Direct support workers who care for people with disabilities gather at the Ohio Statehouse in 2018 to raise awareness about their industry’s employee shortage and its low pay. (Jonathan Quilter/The Columbus Dispatch/TNS)
LILBURN, Ga. — Matthew Southern, 35, who has intellectual and developmental disabilities, is able to stay out of an institution because health aides paid through a Medicaid program assist him and his roommate with ordinary tasks.
But amid a worker shortage worsened by the pandemic, Southern’s father, Dan, has had to step in to fill in gaps in his son’s care by volunteering at their home 45 minutes away from his northwestern Atlanta suburb. He blames the low pay across the industry.
“No one wants to work for $12 an hour,” Dan Southern said. “People can work at Burger King and make more money.”
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Last year brought an injection of hope: The federal government, through the American Rescue Plan Act that President Joe Biden signed into law in March 2021, increased funding with a 10-percentage point match that could amount to some $25 billion in federal money for Medicaid home and community-based services, which have long faced staffing crunches. That massive infusion of cash could be used by states to buttress wages, move people off waiting lists for disability services, train more workers, or expand covered services for those who are elderly and people with disabilities, helping to keep them out of nursing homes.
But almost a year later, Indiana, Massachusetts, New York, North Carolina, Ohio and Washington were among 19 states as of Feb. 17 yet to receive the “conditional approval” needed from the Centers for Medicare & Medicaid Services to fully access the money.
Over half of states — 28 of them — received such approval in 2022, according to CMS. That’s more than nine months after the relief package was signed into law. California, for example, received its conditional approval Jan. 4. Other states are waiting for legislative or other approvals, KHN found by querying all state Medicaid offices.
“We all would have liked to see the money out sooner,” said Damon Terzaghi, a senior director at ADvancing States, a national membership association for state aging and disabilities agencies. “Bureaucracy is what it is.”
Daniel Tsai, director of the CMS Center for Medicaid and CHIP Services, said that this infusion of federal aid was a “life-changing amount of funding,” and that CMS staffers were doing everything they could alongside states to “move forward as quickly as possible.”
Tsai also pointed out that the states’ partial approval, which they’ve all received, allows them to access some of the money. But some states — such as Kansas and Wyoming — have been reluctant to do so without full …….