NCD Advises Congress to Address HCBS in Fourth Coronavirus Package

The National Council on Disability (NCD), an independent, nonpartisan federal agency that provides advice to the President and Congress on disability policy issues, has issued a letter to Congressional leadership advising that “the next COVID-19 legislative package be inclusive of several critical home-and-community-based service (HCBS) system provisions that will save potentially tens of thousands of lives of people with disabilities and those who support them during the COVID-19 outbreak.”

According to the letter, the next COVID-19 legislative package presents a critical opportunity to:

  • Designate those who assist people with disabilities with activities of daily living, like bathing, toileting, and eating, as “essential” so that they can receive priority access to emergency resources and PPE; and
  • Address an oversight of previous COVID-19 packages by including HCBS grants that will enable states to train and shore up a DSP workforce and provide overtime wages during the influx of staffing shortages caused by the pandemic.

NCD points out that because the current federal definition of “essential workers” does not include these vital workers, they have no priority in acquiring personal protective equipment (PPE) and urges Congress to pursue this as a “fix” in the next COVID-19 legislative package. In addition to the issue of designating these direct care workers as “essential,” the letter advises Congress to address their shortage and the tenuous nature of the entire system of which they are a part as a result of the COVID-19 pandemic. “With more direct care workers unable to deliver critical services owing to their own illness, their family members’ illness, or their lives and careers impacted and disrupted by COVID-19 in other ways everyone is currently experiencing, the pre-existing worker shortage, high turnover rates, and low wages are culminating into a desperate cause-and-effect situation for scores of Americans with disabilities,” NCD writes, pointing out that “without the critical services provided by direct care workers that allow people with disabilities and seniors to remain independent and in-community, people with disabilities and seniors often end up routed to … institutional placements” that are “far more expensive than supporting people to live in their homes and other community settings.”

NCD points out that this guidance, “while novel in application to COVID-19, is not at all new but rather longstanding advice to Congress across numerous administrations that ‘America needs a coherent and comprehensive framework for its [long-term services and supports] policies, programs, and funding’ based in part on the assumption that ‘formal and informal caregiving must be sustained, including examination of family needs and workforce recruitment and retention challenges.’”

FMI: Read the letter at