Step by Step

Gov. Matt Blunt wants alternative funding for disability program
Tuesday, March 1, 2005 | 12:00 a.m. CST; updated 6:23 a.m. CDT, Friday, July 18, 2008

Gov. Matt Blunt wants to curb the increasing costs of the First Steps program by placing its financial responsibility into the hands of private insurance providers, he said during a visit to Columbia and three other Missouri cities on Monday.

First Steps provides in-home therapy and services to children younger than 3 who have developmental disabilities. The program could lose much of its state funding to Medicaid and budget cuts that Blunt has proposed.

First Steps, which has been funded entirely by the state, served 8,041 children in Missouri last year at an estimated cost of $27.2 million. Blunt has proposed legislation that would require private insurance companies to cover the majority of the costs of First Steps’ most common services to make sure they remain available. State Rep. Brad Lager, R-Maryville, plans to shepherd the legislation through the House.

“A health insurance requirement I think ought to exist to cover physical, occupational and speech therapies,” Blunt said during an afternoon news conference at Boone County Group Homes and Family Support. “Insurance companies ought to meet the total health-care needs of the people of this state.”

While transferring the program to insurance providers would mean some new costs to families who rely on the program, Blunt said required co-payments would be minimal, ranging from $5 for the poorest of families to $100 for those making $143,000 or more per year.

Laura Gash of Centralia, whose son Nikohlas is autistic, said she is still concerned about these out-of-pocket expenses.

“Five dollars is like $1 million — it might as well be to me,” she said. “Five dollars buys my son a package of diapers that lasts a week. Five dollars can feed my kids for three days. I just want to make sure that even people that (are) not Medicaid-eligible are able to make that payment. These are services they need.”

Blunt took a lot of heat two weeks ago when he announced plans to craft a program to provide First Steps services. More than 100 families and First Steps proponents filled the Capitol to protest and served the governor with a petition 28,000 signatures strong.

Blunt said there was a misconception that he planned to end the program, and he tried to emphasize Monday that was never his intent.

“We have been trying to combat this bad information,” Blunt said. “When I presented the budget to the Missouri General Assembly was when I was first asked about this. I said then that we are going to ensure these services are still available, and we’ve been crafting a new program. I think it’s a better program.”

Blunt said the program will have three sources of funding: the insurance payments and co-payments, Missouri taxpayers and federal funds. He said state taxpayers would ante up about $14.5 million in the coming fiscal year, or about $2 million less than last year.


Laura Gash and her 2-year-old autistic son Nikohlas wait to hear the future of First Steps, a program for children with disabilities. (Benjamin Reed/Missourian)

Under Blunt’s proposal, the Missouri Department of Elementary and Secondary Education would continue to administer the program in collaboration with the state Department of Mental Health.

Blunt said the changes will also be logistical.

“We are taking a more regional approach to the program so that communities will be able to band together and gather the resources to access these services,” Blunt said. “What works here may not work in Kansas City.”

Many parents who were at the conference have children involved with First Steps. They said before Blunt’s remarks that they were confused about the nature of his proposals.

“I was afraid he was going to cut it all out,” said Kristi Wilson, whose son Kolten suffers from severe hearing loss. “We just weren’t sure what was going on. We had heard so many different things. What he said sounded fair.”

Gash said Blunt at least calmed her fears about the program being cut.

“I was just afraid that one day people would no longer be able to be part of the program because they couldn’t afford it,” she said. “He made me feel better.”

Boone County Group Homes and Family Support administers the First Steps program locally. Director Les Wagner said the agency will continue to do all it can to provide First Steps services, regardless of how the program might change.

“What we have done in the past is to be as flexible as possible in utilizing the choices of the families, and we will continue to do that,” Wagner said. “When we run into unnecessary paperwork and red tape, we’re going to go head-to-head with it.”

Blunt also visited Springfield, Chesterfield and Mount Pleasant on Monday.

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