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Public Policy

The goal of the Disability Policy Collaboration is to impact national public policy for people with developmental disabilities, including those with cerebral palsy and intellectual disability, and their friends, families and loved ones.

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Direct Care Personnel

UCP Provides Comment on "Removing Federal Barriers to Community Living"

The ability of many people with disabilities to live independently is threatened by the critical shortage of community support attendants, also known as direct-care aides. The federal Department of Health and Human Services has requested public comment on how the federal government can increase independent living by people with disabilities.

August 27, 2001

New Freedom Initiative Group
U.S. Department of Health and Human Services
PO Box 23271
Washington, DC 20036-3271

RE: Removing Federal Barriers to Community Living

Dear Sir or Madam:

This letter is in response to the request from the U.S. Department of Health and Human Services (DHHS) for public comment for the "Removing Federal Barriers to Community Living" Initiative.

The most fundamental barrier preventing individuals with disabilities from living successfully in the community is the crisis in direct care (support) personnel. There are many factors that have contributed to this crisis, such as, the overall job market/economy and State Medicaid policies. However, the fundamental contributing factor is inadequate Federal Medicaid payments rates for community attendants who assist people with disabilities in performing such daily living activities such as eating, dressing and using the bathroom.

These community attendants are essential to hundreds of thousands of people with disabilities. Regardless of their specific disability, the ability of many people with disabilities to work and enjoy a good quality of life -- sometimes just to stay alive -- depends on an adequate supply of qualified personal attendants. The U.S. Department of Labor has estimated that 100,000 additional community attendants will be needed by Year 2006, yet even now there are high vacancy rates in these jobs. The main reason is that community attendant wages are very low, averaging only $7.72 nationwide an hour in 1999.

Wages are so low because Medicaid, the federal/state program that covers most community attendant services, reimburses poorly for these services in most states. As a result, attendants are often paid less than entry-level fast-food workers, even though attendant jobs are physically, intellectually and emotionally demanding.

To address this fundamental barrier to community living for persons with disabilities, HHS could consider the following:

  • investigate the nature, extent and impact of the "direct care personnel crisis" and develop recommendations to remove this specific barrier; and

  • plan and host a special public forum (meeting, teleconference) or otherwise invite specific public comment on the barrier of inadequate supplies of qualified direct support personnel.

Thank you for this opportunity to provide comment on "Removing Federal Barriers to Community Living."

Sincerely,

Kirsten A. Nyrop
Executive Director

United Cerebral Palsy Associations
1660 L Street, NW, Suite 700
Washington, DC 20036-5602
Tel: 202-776-0406