September 27, 2021

A collective of Texas-based organizations representing millions of Texans with disabilities of all ages are 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.

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.

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.

PACSTX has been participating with 10 other organizations in an effort to get media attention and attention at the Capital on the workforce crisis impacting IDD services and community attendants supporting seniors and those with disabilities. Below is an update on those activities:

3^rd Special Session of Texas Legislature Activities

• The 3^rd Special Session of the Texas Legislature convened this week. Included on the call is the opportunity for the state to appropriate $16 billion in state controlled American Rescue Plan Act (ARPA) funds. The coalition has met with HHSC Executive Commissioner Young and has two meetings with HHSC on staffing crisis. The coalition is working to meet with the governor’s office next week, schedule joint meetings at the capitol and potentially a press conference.
• As part of this effort, the three IDD Provider Associations (PACSTX, PPAT, and Texas Council) are advancing a proposal for recurring funding to support the staffing crisis for the IDD-services including HCS, TxHmL and ICF. The request is for a total of $200 million/year .

What you can do to help! Action Needed:

• Given the short timeframe we have (less than 30 days) and the fast pace with which legislators are moving, the 3 IDD associations are pooling their resources (staff and lobbyists) to work on this critical IDD initiative.
• While calls to legislators who represent you are important, the most effective way to assist with this effort is to contact legislators with whom you have an established relationship, particularly if those legislators sit on either the Senate Finance Committee or House Appropriations Committee.  See below for talking points.
• To find out who represents you go to:  https://wrm.capitol.texas.gov/home
• To see if your State Representative or State Senator sits on either the Senate Finance or House Appropriations Committees
• Though Senate Finance and House Appropriations are key, if you have a close relationship with any member of the House or Senate, regardless of their committees, it would be helpful for you to reach out to them to let them know about your workforce issues and the remedy we are proposing.

Talking Points (What to Say)

Explain the purpose of your call; i.e., to discuss the impact of the workforce shortage your organization is experiencing and to request their support for the $200 million/year All Funds (AF).

Let them know that while an increase in the base wage rates of direct care workers to even compete with other industries is what we need, you recognize that creating long term liability for the state’s budget is not an option at this time. 

Comment that until a longer term strategy can be realized, funding for the short term strategy (the $200 million in ARPA funds) is critical.  Explain that the funds will allow your organization to offer sign-on bonuses and periodic incentive payments which will not only greatly assist in stabilizing your direct care workforce, but also in stabilizing your operations and the services and supports on which the persons you serve rely to remain in the community. 

Thank you for your help with this critical need to support our clients and staff!