Caregivers, kids, and dental care: Joint Finance Committee takes some positive steps, rejects others on critical disability issues

The Wisconsin Board for People with Developmental Disabilities (BPDD) appreciates Joint Finance Committee’s (JFC) actions that begin to acknowledge the depth and critical nature of Wisconsin’s workforce crisis.

The Committee’s vote to increase the Medicaid Personal Care Services rate and set aside additional dollars for direct care workers in Family Care will result in a modest wage increase for these low-income workers that so many people with disabilities rely upon to stay in their homes.

Low wages are only one factor that make recruitment and retention of quality workers difficult, but small increases to wages will not be enough to stabilize and grow this needed workforce.

“A robust package of ideas is needed to improve benefits like health insurance and sick leave and ensure there are career advancement opportunities for these workers,” said Beth Swedeen, BPDD Executive Director. “Caregiving jobs are competing with other low-wage positions that offer better benefit, compensation packages, hours, and working conditions. In absence of paid caregivers, the pressure on family caregivers is mounting and unsustainable.”

Across the state, family caregivers have been forced to reduce hours or leave the workforce entirely to take care of aging adults and people with disabilities. BPDD consistently hears from people with disabilities and families whose lives and schedules are upended and spent addressing a crisis resulting from the workforce shortage. People with disabilities are reporting going without needed care and being afraid to fire bad workers because there is no one else to hire.

BPDD awaits the Governor’s Caregiver Taskforce as an important opportunity to develop a comprehensive set of policy recommendations that can address the needs of people with disabilities, older adults, family members, and the workers who provide care.

JFC’s decision to fund $2.5 million in a dedicated pot of money for dentist who serve Medicaid recipients with physical or intellectual disabilities does not resolve the fundamental challenges people with disabilities face to try and take care of their teeth. Currently, too few dentists take Medicaid patients, and an even smaller number of dentists have accessible practices to accommodate mobility equipment, sensory needs, or sedation dentistry.

“People with autism, cerebral palsy and other developmental disorders face enormous barriers to adequate and timely dental care,” said Swedeen. “Families have described people with disabilities waiting with tooth infections and other serious dental issues that cause pain and other health impacts for months. Many people with disabilities have no access to preventive care. Their only dental care ends up being tooth extraction.”

BPDD appreciates JFC’s investment to ensure that the more than 1,000 children with disabilities currently waiting for Children Long-Term Supports waiver services can finally access needed supports. However, BPDD is concerned that the door remains open for more children ending up on a waiting list in the future.

“Advocates had asked for language that would have guaranteed that all kids that need services would receive them,” said Swedeen. “That language was not included, which means if there is not enough money to cover all the kids that need services, some would have to wait.”

Additionally, the Governor’s proposals for children’s resource centers, benefits specialists and ombudsman services were not included.

BPDD looks forward to working with the Governor’s office and Legislature on ways to explore Medicaid expansion to improve the necessary supports for Wisconsin residents living with disabilities and their families.