There’s a workforce crisis in human services that funding alone can’t fix | Opinion

By Marian Baldini

Human services providers for individuals with Intellectual/Developmental Disabilities (I/DD) diagnoses are floundering across the United States, including Pennsylvania. They can’t afford to keep the people most vital to their success — those working direct support positions.

The pandemic has only magnified a crisis this industry has tried to look away from for years, and now it’s standing right on our doorsteps.

According to ANCOR (a leading human services advocacy organization), the average direct support professionals (DSPs) turnover rate for human services providers per state in 2020 exceeded 50 percent, in large part due to a median hourly wage for DSPs of just $12.09.

How can we hire quality staff to support the individuals in our programs if we can’t offer them a living wage, let alone a quality rate?

KenCrest, like many providers across the country, has met with families of those our organization supports in group homes regarding concerns they’ve had for their loved ones. Almost all of the issues were connected to workforce shortages.

As an agency, we’ve attempted everything to address shortages; our turnover is half the national average. It’s a very complex challenge, and there are simply not enough people in the population to meet the demands of direct service.

Adding to the complexity, I/DD providers don’t set their own wages—the government does—which eliminates a provider’s ability to increase them and become more competitive employers. Across the US, the need for DSPs grows, as the waiting lists for services and placements also continue to increase.

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Here are a few creative paths to resolution.

Advance for less labor: It’s time to address the inadequate resources in human services and adapt new approaches that emphasize the use of enabling technology. Installing sensors, smart devices for medication distribution, and tablets that promote independence can reduce the need for round-the-clock direct care.

Many people with I/DD could live largely independently or in Lifesharing arrangements with tech supports. Both of these options are lower-cost models of support that require less staffing than group homes.

Credential the DSP workforce: Those working in direct care positions cannot afford to give up income to advance their educations. Why not advance their education on the job?

By credentialing direct support personnel, we enhance the quality of support, reduce staffing needs, and improve the pay rates. It’s a challenging task to plan the shift, but the math is simple: pay one quality worker well or three inadequate workers poorly.

Eliminate fee for service: Provider agencies spend 3 percent to 6 percent of their budgets on chasing units. Currently providers document units of service as small as 15 minutes, which are accompanied by progress notes and logged into auditable systems. Health care overall has realized that more service, more fees, and more tracking doesn’t retain better outcomes. Let’s design the system to encourage creativity, adaptation, and decent change because financial requirements shouldn’t drive organizational focus. 

Employ more people with I/DD in gainful roles: Individuals with disabilities desire the same positions, incentives, and benefits as the rest of the working world, so why aren’t we helping more of them get employed? We talk about creating workspaces that value equity and inclusion; let’s create ones where those with diverse abilities can access the same opportunities.

The DSP crisis is fixable. There are still a handful of opportunities that are plausible when possibilities are explored instead of overlooked due to budget restraints.

The COVID-19 pandemic has severely impacted the human services industry and its workforce crisis, but it also presents a unique opportunity for remodeling. After this past year, legislators know the community services system is essential and that their constituents are families who depend on these services.

Congress and state governments have the opportunity to invest in the I/DD services system and provide the necessary funding to not only stabilize it, but to innovate and transform it.

It’ll take the renaissance of our entire industry. It’s time to get serious about change and inclusion. It’s time to get proactive.

Marian Baldini is the president & CEO of KenCrest a human services provider that serves 12,500 people throughout Pennsylvania, Connecticut, and Delaware.