We have helped many clients with disabilities who either have or wish to receive help at home with activities of daily living, such as bathing and dressing.  Medicaid can pay for attendants and other assistance for such people through programs called “Home and Community Based Services (HCBS) Waiver” programs.  Participation in these waivers can be based on intellectual or developmental disabilities, traumatic brain or spinal cord injuries, or residence in certain assisted living facilities.  However, due to a shortage of personal care attendants and funding to provide the needed services, many of these waiver programs have years-long waiting lists.  The Senate Budget Resolution introduced by the Biden Administration seeks to address these problems.  A draft of that resolution is copied below.

Even before COVID-19, our country was in the midst of a caregiving crisis. In addition to caring for children, families feel the financial burden of caring for aging relatives and family members with disabilities, and there is a financial strain for people with disabilities living independently to ensure that they are getting care in their homes. At the same time, hundreds of thousands of people who need better care are unable to access it, even though they qualify under Medicaid. In fact, it can take years for these individuals to get the services they badly need. Aging relatives and people with disabilities deserve better. They deserve high-quality services and support that meet their unique needs and personal choices.

Caregivers – who are disproportionally women of color – have been underpaid and undervalued for far too long. Wages for essential home care workers are approximately $12 per hour, putting them among the lowest paid workers in our economy. In fact, one in six workers in this sector live in poverty. President Biden is calling on Congress to make substantial investments in the infrastructure of care in our country. These investments will help hundreds of thousands of Americans finally obtain the long-term services and support they need, while creating new jobs and offering caregiving workers a long-overdue raise, stronger benefits, and an opportunity to organize or join a union and collectively bargain. Research shows that increasing the pay of direct care workers greatly enhances workers’ financial security, improves productivity, and increases the quality of care offered. Another study showed that increased pay for care workers prevented deaths, reduced the number of health violations, and lowered the cost of preventative care.

President Biden’s plan will:

·  Expand access to long-term care services under Medicaid. President Biden believes more people should have the opportunity to receive care at home, in a supportive community, or from a loved one.

·  Put in place an infrastructure to create good middle-class jobs that will improve wages and quality of life for essential home health workers and yield significant economic benefits for low-income communities and communities of color.