Email the Governor

Dear Governor Kehoe

My family has been using Self-Directed Support Medicaid services for the past {number} years to support our {age}-year-old loved one. 

{insert short personal story here}

Without the opportunity to have consistent, qualified staff to support my loved one in the home, we would likely have to consider out-of-home placement as we have difficulty supporting him in all his daily routines. Despite the complex medical and behavioral support needs, we want them to age-in-place with us, so we can continue to direct their care (for free under SDS).

If pay cuts were put in place, we would likely lose all our current support staff and have great difficulty hiring new staff, as the highest proposed pay rate would be $22.88.  This is not sufficient for our valued staff to purchase health insurance, save for paid time off (sick pay and vacation/paid holidays), or save for retirement.  It also offers no reimbursement for mileage and no opportunity to work overtime.  Many users of the SDS program have complex support needs, and any budget reduction puts their ability to live in the community at risk. 

Unfortunately, out-of-home residential placement would be difficult to obtain because of the waiting list, the complexity of their care, and the limited capacity of agency providers to take on new clients. This leaves only a state-run habilitation center or a nursing home as the only option.  An out-of-home residential placement would cost the state two times as much and an institutional placement would cost even more.

Along with hundreds of other families using Self-Directed Supports, I worked to help my legislators understand that SDS is the most cost-effective program for individuals with developmental disabilities. It provides high-quality, person-centered supports in home and community-based settings.  It is a highly efficient use of state funds with nearly 98% of every dollar going to the actual worker.  SDS has a robust and effective monitoring system that has produced an exceptionally low rate of fraud, waste, and abuse.  According to the SDS director, for FY 25 there were 129 Improvement plans initiated (less than 4% of the entire program), resulting in only 10 ultimate terminations of the service.

Funding HCBS programs aligns with the policy priorities at the federal level in the One Big Beautiful Bill (OBBB), which included the Helping Communities with Better Support (HCBS) Act which emphasized expanding access to home- and community-based services and increasing transparency and accountability.

I respectfully ask you to support the legislative budget, specifically HB 2010, with the Personal Assistance (PA) pay rate restored and Day Habilitation programs fully funded for Missourians with developmental disabilities. Missouri should align its budget priorities with the federal direction set by President Trump under the One Big Beautiful Bill by strengthening home-based care rather than dismantling it.

Respectfully,

{Name, address, phone, email}