Editor's Note: This is the second of a two-part series of stories investigating conditions in Oklahoma's group homes for the mentally disabled, mentally ill and elderly. The investigation was conducted by reporters from the Tulsa World and The Oklahoman. A proposed cut in funding could financially cripple homes for the mentally disabled. Residents at these facilities pay a portion of their living expenses. The remainder is subsidized by federal Medicaid funds, which is set by the Oklahoma Health Care Authority. The rate is $154.10 a day per person, but administrators say the actual cost ranges from $160 to $200 a day. A budget agreement approved Thursday allocates an additional $33 million to the Oklahoma Health Care Authority to help offset a 6.75 percent reimbursement rate cut to providers. Agency officials will go to their board in March and recommend rate cuts be held at 3.25 percent. David Svedman, chief executive officer for Home of Hope in Vinita, said Medicaid is nearly the entire budget in serving about 200 mentally disabled people. Employee wages account for about 80 percent of the budget. “... this cut would be devastating for us, who are already suffering financially. Unlike a hospital, doctor or some clinics, we do not bill insurance or private pay. We are 99 percent Medicaid funded.” To make up that difference, many homes hold fundraisers and seek grants. Employee wage increases have ceased except for bumps if an employee meets a higher certification. Staff start at $7.75 an hour, he said. Information from the Oklahoma Foundation for Medical Quality, an organization that works with the Centers for Medicare and Medicaid Services, shows the turnover of certified nurse aides in the state is nearly 140 percent. The optional Medicaid benefit for the mentally disabled became available in 1972. Before, they were placed in state institutions. The philosophy emphasizes independent living in small homes with job and social networking opportunities. Finding job opportunities for residents, which is a federal requirement for homes, has been a challenge in a recession, administrators said. Another alternative is falling short Thousands of mentally disabled Oklahomans are already waiting as much as five years for services that could help them remain in their homes. Of the 5,000 people who've applied for community care services from the state Department of Human Services, more than 75 percent are facing a wait of three years or more. Sheree Powell, spokeswoman with the DHS disability services division, said state-run centers for the mentally disabled in Pauls Valley and Enid are no longer taking patients. Many workers there have already taken buyouts. This leaves many families with one option: an Intermediate Care Facility for the Mentally Retarded.