With financial pressures mounting, disability service providers across the country are increasingly weighing whether to cut more programs and they say that in-home supports are among their most vulnerable offerings.
A new survey of 469 community-based providers of intellectual and developmental disabilities services in 48 states and Washington, D.C. reveals an industry that is facing added struggles to remain afloat after years of challenges.
Some 52% of providers indicated that they are considering program cuts if recruitment and retention of staff does not improve, according to findings from the annual survey conducted by the American Network of Community Options and Resources, or ANCOR, which represents disability service providers nationally. That’s up significantly from 34% last year.
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Service providers have faced growing strain as extra COVID-era funding to support wages for direct service workers expired and federal lawmakers approved a bill over the summer that’s expected to lead to $1 trillion in Medicaid cuts, ANCOR said.
Already, 88% of providers said they experienced moderate or severe staffing shortages in the past year. As a result, 62% said they turned away new referrals and a similar number said they were struggling to achieve quality standards while nearly a third ended programs or service offerings.
In cases where providers cut programs, 42% said they axed residential habilitation services, which enable people with intellectual and developmental disabilities to remain in their homes.
“Even before massive federal Medicaid funding cuts go into effect, our national system of community-based disability services was facing an array of substantial challenges, threatening to undo the progress that had been made in recent years. Add to it the nearly $1 trillion in funding cuts passed earlier this year in the budget bill and it’s not hard to understand why people with disabilities are gravely concerned about the future of their services,” said Barbara Merrill, CEO at ANCOR.
While forthcoming Medicaid cuts do not specify changes to disability services, advocates have warned that people with disabilities will inevitably feel the effects of a dramatic drop in federal investment in the program, especially through optional offerings like home and community-based services.
“The resulting pressure on state budgets will leave many with no choice but to consider cuts to ‘optional’ services,” Merrill said. “Meanwhile, providers are already shuttering programs, already turning away people with IDD seeking services, and already delaying innovations and the development of new programs designed to support people in underserved areas and those with highly specialized needs. Without immediate action to address inadequate Medicaid reimbursement rates, we risk reneging on the fundamental promise of community inclusion for all.”
