This Policy Decision is Haunting Texas in the Coronavirus Pandemic
What does our society value more, the dignity of a human being or a chicken sandwich? The coronavirus pandemic seems to be revealing more deficiencies in our healthcare system every day. But what about the systems designed not to treat illnesses, but to maintain good health? For people with attendant care needs, the coronavirus is bringing a perfect storm that is largely of our own making.
Among the people at highest risk for hospitalization and death from COVID-19 are those with underlying health issues. In Texas, these include people with disabilities and older adults in Medicaid community care programs, individuals who have been assessed and authorized to receive community attendant services. Community attendants assist people in their homes with activities of daily livings—some as basic as ensuring a safe, clean home, others as detailed as bathing, eating, dressing, and personal hygiene.
Community attendants in Texas Medicaid are grossly underpaid. Most programs pay a base wages of $8.11 per hour with no benefits. Here’s the perfect storm: attendants belong to the workforce of earners who must go to work sick to make ends meet, and they’re going to a workplace that is the home of our most threatened citizens. Others will stay home, leaving their care recipient with no services. If an individual’s attendant is not available, she may lose independence and end up in a hospital or nursing home, very dangerous places for someone trying to avoid COVID-19.
How did this no-win and very costly situation happen? Whereas competing unskilled jobs like fast food and entry-level retail have wages set in the free market, the Texas Legislature essentially sets Medicaid rates in its state budget. The result is a history of neglect of the attendant workforce. Since 2015, the total raise over six years is a microscopic 25 cents. Meanwhile, the neighborhood taco stand advertises at least $14 per hour, Pizza Hut’s sign says delivery drivers earn up to $20 per hour and the fast food chicken place a block away has a starting hourly wage of $15.
To the original question: it’s not even close, society values a chicken sandwich much more than the dignity of a human being.
Fellow Texans, fellow Americans, can we agree this is not acceptable? In the coronavirus response, our leaders should prioritize an attendant base wage of $15 and paid sick leave. This will allow people who are already health-compromised and whose care is paid though our public health programs to stay as healthy as possible and, yes, actually save taxpayer dollars. And in the post-virus world, let’s establish a policy of adjustable, free market wages for community attendants. The coronavirus has given us a teachable moment. We should seize it.
Dennis Borel is the Executive Director of the Coalition of Texans with Disabilities, and Don Langer is CEO of United Healthcare Community Plan of Texas