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The Senate released their version of the "One Big Beautiful Bill Act," making even deeper Medicaid cuts than the House version while maintaining work requirements and new eligibility restrictions. The Senate draft would permanently prohibit implementation of Biden-era rules that streamlined Medicaid enrollment and imposed minimum staffing standards for long-term care facilities. Key changes include reducing retroactive Medicaid coverage from three months to one-two months, barring lawfully present immigrants from premium tax credits, and appropriating $200 million for states to implement work requirements by 2026.

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ACL Announces Nearly $2 Million for Second Round of Grants To Fund State Implementation of the National Strategy To Support Family Caregivers

Applications due Wednesday, July 16, 2025, at 11:59 p.m. ET
ACL is pleased to announce the availability of approximately $2 million to support statewide implementation of the National Strategy to Support Family Caregivers. ACL will award four cooperative agreements to state units on aging (SUAs) to undertake a range of activities in response to this Notice of Funding Opportunity (NOFO). Each project will be fully funded for a period of 24 months with one, 24-month budget of up to $490,000. Each grantee will be expected to focus on implementing at least three of the five goals of the Strategy, as determined by the state’s needs and priorities, including:
  • Goal 1: Increasing awareness of, and outreach to, family caregivers
  • Goal 2: Advancing partnerships and engagement with family caregivers
  • Goal 3: Strengthening services and supports for family caregivers
  • Goal 4: Ensuring financial and workplace security for family caregivers
  • Goal 5: Expanding data and the use of research and evidence-based practices to support family caregivers
Successfully implementing the actions and recommendations contained in the Strategy will require the grantees to break down siloes that exist through close collaboration by multiple agencies in the state. In this regard, each grantee will be required to work with their state’s developmental disabilities services agency and at least one other state agency (e.g., state Medicaid, public health, mental health, education, transportation, child welfare, labor, state universities, etc.) or tribe/tribal entity over the course of the project.
This will be the second round of State Implementation grants awarded to states. In 2024, the first round of four Advancing State Implementation of the National Strategy to Support Family Caregiver grantees were funded. Learn more about their current projects on ACL's grantee page.
An informational call for 2025 prospective applicants will be held on July 1, 2025, at 2:00 p.m. ET.
  • Phone number: 888-324-9242
  • Passcode: 1543760
Learn more and apply
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The Trump administration is proposing a reorganization and staffing cuts at Department of Health and Human Services (HHS) that create uncertainty about the potential effects on older adults, who receive services authorized under the Older Americans Act. This brief provides an overview of programs and services provided under the Older Americans Act, the role played by the Administration for Community Living in administering these programs, and trends in program funding and service utilization by older adults.

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Under a new bill being introduced in the Wisconsin Legislature, people who falsely claim their pet is a service animal in public businesses could face a $200 fine for their first violation. Future offenses could total $500 each. The Americans with Disabilities Act doesn't require proof that service animal is certified.

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Wisconsin’s direct caregiving workforce is the backbone of home and community-based services. However, the direct caregiving industry is in crisis—one in four direct caregiver positions is vacant. 


The Wisconsin Department of Health Services (DHS) is actively addressing this crisis to understand what is needed to expand, enhance, and strengthen the direct care workforce. Workforce surveys are providing the data needed to assess the direct care workforce challenges and provide insights to potential improvement opportunities.   



Workforce Surveys


Wisconsin has participated in the National Core Indicators Aging and Disabilities (NCI-AD) and the National Core Indicators Intellectual and Developmental Disabilities (NCI-IDD) state of the workforce surveys since 2022. Every other year, these surveys collect data about direct support professionals (DSPs) who support adults with IDD and AD. The NCI reports provide reliable data on employment metrics. This includes turnover, wages, benefits, and recruitment. Each survey helps states:  

  • Examine workforce challenges
  • Identify areas for further investigation
  • Benchmark the workforce data
  • Measure improvements from policy or program changes

States can also create their own questions and can compare their data to other states and national averages. Agencies from all 72 Wisconsin counties participated in the IDD and AD surveys in 2021, while 70 participated in 2023. The most recent findings on all workforce metrics are available at the DHS Workforce Surveys webpage


To learn more about the NCI-IDD and NCI-AD surveys, visit the DHS Workforce Surveys webpage. You can also read the national reports at NCI-IDD and NCI-AD.   



To explore other DHS workforce reform initiatives, see the DHS HCBS Direct Workforce Reform and Analysis webpage.


Learn more about our workforce surveys

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This episode of the Work in Progress podcast, talks about the critical role paid and unpaid home caregiving workers play in our society, and the economic, physical, and emotional toll they face on a daily basis. Hear a conversation about what can be done to support them as they support us.

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When companies talk about inclusion and diversity, they often forget about one of the most underrepresented groups: people with disabilities. Studies have shown that people with disabilities often bring unique traits to the workplace. This blog talks about some of them.

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Data for Progress polling reveals effective strategies for advocates opposing Medicaid cuts: remind voters that home care services they may need come through Medicaid (not Medicare), clarify that popular state healthcare programs are actually Medicaid, rename "work requirements" as "job loss penalties,” and emphasize how cuts affect seniors and people with disabilities who depend on home-based services for independent living—messaging that resonates across party lines.

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