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Welcome.  My name is Ron Rucker and I'm President and CEO of VIA of the Wehi 
Valley, a large community rehabilitation program located in Eastern 
Pennsylvania.  Today, I'm honored and pleased to be here to talk to you as part 
of the T-TAP Program about the whole process of conversion and all the 
components that are involved with that.  The one that I'm going to be focusing 
on today with my good friend, Nancy Brooks-Lane, is funding.  Because 
interestingly enough there are a lot of sayings about money, and one of them is, 
"Show me the money," the other one is, "Follow the money," and pretty much, 
"Money talks."  

When I go around the country or even in the bars with my friends, where I work, 
in the state that I work in, most of what I hear about why people can't do what 
we need to do [in order] to help individuals with disabilities find and keep 
jobs, is about money.  Money seems to be the biggest barrier, or one of the 
biggest barriers.  What Nancy and I hope to do today, is give you a little bit 
of an insight, hopefully some humor about the whole situation, but also [give]  
insight into the fact that money really does not have to be the barrier. There 
is good news as far as funding as a barrier to providing services for people 
with disabilities in the community and real jobs for real people.  

Some of [it is] good news.  It is very important that we get some of the 
statistics and some of the data out there, because a lot of stuff has happened 
in the system. We need to acknowledge that.  That's the first step to getting 
over the fear and the disincentive of funding.  The good news is that in 2000, 
nationwide spending for DD Services reached 29 billion dollars, including 22 
billion for community services.  In 1996 through 2000, inflation adjusted 
spending for community services grew 18%. In 2001, about 835,000 people received 
residential or other services.  In 2001, total spending for ICFMR and HCBS Home 
and Community Based Services, Waiver Services, climbed to 21 billion.  It is 
very important, because in that waiver program is where we are and should be 
targeting employment services for people with disabilities. For the first time, 
waiver services overtook ICFMR spending.  We're getting away from the facility 
based approach to providing services.  

In 2001, Medicaid dollars supported about 442,000 individuals, including 328,000 
who were waiver participants.  Medicaid dollars supported more than twice as 
many people in 1990.  That's really good news and bad news, because a lot of 
people are jumping in the pool that were not in the pool. [People] are competing 
for those dollars that were not previously competing with us as a DD provider or 
DD system.  In 2001, the number of people served in public institutions dropped 
to 46,000 people.  That cannot be anything but good news.  

The problem is, as you'll see later in my presentation about funding, that trend 
is not only stalled, there actually are beginning to be placements, new 
placements, in institutional settings. That's another challenge for another 
presentation, but it certainly is part of the funding piece.  [There is] more 
good news. 

Community centered systems offer more diverse and flexible services and 
supports, as you'll see in many other presentations, this is happening.  The 
interesting thing is [that] many people don't believe its happening.  We want to 
give you assurance that both financially and programmatically that great 
individualized flexible services are growing.  There's steady progress, progress 
toward embracing the principles of person centered supports.  There's been a 
massive infusion of dollars into the community itself.  

The problem with that is, we've raised the bar.  There are heightened 
expectations.  People and families now expect the public systems will provide 
them the help they need to live and participate in the community.  With many 
legislative changes, both in the RSA System and in what's considered a closure, 
we have fewer people, hardly any people, coming out of schools and asking for 
segregated services, mostly driven by money and funding. 

In the 1990s, state budgets were extraordinarily healthy.  The strong economy 
generated high revenues for states. State revenues benefited from the strong 
stock market. States could grow spending money and new revenues and more 
importantly cut taxes.  The states during that time leveraged massive amounts of 
federal Medicaid dollars through the Waiver Program and the cost of community 
expansion to states was low.  Federal policy encouraged states to expand 
community services, a wonderful trend. Then the “Yeah buts” started.  “Yeah but, 
yeah but.” How many of you know the “Yeah but” people? It's what have you done 
for me lately, in essence.