Governor, legislator disagree on disability reform

By Cydney Gillis

He’s played in countries all over the world and in all 50 states. He’s appeared on “The David Letterman Show” and can be heard furiously playing his spoons on Frank Zappa’s “Civilization Phaze III.”

But after all his tours, for all his notoriety, Artis the Spoonman has never earned more than a pittance in his life and has never been able to hold down a job. It wasn’t until he signed up for a state disability program in 2002 and started going to doctors that he finally figured out why.

The 61-year-old Artis – his single, legal name for many years – says he’s always known that he had severe emotional problems. Slowly, however, the social workers and doctors that the state paid for him to see pieced together that, while he might appear functional while riffing with the stars, Artis suffers from a combination of bipolar disorder, panic attacks and severe brain trauma from several head injuries he suffered as a young man.

The program he got onto in 2002 is called General Assistance-Unemployable, a little-known state program that provides medical coverage and $339 a month in cash to those with a disability that a doctor has certified will keep them from working for at least 90 days. Like Artis, however, many of the 18,000 people across the state who receive GAU – roughly a quarter of them homeless – have combinations of ongoing physical or mental disabilities that are tougher, and take longer, to diagnose.

The correct diagnosis can not only end years of anguish, as it has for Artis, who now lives a much calmer life in a small flat in Port Townsend, but qualifies the diagnosed for double the income from Supplemental Security Income, the federal program for those like Artis who’ve never been able to work and can document a disability of at least a year’s duration.

It took eight years and two appeals to the Social Security Administration, but Artis says he just got a letter this month approving him for $675 a month from SSI, which he will transition to shortly from GAU. But if it hadn’t been for the General Assistance-Unemployable program, he says, he’d have been homeless a long time ago. Now he worries about what’s going to happen to thousands like him if the state eliminates or a puts a time limit on GAU benefits.

With the Legislature facing a $2.6 billion revenue shortfall in the second half of the state’s 2009-11 biennium, those are two possibilities that Gov. Christine Gregoire has put on the table. In her first budget, released in December, the governor repeated last year’s call to completely ax the program, which receives no federal funding and is slated to cost the state about $188 million in fiscal year 2011. That’s after a cut of about $58 million that the Legislature made to the program last year.

The governor’s second budget, released this month, calls for raising $779 million in new taxes in fiscal year 2011, part of which would be used to save a limited version of GAU: The governor would reduce the monthly grant to $250 and impose a lifetime cap of six months. If the accompanying legislation, S.B. 6704, introduced last week by Sen. Jim Hargrove (D-Hoquiam), were to pass, it would take effect in September 2010 and anyone who had already received GAU for six months would be dropped immediately, says Roger Gantz, policy director for the Health and Recovery Services Administration inside the Department of Social and Health Services.

“No way,” Artis says. “What’s the justification? If you haven’t got a terminal illness, how are you going to prove the longevity of your desperate illness or desperate situation, whether it’s mental or otherwise? I couldn’t have.”

Rep. Mary Lou Dickerson (D-Seattle), chair of the House Human Services Committee, has a different idea and a different kind of time limit, but it, too, worries Artis.

Like the governor, Dickerson is trying to raise GAU’s profile by giving it a name that she says the public will have a better chance of recognizing and understanding. The governor would rename the program Temporary Assistance for Unemployable Persons. Under Dickerson’s Security Lifeline Act (House Bill 2782), the program would be called Disability Lifeline. One difference between the proposals is that Dickerson wants to give the Department of Social and Health Services a 90-day deadline to move people who appear eligible for federal disability benefits from General Assistance-Unemployable to an SSI-waiting category currently called General Assistance-Expedited.

Dickerson’s bill also calls for using the Community Health Plan of Washington, the organization that currently manages GAU medical coverage, to quickly assign recipients to a “medical home” and provide assistance in documenting their SSI claims. That, in turn, Dickerson says, will step up the recipient’s and the state’s chances of success: Once an SSI claim is approved, the federal government reimburses the state for the GAX funds it has paid out.

“The more people we get to do that, the less it costs the state,” Dickerson says. Yet, today, she says, it can take DSHS up to 18 months to determine if someone is eligible for SSI.

There’s more than one reason for that, says Betsy Jones, director of product development with the Community Health Plan of Washington. In testimony last Thursday before the House Human Services Committee, Jones pointed out that, in some cases, it can take much longer than 90 days to gather the medical evidence needed to document a claim.

In situations of co-occurring disorders or combinations of physical and mental disabilities, “it’s a little more complicated to prove the disability,” Jones says, especially for people whose records are scattered across the country or who haven’t had any medical services in years.

Dickerson is currently working to change the bill’s language, not to remove the 90-day deadline, she says, but to provide DSHS some flexibility. “I’ll give enough time to do the job, but I want to make the point that it needs to be done much more quickly than it has been,” she says of GAX determinations.

“I think [Dickerson is] under the impression, as I am,” says Robin Zukoski, a Columbia Legal Services attorney and General Assistance advocate, “that case workers put people on GAU and don’t consider GAX. She’s trying to force that to happen and force it to happen fast.”

Dickerson’s bill also calls for creating a pilot project in one or two counties in which nonprofit organizations would provide housing for Disability Lifeline recipients, who would get a reduced grant of perhaps $250, with the other $80 going to their housing – an idea based on San Francisco’s Care Not Cash program. Human services advocates say housing is critical to stabilizing those who have been homeless and ensuring they can actually make use of any services they receive.

By contrast, the six-month benefit limit that the governor has proposed is short-sighted, Jones says, because it doesn’t acknowledge the people who need more time. For those who can’t stabilize in six months, she’s says, “they’re back in the emergency rooms and jails and we’re paying for them one way or another.”

At last week’s hearing, Alexis Oliver, an aide of the governor’s, questioned where the money would come from for the housing pilot project and stated that, in the current fiscal climate, the state can no longer sustain a disability program for adults who cannot work. The governor’s office said Monday that Gregoire has taken no position on the Security Lifeline bill, which must be voted out of committee by next Tuesday.

Dickerson says she believes the bill will pass the House, where support for the GAU program is strong. After that, she says, she’s making no predictions.

“If it gets out of the House, I think the governor’s office will participate in negotiations about the bill,” Zukoski says. “It’s hard to read which way that’s going to go… but there’s certainly a very clear line between the two approaches.”

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