Frontline Initiative Supporting Families

ANCOR's National Advocacy Campaign:
The Direct Support Professionals Fairness and Security Act


ANCOR is a national non-profi t organization for private providers of supports for people with disabilities. ANCOR, the American Network of Community Options and Resources, strives to provide members with the most up-to-date information on issues that effect the work of Direct Support Professionals (DSPs). ANCOR also advocates for its member organizations in the area of public policy and legislation at the state and national level.

National Advocacy Campaign

In 2001, ANCOR launched its’ National Advocacy Campaign, a multiyear, multiple-strategy national public policy initiative to address Medicaid funding and workforce issues. The mission of the campaign was to obtain the resources to recruit, train, and retain qualified DSPs that will, in turn, enhance and promote community living and enrich the lives of Americans with disabilities. One of ANCOR’s key strategies in this endeavor is lobbying to affect national public policy. During the summer of 2004, ANCOR did just that by working with both houses of Congress to develop bipartisan legislation to help address the crisis in recruitment and retention of DSPs. Contributing factors to the workforce crisis are —

  • DSPs that provide community-based services and supports are often paid less than DSPs working for less desirable state-operated institutions.
  • Organizations providing services must work within the constraints imposed by policies of state governments, which establish the reimbursement rates for services available in the Medicaid program. Otherwise, the providers have to fi nd sources of funding elsewhere, which is often impossible.
  • Many DSPs fi nd that they can earn higher hourly wages, and receive better benefi ts in far less demanding jobs in the fast food and retail industries. This results in high turnover rates (from 40 to 75%) and poor supports for people with disabilities that directly affect their quality of life.

The Direct Support Professionals Fairness and Security Act

ANCOR is grateful that Representatives Lee Terry (R-NE) and Lois Capps (D-CA) have taken the lead on bringing these issues to the forefront. On March 10, 2005 they introduced to Congress H.R. 1264 to address the crises in programs funded by the federal/state Medicaid program. The Direct Support Professionals Fairness and Security Act would take important steps to ensure that DSPs are paid wages that enable them to stay in their jobs and provide the critical services that people with disabilities rely upon.

This bill would amend the Medicaid program (Title XIX of the Social Security Act) to provide funds to States to enable them to increase the wages paid to targeted DSPs in providing services to individuals with disabilities. The program is designed as an option to states and would provide enhanced federal medical assistance percentage (FMAP) for five years to states to increase wages. It is designed to increase wages and eliminate the gap between wages paid to private employees and public employees in the state.

In order to receive the enhanced FMAP, states would be required to submit a fi ve-year plan and must assure continuation of the increased wage rate after the fi ve-year period. The state plan must be developed in conjunction with individuals with disabilities and family members, private providers, and direct support professionals.

The bill targets the increased FMAP to cover DSPs working for private employers who provide supports and services to people with disabilities who are eligible for and receiving Medicaid under the following state plan services: personal care option for personal assistance; rehabilitation option for rehabilitation or habilitation; home health services; home and community-based services under Section 1915(c) or Section 1115 waivers; and intermediate care facility services for persons with mental retardation and related conditions (ICFs/MR).

 The legislation provides for federal funding for state planning grants. It also mandates a Government Accountability Office (GAO) study on recruitment and retention and an Inspector General Audit of progress in reducing/eliminating the wage gap.

Personal interest

Representatives Terry and Capps have personal insight and are committed to bringing the issue of low wages for DSPs and the inequity in wages between private and state employers to the forefront — Terry says, “It’s the right thing to do.”

At ANCOR’s 2004 Governmental Activities Seminar, Terry urged ANCOR members to take their case to Congress and to invite other U.S. Representatives to co-sponsor the Direct Support Professional Fairness and Security Act of 2004. Terry also stressed the importance of adding a personal face to this issue and emphasizing what is at stake for people with disabilities, their families, and DSPs.

Representative Terry has a longstanding personal connection to this issue. Decades ago his father, a journalist, exposed the conditions in Beatrice, a Nebraska state institution. Representative Capps also has fi rst-hand connection to the importance of quality support. Her late husband's aunt received supports from ANCOR member agency Mosaic of Omaha, Nebraska.