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 - 12.16.19

State News 12/16/19

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Rights & Access

Alaska – (KTUU.com, 12/13/19) The state has decided to reinstate dental coverage for Medicaid recipients and will retroactively cover patients from 10/1-12/31/19 when the coverage is fully reinstated. The reversal comes after the state’s Department of Health and Social Services realized it hadn’t followed provisions of the Affordable Care Act when it made the decision to cut adult dental services in July.  In recent budget documents, the state acknowledged that preventative care could help reduce emergency dental costs saying, “Preventive dental services help deter higher costs that would be incurred through utilization of emergency dental services instead.”

Texas – (Stock Daily Dish, 12/16/19)  The Supreme Court has ruled that Texas has been using an unconstitutional and obsolete standard for determining “mental deficiency” in cases considering the death penalty.  The ruling came in the case of Bobby James Moore who killed a store clerk during a robbery in 1980.  He was convicted and sentenced to death at age 20.  At the time, the Supreme Court said the such an execution violates the Constitution’s ban on “cruel and unusual punishment” but left room for the states in how they defined “mental retardation”.  By 2014, the Supreme Court clarified its position and told states they are not free to use a rigid IQ determination and they “must be informed by the medical community’s diagnostic framework”.  However, the Texas court of appeals continued to use a 1992 definition from the AAIDD and declared that states are not obligated to use current medical standards alone and determined that Moore was “not sufficiently disabled to qualify for exemption from the death penalty”.  Last week the Supreme Court rejected all the elements of the Texas standard.  Justice Ginsburg, writing for the five-justice majority said, “Texas cannot satisfactorily explain why it applies current medical standards for diagnosing intellectual disability in other contexts,” like schools and the provision of social services, while at the same time it “clings to superseded standards when an individual‘s life is at stake,”.  The ruling will likely force the state to re-examination of about two dozen sentences for inmates currently on death row.

West Virginia – (Metro News, 12/14/19) Gov. Jim Justice is directing his Department of Health and Human Resources to conduct a formal study on the I/DD Waiver program in an effort to determine options for eliminating the waiting list for services.  Justice said in a statement that some of the state’s most vulnerable citizens have been waiting too long and that they must find a way to eliminate the waitlist.  In doing so, approximately 1,060 people would gain access to services.

 

Medicaid, Medicaid Expansion, MLTSS

South Carolina – (The Washington Post, 12/12/19) CMS has approved the state’s request to impose work requirements on certain people receiving Medicaid.  This decision suggests that the administration is continuing to try to reshape the program which is the cornerstone of the 1960’s War on Poverty.  South Carolina will become the 11th states to receive such approval as the administration wants to give people “the right incentives to live healthier, independent lives”.  As South Carolina has not adopted Medicaid expansion, this plan is unique in that it will require work or other productive activity for people currently in the program and is focused on two populations: parents or caretakers with incomes slightly higher than the state’s 67% of FPL threshold and adults who are homeless, in need of drug treatment or are involved in the criminal justice system.  Additionally, those newly applying for Medicaid will have to prove they are already working or performing other types of “community engagement” for at least 80 hours per month to qualify. 

 

State Budget

Virginia – (The Center Square, 12/13/19) Gov. Ralph Northam has announced that his two-year budget proposal will include $92 million to combat homelessness and reduce evictions.  As part of this package, $8.9 million will be earmarked for 350 rental assistance slots for people with I/DD and $8 million for permanent housing for people discharged from behavioral health facilities.  In a statement the Governor said, “We will continue to work with our partners to address housing instability and homelessness, provide permanent supportive housing for our most vulnerable citizens, and expand the supply of quality, affordable living options to meet the needs of a growing and diverse Virginia workforce.”

West Virginia – (Spring Hill News, 12/12/19) Department of Health and Human Resources Secretary Bill Crouch told event attendees that if lawmakers do not support the governor’s proposed budget, a “large number” of vulnerable people will face a significant loss of service.  The proposed budget calls for tax increases to avoid a projected cut of 25%, or $22 million. The focus was on the state‘s Intellectual / Developmental Disabilities Waiver Program, which provides in-home and community-based services.  Gov. Justice‘s proposed tax increases include a half-cent increase to the state sales tax, an increase in DMV fees from $30 to $50, and raising the cost of tolls on the West Virginia Turnpike by $1.