September 15, 2023

VOR's Weekly News Update

VOR is a national non-profit organization that advocates for

high quality care and human rights for all people with

intellectual and developmental disabilities.

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Why ICFs Matter

Join us for our next Quarterly Networking Meeting, when we present a forum on the importance of Intermediate Care Facilities to a full continuum of care for people with intellectual and developmental disabilities and autism.

September 21, 2023

7 pm Eastern / 6 pm Central / 5 pm Mountain / 4 pm Pacific

On Zoom

Our panel will be moderated by Roslyn Leahey, and will feature VOR Board Members Rita Winkeler (Murray Center, Illinois), Sybil Finken (Glewood Resource Center, Iowa), Terry Lafleur (Pinecrest Center, Louisiana) and Joanne St. Amand (Greenbrook Developmental Center, New Jersey),

We look forward to hearing from you about the importance of ICF care for your loved one with I/DD or severe autism.


To join the meeting, click on the Zoom link below

Meeting ID: 884 2544 2450

Passcode: 122333


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Back Issues of VOR's Weekly Newsletter are available on our web site.

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National News:

Cardin, Collins Lead Senate Recognition of Direct Support Professionals Week

Press Release from Senator Ben Cardin, S[egt 13, 2023

The Senate has unanimously approved a resolution from U.S. Senators Ben Cardin (D-Md.) and Susan Collins (R-Maine) recognizing this week as Direct Support Professionals Week. Their resolution (S. Res. 337) designates September 10-16 as a time to honor frontline health care workers for their dedication and work enhancing the lives of individuals with chronic illness, seniors and those living with a disability.

“This week, we honor direct support professionals, the frontline health care workers who are on the job around the clock to make daily life more manageable for individuals with intellectual and developmental disabilities, chronic illnesses and seniors. They bring dignity back to people’s lives and make a difference 365 days a year,” said Senator Cardin. “We value your service and dedication all year, but this week, is a special time to recognize the challenges you face as you help patients. Building on your example, we will continue to invest in home- and community-based services and building up the home care workforce with appropriate income and support they deserve.”


Read the bill here

Note: While VOR endorses the Senate's support for our Direct Support Professionals, and appreciates The provision to "encourage the Bureau of Labor Statistics to collect data that is specific to direct support professionals", we would hope that these senators will follow through with their good intentions by addressing the critical issue of increasing the wages for DSPs.

Social Security, SSI Likely To See Increase As Lawmakers Eye Reforms

By Michelle Diament, Disability Scoop, September 14, 2023

Social Security and Supplemental Security Income benefits are expected to rise again next year, a new estimate shows, and more changes to the SSI program could soon be on the way.

Monthly benefits are likely to grow by 3.2% in 2024, according to a projection this week from The Senior Citizens League, a nonprofit that advocates for seniors.

While far lower than the 8.7% jump this year, it’s an above average increase, the group said.

The change in benefits is due to an automatic cost-of-living adjustment, or COLA, that Social Security and SSI beneficiaries receive annually to account for inflation. COLA is based on third quarter results from the government’s Consumer Price Index and The Senior Citizens League said it made its estimate using data collected through August.

The group’s latest report comes as a bipartisan group of lawmakers in the U.S. Senate and House of Representatives are reviving legislation that would increase the amount of money that SSI recipients can save without losing their benefits.

Under rules dating back to 1984, individuals cannot have more than $2,000 in assets at any time. The limit for couples is $3,000.

The measure dubbed the SSI Savings Penalty Elimination Act would increase those caps to $10,000 for individuals and $20,000 for married couples while also tying the figures to inflation going forward.


Read the Press Release from joint sponsors Sen. Bill Cassidy, M.D. and Rep. Sherrod Brown here

Note: In response to the Raise the Wage Act introduced in Congress by Sen. Bernie Sanders and Rep. Bobby Scott, Senate Republicans have introduced their own bill to increase the minimum wage. Aside from the difference in the amount of the increase, the Republican's bill does not contain provisions for eliminating 14(c) programs or sheltered workshops that offer employment opportunities to people with I/DD and autism.

Bill would Increase Federal Minimum Wage to $11 / Hour   

By Kathleen Steele Gaivin, McKnight's, Spetember 15, 2023

The federal minimum wage would increase to $11 an hour gradually over the next four years if a bill introduced Wednesday by Republican Sens. Bill Cassidy (LA), Susan Collins (ME), Shelley Moore Capito (WV), Tom Cotton (AR), Mitt Romney (UT) and JD Vance (OH) is signed into law.

The legislation also would mandate the use of E-verify in an effort to ensure that the wage increase only goes to workers legally eligible to work in the United States.

“Despite rising costs of living, the federal minimum wage has not been increased in more than a decade, which has left millions of Americans struggling to make ends meet,” Romney said in a statement. “Our proposal would raise wages for millions of workers without risking jobs and tether the wage to inflation to ensure it keeps up with rising costs. Additionally, requiring employers to use E-Verify would ensure that the wage increase goes to legal workers, which would protect American jobs and eliminate a key driver of illegal immigration.”

The bill, named the Higher Wages for American Workers Act of 2023, automatically would raise the minimum wage every two years to match the rate of inflation. It would create a slower phase-in for businesses with fewer than 20 employees. Additionally, the proposed legislation, if passed as written, would raise civil and criminal penalties on employers that hire unauthorized immigrants or violate I-9 paperwork requirements.

In July of this year, Sen. Bernie Sanders (I-VT) spearheaded legislation to raise the federal minimum wage to $17 by 2028. At the time, Sanders called the $7.25 an hour federal minimum wage a “starvation wage.” For a 40-hour work week, it would translate to $15,000 per year, an amount that is below the federal poverty line for a two-person household.

“It seems unlikely that either of the current proposals will be enacted. Instead, federal minimum wage will likely remain at $7.25 per hour, where it has been for well over a decade,” attorney Keith E. Kopplin with Ogletree Deakins in Milwaukee told the McKnight’s Business Daily. “Be that as it may, employers must still comply with higher state and local minimum wage requirements, many of which are automatically adjusted at regular intervals.”

States with their own minimum wage rate can exceed the federal minimum level. This year, the minimum wage exceeds the federal rate in more than half of the states. Washington state leads the nation, with a minimum wage of $15.74 an hour. Washington, DC, has a higher rate than any state, at $17 per hour as of June. 

Read the full article here

CMS Issues Proposed Rule on Minimum Staffing Requirements for Long-Term Care Facilities

J.D. Supra, September 14, 2023

On September 1, 2023, CMS issued the Minimum Staffing Standards for Long-Term Care (LTC) Facilities and Medicaid Institutional Payment Transparency Reporting proposed rule (the Proposed Rule), which imposes nurse staffing requirements in LTC facilities participating in Medicare or Medicaid. These rules are intended to improve the quality of care furnished to LTC facility residents.

CMS estimates that approximately 75 percent of LTC facilities would need to increase staffing to comply with the proposed staffing requirements. The Proposed Rule includes possible one-year hardship exemptions if the facility meets certain criteria, such as workforce unavailability, facility location, showing good faith efforts to hire and retain staff, and demonstrating a financial commitment to staffing through documentation of staffing expenditures relative to revenue. If implemented, facilities that fail to comply with the proposed requirements would be subject to enforcement actions, including termination of Medicare or Medicaid provider agreements, denial of Medicare or Medicaid payments, and civil monetary penalties.

Also, in the interest of promoting public transparency, CMS is proposing that states publicly report the percentage of Medicaid payments for services in nursing facilities and intermediate care facilities for individuals with intellectual disabilities that are spent compensating direct care workers and support staff.

Interested parties may submit a comment by November 6, 2023. The Proposed Rule is available here and the fact sheet is available here.

Read the full article here

PHI Issues New Report:

Direct Care Workers in the United States: Key Facts 2023

September 11, 2023

Direct Care Workers in the United States: Key Facts provides a new annual snapshot of the direct care workforce, including its demographics, occupational roles, job quality challenges, and projected job openings. The report includes detailed overviews of three segments of this workforce: home care workers, residential care aides, and nursing assistants in nursing homes.

Key Takeaways:

  • Between 2021 and 2031, the direct care workforce is projected to add more than 1 million new jobs. During the same timeframe, nearly 9.3 million total direct care jobs will need to be filled.

  • As a result of low wages and part-time hours, median annual earnings for direct care workers were only $23,688.

Click here to download the report from PHI's website 

State News:

California Lawmakers Approve Nation-Leading $25 Minimum Wage for Health Workers

By Don Thompson, California Healthline, September 15, 2023

A sweeping agreement between labor and the health industry would gradually raise the minimum wage for hundreds of thousands of health workers in California to a nation-leading $25 an hour while ending a years-long battle over dialysis clinics.

The pact approved by state lawmakers on Thursday, the last day of this year’s legislative session, would phase in the wage increase for hospitals, nursing homes, and other medical and psychiatric services providers. The bill now heads to the governor’s desk. A spokesperson for Democratic Gov. Gavin Newsom, Izzy Gordon, said the governor will evaluate the bill on the merits before his Oct. 14 deadline to act on the legislation.

SB 525 would raise the hourly minimum at large health facilities and dialysis clinics to $23 next year, $24 in 2025, and $25 in 2026. It would boost hourly wages at community clinics to at least $21 in 2024, $22 in 2026, and $25 in 2027. Other health facilities would go to at least $21 an hour in 2024, $23 in 2026, and $25 by 2028.

The agreement “now strikes an important balance between supporting workers and protecting jobs and access to care in some of our most vulnerable communities,” Carmela Coyle, president and CEO of the California Hospital Association, said in a statement. “The bill creates a pathway to improving wages for our lower-wage health care workers, while also recognizing the needs of our state’s most troubled hospitals.”

Union leaders say lower-income health workers such as certified nursing assistants, patient aides, and food service workers — many of them racial minorities — need the additional money to keep up. “Health care in California will be more accessible and equitable because workers and healthcare providers stood together and stood up for patient care,” SEIU California Executive Director Tia Orr said of the health care deal.

The phase-in would be slower at hospitals with a high percentage of patients covered by Medicare or Medicaid, rural independent hospitals, and small county facilities. The minimum hourly wage there would go to $18 next year, then increase annually by 3.5% until it reaches $25 in 2033.

The original bill cleared the Senate in May with no votes to spare amid strident opposition from employers, who said they couldn’t afford it. The California Chamber of Commerce put the proposal on its annual “job killer” list, a designation that often is enough to kill controversial legislation. The No SB 525 coalition, which included hospitals, doctors, and business and taxpayer groups, had said the bill would cost $8 billion annually, endangering services and leading to higher premiums and higher costs for state and local governments.

Read the full article here

Colorado - National Disability Provider Crisis Impacts Local Services   

By Tara Kiene, The Durango Herald, September, 8, 2023

Last week, I had the pleasure of attending a statewide gathering of disability service providers where we explored the Colorado and national trends impacting the support of people with intellectual and developmental disabilities to live successfully in their communities. The theme was resounding: We need workers.

The national caregiver crisis isn’t recent news. We’ve seen this coming for decades and have been ringing the alarm bells. But according to national data, what was previously a crisis has risen to level red with the pandemic. It’s an emergency.

National data collected in 2021 revealed turnover rates of 43.3% and vacancy rates over 20% for the Direct Support Professionals who provide direct care for most people with disabilities who receive services. Turnover is disruptive enough. Beyond the learning curve of a complicated job, there is the trust and confidence broken every time a person with a disability must develop a new relationship with a new support professional with new approaches to care, new routines, and evolving levels of competence.

High levels of vacancy are even worse. When one out of five positions is unfilled for long periods of time, services suffer in quality, ratios become dangerous, and providers must make difficult decisions about whether they can continue providing services at all.

These outcomes are not theoretical. They are already happening. Ninety-two percent of providers self-report that they are struggling to meet quality standards. Eighty-three percent of providers are turning away new referrals, and 63% of providers have discontinued services (an increase of 85.3% from pre-pandemic reports).

The problem is not the work. Most people find disability services a rewarding career that promotes personal and professional growth. The problem is that the rates states reimburse providers for the services they provide keep wages incredibly low. The same report that raised the alarms about turnover and vacancies revealed the source of the problem. National average wages for DSPs are at an abysmal $14.50.

Read the full article here

Virginia - Parents Say Special Education Fails VA Students with Disabilities

By Sean Jones, Richmond Times-Dispatch, September 8, 2023

Wendy Little says she has been fighting for over a year to get Chesterfield County Public Schools to approve an Individualized Education Program, or IEP, for her 15-year-old son with autism, while facing constant pushback from school staff.

The school system has proposed cutting needed services to his education, placing him at the wrong school and reducing service hours with a special education teacher without so much as a conversation, Little said. The disagreement over this IEP document resulted in Little’s son, Eryn, being unenrolled for the entire 2022 school year with nowhere else to go.

“Going a whole year without education, he’s become extremely reclusive,” Little said. “I can barely get him to leave the house for anything, and there’s been a lot of psychological damage in addition to educational damage.”

Parents and advocates have faulted Virginia’s system of teaching special education for years — through multiple governors’ administrations — asserting that when parents buck local school divisions’ plans for their children’s education, parents rarely prevail. Parents’ concerns have sparked civil suits, federal scrutiny and a 2020 state watchdog agency’s report that found the state education department does not adequately meet the needs of students with disabilities.

At a June meeting of the Virginia State Board of Education, board member Bill Hansen called the special education system “fundamentally broken.”

Full article and video available here

Georgia - Mom Explains Lawsuit Against Aiken County Schools

By the staff of WRDW/WAGT, September 11, 2023

A North Augusta mom has filed a lawsuit against the Aiken County Public School District and the North Augusta Department of Public Safety over an incident involving her son in 2021.

On Tuesday morning at 10 a.m., the mom, Sylvia Brannon, was outside the Aiken County Courthouse with her attorney to talk about the suit.

According to the complaint, the student, who is on the autism spectrum, was having a mental health crisis on Aug. 27, 2021, when he was approached by the school resource officer at North Augusta High School. The student was then tackled to the ground, handcuffed, and arrested, according to the complaint.

The lawsuit was filed on Aug. 23.

According the lawyer, her son was about to pick up lunch when the incident unfolded. The mom says the school is ill-prepared to care for special needs students and has had to repeatedly stand up for her son.

“As I got into the driveway, I saw the police with my child and they had my son in the back of a patrol car handcuffed and he was crying,” she said. “Ii immediately asked them to uncuff my child and let me get my kid. that’s when he called his backup and they came and I put my hands up because when they got out the car they pulled their out their guns.”

The charges against her son have now been dismissed but the family attorney says they are now seeking accountability for the incident. The complaint alleges gross negligence, negligent hiring and supervision as well as malicious prosecution and false imprisonment.

Read the full article here

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VOR Bill Watch:

[Please click on blue link to view information about the bill]


S.1332 / H.R.2941 - Recognizing the Role of Direct Support Professionals Act

Sen Maggie Hassan (D-NH) / Rep. Brian Fitzpatrick (R-PA) This bill requires the Office of Management and Budget to establish a separate category within the Standard Occupational Classification system for direct support professionals (i.e., individuals who provide services to promote independence in individuals with an intellectual or developmental disability) for data reporting purposes.

H.R. 553 - Workplace Choice and Flexibility for Individuals with Disabilities Act

Rep. Glenn Grothman (R-WI-6) - This bill would amend the Rehabilitation Act of 1973 to clarify the definition of competitive integrated employment.

H.R.1296 - Restoration of Employment Choice for Adults with Disabilities Act Rep. Glenn Grothman (R-WI-6) - To amend the Rehabilitation Act of 1973 to ensure workplace choice and opportunity for young adults with disabilities.

H.R.485 - Protecting Health Care for All Patients Act of 2023

Rep. Cathy McMorris Rodgers (R-WA-5) - This bill prohibits all federal health care programs, including the Federal Employees Health Benefits Program, and federally funded state health care programs (e.g., Medicaid) from using prices that are based on quality-adjusted life years (i.e., measures that discount the value of a life based on disability) to determine relevant thresholds for coverage, reimbursements, or incentive programs.

H.R.670 - Think Differently Database Act

Rep. Marcus Molinaro (R-NY-19) - This bill would amend title IV of the Public Health Service Act to direct the Secretary of Health and Human Services to establish a clearinghouse on intellectual disabilities, and for other purposes. Such clearinghouse shall include information on individual community-based services and long-term support services available to individuals eligible for medical assistance under a State plan under the Medicaid program under title XIX of the Social Security Act.

S.1298 - Supporting Our Direct Care Workforce and Family Caregivers Act

Sen. Time Kaine (D-VA) A bill to award grants for the creation, recruitment, training and education, retention, and advancement of the direct care workforce and to award grants to support family caregivers.

H.R.2965 / S.1333 - Autism Family Caregivers Act of 2023

Rep. Grace Meng (D-NY) / Sen. Robert Menendez (D_NJ) To award grants for providing evidence-based caregiver skills training to family caregivers of children with autism spectrum disorder or other developmental disabilities 

H.R.3380 - HEADs UP Act of 2023

Rep. Seth Moulton (D-MA) This bill authorizes the Department of Health and Human Services (HHS) to award grants to support health centers that provide services for individuals with developmental disabilities, including dental care. Grant recipients must provide specialized treatment to individuals with developmental disabilities as necessary.


S.533 / H.R.1263 Transformation to Competitive Employment Act

Sen. Bob Casey (D-PA) / Rep. Bobby Scott (D-VA 3) - This bill would support employers who wish to transform their facilities to provide only competitive integrated employment while forcing the elimination of programs that offer employment opportunities under Section 14(c) of the Fair Labor Standards Act. This bill would be unlikely to create a significant increase in employment for people with I/DD and autism, but would deprive over 120,000 individuals of the opportunity to work, develop skills, and be part of their community.

S. 1148 - The Guardianship Bill of Rights

Sen. Bob Casey (D-PA) - A bill to establish rights for people being considered for and in protective arrangements, including guardianships and conservatorships, or other arrangements, to provide decision supports. This bill would give ACL power to create a Guardianship Council and appropriate more money to P&As so they may encourage people to leave guardianships and move to Supported Decision Making. Dangerous over-reach in response to media hype on Britney Spears, et al.


S.100 / H.R.547- Better Care Better Jobs Act

Sen. Bob Casey (D-PA) Rep. Debbie Dingell (D MI) This bill establishes programs and provides funds for state Medicaid programs to improve home- and community-based services (HCBS), such as home health care, personal care, case management, and rehabilitative services.

The bill also makes permanent (1) the Money Follows the Person Rebalancing Demonstration Program (a grant program to help states increase the use of HCBS for long-term care and decrease the use of institutional care), and (2) certain provisions regarding Medicaid eligibility that protect against spousal impoverishment for recipients of HCBS.

S.762 / H.R.1493 - The HCBS Access Act

Sen. Bob Casey (D-PA) Rep. Debbie Dingell (D MI) While this bill purports to eliminate waiting lists and provide more Home and Community-Based Services for people with I/DD and autism, it favors the aspirations of those individuals who are most independent and neglects the very real needs of those most dependent on Medicaid Long-Term Services and Supports. It would not distribute funds appropriate to the varying needs of individuals, but to providers of HCBS programs. It fails to recognize the severity of the DSP and Nursing Crises, and paints an unrealistic picture of a simplistic solution. This is a purely political bill that would ultimately fail to make the extensive changes that the DD/A system needs.

VOR supports increasing funding for people with I/DD, but we have concerns that the above bills, in their current form, would discriminate against people with the most severe I/DD and autism and jeopardize the higher-care facilities that are most appropriate to their needs.

Please share this offer with your loved one's

Direct Support Professionals!



Our loved ones' caregivers are essential to their health, safety, and happiness.

In appreciation of their good work and kind hearts, VOR offers free digital memberships to any DSP who would like to receive our newsletter.

We encourage our members to speak with their loved ones' caregivers to extend this offer of our gratitude.

If you are a Direct Support Professional interested in receiving our newsletter and e-content, please write us at

[email protected]

with your name, email address, and the name of the facility at which you work. Please include the name of the VOR member who told you of this offer.

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What's Happening In Your Community?

Is there an issue in your loved one's home that you need help with?

Do you have information or a news story you would like to share?

Is there legislation in your state house that needs attention?

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