Our Legislative Priorities

Adequately Fund Services For People With Developmental Disabilities (DD)

  • Restore the 3% Provider Core Cut
  • Support Rate Rebasing Efforts
  • Support Cost of Living Adjustments
Current Reimbursement Rates are Inadequate
– Fully fund the Department of Mental Health Division of Developmental Disabilities
– An FY17 actuarial study indicates that LTSS are underfunded by more than 40%

Direct Support Staff (DSP) Need a Living Wage
– Median wage for DSPs in MO is $10 per hour
– 52% of DSPs require public assistance
– 31% of DSPs access Medicaid

Help People With Disabilities Work In Competitive, Integrated Settings Where They Can Earn Money, Pay Taxes, And Reduce Reliance On Public Programs

  • Support Vocational Rehabilitation and DMH-DD Employment Programs
  • Support Legislative efforts to make Missouri an Employment First State
Fully Fund Vocational Rehabilitation
– In FY17, 5,173 people with disabilities got a job making at least minimum wage. With a nearly 80% federal match, this is a cost-effective investment.

Support Medicaid-funded employment programs through the DMH-DD
– Only 12% of people with DD are employed through competitive or supported employment. Gainful employment reduces dependency on public assistance.

Make Missouri an Employment First State.
– Support Legislative efforts to require MO to make employment the first and preferred outcome in provision of services for people with DD.

Oppose Managed Care For Long Term Services And Supports (LTSS) That Adversely Impacts Service Delivery

  • Oppose Managed Care that limits individual choice, reduces necessary critical support services and does not comply with the Home and Community-Based Services (HCBS) Final Rule
  • Oppose Managed Care that reduces provider reimbursement rates
Current Managed Care Models Have Produced Poor Outcomes for People with Disabilities
– Poor outcomes in Iowa have led to lawsuits and have disrupted individuals ability to remain in the community with appropriate supports
– Implementation of Managed Care has reduced reimbursement rates (IA, WI, KS) to service providers, which has caused many to close their doors and has reduced choice and quality.

Managed Care (LTSS) Does Not Save Money
– MCOs have reported losing hundreds of millions of dollars within the first year, forcing states to increase payments to MCOs.
– The DMH-DD system in Missouri is already underfunded according to Mercers actuarial published study