Nicky Boyte starts her day like most Texans by getting out of bed, taking a shower and making breakfast at home.
These simple rituals may sound mundane or ordinary, but Nicky savors them because the fact is she wouldn’t be able to live at home without the assistance of her Community Attendant, Chris Hofmayer.
Community Attendants are a central part of the lives of hundreds of thousands of people with disabilities like Nicky and older Texans throughout the state of Texas.
Without the support of Community Attendants, many people would be forced into more costly nursing homes and other institutional settings when all they really need is just a few hours of services and supports to assist them with things like bathing, cooking, eating, going to work or just getting some time outside the house.
Not only do people overwhelmingly prefer to stay in their own homes, the costs of nursing homes and other institutions are three to four times the costs of Home and Community Based Services, HCBS.
In Texas, where Medicaid pays the vast majority of home and community based services, we have approximately 200,000 people receiving HCBS and about 150,000 people waiting for services so they can remain in the community.
There is much good that comes about when there is availability of Community Attendants: more independence, ability to age in place, better physical and mental health and community integration.
However there is a looming crisis in the HCBS system that too few people are talking about. While the demand for HCBS is growing, the community workforce remains unstable and plagued by low wages, few benefits; high levels of turnover that disrupts the continuity of HCBS services.
If the 84th Legislature Budget Conference Committee doesn’t address this looming Community Attendant workforce crisis, we will see unnecessary institutionalization, increased health problems and disruption of families who have few options to address the needs of a loved one.
The current base wage for Medicaid Community Attendants is $7.86. Most Community Attendants have no health insurance and get no vacation or sick leave. Home Health agencies and people with disabilities are competing with Walmart, Target and other private sectors employers who are raising their beginning wage rate to $10 or more per hour with benefits.
The Texas Senate and House have passed budgets that increase the base wages for Community Attendants to about $8 per hour with no funding for benefits. Governor Abbott’s Texas Healthy Plan called for a five percent increase for Community Attendants, which if adopted would result in a base wage of only $8.25 with no funding for benefits.
If the Budget Conference Committee does not find additional dollars to raise the base wage rate for Community Attendants to $10 per hour, workers who need to support their own families will not be able to pursue a job as a Community Attendant and people with disabilities of all ages will not be able to get their support needs met because they can’t find an attendant.
By not addressing this looming crisis the Budget Conference Committee is abandoning people with disabilities and older Texans who rely on our legislators to fund these critical community services.
Editor’s Note, Cathy Cranston, an organizer with the Personal Attendant Coalition of Texas and Frank Lozano, an organizer with ADAPT co-wrote this op-ed with Bob Kafka. Cranston can be reached at [email protected]; Lozano can be reached at [email protected]