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 - 06.16.20

ANCOR Joins Coalition Letter Asking Senate for Resources for Long Term Supports and Services

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As part of its coalition work with the Managed Long Term Supports and Services (MLTSS) Health Plan Association, ANCOR joined letters to targeted Senators requesting continued policy changes during the COVID-19 pandemic to support the systems on which people with disabilities rely to remain healthy and safe.

As written in the letter:

“We greatly appreciate the work you have done thus far to advance bipartisan efforts to respond to the effects of the COVID-19 outbreak. Many of the provisions included in earlier legislative packages, along with administrative changes advanced by the Centers for Medicare & Medicaid Services (CMS), are of great help to us in meeting the needs of older adults and people with disabilities.

Given these extraordinary circumstances more must be done to protect vulnerable populations and the systems of care that support them. We remain concerned about the terrible realities facing this country’s congregate living facilities, including nursing homes, assisted living facilities, and skilled nursing facilities. In a recent announcement from the Centers for Medicare & Medicaid Services (CMS) related to enhanced enforcement actions in nursing homes, CMS stated that ‘as of May 24, 2020, about 12,500 nursing homes – approximately 80 percent of the 15,400 Medicare and Medicaid nursing homes … reported over 60,000 confirmed COVID-19 cases and almost 26,000 deaths.’ At the same time, more must be done to support those with functional limitations who receive services at home or in other parts of the community. Without critical home and community-based services (HCBS), vulnerable populations are more likely to end of in a more costly care setting, like the emergency department or a nursing facility, where they are also at greater risk to either contract or transmit COVID-19.

To address these concerns, we request further policy changes to: 1) support individuals with functional limitations to remain safe and healthy, 2) promote the safety of the LTSS workforce and equip it to meet growing economic and safety concerns, and 3) provide states with the resources and flexibility to meet the demands of this emergency.”

The policy changes listed are provisions from the HEROES Act, which passed the House but is still pending in the Senate. They include:

  • The temporary increase for the Medicaid Federal Medical Assistance Percentage (FMAP).
  • Additional funding for Medicaid Home and Community-Based Services (HCBS) during the pandemic.
  • Defining Direct Support Professionals (DSPs) as essential workers.
  • Additional funding for critical programs such as those run by the Administration for Community Living (ACL).

In addition to writing to Senate Majority Leader Mitch McConnell (R-KY) in the letter linked above, the coalition also sent the letter to Senators John Thune (R-SD), John Barrasso (R-WY), Ted Cruz (R-TX), John Cornyn (R-TX), Rand Paul (R-KY), Chuck Grassley (R-IA), Pat Toomey (R-PA), Lamar Alexander (R-TN) and Susan Collins (R-ME).