The Arc of Texas Provides Input on Access to Home and Community Based Services

Madam Chair, members,

My name is Sabrina Gonzalez Saucedo, and I serve as the Director of Public Policy & Advocacy for The Arc of Texas.

Thank you, Senator Perry and Senator Zaffirini, for the discussion yesterday highlighting key issues related to Medicaid waiver programs and supports for people with IDD.

Right now, we are unintentionally operating in a crisis-driven system, where people may wait over a decade on the interest list, only to receive services through an emergency crisis diversion slot after a caregiver passes away.

Although we appreciate any increase in the number of waiver slots, we also believe it is time for a total waiver transformation. Like Senator Perry, we believe smart minds can come together to build a better system for people with IDD.

We suggest that the Legislature to direct the agency, alongside stakeholders, to develop a 10-year plan to reimagine and transform IDD services, focusing on four key pillars:

1. First, we must strengthen Provider Accountability. This meansimproving safety measures and ensuring timely investigations of abuse, neglect, and exploitation.
2. Second, we must Ensure Quality Providers by providing wages for direct support professionals that are adequate to attract and retain a skilled workforce that enables people with IDD to live in their communities.
3. Third, we must improve Connections to Existing Services for People on the Interest List: Many on the interest list are eligible for other services but aren’t aware of it. We must improve access to these services while people wait. Additionally, we should explore policies like Louisiana’s TEFRA option, which extends Medicaid to children with complex disabilities by considering only the child’s income, not the parents’.
4. Finally, we must Expand Waiver Slots to address the over 174,000 Texans with IDD waiting for critical supports. One option is to establish a permanent endowment to create a steady revenue stream for long-term planning and reduce the list.

We need to lay the foundation for a long-term transformation—one that ensures Texans with IDD receive the services they need before reaching a crisis point. Thank you.