Public Policy: Disability Advocacy in Missouri

Our 2025 Legislative Priorities

Paraquad works on disability advocacy in Missouri. Our efforts are guided by the belief that people with disabilities should have access to home- and community-based services that allow them to live independent lives in their homes and communities.

• Through legislative advocacy, we support increasing funding for the Consumer Directed Services (CDS) program to 100 percent of the funding for nursing home care. This allows people with disabilities who meet a nursing home level of care to survey community resources for independence and utilize in-home support to remain independent.

• We support responsible reform of the CDS program to ensure the integrity of this essential service.

• We support increasing provider rates for Consumer Directed Services. (An updated and accurate Mercer Study is one part of this process.)

Disability advocacy in Missouri helps ensure that people with disabilities have opportunities to pursue economic independence.

• We will monitor the implementation and appropriations for Missouri’s improved MO HealthNet Buy-in (MBI) Program—the Ticket to Work Health Assurance Program as amended in 2023 -- and evaluate if it is meeting the needs of workers with disabilities.

• Our legislative advocacy pushes for periodic cost of living adjustments to asset and income limits in federal and state programs.

• People with disabilities should be protected by labor laws that safeguard safety and access to basic human needs (food, shelter, etc.) through community resources for independence.

• We will monitor implementation of the “Employment First” policy as passed in 2023 to see that it truly prioritizes competitive, integrated employment settings where disabled workers interact with nondisabled coworkers.

• We advocate for partnerships between state agencies, supported employment providers and employers to overcome barriers in meeting workforce needs.

People with disabilities should have access to quality, affordable health care that meets their needs.

• As we promote disability advocacy in Missouri, we oppose any efforts to weaken the vital “safety net” (e.g., implementation of block grants or per capita cap models of Medicaid).

• We oppose implementing work-hour documentation requirements for Medicaid recipients.

• Through legislative advocacy efforts, we oppose efforts to include people with disabilities in managed care delivery systems that do not ensure access to quality, affordable health care for people with disabilities.

• We will continue to monitor implementation of the expanded Medicaid program, passed by citizen initiative in 2020, to ensure that it provides equal coverage for the expansion group and covers home and community resources for independence.

Paraquad supports disability advocacy in Missouri that increases Independent Living funding to the level recommended by the federal government.

• Centers for Independent Living (CILS) are nonprofit organizations in place to provide broad services, support and resources to help Missourians live and remain independent at home. Every county in Missouri is served by a CIL.

• CILs serve people with ALL disabilities and those of ANY AGE; they have disability resource expertise and are well-connected to assist those who are born with a disability, acquire a disability in life or develop an age-related disability.

• According to a 2014 National Base Level Funding Study, centers should be funded at $570,000 per center. Most Missouri centers are currently funded at $255,862. This is a $314,138 SHORTFALL per center.

People with disabilities should have access to safe, affordable, accessible housing.

• Understanding that the inability to secure accessible housing is a significant barrier to independent living and de-institutionalization, our disability advocacy in Missouri aims to address the shortage of more than 120,000 rental units across Missouri for people with low incomes.

• Our legislative advocacy supports continued reform to the Low-Income Housing Tax Credit including universal design and extending the affordability period.

• Missouri should prioritize stable community resources for independence and protect vulnerable people by addressing housing needs before, during and after the eviction process.