The State of America’s Direct Support Workforce Crisis 2022

The longstanding direct support workforce crisis, exacerbated by the COVID-19 pandemic, has led to closures of critically needed services and a denial of access to community-based supports.
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ANCOR in the News - 03.10.21

ANCOR Advocates Achieve Landmark Victory with Passage of Nearly $13 Billion in HCBS Funding

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ANCOR Applauds Congress, Biden Administration for Passing Landmark American Rescue Plan Legislation

 

Earlier today, the U.S. House of Representatives voted to approve the American Rescue Plan Act of 2021, a sweeping $1.9 trillion COVID-19 relief package that will deliver badly needed economic relief not only to community-based provider organizations, but also to individuals, families and governments across the country. The bill now heads to President Biden’s desk, where it is expected to be signed into law before the end of the week.

In reacting to the House’s passage of the American Rescue Plan, ANCOR President Heidi Mansir stated, “This legislation is truly historic and precedent-setting. This bill includes a wide range of critically needed financial relief that will directly benefit people, their families, direct support staff and the community service providers that employ them. We are greatly appreciative to the Biden Administration and Congress for responding to our advocacy by recognizing the impact the pandemic has had on our community. We are also deeply grateful to all ANCOR members for their advocacy in ensuring people with disabilities are no longer the pandemic’s forgotten faces.”

“What happens next at the state level matters greatly,” ANCOR CEO Barbara Merrill added. “It will be critical for states to use the additional HCBS funding to address providers’ most pressing needs and to ensure the continuation of quality services. Whether it’s continuing retainer payments to ensure closed programs can re-open, or payments to address extraordinarily high direct support staff turnover, we urge providers and other stakeholders to begin advocating immediately at the state level to ensure congressional intent is carried out at the state level by addressing these priorities.”

Among the wide array of provisions in the American Rescue Plan are three in particular that have transformative potential for community-based providers of services to people with intellectual and developmental disabilities:

  • A 10 percent increase in the federal Medicaid match percentage (FMAP). The FMAP increase, which goes into effect for one year starting on April 1, specifically targets the Home and Community Based Services (HCBS) program and is in addition to the existing 6.2 percent FMAP increase initially authorized by the CARES Act that was signed into law in March 2020.
  • Significant expansion of the Paycheck Protection Program (PPP). The American Rescue Plan makes certain larger nonprofit organizations eligible for PPP loans by considering the number of employees at a particular site, rather than the number of employees overall. For example, a nonprofit service provider with 1,000 employees would previously have been considered ineligible; if those employees are spread across operations in five different states, they would now be eligible to apply.
  • $350 billion in funding for state and local governments. Although this funding can be used in a wide variety of ways, it is important for Medicaid-funded community providers because it alleviates pressure on state governments that might have targeted Medicaid as a source of spending cuts in response to budgetary constraints wrought by the pandemic.

Furthermore, the American Rescue Plan includes several provisions targeted toward low- and moderate-income households and households of color. Although not intended to impact community-based providers of disability supports, these provisions do have the potential for significant positive impact on the direct support workforce, which is disproportionately composed of low- and moderate-income workers and workers of color. Key highlights of these provisions include:

  • Relief checks for all but the highest-income households. Individuals with adjusted gross incomes of less than $75,000 and married couples with adjusted gross incomes of less than $150,000 will be eligible to receive $1,400 per person and per qualifying dependent. For example, an unmarried direct support professional (DSP) with two children earning the median annual wage of $24,960 would receive $4,200.
  • An historic expansion of the Child Tax Credit (CTC). The American Rescue Plan strengthens the CTC by increasing the maximum allowable credit, expanding eligibility criteria and converting the credit from deductible to refundable. In addition to lifting an estimated 4.1 million children out of poverty, this provision has the potential to better situate low- and moderate-income households—including DSPs and their families—to weather this and future financial storms.
  • Extension of federal Unemployment Insurance benefits. For a variety of reasons, many DSPs have been temporarily displaced from the workforce. The American Rescue Plan extends the Pandemic Unemployment Assistance Program through September 6, offering unemployed workers $300 per week in unemployment benefits on top of states’ benefits, thereby helping ensure DSPs and other displaced workers can make ends meet until they’re able to return to work.

As always, ANCOR will continue to keep its members apprised of developments regarding this and other COVID-19 legislative and regulatory actions, and is already actively working to support its members to advocate in their states to ensure the federal relief offered by the American Rescue Plan reaches providers most in need. You can stay informed about and lend your voice to these efforts by visiting ANCOR’s COVID-19 Resource Center.