The State of America's Direct Support Workforce Crisis 2024
ANCOR Issues Statement Calling for Allocation of CARES Act Relief to Medicaid-Funded Providers of Community-Based Disability Services
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Call on administration to issue clearer guidance comes in response to HHS announcement regarding latest distribution of emergency funding
ALEXANDRIA, VIRGINIA – On Wednesday, the U.S. Department of Health & Human Services (HHS) announced further details of how it plans to distribute the $100 billion for the Public Health and Social Services emergency relief fund authorized by the CARES Act. The announcement, which follows previous communications from HHS declaring that the first $30 billion of CARES Act funding would be allocated to Medicare services, states that Medicaid-funded services will also receive relief.
However, despite naming “providers that solely take Medicaid” as future recipients of COVID-19 relief funding, HHS’ announcement failed to specify that Medicaid-funded providers of long-term supports and services for people with intellectual and developmental disabilities (I/DD) will be eligible to receive the CARES Act dollars. Whereas the announcement did enumerate some of the types of providers that will be eligible, such as skilled nursing facilities and dentists, it neglected to identify I/DD home and community service providers and intermediate care facilities (ICF-IID), despite the dire situation in which these providers currently find themselves.
In response, the American Network of Community Options and Resources (ANCOR), the nation’s leading voice for community-based disability providers, is calling on the Trump administration to immediately issue clarifying guidance that explicitly names Medicaid-funded disability service providers among the intended recipients of this latest allocation of emergency relief funding.
ANCOR’s call on the administration to issue this guidance follows previous requests to address the crisis situation facing disability providers. On March 31, ANCOR sent a letter to HHS Secretary Alex Azar seeking an $8.3 billion allocation of funding from the CARES Act for Medicaid providers. Following HHS’ announcement that its original $30 billion disbursement would not include Medicaid providers, the association followed up with a second letter to Secretary Azar on April 10 asking the Department to mirror the provisions of the Medicare funding tranche for Medicaid providers in HHS’ subsequent distributions of coronavirus relief aid. On April 17, ANCOR sent a letter to Calder Lynch, Director of the Center for Medicaid & CHIP Services at the Centers for Medicare & Medicaid Services, seeking the explicit inclusion of I/DD and Autism services in future distributions of CARES Act funding. Most recently, ANCOR sent a letter on April 20 to Secretary Azar and Seema Verma, Administrator of the Centers for Medicare & Medicaid Services (CMS), seeking transparency about CMS and HHS’ plans for announcing future tranches of funding and whether those disbursements would include Medicaid-funded providers.
At the time of press, ANCOR had not received responses from Secretary Azar, Director Lynch or Administrator Verma.
The desperate calls for aid from the national community of disability service providers is the direct result of the devastating situation in which these providers find themselves in their efforts to support vulnerable Americans with intellectual and developmental disabilities and Autism. According to a recent survey fielded by ANCOR of nearly 700 provider organizations in the US, providers on average have reported revenue losses of 28% of their overall budgets. Moreover, respondents reported more than 31,000 vacancies for direct support positions, underscoring the precarious staffing situations in which providers are operating.
Barbara Merrill, chief executive officer for ANCOR, described the dire situation bluntly: “People are dying, plain and simple, because federal aid isn’t coming quickly enough,” Merrill said. “Providers already lacked the staffing needed to keep people with I/DD safe and healthy, and even when the staffing was in place, direct support professionals couldn’t access the PPE they needed to keep safe themselves. Now, the lack of emergency relief aid spells economic ruin for many disability providers, meaning they may not be able to weather this storm, let alone reopen their doors to deliver services long after the pandemic is over.”
Although the Department’s announcement did not explicitly exclude Medicaid-funded disability service providers from eligibility for HHS’ CARES Act funding, ANCOR maintains that these providers must be explicitly named to ensure they aren’t cut out of the disbursement of funds when the next round of fund transfers takes place. “We trust [the Department of Health & Human Services] is doing the best they can to ensure no one is overlooked, but clear, explicit and transparent regulatory language is always essential, but especially so when resources are scarce,” Merrill added.
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For nearly 50 years, the American Network of Community Options and Resources (ancor.org) has been a leading advocate for the critical role service providers play in enriching the lives of people with intellectual and developmental disabilities (I/DD). As a national nonprofit trade association, ANCOR represents 1,600+ organizations employing more than a half-million professionals who together serve more than a million individuals with I/DD. Our mission is to advance the ability of our members to support people with I/DD to fully participate in their communities.