What Keeps me Awake at Night

Honestly, there are several work-related issues that keep me awake at night; the changes in how we provide services and support isn’t one of them.

Although some of those changes are significant, we know that people need to be able to live the lives they choose, and I think changes in services and supports are attempting to head in that direction.

My biggest concern right now might keep you awake as well. It’s simply this: How will we find and retain the people who can provide the care and supports we rely upon in the future when we’re experiencing a near crisis in staffing today?

The Situation

In a front-page story of the Star Tribune on February 28, reporter Chris Serres eloquently outlined the challenges of finding enough staff members to support people who have intellectual and developmental disabilities. Serres identified the staffing shortage as a crisis. If it isn’t one today, it certainly will be. Whether it’s home care agencies or group homes, finding and keeping staff members is a challenge. And our reimbursement systems aren’t providing solutions. In fact, the gap between the haves and have nots in the care community continues to widen as hospitals and nursing homes get increases year after year, while people providing home and community-based services are told to wait yet again. (I was told by a prominent legislator that disability services need to get in line and wait its turn. That was in 2013.)

When the minimum wage changed, disability service providers received a 5% increase and were told that should cover the minimum wage increase. We remade our entire salary structure to accommodate the change.

Unfortunately, that increase didn’t hold. As the Department of Human Services responded to a mandate from the Legislature to contain costs in long-term services and supports, rural providers took a cut to that promised 5% increase from already low rates. Starting in 2016, rural providers are subject to a 3% decrease in their rates. Why? The assumption is that it is less expensive to provide services in rural areas than it is in metro areas based on traditional spending. It’s likely that those who developed this rationale hadn’t considered that rural counties may have less dollars to work with, and may be traditionally more conservative in setting rates than metro counties. And they certainly hadn’t seen the data that shows that rural areas have a greater staffing crisis than metro regions where the prospective employee pool is larger.

In Serres’ article, we hear from a mother who spoke of her frustration with having to manage people and services in addition to everything else she has to do. It’s a story I hear again and again. We’re balancing the budget, and the system, on the backs of those who already have a burden of support.

Behind all of these conversations is the subject of money. Instead of looking for creative and reasonable solutions, the government is creating cookie-cutter solutions based on the needs of a minority. Behind closed doors, some high-placed government officials have been heard to make the comment, “People are going to have to experience some pain.”

Is that what we tell the parents who are struggling to maintain care levels required for safety, let alone a higher quality of life? As Barbara Merrill, CEO of ANCOR, our national association, says in a recent post, “It’s our responsibility to reject that we must accept that we have an economy of scarcity … It’s our job to advocate for what people need, not to settle for what we’re given.”

What We’re Doing

At LBSA, our board has been talking about staffing challenges for some time. We have committed to engage in envisioning new, bigger solutions for staffing challenges. We’ve read the research; we understand the dimensions of the problem; we’re looking for creative solutions. It will take the whole village – communities committed to ensuring that everyone has a place at the table. We’re just beginning the conversation, and we’d love to hear your thoughts.

How You Can Help

Your role? Send us your ideas. Be part of the conversation. And, contact your legislators to support a pay increase for our staff. Encourage them to support the 5% increase included in the House bill. Voice your support. We’d love to hear your creative solutions. Apply for one of our open positions. Share our open positions with a friend.