue to need vocational services, day and/or residential services to continue to live a productive and meaningful life. If the skills Brian learned aren’t maintained, the quality education he received will be but a distant memory.
Furthermore, as all parents, I need to know that my son has a safe, stimulating, nurturing place to live after I am no longer able to care for him.
Please put people first. Funds must be made available so that these essential services are provided to my son with a significant disability and others like him. Please keep Brain in mind during the upcoming budget hearings so my dream for a bright future for Brian will come true.
Yours truly,
Charlene Triplett
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To all members of the Joint Finance Committee of 2002;
My name is Karen Bashkow and this is my son, Ben. Ben was sixteen this past February. He attends the Delaware Autism Program (DAP) in Newark and has been a student there for 10 years. He’s made wonderful strides behaviorally, socially and vocationally. His receptive language skills have also improved since he was a young child. All of these things are thanks to the skilled professionals at DAP who have helped Ben develop and grow each passing year.
Ben has many gifts including his beautiful smile and happy demeanor which often fill my heart with joy. He’s a young man who gets much happiness out of the smallest things. He loves to take a walk with his Mom in the evening after dinner. His pride fills a room when praised for a job well done at Dollarland where he stocks the soda cases, shelves and helps keep the store straightened up. I’m here today out of the concern I have for the time when Ben is no longer a student at DAP. It takes so little to make Ben happy but if there are no services for him when he graduates and he has little or nothing to fill his life, I imagine the happiness will no longer be obvious on his face.
There are many frightening things I’m hearing with the budget cuts that have already occurred. I hear that only kids with the severest of disabilities are receiving residential services and that many parents are desperately trying to cope with their adult child at home because there are others more severe that must be served first. I hear that the group homes are often staffed with personnel, with little or no understanding of autism, that allow behaviors to occur that those trained to teach autistic people would find simply unacceptable, just as you and I would find them unacceptable.
Should I conclude that these kids go to school and learn how to act appropriately only to be disqualified or put at the bottom of the list to receive services? And that they are allowed to regress when cared for by staff that are unfamiliar with autism?
These individuals with autism are not capable of achieving the level of independence that we in this room have achieved. They desperately need your help. There needs to be proper funding to provide vocational,, day and residential services for those adults already in the system and those students coming out of school this year. Behaviors may be under control now but if a child is forced into inactivity because there is no money available to provide services, the behaviors will return when that person no longer has a job or a purpose or no longer lives in a structured, nurturing environment. They will also lose skills it has taken years to teach them.
As the parent of this handsome young man, I am asking for my son, to please help provide funds so services can continue to be offered to all those individuals with disabilities today, tomorrow and in five years when Ben will be an adult. Then the quality of life he has now, will continue and he will find happiness in the small joys of living.
Thank you for listening,
Karen Bashkow
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Stefan Aghazadian - Age 31
March 7, 2002
Senator Vaughn, Representative Di Pinto, and distinguished members and representatives of the Joint Finance Committee, the Division of Developmental Disabilities Services, and the Budget Office:
My name is Marie-Anne Aghazadian.
Thank you for the opportunity to address you today, as this marks my 15th testimony in front of this committee.
I am the Chair of the Adult Issues Committee of the Autism Society of Delaware and also the parent of Stefan, an adult with autism.
Although the reason for my standing here today has not changed over the years, the world we live in has. The events of September 11th, have led us to question whether our children and loved ones live in a world that is safe and promising. Those feelings of loss and uncertainty have given us a new sense of who and what truly matters.
Governor Minner has demonstrated that children matter by exempting the Children’s Department from budget cuts asked of all other state agencies. In fact, to enhance the Children’s Department’s programs for foster and kinship care, her administration allocated additional funds for FY 2003. She has kept her campaign promise of insuring that the State’s budget not be balanced on the backs of Delaware’s children and that vulnerable populations not become victims of a declining economy.
Unfortunately, her grave concern for children did not extend to children with developmental disabilities and their families.
The two percent cut and zero growth in the 2003 budget that she has requested of the Division of Developmental Disabilities Services will dramatically affect the Division’s ability to plan for graduates of special education programs, and family support services such as respite and case management.
Are we to assume that families of children with disabilities are not worth the same consideration as Foster and kinship families, and do biological families have to give their children up to foster care so that they receive the services they need? Governor Minner’s actions seem harsh and unfair, leaving many families of children with disabilities devalued and hurt.
Beyond the inequity of her decision lie considerable economic and human factors. Taking into account how much money and effort have been spent on the education of children with disabilities, how can we justify shattering their aspirations for a life of purpose and meaning? And after the testimonies you heard today, how can you ask families to make the kind of personal, emotional and financial sacrifice that the lifelong care for their disabled child would demand?
In 1989, your then fellow legislators recognized that young people with severe developmental disabilities, including autism, needed support and services well beyond their school years to continue functioning in their communities. They responded by creating the Post-21 Program, which was designed to serve youth, who because of the urgency and severity of their needs, could not be served in typical adult community services of placed on a wait list.
My own son, Stefan, now 31 years old has been receiving services through the Post-21 Program for the past ten years. He has been in supportive paid work for eleven years and is living in a home of his own in Newark. He has three roommates, friends in the community and is supported by capable staff who truly cares about him. Stefan’s well being has made a huge difference in our lives allowing him and use to be productive and taxpaying members of our Delaware community.
I realize that our State is facing a downturn in revenues, that money is scarce, and numbers drive decisions. Yet, I have to trust, that you as I, believe that numbers and needs don’t always match.
You have the unique opportunity to set a wrong right and make sure that they welfare of all our children stays a priority when you draw up the States budget bill.
Respectfully submitted,
Marie-Anne Aghazadian