DDD is At Risk Again!!

DDD is At Risk Again!!DDD is At Risk Again!!DDD is At Risk Again!!
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DDD is At Risk Again!!

DDD is At Risk Again!!DDD is At Risk Again!!DDD is At Risk Again!!
  • Home
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    • Provider Agencies
    • DDD Members & Caregivers
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  • About

How did we get here?

Updates will be added to the bottom of this page. 

You can read the history as it has unfolded starting at the top,  or scroll down to find the most current information at the bottom. 

Background

 In December 2024, the JLBC met and gave an unfavorable review of the DDD and AHCCCS budget spending. They discussed at length how funds were allocated and scrutinized the Parents as Paid Caregivers (PPCG) program. On January 29, 2025, the House Appropriations Committee met to continue discussing the budget deficits and the Governor's budget recommendations for DDD and DES. During that meeting, Representative Livingston suggested that additional appropriations would not be given to DDD until the final budget was passed. He also explicitly stated that he wanted to see the DDD and DES budgets cut by 25% in order to balance the budget. When asked if he was suggesting cutting services for disabled individuals to balance the budget, he confirmed, "Yes!" 


 A recording of the January 29th Appropriations Committee Meeting:

 https://www.azleg.gov/videoplayer/?clientID=6361162879&eventID=2025011093 

Current Concerns

Right now, there is a budget deficit, and funds will run out in May and June 2025 for all DDD programs and services if appropriation funding is not provided by our legislature before then. Next year’s budget (which begins July 1, 2025) offers potential room for negotiation within the legislature and governor's office. Cutting the Parents as Paid Caregivers program won’t change the bottom line.


In January 2025, DDD and AHCCCS circulated a slide deck explaining the complex reasons for their cost increases. These slides were attempted to be presented at the Appropriations Committee meeting on January 29, 2025, but only the first two slides were shown.


During the House Appropriations Committee meetings in January and February 2025, misinformation about the Parents as Paid Caregivers (PPCG) program led to false assumptions. The program was wrongly blamed for rising DDD service costs, and its inclusion in the 1115 waiver was questioned. In reality, Arizona’s low wages and inability to staff Direct Care Worker (DCW) positions left a critical gap—one that parents of minor DDD children stepped in to fill. With wages still far below the national average, there is no alternative workforce to take on these essential roles.

UPDATE 4/7/2025 - Republican Proposed Bill - HB2945 - VOTE SCHEDULED - April 15

To see the text of the actual bill - click here  bit.ly/4jmcSMX 


Below is a Chat GPT worded interpretation of the bill using the prompt:  


"Act as a government expert and legal expert and explain the bill HB2945. It should be fully accurate, nonpartisan, and written clearly and easy to understand. Include brief, non-partisan counter points."


NOTES:  While ChatGPT is helpful - it can be incorrect. So please read the bill for yourself and consult whatever legal resources you have. Anything in parenthesis is personal input that I feel is important to note.  The ChatGPT used for this interpretation has been prompted over time to look at how anything I've entered might also impact adults, as I care for an adult who receives DDD services. And as such this interpretation includes that perspective. 


Also Note - This bill passed with important amendments which are listed in the above section under UPDATE. 


The bill allows for the Supplemental/GAP funding of DDD with critical changes. 


HB 2945 and SB1734 – Developmental Disabilities, Waivers & Funding - Original Bills WITHOUT Amendments

Summary of Key Provisions


  1.  Parents as Paid Caregivers

  • Arizona will continue allowing parents to be paid for caring for their children with developmental disabilities (that require extraordinary care and would qualify for institutionalization) through Medicaid.
     
  • Starting July 1, 2025, there will be a 40-hour per week cap per child for paid parent caregiving. (A cut from the current allowance that was established during Covid).
     
  • (The adopted amendments push this date out to July 2026) By October 1, 2025, the state is required to submit a request to the federal government to lower the cap to 20 hours per week per child. (There is a critical shortage of providers for this care and because of the funding situation, many agencies are on hiring freezes.)
     
  • This change only affects how many hours parents can be paid—it does not reduce the total number of care hours a child can receive from all sources. (However, the caregiver shortage is still a huge issue in obtaining care.) 


  • At this time, the bill appears to apply only to the program serving minor children, which is currently the only DDD parent caregiver program in Arizona. However, the bill's language is broad and nonspecific, and it gives the Legislature authority over all DDD-funded programs. Because of that, there is concern in some communities that its provisions — such as the proposed hourly cap — could later be extended to caregivers of adult children if not clarified in future versions.


  • To be clear: the bill does not currently set an age limit, and no adult-specific parent caregiver program exists in Arizona at this time. But many families are watching closely to see how this bill evolves, and how it might shape future caregiving policy — especially for families of adults who rely on support from their parents.

     

2. Legislative Oversight of Medicaid Waivers


  • Arizona’s Medicaid agency (AHCCCS) and the Department of Economic Security (DES) must get approval from the state legislature before submitting, renewing, or ending any Medicaid waiver programs.
     
  • These waivers cover important disability services, and this provision ensures greater transparency and legislative control. 


  •  The process could become slower, delaying needed updates to programs.  It adds the possibility that politics could interfere with timely decisions on services. And reduces the flexibility of agencies to respond quickly to federal changes or community needs.  
     

3. Federal Funds Oversight


  • State agencies must report detailed information about how they use federal grant funds, including:
     
    • How much they receive and spend
       
    • When funds will expire
       
    • Whether state programs rely on this funding to continue
       
    • Plans for what to do if those funds are reduced or lost
       
  • This is supposed to help the state plan ahead and understand the impact of losing federal dollars.


  • Preparing these reports adds an administrative burden on already busy agencies.  Reports could be used to justify cutting services if lawmakers decide not to replace lost federal funds.   It could be used to scale back programs if they appear too dependent on outside funding.
     

4. Supplemental Appropriations for Disability Services


  • The bill allocates over $522 million in additional funds for the developmental disabilities Medicaid program in FY2024–2025:
     
    • $10 million from the Arizona Competes Fund
       
    • $38 million from the Housing Trust Fund
       
    • $61.2 million from the Prescription Drug Rebate Fund
       
    • $403 million in Medicaid spending authority
       
  • An additional $13.1 million is allocated for a cost-effectiveness study and related client services.
     
  •  Much of this funding appears to be one-time, raising questions about long-term sustainability.  Redirecting funds from other areas (like housing or economic development) could impact those programs.  The bill does not clearly explain how the funds will be used, which makes it harder to assess impact or effectiveness. 


5. Emergency Clause

  • The bill is marked as an emergency measure, which means it takes effect immediately to protect public peace, health, or safety.


  •  Emergency measures can limit public input or delay community awareness.  Agencies may have less time to prepare for implementing changes, increasing confusion or risk of disruption. 


END OF BILL SUMMARY

UPDATE (4/11/2025)

Right now, Arizona’s Division of Developmental Disabilities (DDD) is facing a critical budget shortfall. If the legislature does not approve appropriation funding, all DDD programs and services will run out of money in May and June 2025.


What Happens Without Gap Funding?


  • DDD has stated that if gap funding is not provided, they will not be able to reimburse services for May and June 2025.
  • Nearly 60,000 Arizonans who qualify for institutional-level care through DDD will be impacted.
  • Eliminating the Parents as Paid Caregivers (PPCG) program will not solve the deficit—it’s not the financial driver of the problem.


January 2025: Misleading Narratives Took Hold


In January 2025, DDD and AHCCCS created a slide deck explaining the complex reasons behind the cost increases. These slides were brought to the House Appropriations Committee on January 29, but only the first two slides were shown, cutting off crucial context. 

During committee meetings in January, February, March and April, significant misinformation circulated regarding the PPCG program, including:


  • False claims that PPCG was driving all cost increases
  • Confusion about how it was added to the 1115 waiver
  • No acknowledgment that PPCG exists because Arizona cannot staff Direct Care Worker (DCW) positions at scale due to low wages
  • House Republicans refuse to hear from the DDD community in multiple committee sessions regarding this topic which would greatly assist with clearing up mis information. 


In reality, parents of minor DDD children fill a critical gap in the system. Without them, there is no replacement workforce.


As of April 10, 2025: No Resolution Yet


  • No gap funding has been issued.
  • HB2816, which would authorize DDD gap funding for May and June without conditions immediately, has not been heard in committee or on the House floor. This bill would allow the program to continue through the end of FY2025 stabilizing the hundreds of small businesses and hundreds of thousands of jobs in Arizona that revolve around the DDD program, with any proposed changes or long-term reforms to be debated during the 2026 budget process—not under emergency conditions.
  • With only  22 days remaining of funding, House Representative David Livingston dropped HB2945 and Senator Kavanagh dropped SB1734 in a “companion bill” strategy designed to expedite a bill’s move into law. These identical bills add layers of bureaucracy making services for our most vulnerable more difficult to access. Once enacted into law, legislators will have been handed sweeping power over critical decisions that should be guided by urgency and needs of the community—not politics.


What’s Next?


We need your help and action! Email and call your Arizona Legislators and explain that their treatment and hostage negotiation tactics surrounding the DDD community is abhorrent and unacceptable!
 

Take Action

UPDATE - 4/15/25 David Livingston Stacks Committee to Push Through His Own Agenda

House Appropriations Chair David Livingston added three members — Reps. Bliss, Carbone, and Gillette — to the committee minutes before the committee was set to vote on amendments for HB2945. This last-minute move changed the outcome of the vote, blocking a bipartisan amendment from Republican Rep. Willoughby that had enough support to pass - and would have ended the DDD funding crisis almost immediately. Instead, Livingston’s last minute addition of three representatives killed the Willoughby Amendment and pushed his own through. 

Volunteer To Help Recall Livingston

UPDATE - 4/15/25 AZ House and Senate Pass HB2945 & SB1734 with Amendments

Arizona legislators passed both bills. HB2945 is carrying forward with the Livingston Amendment and SB1734 with the Kavanaugh Amendment. 


What This Means: 

  • No gap funding has been issued.
  • HB2816, which would authorize DDD gap funding for May and June without conditions immediately, has not been heard in committee or on the House floor. This bill would allow the program to continue through the end of FY2025 stabilizing the hundreds of small businesses and hundreds of thousands of jobs in Arizona that revolve around the DDD program, with any proposed changes or long-term reforms to be debated during the 2026 budget process—not under emergency conditions.
  • With only  13 days remaining of funding, House Representative David Livingston passed HB2945 and Senator Kavanagh passed SB1734 through committee in a “companion bill” strategy designed to expedite a bill’s move into law. These identical bills add layers of bureaucracy making services for our most vulnerable more difficult to access. Once enacted into law, legislators will have been handed sweeping power over critical decisions that should be guided by urgency and needs of the community—not politics.
  • Both amendments are basically identical with only a difference in where exactly funding comes from.   
  • These amendments temporarily protect Parents as Paid Caregivers at 40 hours/week, but force a cut to 20 hours/week starting July 2026 — and lock all future Medicaid decisions into politics. 


Next Steps in the Legislative Process 

(this is typically what happens, not sure if any of these steps are different in this case)


  1. Rules Committee Review: Each bill proceeds to the Rules Committee in its respective chamber to ensure compliance with legislative rules and constitutional requirements.​
  2. Caucus Discussions: Republican and Democratic caucuses will review and discuss the bills, allowing members to express support or concerns.​
     
  3. Committee of the Whole (COW): The full chamber will debate the bills, consider amendments, and vote on whether to advance them.​
     
  4. Third Reading: A final vote in each chamber determines whether the bills pass.​
     
  5. Cross-Over: If passed, each bill moves to the opposite chamber to undergo a similar process.​
     
  6. Reconciliation: If both chambers pass identical versions, the bill proceeds to the governor. If there are differences, a conference committee may be formed to reconcile them.​
     
  7. Governor's Decision: The governor can sign the bill into law, veto it, or allow it to become law without a signature.​
     

Advocacy Considerations:


Given the expressed concerns by some representatives, it's crucial for advocacy groups to engage with legislators, provide input, and suggest amendments that address specific issues. Active participation can influence the final content of the legislation and ensure that the needs of individuals with disabilities are adequately represented.


YOUR VOICE STILL MATTERS!

Take Action

UPDATE 4/17/25 - Governor Announces Bill Signing Moratorium Pending DDD Funding Resolution

Governor Katie Hobbs has announced a temporary moratorium on signing new legislation until the Arizona Legislature passes a bipartisan supplemental funding bill to address the budget shortfall in the Division of Developmental Disabilities (DDD).


  • The moratorium applies to any bill not yet transmitted to the governor.
     
  • The governor will continue to act on bills that have already been sent to her desk.
     

Governor Hobbs stated that the DDD shortfall impacts nearly 60,000 Arizonans with disabilities, including individuals with autism, Down syndrome, and cerebral palsy, who rely on services to live independently. She characterized the current legislative proposal as inadequate and said she will not support it in its current form.


She confirmed her willingness to continue negotiations and named the Prescription Drug Rebate Fund as one potential source for funding. The governor also noted that she is encouraged by bipartisan opposition to the current proposals and reiterated that business as usual will not continue until a viable funding solution is in place for DDD and its service recipients.


Link to Gov Hobbs website and press release:

https://azgovernor.gov/office-arizona-governor/news/2025/04/governor-katie-hobbs-announces-bill-moratorium-until-extremist?fbclid=IwY2xjawJuDt9leHRuA2FlbQIxMQABHmY-gsZ_fSKD1PFQa3mRw1dXEhcBnprM07w9cwYy4W6aO62ZvAUO4gq5GQrz_aem_4GTKGbQk_WepiOwhXtYa9A

UPDATE 4/17/25 - Recall Petitions Filed

Recall Petitions have been filed against Montenegro, Carbone, Livingston & Gress


  • Parents of children with disabilities have filed recall petitions with the Arizona Secretary of State against four state lawmakers following months of inaction on critical funding for the Division of Developmental Disabilities (DDD).
  • During a critical Appropriations Committee hearing on April 15, 2026, a bipartisan amendment—introduced by another Republican—was expected to pass and offer a more balanced path forward for funding. But at the last moment, Chairman Livingston added three new Republican members to the committee, shifting the vote count and blocking the amendment from advancing. 


These recall filings were made by parents and voters, mostly conservative, who have been advocating for the disability community for months. The Governor has nothing to do with these petitions.


The petitions target the following elected officials:


  • Speaker of the House - Steve Montenegro -  Legislative District (LD) 29
     
  • Majority Leader - Michael Carbone  - Legislative District (LD) 25
     
  • Appropriations Chair - David Livingston - Legislative District (LD) 28
     
  • Appropriations Member - Matt Gress - Legislative District (LD) 4
     

This action was taken after repeated efforts to meet with lawmakers, attend hearings, and advocate for urgent funding solutions went unanswered or ignored. 


Parents, caregivers, organizations, and advocates have shown up consistently for over three months — testifying, calling, emailing, and submitting more than 500 RTS (Request to Speak) “against” positions on each version of the committee passed bills. 


Despite that, the voices of families were sidelined.  


During a critical Appropriations Committee hearing on April 15, 2025, a bipartisan amendment—introduced by another Republican—was expected to pass and offer a more balanced path forward for funding. But at the last moment, Chairman Livingston added three new Republican members to the committee, shifting the vote count and blocking the amendment from advancing. 


What Happens Next? 


To trigger a recall election, each campaign must collect the required number of signatures by August 15, 2025:


  • Montenegro – 27,381 signatures
     
  • Carbone – 21,747 signatures
     
  • Livingston – 26,342 signatures
     
  • Gress – 34,399 signatures
     

If enough valid signatures are submitted and verified, the lawmaker has five days to either resign or face a recall election in August 2025.


The lives and futures of nearly 60,000 Arizonans with disabilities depend on stable, fully funded services — and families should never be put in this position again.


Source:  AZcentral

https://www.azcentral.com/story/news/politics/legislature/2025/04/17/arizona-lawmakers-face-recall-disability-funding/83137669007/?fbclid=IwY2xjawJuUlVleHRuA2FlbQIxMQABHpEw8W-ktWHtsGoscywGvPf88t-r2jUhntiaVzvqyj4sxg5U7nu0s7xDjr54_aem_jqx3NGuq7sfhZhnc2FFiPw

Volunteer For Recalls

UPDATE 4/18/2025 Disability Advocates Propose Common Sense Amendments

Brandi Coon from Raising Voices Coalition submits a letter of compromise to legislators.  This letter urges them to support a balanced, data-driven supplemental package that protects access to care, ensures program accountability, legislative oversight, and provides long-term stability for those who need it most. 


Proposed Amendments to the Supplemental Bill: 

  • Oversight & Transparency
    • Require AHCCCS to notify the Joint Legislative Budget Committee (JLBC) of any proposed changes to the 1115 Medicaid waiver. This ensures the Legislature has visibility into program changes and can act when necessary.
    • Require a new HCBS assessment that ensures every Attendant Care and Habilitation hour authorized for members meets the standard of extraordinary care. 


  • 40-Hour Cap for PPCG
    • Limit PPCG providers to a 40-hour weekly cap per child, effective July 1, 2025.
      Total hours must remain based on the child’s assessed needs and cannot exceed the authorized care plan.


  • Data & Reporting Requirements
    • Require quarterly reports from AHCCCS and DDD beginning July 1, 2025, including:
      • Number of PPCG participants
      • Authorized vs. utilized hours
      • EVV data on delivery by provider type (PPCG vs. non-PPCG)
      • Require annual reports on vendor call fulfillment, hospitalization rates, and incident reporting across the DDD system.


  • Responsible Funding Source
    • The supplemental should not draw from other vulnerable groups or critical services. The proposed use of the Prescription Drug Rebate Fund and general fund authority is a responsible approach that avoids further harm.


These common sense solutions protect Medicaid long term and propose a reasonable solution to the caregiver shortage.  For many families, the PPCG program is the only consistent care the child or family member receives. Without it, they would face hospitalization, institutionalization, or complete caregiver burnout.  This program is working—and it can work better with the added oversight and structure proposed above.

Tell Legislators You Support ThE Coon Proposal

Update April 24, 2025

 HB2945 with serious amendments passes both house and senate and is officially signed by the Governor!


The amended bill fully funds DDD with these provisions moving forward: 


1. The 20-hour weekly cap was removed from the PPCG program.
They will not reduce the allowed care hours to 20 per week per child. The previously approved 40-hour/week limit stands for now.


2. Parents may continue providing care, but with clearer boundaries:
• Must live in Arizona for at least 6 months to be eligible.
• May only be employed by one agency under PPCG.
 Cannot bill for services when the child:
• Is not present (e.g., at school or in inpatient care),
• Or for “typical parenting tasks” like laundry, meal prep, or housekeeping.


3. Care must happen between 6:00 AM and 10:00 PM, unless the child’s care plan specifically allows otherwise.


4. New oversight systems will be implemented:
• An electronic visit verification system will distinguish parent vs. non-parent providers.
• Quarterly usage reports will be required by DES and AHCCCS to monitor program integrity.
• A new standardized assessment tool must be implemented by October 1, 2025 to determine need for extraordinary care.


5. A full special audit is planned, with a report due by August 1,  2026, comparing Arizona’s PPCG program to best practices in other  states.

⸻

Budget and Funding:
• The legislature approved $109.2 million from the Prescription Drug  Rebate Fund (up from $61.2 million) for the Developmental Disabilities  Medicaid Program.
• $403 million more in expenditure authority was granted for Medicaid DD services overall.
• An additional $13.1 million was allocated for a client services cost-effectiveness study.

Update April 25, 2025 - Heads Up - The fight isn't over!

Yesterday was a moment to celebrate!! It was huge victory for our incredible and determined community!


Since  January, through our collective effort, we have shown Arizona’s  politicians that we are organized, powerful, and unwavering. Because of  your voices, your prayers, your persistence, yesterday’s bill signing  secured two months of life saving funding and protected the Paid Parent  Caregiver Program.


This victory is historic; and it belongs to each and every one of you who refused to give up.

And here’s the truth: We’re just getting started.


In  the coming weeks, budget negotiations will begin for the new fiscal  year. Some legislators have already made it clear to us they plan to  come after our community again. But this time, they know exactly who  they’re up against — and they know we are stronger than ever.


Aside from a few  courageous individuals, many politicians still see our children as a  line item to cut. We are here to show them differently.


Arizona values life over dollars.

Arizona defends its most vulnerable.

And Arizona families will not be silenced


We’re  in this together, and together, we are unstoppable!! Thank you for  standing strong. Thank you for making history. And despite what it has  cost us on every level, thank you for being the hope our disabled children  and adults deserve. 


Updated calls to action will follow soon. 

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