Commentary

Pennsylvania’s most vulnerable residents are at risk. Only lawmakers can fix it | Opinion

The plight of Pennsylvania’s most vulnerable residents and their families must be a top priority this budget season

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By Richard S. Edley

With the primaries finished and politics on a brief pause, it’s back to legislating, as lawmakers only have a few weeks to craft a final state spending plan before the end of the fiscal year on June 30.

The plight of Pennsylvania’s most vulnerable residents and their families must be a top priority.

COVID-19 has worsened a workforce crisis that affects nearly every human services field, including intellectual disabilities and autism, mental health, substance use disorder, children’s services, brain injury, physical disabilities, and rehabilitation services. Staff turnover is epidemic. Open positions remain unfilled. Vacancy rates are at all-time highs.

This situation has impacted all of human services; many family members have had to quit their jobs to fulfill the role that direct support professionals once provided. Similarly, with fewer clinical professionals (e.g., mental health), many individuals in crisis are finding it harder to access care or are going without services entirely. Community agencies face the difficult choice of cutting services or eliminating programs altogether because there simply are not enough workers and professionals to provide the services.

Direct support and clinical professionals who remain on the job are working longer hours, nights, weekends, overnights, and overtime. The administrative burden (e.g., regulations) placed on public sector agencies compounds the situation. Individuals make the difficult decision to move on from their chosen career. With staff leaving these professions, the state’s human services network simply doesn’t have the capacity to serve the thousands of Pennsylvanians currently receiving and waiting for critical services.

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Individuals entering the field to work with vulnerable citizens do so out of a mission and desire to help, but this should not mean living in poverty. Most human services professionals are paid less than $15 per hour, which simply isn’t competitive, especially for jobs so challenging that they require great skills to master to ensure specialized, life-sustaining tasks are performed properly.

These human services professionals are trained to assess and support individuals with significant needs, such as children and adults with intellectual and developmental disabilities, mental health disorders, physical disabilities, and other severe and chronic health care conditions.

The services provided may help the individual to live in their community by supporting them with their basic daily living needs, thus ensuring their health and safety by administering medication, providing job and life skills trainings, and more.

Wages in every other area of employment have increased, so competition from the private sector is considerably stiffer. Some warehouses are paying more than $20 per hour — with signing bonuses. It may not be the job they want, but direct support and clinical professionals now have more reason to switch jobs and change careers.

Because human services are funded primarily by Medicaid, the provider agencies employing these professionals cannot simply raise prices like private businesses to pay higher wages. State lawmakers have to play a role. 

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For more than a decade, the Commonwealth has chronically underfunded health and human services and, thus, the individuals who provide the care. The COVID-19 pandemic has only made a dire situation worse.

Fortunately, it appears that lawmakers and the administration are finally recognizing the problem and are trying to help. The state, for example, received authorization to spend federal money from the American Rescue Plan Act (ARPA) to shore up portions of home and community-based services.

But the allocation doesn’t come close to fixing the larger and more widespread problem. This workforce crisis is growing far worse, and quickly, so more must be done now.

Pennsylvania is now sitting on billions of federal dollars and state “rainy day” funds that could be used to increase wages to help retain direct support and clinical professionals and attract and train a new workforce. Yet that money remains unspent as the needs of our most vulnerable residents and their families go unmet.

During the pandemic, many direct support and clinical professionals were called heroes. It’s nice to pay them a compliment, but it’s time to pay them a fair, life-sustaining wage that shows the value of the care they provide and recognizes their importance in the lives of the individuals and families they serve.

Richard S. Edley is the president & CEO of the Rehabilitation and Community Providers Association. He writes from Harrisburg.

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