Last Tuesday, March 16, members of Congress released draft legislation called the Home and Community-Based Services Access Act (HAA), increasing Medicaid to state funding for HCBS, making HCBS services portable across state lines, and providing other gains for people served under these guidelines.
HCBS services allow assistance for those with disabilities to do functions such as getting a job in a community, preparing and consuming food, managing money and medications, and providing support for assistance in daily living activities such as bathing and dressing.
The Arc of the United States and advocates have been working on this legislation for years. The legislation is called “transformative,” creating and maintaining avenues for people with disabilities to engage in community-based services.
The HAA builds on both the Americans with Disabilities Act and the Supreme Court’s Olmstead, providing federal money to fulfill these promises. On Tuesday, senators Maggie Hassan (D-NH), Sherrod Brown (D-OH), and Bob Casey (D-PA), and representative Debbie Dingell (D-MI) unveiled that HAA will:
- Eliminate waiting lists. At present, approximately 850,000 are on a waitlist for HCBS services across 41 states. Many times, people are waiting decades to access these critical services.
- Increase federal Medicaid funding for states and HCBS. Additional grant funding will help states build capacity for serving those on HCBS Medicaid waivers.
- Address the direct support professional workforce inequities. The act aims to help the support staff of those with disabilities, who are often women of color. Presently, direct support professionals have a 50% turnover annually, and the average wage is less than $11 per hour. The HAA will require states to ensure that this workforce is paid a sustaining wage.
- Allow state-to-state transfers for HCBS services. Often family situations, such as the death of a parent, leads to the individual receiving HCBS services needing to move across state boundaries. Today, the various implementations of these programs don’t afford this move. The HAA calls for the creation of a set of services that all states must provide.
HCBS services are “an artifact of law that is over 55 years old and never envisioned community-based support for older adults and people with disabilities. This HCBS patchwork is built on waivers that does not serve everyone in need of long-term services and supports and does not adequately support the work force,” states a memo released by the offices of The Offices of Sens. Hassan, Brown, and Casey and Rep. Dingell.