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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Capitol Correspondence - 01.06.20

2020 Vision: Opportunities, Challenges in the New Year

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ANCOR wishes our readers a happy new year as we enter a new policy landscape in 2020! Having covered over 120 topics in this publication in 2019 alone, we expect to have a lot of timely updates this year as the policy landscape takes shape. As we begin to engage with policymakers, here is our read-out for early 2020. This includes issues we will be focusing on in the coming weeks and challenges to expect from the broader political climate.

Our focus for the first quarter of 2020:

  • Strengthening the DSP workforce: As you may have seen before the holidays, the House introduced Isaiah and Margie’s bill to allow states to reimburse, if they choose, for DSP’s time assisting individuals during short-term hospital stays. We expect the Senate to introduce a companion bill soon. We will also be continuing our advocacy for two bills, one creating a grant program for DSP pipeline recruitment and the other creating a standard occupational classification for DSPs.
  • Permanently renewing Money Follows the Person: A proposal to permanently renew this important rebalancing program is included in a broader drug pricing bill by Senators Chuck Grassley (R-IA) and Ron Wyden (D-OR). We expect this issue to gain more traction in the spring, when short-term funding for several health programs ends and forces Congress to turn its attention to health care issues.
  • Monitoring the Administration’s efforts to implement greater accountability and lower spending for Medicaid, including:
    • Block grant guidance, which has been undergoing final review for months at the Office of Management and Budget (OMB) in the White House.
    • Efforts to close loopholes surrounding the Medicaid provider tax – ANCOR is working with a consultant to inform our comments on this proposed rule.
    • Policies seeking to shift away from fee for service in general – while the Center for Medicare and Medicaid Services’ (CMS) payment reform focus has been more on Medicare, there is a general interest within the Administration to shift away from fee for service models.
  • Stay tuned for more – today is the first day of the two-day Government Relations (GR) retreat in Baltimore, MD. We will be discussing our policy priorities with ANCOR members who sit on our Government Relations Committee. We will share updates on that discussion next week. In the meantime, if you are interested in joining the Committee or learning more, please reach out to Doris Parfaite-Claude, Federal Advocacy and Research Manager, at [email protected].

Forecast for the broader political climate:

  • Impeachment proceedings will push most policy discussions into late winter / spring. With the Senate negotiating to have the House send over articles of impeachment, we expect the proceedings to take most of Congress’ bandwidth for all of January, and possibly into February.
  • This election year, the pressure is on for health care legislation – which cuts both ways for disability proposals. With the viability of the Affordable Care Act (ACA) on its way to being revisited by the Supreme Court, health care will again be a key issue this election cycle, creating both opportunities and challenges.
    • Opportunity: This will put pressure on members of Congress to show they are fulfilling campaign promises from 2018, such as reducing surprise billing and addressing high drug prices, and look into new ideas to improve constituent lives. This will create openings to attach disabiltiy proposals to key health legislation.
    • Challenge: The election climate will also give members of Congress reasons to attack each other’s proposals or be cautious about new ideas.
    • Side effects: Eagerness and tensions alike could spill over to proposals such as the permanent renewal of MFP, which is being tied to drug pricing legislation to motivate bipartisan discussions.
    • Additional read: Readers will find a broader health policy update on Politico Pulse, which looked at 10 health policy questions to answer in 2020.
  • Members of Congress up for re-election will be spending more time in their districts. This will slow down policy-making discussions as policy staff will have fewer opportunities to discuss proposals with their bosses in-person. However, it also presents opportunities for fruitful grassroots / in-district activities.
    • Pro-tip: Sign up now to receive emails from the campaigns of your elected officials so that you are aware of opportunities to interact with them in-person, such as town halls or constituent breakfasts. After the contentious town halls of 2017, events such as these are not as broadly advertised as they used to be.

Don’t miss our action alert emails! As our policy initiatives take shape, we will let our members and allies know when it is critical that Congress hears from you via our action alerts. If you have not received those in the past, you can sign up for them in the “Stay Informed” section of our Amplifier page.