President Joe Biden is renewing his push to improve support for people with disabilities living in the community.

Biden used his State of the Union address late last week to urge Congress to add funding for Medicaid home and community-based services.

“Imagine — imagine a future with home care and eldercare, and people living with disabilities can stay in their homes and family caregivers can finally get the pay they deserve,” he said in the speech, which also included a call for paid leave and a commitment to protect Social Security.

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The president followed up on Monday by including $150 billion over 10 years “to strengthen and expand Medicaid home and community-based services” in his budget request for the 2025 fiscal year, which begins in October.

This is not the first time Biden has used his bully pulpit to take up the issue of caregiving. Biden originally proposed $400 billion in spending to expand access to Medicaid home and community-based services in 2021, but the plan never came through. However, a pandemic relief bill has provided about $37 billion extra for the program since that time.

Disability service providers have struggled mightily in recent years to hire and retain direct support professionals to assist people with disabilities. As a result, a survey of providers from last fall found that nearly half have discontinued offerings and 77% are refusing or no longer accepting referrals.

“(Biden’s) recognition of the critical need for a direct (support) workforce, compensated with a living wage to turn this vision into reality, marks a significant step forward,” said Kim Musheno, vice president of public policy at the Autism Society of America. “It is in our nation’s best interest to provide the support people with disabilities need so that they can live fully.”

Beyond requesting more investment in home and community-based services, Biden’s budget includes a $200 million increase in spending on special education services, $10 million more to train special educators and early intervention providers as well as funding to improve customer service at the Social Security Administration.

The budget request is largely viewed as a wish list highlighting the president’s priorities. It will now be up to Congress to determine what will ultimately be included in the federal budget for the upcoming year.

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