ANCOR Applauds the Reintroduction of Better Care Better Jobs Legislation

Yesterday, U.S. Senator Bob Casey (D-PA) and U.S. Representative Debbie Dingell (D-MI) reintroduced the Better Care Better Jobs Act. ANCOR applauds Senator Casey and Representative Dingell for championing this legislation for the potentially transformative impact it would have on the community I/DD services system.

As the Better Care Better Jobs Act recognizes, the Medicaid Home and Community Based Services (HCBS) program plays a critical role in ensuring people with intellectual and developmental disabilities (I/DD) can be supported in their homes and communities. However, years of underinvestment in the program has led the service delivery to the brink of collapse, due in no small part to a direct support workforce crisis so dire that it is hampering the ability of people and families to access critical community-based services.

In response, the Better Care Better Jobs Act provides a much-needed investment in the HCBS program to strengthen the direct support workforce. The legislation would provide badly needed funding to states and providers through an increase in the federal investment in Medicaid. And just as importantly, it would require states to regularly review their reimbursement rates, a measure that could help ensure that payments don’t stagnate as the cost-of-service provision increases.

The need for these provisions is reinforced by data from ANCOR’s most recent survey, the State of America’s Direct Support Workforce Crisis 2022, which reveals that more than six in 10 community providers have discontinued programs or services in response to high rates of turnover and vacancy. Meanwhile, providers that have not yet been forced to close their doors are overwhelmingly turning away new referrals due to insufficient staffing. This leaves people with I/DD at greater risk for undue hospitalization and institutionalization.

More specifically, the Better Care Better Jobs Act would:

• Enhance Medicaid funding for HCBS by providing a permanent 10 percentage point increase in the federal Medicaid match to eligible states.

• Strengthen and expand the HCBS workforce by addressing HCBS payment rates to promote recruitment and retention of direct care workers, requiring states to update HCBS payment rates with public input every two years.

• Fund quality and accountability efforts, such as technical assistance to implement the bill and the creation of ombudsperson programs.

• Help states plan implementation, including requiring them to develop plans for implementation with public input.

• Make permanent the Money Follows the Person program, providing support for individuals to transition to appropriate long-term services and supports in the settings of their choice, including in home and community-based settings.

“Never before have we needed the leadership of Senator Casey and Representative Dingell as badly as we do now,” said Barbara Merrill, ANCOR’s chief executive officer. “If signed into law, Better Care Better Jobs would truly transform our service delivery system, to the benefit of the people with I/DD supported by our community of providers, as well as their family members and the workforce that is often the direct link between people and community. We applaud these lawmakers for their advocacy on behalf of home- and community-based services.”

ANCOR looks forward to continuing to work with members of Congress under the leadership of Senator Casey and Representative Dingell to advance disability policy in the 118th Congress. For more information on the bill, please see the fact sheet.