Direct service providers rally for more money in the 2022-23 state budget at the Pennsylvania State Capitol on Tuesday, May 24, 2022 (Photo by Amanda Berg, for the Capital-Star).
Low wages and high turnover are helping to fuel a staffing crisis among those who work with Pennsylvanians living with intellectual disabilities and autism, affecting the quality of care and support they receive, accordingly to newly released research.
That shortage has forced providers to contract out for services, further driving up costs, according to the Center for Healthcare Solutions, a western Pennsylvania-based industry trade group, which conducted the research on behalf of three advocacy organizations: The Arc of Pennsylvania, the Rehabilitation and Community Providers Association (RCPA), and The Provider Alliance (TPA).
Fifty-two organizations, “representing a full array of services” from every region across Pennsylvania participated in the survey, which collected data on pay practices, hourly wages (starting, average, and maximum), scheduled and filled positions, and employee separations, the trade group said in a statement.
The survey looked at 9,000 employees, working in 40 different positions, to evaluate wage compression issues, as well as critical data on over 7,000 direct support professionals (DSPs), residential supervisors, and other program supervisors. The report reflects salaries in effect as of Sept. 30 of last year.
The bottom line: “This is a system that is severely strained past its breaking point,” the trade group’s president and CEO, Nick Vizzoca, said in the statement. “There isn’t a single survey respondent that isn’t feeling the effects of this workforce shortage.”
According to the report, 14 percent of all direct-service providers’ hours are paid at overtime rates.
As a result, “providers must dig deeper to provide credentialing incentives, tenure rewards, or bonuses simply to retain the workers they have,” according to the report.
The wage study “reinforces what we have been saying for a long time now. Low wages are directly related to the high turnover and high vacancy rates that we’re seeing among Pennsylvania’s ID/A providers, and the individuals who are affected the most are those seeking care and support,” Richard Edley, the president and CEO of RCPA, said in the statement.
The 2022-23 state budget included $100 million in funding for mental health services. But lawmakers did not approve a plan to spend the money at the end of last year’s legislative session, which means the issue will carry over into the new legislative session that started this month.
A special commission charged with deciding how to allocate that one-time injection of funds recommended, among other things, spending $37 million on workforce development to train and retain mental health workers, the Capital-Star reported last fall.
“With staff leaving these professions, ID/A providers are strained to serve the thousands of Pennsylvanians currently receiving and waiting for critical services,” Sherri Landis, executive director of The Arc of Pennsylvania, said in the statement.
The providers noted that because such services are primarily funded through Medicaid, they’re unable to raise prices to underwrite higher wages. In addition, “chronic” underfunding by the state over the last decade only has exacerbated those challenges.
“Services are being reduced and, in some cases, eliminated entirely,” Patrick DeMico, the executive director of The Provider Alliance, said. “We can’t expect to recruit and retain direct support professionals at below-market wages and with no inflation adjustment for three years.”
The survey’s authors noted that their conclusions mirrored “other studies that have shown providers facing major staffing shortages, reducing caseloads, or cutting programs because of workforce issues, and trying to manage unprecedented vacancy and turnover rates, largely the result of inadequate state reimbursements that keep wages low.”
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