Support HB 18-1407: "Access to Disability Services and Stable Workforce"

On this page you will find:

Click HERE to Sign the Petition to Support this Bill

Click HERE to read HB 18-1407

Click HERE to view the fact sheet

Click HERE to add your agency name to the fact sheet

Click HERE to Email the House Committee to Support HB 1407

The Problem

THE PROBLEM

To ensure support for people with IDD in our community, Colorado must address these inextricably linked issues:

Aging caregivers and individuals with IDD should not have to wait until they reach a crisis point to get help.

Colorado has long sought ways to eliminate the waiting list for comprehensive IDD services (the Developmental Disabilities, or HCBS-DD, waiver). Approximately 2,900 people are on the waiting list, most of whom have been waiting for years or decades. As of March 2018, approximately 300 people on the waiting list are aged 45 or older and are likely to have an aging caregiver. Aging caregivers are more likely to have chronic illnesses or otherwise have diminished capacity to care for their loved ones with IDD. Currently, these caregivers must continue to provide support until their loved one’s name comes to the top of the list, or until an emergency occurs when the caregiver dies or can no longer physically provide supports. Colorado does not consider the age or health of caregivers in its waiting list criteria.

The workforce crisis among IDD Direct Support Professionals is a barrier to ending the waiting list.

Insufficient Medicaid provider rates have resulted in an IDD Direct Support Professional (DSP) workforce crisis, which in turn is jeopardizing the sustainability and continuity of supports for people with IDD. A dedicated workforce of DSPs provides supports so that people with IDD can live full lives in the community instead of institutions. Unfortunately, due primarily to low reimbursement rates, these workers often make poverty-level wages that are not commensurate with the responsibilities of their work. This leads to high turnover and vacancy rates, which translates to service disruption for people with IDD. Colorado currently has an average 39% DSP turnover rate, with some agencies experiencing up to 81% turnover. Each turnover costs agencies between $4,200 and $5,200 in direct and indirect costs. This crisis prevents Colorado from meeting the demand for services.

Aging caregivers worry who will care for their loved ones, who will advocate for them, and who will provide services when they no longer can.

Support Aging Caregivers!

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A DSP is a worker who assists a person with disabilities to lead a fulfilling life in the community though a diverse range of services...

Support Direct Support Professionals!

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The Solution

THE SOLUTION

The proposed bill would:

Fund 300 new HCBS-DD waiver resources for those who have been waiting the longest and are most likely to have aging caregivers. This infusion of new resources to be initiated in FY 2018-19 and distributed on a first-come-first-served basis will help ameliorate growing caregiver concerns across Colorado and begin to draw down the waitlist.
Direct the Department of Health Care Policy & Financing to promulgate rules to add emergency enrollment criteria related to caregiver status. This will create a mechanism to assist people on the waiting list who are reaching a crisis point due to caregiver concerns such as advanced age, terminal illness, or incapacitation. Rulemaking is inherently a stakeholder process, but the bill would also ensure that HCPF solicit feedback on the rules from people with IDD and their families, who are most impacted by the waiting list.
Ensure stakeholder awareness of the HCBS-DD waiver waiting list by releasing data on how many people are coming off the waiting list on a monthly basis.
Provide a 6.5% rate increase for specific services on the Supported Living Services, Children’s Extensive Supports, and Developmental Disabilities waivers, 100% of which must be used to increase DSP compensation as defined in the bill. This will begin to address the IDD direct support workforce crisis that Colorado is experiencing.
Establish robust accountability for the 6.5% increase through provider reporting which includes:
- An attestation from the Executive level that the funds are spent as directed and that reporting is accurate;
- A statement not only on who the funds can be spent on (compensation for program workers, meaning direct support professionals, case managers, program supervisors, etc.), but also on who and what the funds can’t be spent on (compensation for administrative workers and tasks, including, IT, HR, CEOs, COOs, CFOs, etc.); and
- A directive for HCPF to track the expenditure of these funds using an agreed-upon tool. We propose a tool that tracks increases by position and differentiates between wages and other forms of compensation; and
- A “claw-back” or recoupment measure so that if the increase is not spent on compensation, those funds can be recouped by the Department.
Require the Department to participate in the National Core Indicators Staff Stability Survey to collect independent data on Colorado’s direct support workforce.
Require the Department to use existing National Core Indicator data to examine the impact of the rate increase on individuals with IDD.