Blog: Raise the floor, don’t lower the ceiling on attendant wages

Dennis Borel
CTD Executive Director

May 17, 2017

Adapted from a letter we sent to the Texas Health and Human Services Commission (HHSC) on proposed attendant wages rate cut. You can take action on this issue here.

Adding our voices to the many attendants, consumers, and advocates, CTD is opposed to HHSC's proposed rate cuts to Home and Community-based Services (HCS) and Texas Home Living (TxHmL).

As an organization with a strong track record advocating for an increase in attendant wages in the lowest-paying community care programs, CTD has consistently supported a maintained wage in higher-paying programs like HCS and TxHmL.

Again, the consistent message has been to raise the floor, not lower the ceiling.

To come forth at this time with a wage cut is, in our view, an exercise in ignoring reality. While all community attendant wages have been nearly stagnant for years, it is most recently that the crunch has been felt. That is because alternative jobs generally considered low-skills have become much more competitive. Crossing guards and fast food workers now command $13 or more to start.

It's also important to note that the Texas Workforce Commission ranks community attendants as the top growth occupation in Texas—so large a growth that it exceeds the cumulative total of the next eight high-growth occupations combined.

HHSC must consider these economic forces outside its own bubble if the agency has any interest in quality care for individuals with disabilities. A wage cut will absolutely drive workers to quit their jobs, while making it extremely challenging to recruit new workers. HHSC might consider the impact to its own operation if it cut its employees' pay by 20%.


Reliable attendant care has a direct impact on a consumer's health. Without it, you can count on higher acute care, ER visits, hospitalizations and unnecessary institutionalization. The harm in human terms is incalculable.

We understand a desire to transition to a more sustainable public health program. CTD wants the same. To do so requires better investments in cost-effective services, like community attendant care at all levels, rather than low-balling smart front-end expenditures in favor of much higher costs down the road--and that road may be quite short indeed.

Take Action! Send a message to Commissioner Charles Smith. 


About Dennis

As CTD's Executive Directed since 2000, Dennis is frequently called upon for research, policy analysis, and recommendations to the Texas Legislature and state agencies on issues surrounding disabilities.

Read Dennis' full bio.