By Debbie Bennett, President and CEO, Hillcroft Services—
MUNCIE, IN—In Indiana, more than 50,000 people with intellectual and developmental disabilities (I/DD) rely on Medicaid for their long-term care and support needs. These are our neighbors, our family members, our friends—and they deserve to have the support needed to live independently, have careers, and thrive in their communities.
That support might be in the form of someone coming to their home to help them with activities of daily living, helping them find and retain a job and providing transportation to it, or ensuring they can participate in community events and maintain meaningful relationships.
Unfortunately, proposals to slash Medicaid funding that are moving through Congress as part of the reconciliation process threaten to unravel the vital support system hundreds of thousands of Americans with intellectual and developmental disabilities rely on to remain in their homes and communities.
Medicaid is not just a line item in the federal budget – it is a lifeline for our family, friends, and neighbors. As lawmakers consider drastic cuts to Medicaid funding, they risk dismantling a system that allows people with disabilities, and the people who care for them, to live, work and thrive in their communities. Medicaid is funded by our state with matching funds from the federal government. Any cuts to federal funding for Medicaid will force our state to make impossible choices about crucial and life-saving programs and services.
Significant cuts to federal Medicaid funding will place additional financial strain on state budgets, forcing states to absorb the increased costs. State budgets must prioritize mandatory Medicaid services, leaving optional services like community-based services vulnerable to reductions. Without access to community-based services, people with I/DD will either go without the support they need or end up in high-cost, state-run institutions–the very institutions we have worked for more than 50 years to move away from.
The idea of reducing Medicaid funding is even more devastating given that our state is already struggling to provide the home- and community-based services promised to people with I/DD due to a lack of workers in the field. Wages for Direct Support Professionals (DSPs), who assist with everything from personal care to job training, are directly tied to Medicaid reimbursement rates that have long been insufficient to attract and retain workers to this meaningful but challenging profession.
According to recent research from ANCOR, 90% of community-based service providers experienced moderate or severe staffing challenges in the past year, forcing some to discontinue their programs and services. Many of these providers are the only ones in their area offering these services.
In Muncie, my organization, Hillcroft Services, is one of these service providers. We serve over 600 people with I/DD. Over 80% of our operating budget consists of employee wages and benefits. For years, we have struggled with recruiting and retaining employees due to the hourly rate we can afford to offer from Medicaid reimbursements, coupled with the massive responsibilities it takes to support our clients for this wage. We have had many employees lured away from the job they love because they are able to earn more money elsewhere in the face of the increasing daily cost of living. Additional cuts to funding services for people with I/DD will only exacerbate those difficulties further and leave a vulnerable population without options.
Community-based services fuel local economies, not only by creating direct support jobs, but also by helping people with I/DD to stay employed, and allowing their family members or caregivers to stay in the workforce too. Community providers enable disabled workers to secure employment in high-demand jobs while also being a top driver of job creation themselves, with direct support being the fastest-growing profession over the next decade.
Medicaid cuts will not save money but merely shift costs to states, forcing states to cut services or increase the burden on taxpayers.
We call on Senators Young and Banks and Representative Spartz to protect people with disabilities and their families, our economy, and our communities by rejecting Medicaid cuts, whether those cuts are proposed through the reconciliation package or through some other federal action. Simply stated, we need to strengthen–not weaken–our commitment to those with I/DD.
Doing so requires both federal and state investments in these services and in the direct support professionals who deliver them.
