Support Texans with a Medicaid waiver to gain competitive, integrated employment: Senate Bill 50

Thank you for the opportunity to provide input on SB 50, and thank you Senator Zaffirini for filing this important piece of legislation, and your continued commitment to the full inclusion of Texans with intellectual and developmental disabilities (IDD). I am Ginger Mayeaux, Director of Public Policy and Advocacy at The Arc of Texas. The Arc of Texas promotes, protects, and advocates for the human rights and self-determination of Texans with IDD. Enhancing competitive integrated employment for Texans with IDD is a priority for our members across the state, which includes Texans with IDD, their families, and employers.

Work is a fundamental part of adult life. For people with IDD, taking part in working life is an essential condition to equal participation in society. We know that when individuals with disabilities are competitively employed, they are better able to lead independent lives, be self-supporting, and contribute to their communities. Texans with disabilities can be productive and achieve independence with adequate support. Unfortunately, employment supports funded by Medicaid waivers are extremely underutilized while day habilitation services are heavily utilized.

This bill will help Texans with disabilities access the services and supports they need to find competitive, integrated employment in compliance with Texas’ Employment First policy. Employment First policy became law in 2014, thanks again to Senator Zaffirini. Employment First policy states that competitive, integrated employment must be the first and preferred option for Texans with disabilities receiving state benefits, such as Medicaid. However as shown by the following information, Texas has not made much progress toward this philosophy:

• 84% of people with IDD claim they want to work, but do not have or know about the supports to do so.
• A survey of Texans in home and community-based services conducted by the Health and Human Services Commission (HHSC), indicates that individuals are not receiving the support they need to make progress on their employment goals.
• Only 1.7% of people supported by a Medicaid waiver received any employment service, yet 59% received day habilitation.

As you can see, this does not align with Employment First policy and is not a good use state resources.

A major challenge for individuals using a waiver is that they do not know what employment supports are available and do not understand what the services provide. SB50 will help address these barriers by informing and supporting individuals to develop employment goals and providing adequate support to achieve these goals. More specifically, SB50 will create a uniform process to identify employment goals, which will then inform the individuals plan of care or service plan. Employment goals will be reviewed annually as individuals, supports, and the job market change. SB50 will also require HHSC to identify strategies to increase the number of Texans receiving employment supports and require that Texans with a desire to work be referred to and assisted in accessing appropriate supports. Lastly HHSC will track important data on employment outcomes, including the number of individuals receiving employment support and obtaining competitive integrated employment. This data will assist Texas in identifying other barriers and solutions to supporting Texan’s employment goals. As you can see, SB50 takes Texas one step closer to making employment first a reality.

Thank you again for the opportunity to provide comments.