Workforce Crisis Puts Essential Services for Texans with Disabilities in Jeopardy

Posted on

September 21, 2021


Edie Surtees, Disability Rights Texas, esurtees@drtx.org, 512-407-2739
Summer Mandell, The Arc of Texas, smandell@thearcoftexas.org, 512-485-9728

Organizations Call for Texas Legislature to Address Funding for Direct Care Workers During Third Special Session

AUSTIN—A collective of Texas-based organizations representing millions of Texans with disabilities of all ages is calling for the third special session of the 87th Texas Legislature to address decades of severely inadequate funding for Medicaid community attendants and direct care workers.

Community attendants and direct care workers support Texans with disabilities so they can live with family, in their own home, or other community settings such as small group homes—all options allowing people to live and thrive in their community and age in place.

This workforce performs a variety of skilled and unskilled essential tasks, such as helping people with disabilities get out of bed, toilet, bathe, and dress so they can participate in community activities. They may coach people with intellectual, cognitive, or developmental disabilities on everyday tasks so they obtain and retain life skills.

Community attendants and direct care workers in Texas are primarily paid by Medicaid, which is funded based on policy and budget decisions made by the Texas Legislature. Long underpaid, the COVID-19 pandemic is devastating this essential workforce.

“Though their services are vital to maintaining the health, independence, and dignity of thousands of Texans, community attendants hold some of the worst-compensated jobs in the state,” said Coalition of Texans with Disabilities Executive Director Dennis Borel.

Many work more than 40 hours a week across various employers and receive either limited or no benefits, such as sick leave or health insurance. Their base rates start as low as $8.11 an hour—far less than starting wages for a variety of jobs throughout Texas.

“The federal American Rescue Plan Act funds create a real opportunity for the Texas Health & Human Services Commission and the Texas Legislature to address rampant staffing issues, stabilize an essential workforce, and initiate actions toward a longer-term solution,” said Texas Council of Community Centers CEO Danette Castle. “As an urgent first step, the state must use these federal funds to provide meaningful recruitment and retention payments for community attendants and direct care workers. Longer term, HHSC should consider the activities of other states to raise the base wage rates of the workers who provide these critical day-to-day, hands-on services and supports for Texans with disabilities.”

The community attendant and direct care workforce establishes the foundation of cost-effective community-based services. Unfortunately, Texans with disabilities of all ages are falling through the cracks in the community system on which they rely, facing unnecessary hospitalization and institutionalization which come at a substantially higher cost to Texas than community-based services.

“It’s time to end this systemic, worsening crisis and implement solutions that will stabilize the foundation millions of Texans build their lives upon,” said The Arc of Texas Director of Public Policy & Advocacy Ashley Ford.

“People with disabilities and seniors rely on Texas legislators to take action to prevent harm due to their lack of access to community attendants and direct care workers. The special session is the right time to do the right thing,” said Bob Kafka, organizer, ADAPT of Texas.

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The Arc of Texas promotes, protects, and advocates for the human rights and self-determination of Texans with intellectual and developmental disabilities.

ADAPT of Texas is a statewide, grassroots, disability rights, consumer-run organization, fighting since 1984 for the rights and services people with disabilities of all ages require to live in the community.

Disability Rights Texas is the federally designated legal protection and advocacy agency (P&A) for people with disabilities in Texas established in 1977. Its mission is to help people with disabilities understand and exercise their rights under the law, ensuring their full and equal participation in society.

The Coalition of Texans with Disabilities, founded in 1978, is a statewide cross-disability advocacy organization with a mission to ensure that people with disabilities may live, learn, work, play and participate fully in their community of choice.

EveryChild, Inc.’s mission is to create a system that ensures children with disabilities grow up in families instead of institutions. EveryChild, Inc., believes that all children can grow up in a family. Even children with the most significant disabilities and fragile medical conditions can live with families.

The Personal Attendant Coalition of Texas (PACT) is a grassroots coalition of attendants and their supporters, working in homes and community-based service programs. PACT provides a voice for the approximately 300,000 statewide attendants to strengthen the salaries, benefits, dignity and position in the community. PACT supports the independence of aging Texans and persons with disabilities throughout their lives in the community.

Private Providers Association of Texas (PPAT), established in 1984, provides leadership and support to providers of community-based Medicaid services for persons with intellectual and developmental disabilities (IDD). Services are primarily provided through the Home and Community-based Services (HCS) and Texas Home Living (TxHmL) waivers and the Intermediate Care Facilities for Individuals with Intellectual and Developmental Disabilities or Related Conditions (ICF/IID) program. PPAT’s mission is to advocate for and strengthen the capacity of providers to provide quality, person-centered and integrated community-based services to persons with IDD.

Providers Alliance for Community Services of Texas is an association for long-term care providers offering services in the Home and Community-based Services (HCS), Texas Home Living (TxHmL) waiver programs and in intermediate care facilities for individuals with intellectual and developmental disabilities or related conditions (ICF/IID).

The Texas Association for Home Care and Hospice (TAHC&H) has championed the collective interests of Texas home care and hospice agencies, organizations, and individual professionals since its founding in 1969. Its mission, to advocate for ethical practices, quality, and economic viability of licensed providers in Texas joins together member organizations and individuals in a shared commitment to every citizen in need of quality, affordable in-home services.

The Texas Council of Community Centers is an association that represents the public system of Local Mental Health and IDD Authorities serving Texans across all 254 counties.