Advocates say Utah has a shortage of qualified workers to deliver home and community-based services to people with developmental and intellectual disabilities.
Lawmakers at both the state and federal levels are debating measures to increase funding for both public and private care providers, but no action has been taken.
Utah lawmakers heard a report last week from state health officials, showing they have almost 1,000 unfilled positions for disability-care providers.
Nate Crippes, supervising attorney for the Utah Disability Law Center, said the hiring gap limits access to care.
"There are about 6,000 people in these services right now," Crippes reported. "The state currently has a waiting list of 4,000. And if providers can't get staff to provide the support these folks need, it's going to lead to some real problems."
Crippes pointed out in recent years there has been an effort to take people out of institutions to provide treatment. The Utah State Developmental Center provides direct care, but also partners with private groups for home and community-based services.
The average pay in Utah for disability care workers is well below what many consider a "living wage." Crippes contended the industry cannot attract qualified staff because their budgets are ultimately decided by the state Legislature.
"Folks who provide services to folks with intellectual and developmental disability in home and community-based settings say the rates for those workers are really, really low," Crippes asserted. "I think the average is about $11.50 an hour."
The Social Services Subcommittee at the Utah Legislature heard comments last week on pending legislation to increase disability-care spending by as much as $40 million. Crippes emphasized advocates are hoping Congress can pass a section of the stalled Build Back Better Act which allots $150 billion for community-based care.
"It sounds like maybe there's some interest in trying to do pieces of that legislation individually as opposed to the whole package," Crippes remarked. "I think it would make a huge difference that would certainly enable the state to potentially expand services or do more."
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Rural Nevada is facing a housing and transportation crisis. Advocates for those with disabilities say things are getting out of hand.
Dee Dee Foremaster, director of the Rural Center for Independent Living, said there is not enough available low-income housing, and added the units that are available to folks on the Housing Choice Voucher program, formerly called Section Eight, is "substandard."
She added the average Nevadan on Social Security receives almost $1,000 a month. But the average Nevadan can expect to pay around $1,400 a month in rent.
"People are having to double up to be able to make their rent. And it makes it difficult because a lot of times some people with disabilities really would prefer to live by themselves," she said.
Foremaster added she is among those who feel like the calls they are making for housing reform are falling on deaf ears. And while local leaders are eyeing federal lands as part of the solution to address the housing shortage, Foremaster said she has solutions that are more immediate, including creating a program for landlords to receive tax incentives for allocating units to low-income Nevadans.
She stressed that even in rural Nevada, the housing supply isn't able to keep up with demand, and said easing restrictions on accessory dwelling units would help everyone.
"So that people have an array of plans to be able to draw from that are approved, so that they don't have to go through the building commission and hoops that we all have to jump through every time we want to build something on a property," she explained.
Margaret Marcucci, with the Elko support staff of the Rural Center for Independent Living, said a lack of transportation is another issue impacting people's daily lives.
"I won't tell you how many times I get calls from friends, going 'I'm stuck, can you come get me?' or 'Can you take me to an appointment?' said Marcucci. "A lot of our seniors and a lot of disabled do not go to the doctor because they can't get there."
Last year, a free ride-share program launched in rural Nevada to help remove barriers to access medical care. But Marcucci is calling for a more diversified and flexible fleet of services that can get folks to where they need to go.
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Maryland is facing a $3 billion budget deficit, and planned cuts in 2026 would include millions in disability assistance. But one advocate says those cuts would threaten lives.
More than 20,000 Marylanders with disabilities receive state support to help their families afford caregiver services. More than 3,500 families use self-directed services, which give families the ability to set up caregiving separately from traditional programs.
Those services in the proposed budget will face cuts, which advocates say would drive caregivers out of the system to better-paying opportunities.
Montgomery County resident Hamza Khan, a disability rights advocate, has two siblings with special needs. He said funding issues stem from the state overextending itself while getting federal COVID-19 assistance.
"As the pandemic wound down, the state also received one-time federal injections of cash into our budget," Khan said. "And it appears that the governor built those into long-term injections of cash - that he built those structurally into the budget, rather than counting for them to be one time."
Gov. Wes Moore's supplemental budget avoided steep cuts through the rest of 2025, but did not address more than $400 million in cuts for next year.
Khan pointed out these cuts to disability assistance come as the state has added 5,000 employees to its payroll. Khan said these proposed budget reductions would run counter to current laws that require more community input - and give Maryland families the right to choose their care.
"Given the fact that 18,000 people are going to suffer extraordinary pain, and some of them might very well die, he should prioritize funding that prior arrangement first," Khan added. "It's been guaranteed under Maryland law for many years, and it's been expected that costs would rise, but they haven't risen so extraordinarily that the budget can't cover for that."
State salaries, wages and benefits are projected to cost Marylanders $12.2 billion in 2025.
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Tennessee's Disability Day on the Hill is an opportunity for people living with a disability to unite, and engage in the legislative process.
The Centers for Disease Control and Prevention reports nearly 1.6 million Tennesseeans have a disability.
Carrie Carlson, director of community engagement with the Tennessee Disability Coalition, said people are encouraged to meet them for the Disability Day on the Hill in Nashville.
The event focuses on issues and challenge policies that threaten protections under the Americans with Disabilities Act.
"Disability Day on the Hill is a day where hundreds of people with disabilities will come to Nashville, to Cordell Hull, and get involved in the legislative process," said Carlson, "meaning having meetings with their Senate and House of Representatives."
She said Tennesseans with disabilities face unequal access to education, housing, transportation, and health care.
The theme for Wednesday's event is Liberty Not Limits, which means having a disability should not limit your liberty to live the life of your choosing.
Carlson said Tennesseans are encouraged to light up and wear "coalition blue," and post to social media in support of Disability Advocacy Day.
She added that this will be the fifth year recognizing March 11 as Disability Advocacy Day, with an annual proclamation that highlights the strength of advocacy efforts.
"Disability Advocacy Day," said Carlson, "is a day where specific landmarks across the state of Tennessee in each region West, middle and East go blue to show the amazing accomplishments and advocacy efforts of Tennesseans with disabilities."
Carlson said Disability Advocacy Day began with key landmarks in Tennessee lighting up blue to raise awareness, and chosen to address transportation barriers.
Now, it has expanded as communities participate in their own ways - lighting homes, wearing blue, and gathering for photos to show support for local advocacy work.
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