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Workforce Crisis

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Workers Who Serve People With Disabilities Must Earn More
By Richard Edley, RCPA President/CEO
Read the print version in the Harrisburg Patriot-News, January 19, 2023

Providers who care for individuals with intellectual disabilities and autism (ID/A) are being pummeled by a workforce shortage driven by low wages and high vacancy and turnover rates.

RCPA partnered with The Arc of Pennsylvania and The Provider Alliance to have the Center for Healthcare Solutions examine the state’s ID/A workforce. The survey evaluated critical data on pay practices, hourly wages, scheduled positions, filled positions and separations for more than 9,000 employees representing 40 positions in 52 organizations.

The findings are stark.

Wages for direct support professionals who help ID/A children and adults with their basic daily living needs average $16.61 per hour, less than some fast-food restaurants. The turnover rate for DSPs is 38%, with providers reporting a vacancy rate of 28%. The numbers are similar for other residential and program supervisors.

The study also found that 14% of all DSP hours are paid at an overtime rate, and 41% of providers are now engaged in a more costly practice of contracting for staffing services to manage the workforce shortage.

Because human services like ID/A are funded primarily by Medicaid, providers cannot raise prices like private businesses to pay higher wages. So chronic underfunding by the state only
exacerbates these operational challenges.

ID/A providers simply do not have the staff they need to serve the thousands of Pennsylvanians receiving or waiting for critical services.

This is a system that is strained past its breaking point, and it needs our support now.

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By The Times-Tribune

Editor: Providers who care for individuals with intellectual disabilities and autism are pummeled by a workforce shortage driven by low wages and high vacancy and turnover rates.

The Arc of Pennsylvania recently partnered with other social service associations to get a better picture of the state’s workforce in the field.

The survey evaluated critical data on pay practices, hourly wages, scheduled positions, filled positions and separations for more than 9,000 employees representing 40 different positions in 52 organizations, including many in Northeast Pennsylvania.

The findings are stark.

Wages for direct support professionals who help children and adults with their basic daily living needs average $16.61 per hour — less than wages at some fast-food restaurants. The turnover rate for direct support workers is 38% with providers reporting a vacancy rate of 28%. The numbers are similar for other residential and program supervisors.

The study also found that 14% of all direct support professionals’ hours are paid at an overtime rate, and 41% of providers now engage in a more costly practice of contracting for staffing services to manage the workforce shortage.

Because human services for those with intellectual disabilities and autism are funded primarily by Medicaid, providers cannot raise prices like private businesses to pay higher wages. So, chronic underfunding by the state only exacerbates these operational challenges.

Service providers simply do not have the staff they need to serve thousands of Pennsylvanians receiving or waiting for critical services. This is a system that is strained past its breaking point, and it needs our support now.

SHERRI LANDIS
THE ARC OF PENNSYLVANIA
HARRISBURG

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Supporting Providers of Color in the Pediatric Workforce: Practices to Diversify the Workforce and Improve Retention
Thursday, January 19, 2023
12:00 pm – 1:30 pm ET
REGISTER

The Center for Health Care Strategies (CHCS) is offering this free webinar on Supporting Providers of Color in the Pediatric Workforce. This webinar is funded by the Robert Wood Johnson Foundation.

When health care professionals reflect the communities they serve, it leads to greater health equity, enhanced patient care, and improved health outcomes. The current pediatric workforce, however, lacks racial and ethnic diversity. The field is also experiencing staff shortages as well as geographic maldistribution in inner city and rural communities, which are projected to worsen in the years to come. These workforce shortages have negative impacts on providers in the workforce and on our youngest patients across the nation, especially children of color.

This webinar will explore innovations in recruitment, training, and retention that can lead to a more representative and supported pediatric workforce. It will also discuss anti-racist training opportunities for pediatric staff and residents to better serve children most impacted by structural racism. The webinar includes speakers from pediatric sites engaged in Accelerating Child Health Transformation, a national initiative led by the Center for Health Care Strategies with support from the Robert Wood Johnson Foundation.

Health care providers, researchers, and organizations, patients and patient advocates, and other interested stakeholders are invited to join this 90-minute event.

FEATURED SPEAKERS:

  • Ben Danielson, MD, Clinical Professor, Department of Pediatrics, University of Washington School of Medicine and Pediatrician, University of Washington Medicine
  • Margaret Tomcho, MD, Medical Director, Denver Health’s Westside Family Health Center and Pre-Health Pipeline Programs; Associate Professor of Pediatrics, University of Colorado School of Medicine
  • Neeti Doshi, MD, MPH, FAAP, Primary Care Pediatrician, Children’s Health Center, San Francisco General Hospital; Assistant Professor of Pediatrics, University of California San Francisco
  • Elizabeth Castro, MHA, Strategic Support Manager, ADOBE (Averting Disparities in Outcomes by Building Engagement) Program

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Shared by RCPA member MITC:

Much of this content was originally published by OPEN MINDS in September 2022. In turn, this content was derived from a presentation by Dee Werline, President and Chief Executive Officer at New Vista, and Dee DeWitt, Chief Operating Officer and Chief Financial Officer at Momentum for Health. The article matched a lot of our own thinking at MITC and thought the content deserved a wider audience.

Download Weathering the Staffing Storm.

Check out these recommendations and best practices: Guidelines for Better Recruiting and Hiring.

Email MITC to talk to a hiring specialist.

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A message from the Department of Health:

We are writing to inform you that the Pennsylvania Department of Health will no longer be able to provide short-term crisis staffing support or staffing support for test swabbing missions as of January 14, 2023. This decision has been made due to the exhaustion of funds designated for this purpose. We want to assure you that we will do our best to assist with a smooth transition.

The Department remains committed to providing opportunities to build long-term resilience into long-term care facilities that includes bolstering Pennsylvania’s long‑term care workforce development and retention.

We strongly encourage you to engage with your local LTC RISE partner. LTC RISE will continue to provide COVID-19 outbreak response consultative support. LTC RISE will also continue to support quality improvement project opportunities, including projects focused on workforce development and retention.

We also remind you that the Long-Term Care Quality Investment Pilot (QIP) is another opportunity which can benefit skilled nursing facilities, personal care homes, assisted living facilities, and intermediate care facilities. We urge facilities to apply for funds to invest in key areas that include staff development and retention. Applications for QIP are due Saturday, December 31, 2022, by 1:30 pm.

Thank you for your continued efforts protecting Pennsylvania’s most vulnerable residents and for your understanding and cooperation during this time.

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Photo by Markus Winkler on Unsplash

The Pennsylvania Independent Regulatory Review Commission (IRRC) has approved RCPA’s request to review the RCPA IBHS Regulatory Review Recommendations within the context of the current IBHS regulations.

The premise of the recommendations addresses the challenges and barriers IBHS providers have faced in creating the staffing infrastructures and meeting the burdensome operational protocols for regulatory compliance. The overreaching nature of the regulations, coupled with the impact of the pandemic, has caused great strain on an already depleted behavioral health workforce. These system stressors limit the ability to provide vital, quality services to children and families. Due to the prohibition for the use of waiting lists, it is difficult to capture the true number of children and families going without these essential services. We contend there are thousands of children across the Commonwealth with unmet treatment needs and written orders for IBHS services who await care.

The current lack of access to care is a result of the workforce crisis and operational requirements of implementing the regulations. We feel these access issues and children waiting for services are compelling reasons, in the interest of the public, to merit a review of the regulations. We have also provided these recommendations to OMHSAS, the HealthChoices BHMCOs, and leadership in the Pennsylvania General Assembly.

RCPA extends its gratitude to our members and those who have supported this process as well as the IRRC for their review. There is no current timeframe for the review, as there are many other, similar regulatory review requests on the docket. With that said, we remain vigilant in our efforts and seek partnership and collaboration with all stakeholders to address the current crisis.

If you have any questions, please contact RCPA Mental Health Policy Director Jim Sharp.

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