Advocacy

6 minute read

CTD has built a reputation as one of the foremost advocates in the state for public policy that protects and benefits Texans with disabilities, their families, service providers, and communities. Whether the Legislature is in session or we're in an interim year, be assured that CTD is working for you at the Capitol!

The 87th Texas Legislature convened Tuesday, January 12, 2021, and adjourned Monday, May 31. The first special session ran July 8 - August 6, the second, August 7 - September 2, and the third convened September 20.

Special Session Priorities

Voting

CTD’s goal in 2021 is two fold: to mitigate the worst parts of any bill that created new barriers for the disability community and to support amendments that would  create better access to the polls. Through the wins and losses in the regular and both specials sessions, we played a vital role in many of the negotiations, while continually reinforcing that election measures lose any semblance of integrity once they interfere with the reasonable, necessary, and legally protected accommodations for voters with disabilities that have already been in place and working well.

Top Priorities

Attendant Wages

Recruitment and retention of this crucial workforce have been at high risk for decades, due to an extremely low base wage, no benefits, increasing demand, and alternative employers paying much higher wages. We recommend an increase in the hourly base wage to $15.00 in 2022-23.

Access to Oral and Dental Care

More than 400,000 adult Texans in Medicaid receive little to no dental services. When these individuals have dental pain, their only option is the emergency room. Plus, poor oral health is linked to serious chronic conditions, like heart disease, hypertension, and diabetes. In the 2021, CTD was proud to lead efforts to pass a preventative dental benefit for adults with disabilities enrolled in Medicaid (STAR+PLUS non-HCBS). Yearly preventative dental visits will improve the oral and overall health outcomes of this population and help them avoid expensive ER visits and hospitalizations, while reducing acute care costs of chronic conditions.

Healthcare Costs

To afford out-of-pocket healthcare costs, many consumers rely on copay assistance programs, where drug manufacturers or other third parties offer copay cards or coupons. A new insurance practice called Copay Accumulators prevent those funds from counting toward a consumer's annual deductible or other out-of-pocket requirements. The Legislators had an opportunity to ban this unfair practice—which results in higher out-of-pocket costs for the consumer—but they did not.

Mental Health & IDD

Access to quality treatment continues to be a problem for individuals with intellectual and developmental disabilities (IDD) experiencing mental illness. Significant workforce shortages of mental health/ IDD specialists, as well a limited knowledge and training for mental health and IDD professionals, create substantial barriers. The Legislature should strengthen efforts to capitalize on the expertise in both fields and establish a seamless, comprehensive, and integrated system of care for this population.

School Discipline & Mental Health Supports

Children and youth with intellectual and developmental disabilities (IDD) are more likely to experience trauma and abuse than their peers. The Legislature should strengthen early childhood and school-based mental health supports and practices to foster a supportive school climate and ensure that school discipline policies do not target students with disabilities and/or mental health issues.

Special Education & Schools

As the state strives to best serve all students, both during and after the COVID-19 pandemic, the Texas Legislature must not leave students with disabilities behind by neglecting to support special education programs and to fund public schools. CTD is opposed to voucher initiatives that take money away from public schools and to censorship in the classroom.

State Budget & Appropriations

The coronavirus pandemic and related unemployment and economic impact have prompted speculation of severe budget cuts in 2021. With a massive Rainy Day Fund, extra billions coming from the federal government, and opportunities to close revenue loopholes, legislators have a choice to prioritize the needs of Texans and plan for the future. In 2021, we urge legislators to fund programs that support adults and children with all disabilities, personal attendants, and families in Medicaid managed care.

Other priorities

Access to Medical Cannabis

We support the expansion of the Texas Compassionate Use Program (TCUP) to cover more Texans and to give patients and their doctors greater control over determining the proper dosing levels of both CBD and THC to best meet the individual's need. In 2021, the state extended its current policy on medical cannabis and qualifying conditions to allow more Texans, some with disabilities, access to safe and legal cannabis. Still others could benefit, and we support efforts to further expand access.

Early Childhood Intervention (ECI)

We join lead organization Texans Care for Children in urging the Legislature to address funding shortfalls and program policies to sustain ECI. This investment will ensure that little Texans get the early intervention services they need to get on a strong developmental track and be ready for school. CTD applauds the 2021 lawmakers for prioritizing ECI in the state budget. We urge the Legislature to further support this program by ensuring that state-regulated private insurance plans cover ECI therapies and other services like targeted case management and specialized skills training.

Employment Opportunities

Adding people with disabilities to the Historically Underutilized Business program (HUB) will increase entrepreneurship, support self-employment, and sponsor small business ventures for a historically disadvantaged minority. This will, in turn, provide the state of Texas with valuable goods and services.

Inclusive Child Care

Parents of children with disabilities face significant barriers to obtaining and maintaining high-quality, reliable, inclusive child care. This results in parents dropping out of the workforce, family isolation, turning to unregulated care, and a missed opportunity to connect with other programs like ECI. In fact, ECI providers report challenges in serving children in their natural environment because they are denied opportunities to work with children who are in child care settings during the day. Child caregivers would benefit from training on working with children with disabilities and supporting early childhood mental health.

Increase the Number of Texans with Health Insurance

Texas' rate and number of uninsured citizens continues to be the highest in the nation—and it's growing. A recent economic study reports that health insurance expansion would produce a net positive to the state budget while creating 231,700 jobs in the first year. Texans with disabilities currently not eligible for coverage would gain it. Meanwhile, the healthcare industry is one of the best at employing people with disabilities, a demographic with a high unemployment rate. We support the Cover Texas Now and Sick of It TX coalitions in advocating for health insurance expansion.

Non-Medical Switching

As a member of the Coalition for Stable Patients, we support measures to end the practice of non-medical switching (or drug switching) in Texas. Non-medical switching is a set of tactics health insurers use to switch stable consumers off their already-prescribed medications for non-medical reasons. It can take months or even years for a person with a chronic condition and their doctor to find an effective medication; insurance companies should not stand in the way of their stable health.

Youth Justice / Criminal Justice

CTD supports legislation that will authorize supported decision-making agreements for those with disabilities during court proceedings, which would allow authorized supporters to help individuals understand their rights during the legal process. We also support more transparency in our jails concerning the release of medical information. CTD supports legislation that will make this process easier for families and agencies to inquire about the physical and emotional wellbeing of individuals with disabilities in custody.

@TXDisabilities