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Caregiver Crisis in Texas

Updated: May 18

My disabled daughter Rachel attends a local adult day care that cares for individuals with intellectual disabilities here in Waco, Texas. She absolutely loves “school” where her friends have nicknamed her “The Princess” and call me “Mrs. Rachel’s Mom”. Her precious classmates have Down Syndrome, Cerebral Palsy, Autism and other Intellectual and Developmental Disabilities. The center gives these beautiful Children of God a place to go and sing, pray, draw, go on field trips and interact with peers. Every morning when I drop Rachel off, a tear literally comes to my eye and I am reminded of Matthew 25:40, which states “Whatever you did for one of the least of these brothers and sisters of mine, you did for me.”


I have spent several hours talking with the Director and Chief Program Officer of Rachel’s day care trying to understand how I can help this community if I am elected to the Texas House of Representatives. The answers are clear. 


First, the wonderful individuals who care for Rachel and her friends everyday are paid less than a livable wage. They feed those who can not feed themselves, change many of these adults’ diapers, attempt to control temper tantrums and disagreements between these sometimes challenging individuals and truly sacrifice themselves to give these souls the best quality of life available. Their pay is based on a rate structure that assumes a minimum hourly wage of $10.40, a funding limitation imposed by the Texas Legislature. Employees at Rachel’s day care could make much more money flipping burgers or stuffing Amazon boxes. It’s not unusual for a direct care worker with any provider of services to people with IDD and related conditions to have multiple jobs.  Keeping and retaining caregivers for our disabled community by increasing their base pay to $15.00 an hour is an issue I will be strongly advocating for if elected to the Texas Legislature.


Second, Texas is one of only 10 states that continues to stubbornly refuse to expand Medicaid. This has resulted in an extremely long waiting list for individuals with disabilities to receive services. For example, if something were to happen to John and I, Rachel would need to be placed in a group home, which is available in the HCS waiver program. However, she is not eligible at the current time because the waiting list for waiver programs is so long. Lack of funding has resulted in many private HCS providers across Texas to close group homes. The Local IDD Authority has closed all but one HCS group home in the past three years because affordable hourly pay rates are too low to attract direct care workers.  . Expanding Medicaid would allow millions of federal dollars to come to Texas that could reduce long waiting lists, lead to increased rates for services, allow better hourly wages, and attract a direct support workforce to sustain community group homes so needed for adults whose family members have passed or can not care for them. 


Respected Waco economist Ray Perryman just wrote a wonderful editorial noting all of the economic and health benefits expanding Medicaid would bring to Texas. You can read his comments here. https://rebrand.ly/expand-medicaid-Ray-Perryman 


Governor Abbott believes that Texas does not need to expand Medicaid because we all should receive our health insurance from our employers. However, few of the individuals at Rachel’s day care will ever be able to obtain a job with a liveable wage and insurance coverage. Governor Abbott, who is disabled himself, is simply wrong.


I have been Rachel Shank’s voice for the past 25 years. I have advocated for her with insurance companies, social security, medical staff and even in Court. I want to take this passion to be a voice for the disabled in Austin. Texas does not have a representative who can give a strong and first hand perspective to what it is like to live as a disabled adult in Texas, and I want to be that voice. The “least of these” are all God’s children, just like you and me, and need a strong advocate who will see that they are cared for by the best caregivers, who receive a livable wage, and have safe homes to live in. 


Please vote for Erin Shank for Texas House on November 5, 2024, because the “least of these” need a passionate experienced voice in the Texas House of Representatives.

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