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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Connections - 06.30.21

Washington Finally *Sort of* Understands the DSP Workforce Crisis

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By Sarah Meek, Senior Director of Legislative Affairs, ANCOR

 Sarah Meek, ANCORIt’s been a looooong time coming, but it seems that both Congress and the Biden administration are both seriously exploring ways to remedy the DSP workforce shortage in Medicaid-funded disability services. While lobbying members of Congress and their staff about the dangers of Medicaid block grants and per capita caps, ANCOR members and other advocates educated a generation of lawmakers and staff on the inner workings of Medicaid-funded disability supports and a true glimpse into the lives of people with I/DD and the DSPs that support them.

Our successes during the COVID-19 pandemic were only possible because members of Congress and their staff now have a solid understanding of these supports and services. Members of Congress and their staff had met with ANCOR members, people receiving supports, and their DSPs. They had been to group homes, day programs, competitive employment, shared living, and more during our “DSP for a Day” campaign so they saw in-person the critical nature of our members’ work. This grassroots advocacy enabled Congress to include ANCOR members in the Paycheck Protection Program, to open up the Provider Relief Fund to Medicaid providers, and to pass a 10% FMAP bump for HCBS in the American Rescue Plan.

And now members of the House and Senate have introduced the Better Care Better Jobs Act, which invests an unprecedented $500 billion over ten years in Medicaid-funded disability services and the direct care workforce that provides those services. Here’s how:

  • Implement a 10% FMAP bump for all HCBS waivers for 10 years
  • Codify the title Direct Support Professional in federal legislation
  • Fund substantial planning for states
  • Require reimbursement rate sufficiency and frequent rate reviews
  • Finance DSP training and recruitment
  • Finalize LTSS quality standards

While this legislation is far from perfect, it is a profound achievement made possible by your decades of tireless advocacy. Finally Congress and the Administration recognize the uniqueness of disability supports and the role that DSPs play as a linchpin. I look forward to working with you to continue our work on this legislation and many bills in the future so that people with I/DD can live full lives of their own choosing.

Sarah Meek is the Senior Director of Legislative Affairs at ANCOR.