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 - 08.19.19

State News!

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Rights & Access

Pennsylvania – (Media.pa.gov, 8/14/19)  The Department of Human Services has announced the closure of two state developmental centers, Polk State Center in Venango County and White Haven State Center in Luzerne County.  These two centers currently house 194 and 112 people with I/DD respectively and is being held up as reflective of Governor Wolf’s administration’s commitment to service more people in the community.  It is expected that the full transition will take about three years.

 

Medicaid, Managed Care and LTSS

Alaska (KTUU, 8/16/19)  Gov. Dunleavy has proposed transferring the state’s Medicaid exchange to a private insurer but a recent report commissioned by the state does not suggest strong feasibility. Specifically it does not describe how the state would save money.  Advocates of the current exchange suggest that Medicaid is more efficient than a potential commercial insurer.

Wisconsin – (GazetteXtra, 08/16/19)  Legislation is being entered that would allow for telehealth services to be billed in the state’s Medicaid plan.  State Reps. Amy Loudenbeck, R-Clinton, and Debra Kolste, D-Janesville, are among the co-authors.  “Loudenbeck told The Gazette the bill would improve access to routine services for rural Wisconsinites and those with mobility challenges.”  The bill targets four goals to improve Medicaid coverage of telehealth and include requiring Medicaid to cover telehealth the same as in-person services;  allowing coverage for benefits similar to those allowed by Medicare;  allowing telehealth services to be accessed in homes or nonclinical settings; and repealing the requirements for telehealth certification for providers of behavioral health and substance abuse services.

National News – (Medicaid.gov, 8/13/19)  Medicaid has released a paper profiling the states with the greatest shift in rebalancing long-term services and supports from 2012-2016.  The states include Arkansas, Connecticut, Colorado, Illinois, Missouri, Massachusetts, Nevada, New York, New Jersey, and South Carolina.  The report cites the achievement as “rebalancing by increasing expenditures on HCBS, decreasing expenditures on institutional services, or both, resulting in a larger share of total LTSS expenditures for HCBS.”

 

Other News

California (curtesy of ANCOR’s subscription to ASAE, 8/15/19)  A bill is making its way through the California state legislature which would dramatically alter the definition of “employee” to include those who were formerly considered to be freelancers and independent contractors.  The bill seeks to attribute to these classes of workers full-time employee status and the right to employer sponsored benefits such as sick time, overtime and health insurance.  While the target of the legislation is “app workers” such as those working for Lyft and Uber, clearly the consequences extend to many more sectors.  The bill passed the state assembly in May and is expected to be taken up by the Senate in September.

Maine (Washington Post, 08/14/19)  This story looks at the growing need of home-care for elders across the nation and the impact of workforce shortages on that much needed service.  The story has profiled Maine which has recently reached a tipping point where a fifth of its total population is over 65 and now meets the category of the “super aged” or the oldest state in the nation.  It is projected that by 2026, at least another 15 states will join that dubious designation including Vermont, New Hampshire, Montana, Delaware, West Virginia, Wisconsin and Pennsylvania, and more than a dozen more are expected to follow suit by 2030.  “Experts say the nation will have to refashion its workforce, overhaul its old-age programs and learn how to care for tens of millions of elderly people without ruining their families’ financial lives.”

Minnesota – (KXRA’s Voice of Alexandria, 08/12/19)  ANCOR member Lutheran Social Services of Minnesota’s CEO, Jodi Harpstead, has been named the new DHS Commissioner effective September 3rd.  Lutheran Social Services of Minnesota is one of the state’s largest human services organizations with 2,300 employees and 8,000 volunteers that serve 1 in 65 Minnesotans.  Among other things, Lutheran Social Services is known for service to older adults, people with disabilities, homeless youth, adoption and supporting military families.

Missouri – (The Eagle, 08/16/19)  Missouri Developmental Disabilities Division Director, Val Huhn, cites low wages as the primary reasons workers leave this sector.  This year the legislature appropriate $20 million in general revenue to help curb that trend and wages have increased to between $9.50-$10.50 per hour.  But advocates worry that is still not enough to convince potential employees to come to this work or for existing staff to stay. “Nationally, the direct support workforce has reached crisis levels, according to a 2017 report by the President’s Committee for People with Intellectual Disabilities KCUR-FM reported.  ‘Not only does the crisis facing this workforce threaten people with intellectual disability and their families; it also undermines the stability, efficiency and ability to grow much needed long-term services and supports and, therefore, undermines the overall U.S. economy,’ Jack Brandt, the committee’s chair, wrote.”

Ohio  (Cleveland.com, 08/16/19)  Tony Thomas, Director for Welcome House and ANCOR Board Member, has been named as the sole recipient of this year’s John F. Kennedy Jr. Award given by NADSP.  The award goes each year to a person who works in a residential or community setting supporting people with I/DD, and who is taking care of daily living skills and helping people live as independently as possible, in a culture that is “entirely person-focused.”

National (Science Daily, 08/15/19)  Scientists studying genetics have published findings regarding a gene associated with a rare condition that results in physical and intellectual disabilities in children.  The study shows that a rare variant in the gene DDX6 is associated with a disruption in the development of the central nervous system.  This gene had not previously been linked to childhood disorders but appears to play a significant role in early brain development.  Dr. Vinodh Narayanan, Medical Director for the Translational Genomics Research Institute was quoted, “We expect that the insight into disease mechanisms gained from our studies will lead to a better understanding of an entire group of neurodevelopmental disorders, and eventually guide us to specific treatments.”