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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Stateside Report - 09.30.19

Stateside Report: September 30, 2019

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Rights & Access Hawaii – (Maui News.com, 09/28/19)  The Maui Disability Alliance hosted a “Family Feud” style event to help education local legislators and community members on disability-related issues.  This year the legislature passed four bills including Senate Bill 330, named “Kai’s Law” after Kai Warrington Silvert, requiring the state Department of Human Services to implement a program to disregard earned income for Medicaid eligibility. Massachusetts – (The Patriot Ledger, 09/23/19)  A bill is making its way through the Massachusetts state legislature which would create a registry of “caregivers” who support people with I/DD.  The bill originally introduced last year now includes provisions to require the state’s Disabled Persons Protection Commission to file the name of an individual with a substantiated charge of abuse or neglect, ensures the accused has due process rights and allows for them to partition for removal from the list after five years. Ohio – (CMS, 09/20/1920) Ohio has received final approval on its HCBS State Transition Plan. Oregon – (State of Reform, 09/25/19)  Governor Kate Brown signed a bill establishing a statewide System of Care Advisory Council.  The council is charged with developing recommendations related to in the provision of services.  The bill also included funding to support the council.   Medicaid, Medicaid Expansion, MLTSS Alaska – (KTUU, 09/26/19) Alaskans’ with disabilities are forced to seek grants to cover dental care after Governor Dunleavy cuts all but emergency dental services from the Medicaid budget. Mini-grants of up to $2500 may be available to Alaska Mental Health Trust beneficiaries which includes people with I/DD, Behavioral Health needs and those with Alzheimer’s disease. Idaho  (Kivitv.com, 09/28/19)  With Medicaid expansion set to go into effect on January 1, 2020, following the voter approved initiative, the state has submitted a waiver allowing them to require twenty hours of work per week to maintain eligibility. Under the expansion plan, Medicaid benefits are available to those earning up to 138% of the FPL. Georgia (Valdosta Daily Times, 09/29/19) According to the US Census Bureau, Georgia has the third highest uninsured rate in the country and is one of the 14 states which have not expanded Medicaid.  Local free clinics are therefore the only option for those who are uninsured.  Clarkson Community Health Center serves nearly 4100 patients and sees a steady, growing demand for care.  Located in a county with a 35% poverty rate, the need for care is taking a toll on clinics such as this one.  The clinic averages ten new patients on Sundays, their busiest day of the week, adding to the constantly growing patient pool. More than 400 volunteers keep the clinic running, with patients filing in and out.  “Our numbers are constantly increasing, which tells the story of how broken our health care system is,” clinic co-founder Dr. Gulshan Harjee said. Texas (Dallas Observer, 09/27/19) – Census data released Thursday indicates that the Dallas-Fort Worth area has the highest rate of uninsured children among the twenty-five largest metropolitan areas across the country. Texas is also one of the fourteen states that didn't expand Medicaid, leaving many families not poor enough to qualify for federal programs like Medicaid but still unable to afford private insurance premiums, which rose by 35% on the Federal exchange last year.   State Budget Florida – (CBS Miami, 09/24/19) The Florida Disabilities Council told legislators that there needs to be investments made in the I/DD service system to reduce the “lengthy” waiting list.  In a recent survey of 1909 people with disabilities and families, the Disabilities Council found that the service identified as most important was that which assists people to remain in their communities with personal care services ranking at the top of the responses.  Their report entitled “Preserving the iBudget” comes at a time when the state is projecting a $50 million deficit by the end of the current fiscal year in the budget for I/DD services. Missouri – (Daily Star Journal, 09/26/19) “The Department of Mental Health announced that effective July 1, 2019, the Division of Developmental Disabilities would implement a waitlist for in-home and residential Medicaid waiver services for individuals with developmental and intellectual disabilities because the Missouri State Legislature did not approve adequate funding.  The Fiscal Year 2020 budget that was approved by the Missouri General Assembly only includes enough funds to serve approximately 444 new individuals annually, which is expected to leave more than 800 individuals waiting for services.”  

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