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Wagons to Waivers - Segment 10: The Waiver Program

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Reba McEntire: After the success of the group home program in Oklahoma,

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the Developmental Disability Service Division

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started exploring new community programs,

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as well as other sources of income.

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Jean Cooper: We wanted to develop a whole array of various support services,

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because we felt like the best way to do this

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was to maintain as many folks at home

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as we could possibly maintain.

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So that's when we created the waiver.

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Reba McEntire: For more than twenty years, parents and advocates

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had been pursuing the federal government

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to provide funding for community programs.

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In 1981, the Medicaid waiver program was put in place.

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They are called waiver programs because

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certain requirements were waived, or set aside,

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to allow services in different settings.

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Using funds available through Title 19 of the Social Security Act,

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states could, for the first time in history,

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fund services in communities.

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No longer were funds tied only to people living in institutions.

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What most people don't understand is that it takes

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state money along with Medicaid funds

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to make these programs run.

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In the early 80's, money was hard to come by in Oklahoma.

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The oil and gas industries,

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which was the bedrock of Oklahoma's economy,

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had suffered major setbacks.

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Major financial institutions, such as Penn Square Bank,

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went belly-up.

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During that time, DHS's dedicated funding

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from the 2% sales tax failed to be enough to pay all the bills.

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The agencies lost the earmarked money,

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and from that point forward,

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all the funding would be subject to legislative appropriations.

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Oklahoma's economy in the early 80's contributed to

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the delay in applying for a Medicaid waver program.

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The state eventually applied for its own community waiver,

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and it was approved in 1985.

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George Miller: If it were not for the Medicaid program,

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and our ability to take a state resource, a limited state resource,

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and parlay that into federal matching,

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it would've been extremely difficult to fund the thing.

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But historically and traditionally,

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most of the time Oklahoma's been able to get

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about $2.30 for every dollar that we invest.

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And so, except for that Medicaid program,

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we would've really been hurting.

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We had some people who were on our commission

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who were very instrumental in assisting this thing.

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One of them was Jane Hartley.

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Jane Hartley knew developmental disabilities.

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She was instrumental in getting the Home of Hope established

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to serve a lot of developmentally disabled people

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up in northeastern Oklahoma.

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And, she also served on served on

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the advisory committee for mental retardation.

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Reba McEntire: Other members of the DHS commission,

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such as John Orr, provided support, stability,

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and leadership in times of rapid change.

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Jean Cooper: The department took an immediate stand

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to be supportive of developing community services,

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so it really was a huge team effort of folks working together.

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The legislature gave us a lot of money to do that.

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And so, I think we were incredibly successful

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in getting it off to a pretty good start.