What I repeatedly see is policy that allows extreme profiting from disability and inequitable delivery and utilization of Home and Community Based Services.
There is a genocide being covered up in America. People with disabilities are being murdered in group homes. Case in point, private group homes owned by KKR are under investigation currently. I'm waiting to see who will get convicted of murder with a life sentence in prison.
What I've experienced/seen:
Myself and others can not find Medicaid Consumer (self) Directed personal care in home attendants because they are not paid anything close to a living wage. A fast food job pays more than a in home Consumer Directed attendant.
Private companies can buy group homes and rack in extreme profit off beds while people with disabilities are abused neglected and murdered. Group homes are allowed to pay more to their attendants than Consumer Directed. Remove penalties for supplementing a CD attendants pay so I can compete with fast food and group homes.
Agencies can start an attendant business anywhere and have lack regulations. Because of agency's unprofessionalism and unethical behavior, their attendant turnover rate is extremely high. The agency is paid when their attendants do not come into work, which is Medicaid fraud. These agencies are numerous which deplete my hiring pool. Shut down agencies and bring back tools to empower people on Consumer Directed such as MySupport.
There is no equity in data. Data collection focuses on Providers and not Consumers. On a similar note, the US Census does not collect any data specifically related to HCBS providers or consumers. Require survey and feedback opportunities be given to Consumers.
Redirect funds to pay a living wage to Consumer Directed personal care in home attendants from these sources:
Agency office getting paid when attendant doesn’t come in to work
Transportation brokers getting paid for each person on Medicaid regardless if that person uses transportation or not (company hub in Georgia}
DOJ annual reviews of Virginia settlement agreement (how many reviews have there been? repeated reviews cost money)
Eliminate evaluations to use AT funding on the DD Waiver. To qualify for the DD Waiver I had OT assessments and evaluations These repeated tests are an example of extreme profiling off disability services
Due to ableism, I hear the excuse of the "fax is lost". I have heard it so many times from various entities, over so many years that I get another provider involved which essentially ends with charging insurance twice.
Require hourly pay rates be on a public webpage for attendants working as Consumer Directed, in home agency and group home.
My husband can not return to work with the current state of in home attendants.
I once worked from home and was paid a full wage. One of the factors of why I resigned was the current state of in home attendants.
I'm on a conveyor belt of a broken system with no choice but a group home to be a paycheck in somebody's pocket.
Close the gab between minimum wage and living wage rates for Consumer Directed Medicaid in home Personal Care Attendants. In Virginia the gap is $7.
End Institutional bias in policy.
How much is Virginia's GDP tied to extreme profiting off disability services? What incentive do policy/law makers have to change policy so there's equity in pay of these three care settings? Group, agency, and Consumer Directed?