Hobbs pauses drastic cuts to children’s disability services following outcry from families
State pauses new attendant care rules as governor directs changes to include exceptions for complex cases
Disability rights advocates gather Feb. 26, 2025, at the Arizona Capitol in Phoenix to urge Democratic Gov. Katie Hobbs and Republican legislative leaders to remedy a funding shortfall in the state’s Division of Developmental Disabilities that could leave them suddenly without essential services. Photo by Caitlin Sievers | Arizona Mirror
Parents of Arizona children with developmental disabilities who were scrambling to deal with massive service cuts finally got some good news today, when the state paused the implementation of those cuts.
Leading up to and following Oct. 1, when Arizona’s Medicaid program began using those new rules to assess the hours of service those children qualify for, desperate parents who had little notice of the drastic nature of the changes begged the state to amend the rules. Some said the changes would leave them in fear of homelessness and their children at risk of being institutionalized.
On Oct. 15, just two weeks after the Arizona Healthcare Cost Containment System, the state’s Medicaid program better known as AHCCCS, began to use the rules, Gov. Katie Hobbs announced a pause on their implementation. Doing so, she said in a written statement, will give the state time to undergo an emergency rulemaking process to amend the new assessment tool to allow exceptions for kids with extraordinary needs.
Michele Thorne, one of the advocates for the developmentally disabled community whose organization, Care 4 the Caregivers, has been lobbying the state for more flexibility in the new rules, reacted to the news with relief, thankfulness and cautious optimism.
“I’m happy that they listened to the caregiver community and instituted a pause,” she told the Arizona Mirror. “We were really struggling with the pace of implementation.”
Details about strict age-based limitations to the services children qualified for through the Division of Developmental Disabilities were only announced publicly about a month before they were implemented, leaving parents panicking about how to deal with huge disruptions in the lives of their families.
The new rules regarding how many hours the state will pay for either a parent or outside caregiver to provide attendant care, or supervision for certain tasks, and habilitation, or skill development to children served by DDD were the result of huge spending increases for those services last year.
While Republicans in the Arizona legislature blamed DDD’s Parents as Paid Caregivers Program for the cost increases, increases in paid hours for parents and outside caregivers both contributed to those increases.
After months of protests from members of and advocates for the developmentally disabled community, in April the state finally passed a bill that provided $122 million in gap funding to DDD to deal with cost increases without sudden cuts to services.
DDD and AHCCCS immediately began developing a new assessment tool to evaluate how many attendant care and habilitation hours each child could receive, based on changes in the law. But many parents didn’t find out how drastic the cuts to those services would be until early September.
During a webinar about the changes on Sept. 25, Zane Garcia Ramadan, assistant director of DDD, and Jakenna Lebsock, a deputy assistant director at AHCCCS, admitted that they made mistakes in communicating about the new rules.
“We acknowledge that the rollout of the new policies was not perfect, and we will commit to doing better moving forward,” Ramadan said.
But Ramadan also emphasized how crucial the cuts are to the future of the entirety of DDD because of huge increases in attendant care and habilitation hours for those under 18 that resulted in exponential cost increases.
Altogether, DDD spent $77 million on attendant care and habilitation services for those under 18 in 2019. That cost rose to $380 million in 2024 and $614 million in 2025. Those increases are coming out of the state’s general fund at a time when deep federal cuts to Medicaid and other programs are coming, and are likely to put the state budget in the red.
It’s for this reason that Thorne still has concerns. Even though this pause will give parents who rely on DDD for attendant care and habilitation services more time to prepare for changes, she said the feared cuts are still coming.
And it’s unclear if some of the Republicans in the GOP-controlled legislature will continue funding DDD at current levels — or if they would again agree to provide supplemental funding to cover more cost increases this year during the next legislative session that begins in January.
“This is a pause,” Thorne said. “It doesn’t mean that the rollout (of the new rules) won’t happen and that cuts won’t be made. At some point, we have to stabilize the system.”
A list of facts about the pause posted by AHCCCS said that it was spurred by advocacy from families and that Hobbs had directed the Medicaid program to reevaluate the assessment tool to include exceptions for children who require “extraordinary care.”
That change was based on pleas from parents like Jessyca and Dominick Damato, of Show Low, whose six-year-old daughter Lilyan needs constant one-on-one supervision and help with all tasks of daily living, from dressing, to showering, to preventing her from injuring herself.
They were just one of many families who scoffed at the new rules that cut supervision services for kids younger than 10 because a parent of a child without disabilities would be expected to watch them closely until that age. The Damatos argued that the constant vigilance required to prevent Lilyan from escaping out a window, banging her head on the sidewalk or burning herself on a hot water faucet were far above and beyond the kind of supervision the parents of a non-disabled six year old would have to provide.
“It’s a huge relief for parents,” Thorne said of the pause and rule changes. “I know that extra time to plan is going to be life saving, and I do mean that.”
Thorne said she was grateful to the Governor’s Office, as well as Republicans and Democrats in the Arizona legislature, for listening to the concerns of the community and taking necessary action.
The state is undertaking an emergency rulemaking process to make these changes, and plans to post them for an expedited public comment period.
“Arizonans with disabilities and their families deserve to have a say in decisions that affect their lives,” Hobbs said in a statement. “By working together, increasing transparency and community input we will continue delivering best in the nation care to Arizonans with disabilities, including intellectual and developmental disabilities, while ensuring these services remain fiscally sound for years to come.”