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2021 Legislative & Annual Report: State Budget

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At the beginning of the year, it appeared that COVID-19 and the economic downturn would put a big squeeze on available funding. Then the state produced less restrictive budget figures, and the promise of federal rescue funds gave us reason for optimism. Of course, we don’t take any funding for granted, especially in a session with limited access to the Capitol, legislative offices, and committee hearings. The following accomplishments in the state budget (SB 1 / HB 1) are the result of the confluence of circumstances and opportunities in this unusual year and steadfast advocacy from the CTD budget team, Executive Director Dennis Borel and Advocacy Director Jolene Sanders-Foster.

Community Attendant Wages

Community attendant wages were ignored by legislators with no increase over the base hourly wage of $8.11 for most community care programs. Over the last four legislative sessions, the total base wage raise has been 25 cents, compounding a crisis in recruiting and retaining community attendants. However, in the third special session, legislators appropriated federal funds from the American Rescue Plan Act (ARPA). Initially, there was zero ARPA money for community attendants, but determined advocacy by CTD and allies resulted in $178M for “retention bonuses” and some of that will benefit direct care workers in assisted living centers and ICFs (left, Dennis with Cathy Cranston of the Personal Attendant Coalition of Texas and community attendants Ana and Amber).

In a separate ARPA bucket of money set aside for home and community based services, approximately $400M is allocated to attendants for bonuses. CTD advocated for the inclusion of attendants in the CDS option and to replace one-time bonuses with a series of smaller bonuses, to avoid an unintended loss of public benefits for attendants, over 50% of whom receive public benefits as persons of low income.

As of the printing of this report, it remains unclear how all this will be implemented, but we can say

• there will be no increase in the hourly wage rate,
• extra money will get in the pockets of attendants, mostly through a series of bonuses, and
• the total amount for compensation and payroll taxes from both buckets is likely between $400M and $500M.

This means the bonus funds are roughly equal to an 89 cent raise for one year. That needs to be the beginning of a larger effort to create a sustainable community care system, which is where older adults and people with disabilities want to live.

Medicaid community waivers interest lists

Interest lists received $76.9M for approximately 1,500 new slots, less than 1% of the current number of unduplicated persons on the interest lists. For a person adding their name today, the wait could be easily 30 years or more.

Early Childhood Intervention (ECI)

This critical program for kids with disabilities from birth to 3, received an additional $33.9M.

Intensive Behavioral Intervention (IBI, also known as ABA)

The state landed on the right side of Early Childhood Intervention funding and backed our colleagues in the autism community to finally get ABA/IBI services covered by Medicaid. ABA/IBI Services in the autism program moved into federal compliance with an appropriation of $111.9M.

Safe Gun Storage

The Safe Gun Storage program in the Department of Public Safety was continued with $500,000 in funding.

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