Last-minute deal poised to avert crisis for 60,000 Arizonans with developmental disabilities

Relief is in sight for Arizonans with developmental disabilities who depend on government-funded services and the loved ones who care for them. 

Just seven days before the state’s Division of Developmental Disabilities is expected to run out of money, the Arizona House of Representatives voted 48-11 to pass a supplemental funding bill that would ensure it can keep paying its bills.

The vote came after 7 p.m. on Wednesday, following hours of closed-door negotiations. After lawmakers approved an amendment adding provisions from a deal Republicans struck with Gov. Katie Hobbs to settle the disability funding, House Bill 2945 garnered unanimous support from Democrats and dissent from only 11 Republicans, most of them members of the far-right Arizona Freedom Caucus. 

“This has not been easy, but we will help save lives.” Rep. David Livingston, R-Peoria, said before voting for the bill. 

The bill will head to the Senate next, where a different funding proposal passed with only Republican support on Wednesday morning, which Hobbs, a Democrat, declared “dead-on-arrival.” That legislation failed to pass the House earlier on Wednesday, sparking the talks that ended up breaking the logjam and leading to a deal.

In a statement on Wednesday evening, Hobbs expressed support for the bill the House approved. 

Arizonans with disabilities and their families have been awash in anxiety, finding themselves forced to grapple with the increasing likelihood that they’ll lose access to crucial services in May, all because the Republicans who control the state legislature and the governor continue to fight over how to resolve a $122 million funding shortage at DDD. 

To get Democrats on board, the House nixed plans to use $38 million that was already allocated to the Housing Trust Fund to shore up DDD and instead opted to cover the gap with money from the Prescription Drug Rebate Fund. 

Legislators in the House also scrapped requirements that the Arizona Health Cost Containment System, the state’s Medicaid program that runs DDD, acquire authorization from the legislature before it amends existing waivers from the federal government. But it kept intact requirements for legislative approval for new waivers or amendments to old waivers that expand services to new populations, increase services offered or make changes that cause a jump in utilization of 10% or more. 

Legislators, who are constitutionally responsible for funding state government, have had since January to negotiate a supplemental funding bill to allocate $122 million to DDD to get it through the end of the fiscal year on June 30. But Republican lawmakers instead played politics for months, letting care for some of the state’s most vulnerable people hang in the balance. 

On Wednesday, Republicans and Democrats in the House thanked one another for their work to come to a compromise that they agreed was not perfect, but that they urged the Senate to approve. 

If the legislature and Hobbs don’t agree on a supplemental funding measure by April 30, the nearly 60,000 Arizonans with conditions like cerebral palsy, autism and other developmental disabilities will lose access to vital services. Parents who rely on those services have been trekking to the Capitol regularly since January to beg legislators to find a solution that won’t mean they have to quit their jobs to care for their children or institutionalize them. 

The Parents as Paid Caregivers program, which was responsible for a large chunk of DDD’s budget deficit, trains parents and then pays them to provide in-home care to their own children — instead of third-party caregivers — but only if they require “extraordinary care” above and beyond typical parenting tasks. That might include assisting a teenager who has cerebral palsy, autism or cognitive disabilities with tasks like bathing, dressing and eating. 

The program was initially entirely federally funded, but beginning this month, the state is on the hook for around one-third of the cost. 

The PPCG program has expanded over the last year from about 3,000 participants to around 6,000, even after Republicans in the legislature refused to provide specific funding for it. They accused Hobbs of executive overreach for allowing the program to balloon without the necessary funding to pay for it. 

But Republicans who supported HB2945 took a slightly softer tone Wednesday evening. 

“The care of our most vulnerable citizens has always been a bipartisan obligation, one that speaks to the conscience of our society,” said Rep. Matt Gress, R-Phoenix. 

He said that Hobbs’ continuation of the program without explicit legislative approval was “well-intentioned,” but praised the “guardrails” that the supplemental spending legislation would put on PPCG, including the allocation of $355,000 for a special audit of the program. 

The House’s version of the bill maintained several stipulations for the program that were included in the Senate version, including a 40-hour per week cap, which Hobbs had already planned to implement last October, but delayed until July. 

It would also prevent parents from billing for care while their children are at school or hospitalized, would limit paid care from 6 a.m. to 10 p.m. and would implement numerous reporting requirements about utilization of the program. 

Several Republicans, including Rep. Jeff Weninger of Chandler thanked Rep. Julie Willoughby, R-Chandler, for her dedication to ensuring that parents who rely on the PPCG program don’t face devastating cuts. Republican leaders in the House last week killed a bipartisan supplemental funding bill that Willoughby proposed by stacking a House Appropriations Committee with additional Republicans who opposed the amendment just minutes before a meeting started. 

In the Senate

Sen. Jake Hoffman, of Queen Creek, was the only Republican in the Senate who voted alongside Democrats to oppose Senate Bill 1743 Wednesday. 

Democrats in the Senate called the waiver approval requirements “poison pills” that could threaten the existence of PPCG — and possibly even AHCCCS itself. 

Senate Democrats criticized Republicans for not including them in the development of the extensive amendment to SB1743 that they said was provided to them only minutes before legislators began discussing the changes on Wednesday.

***UPDATE: This story has been updated to reflect new developments. The headline has also been changed.