As Congress considers its frontline defenses against COVID-19, it must remember disability service providers
Right now, as Congress assesses support for those most impacted by COVID-19, we have a message for them. People with intellectual and developmental disabilities (I/DD), their families and the direct support professionals (DSPs) who work with them must not be left behind.
Like professionals at nursing homes and other health facilities, DSPs are critical lines of defense against this pandemic. Each day, they work in close quarters, doing everything from helping people feed, dress, bathe and care for themselves to supporting people to navigate the community, get a job, vote and more. Yet, as a recent NPR story describes, there’s little guidance and few resources for these dedicated professionals when it comes to staying healthy and safe.
Meanwhile, providers of community-based disability supports face the ripple effects of the coronavirus. They, too, must juggle kids home from school, caring for aging parents, and the financial instability of an economy in peril. Yet on top of it, these professionals work mostly in the homes of the people they support or in small group homes spread across the community. In these settings, there is no asking your colleague to cover for you so you can leave early. There is no running home on your lunch break to check on Mom and Dad. There is no homeschooling the kids when distance learning becomes the norm.
Even before a global health crisis hit, DSPs faced significant challenges as a profession, including significant turnover and high vacancy rates among DSPs. Prior to the outbreak, ANCOR’s national survey of providers found two-thirds indicated that they had turned away people seeking services because they lacked the staff needed to ensure the quality of those services.
Congress must act now to shore up this system—especially as community centers and day programs close to try to limit the spread of COVID-19. Our elected leaders can help providers’ doors stay open by offering stronger overtime and hazard pay to incentivize DSPs to stay in the field. They can create incentives to attract workers to the field; buy more protective gear; offer training on caring for the ill and preventing COVID-19’s spread; and provide financial support for day services so they remain viable after the outbreak.
The good news is that the federal government can bring states’ innovative approaches to scale by codifying them into law. Daily, we’re hearing of states offering providers flexibility so they can exchange staff with one other, replace routine in-person health care visits with telemedicine, share limited supplies, and relax rules about where services can be provided when community facilities close.
These approaches and more are essential if the I/DD community is to emerge from this pandemic with as little harm as possible. In particular, Congress should:
- Prioritize I/DD providers alongside health care providers to receive access to personal protective equipment (PPEs) like respirators, masks and gloves.
- Fund state Medicaid programs to enable providers to cover overtime, hazard pay and paid sick leave. DSP’s paychecks are directly tied to Medicaid reimbursement rates. And paid sick leave is critically important—if providers have the Medicaid dollars to cover those costs.
- Encourage states to offer, as Minnesota has done, free or subsidized childcare for direct support staff.
- Direct the Centers for Medicare & Medicaid Services to develop additional guidance for states and providers to continue supporting people with I/DD where they are, rather than re-institutionalizing them in the warehoused settings we’ve worked so hard to eliminate.
Without congressional action, providers across the country wonder: how many community service programs will have been forced to close their doors when the pandemic ends? State programs alone are ill-equipped to address this concern, which is why Congress must ensure that disability services continue unabated. This includes working according to the spirit and letter of the Home and Community Based Services Settings Rule, which mandates that people with disabilities have the same access and opportunities to community living as anyone else.
ANCOR is proud of the hundreds of thousands of people who will continue to show up and support people who need them. We will stand by them through the entirety of the coronavirus crisis, and we hope Congress will, too.
Barbara Merrill is chief executive officer for ANCOR, the American Network of Community Options and Resources.