Developmental disability services facing ‘crisis’ labor shortage

Shortage of workers in mental health and disability fields at area agencies reflected statewide.

Exacerbated by the pandemic, and years of fewer hires, developmental disability services across the nation are facing a labor shortage of crisis magnitude, health professionals say.

The lack of direct support professionals, or those who work with people with developmental disabilities, is being seen in Greene County and other local counties.

“It’s been called a crisis, but it’s really a systems failure. It’s becoming to the point where it’s unmanageable,” said Mark Schlater, CEO of Towards Independence in Xenia.

Managers at the Greene County Board of Developmental Disabilities say the state has taken strides to rectify the issue, but many issues remain.

“There are fears and frustrations over ‘how are we going to cover the shifts that we need to cover?’ We’ve had to get creative in how we can help in other ways,” said Provider Support Manager Sarah Combs. “The people that are doing what they’re doing are incredible. We just need more of them.”

Towards Independence has about 200 direct support professionals, but Schlater says he could probably “hire 30 to 40 more tomorrow.”

“Most providers in Ohio are not taking on new business. We’re seeing more and more providers in Ohio turning down people for services because they don’t have enough staff,” he said.

As of Sept. 8, 1,822 people are on the waiting list for community or home-based service waivers in the state of Ohio, over half of whom are under the age of 21. More than likely, the waiting list is going to get longer.

The state has taken steps to address the problem. On Sept. 21, the Ohio Department of Developmental Disabilities announced that it would waive the requirement that direct support professionals need a high school diploma or GED through Sept. 30, and temporarily allow 16 and 17-year-olds to be hired. Minor employees perform more limited duties, cannot administer medication, and must work with another direct support professional, but state officials say this measure will attract more candidates to an industry stretched thin.

“As the direct support assistants enter the workforce as adults, they will already have the knowledge and skills necessary to continue to improve the lives of people with developmental disabilities,” Director Jeffrey Davis wrote in an email.

Despite this, major problems remain with the push to hire and retain employees. Agencies are currently struggling to provide competitive pay, and while private businesses can raise wages to address the worker shortage, direct support organizations can’t.

“Other businesses can modify their hours, cut back on services, but we can’t do that,” Schlater said. “Lives are at stake here.”

“The rate that they get is set in rule,” Combs said. “An agency is given a unit rate for the service, and then they pay DSPs based on that. There’s a very slight margin with operating costs.”

“The state matches federal dollars, but the state of Ohio sets those rates,” Schlater said. “We’re seeing more and more companies spending above what they’re getting reimbursed for. It’s a pending disaster.”

Starting pay for support workers starts at $13 per hour. Kelly Bergstrom, a senior services manager for Graceworks Enhanced Living, says in a perfect world, her dedicated workers would be getting twice that.

“This is not just a job where you just come in and take care of somebody. These folks become our family,” she said. “If we want to bring in a quality caregiver, a quality person, our reimbursement rates need to support a living wage.”

Further complicating the issue, many support workers that work full time are still dependent on benefits, including food assistance and childcare.

“The wage either has to stay low enough that they keep their food stamps, or large enough that they can afford daycare full time,” Bergstrom said. “I don’t know what that balance is, but $13 is not it.”

Direct support professionals play an integral role in the lives of people with disabilities, providing assistance in the home, medical assistance, transportation, and activities. Ultimately, the role of a support worker is helping people with disabilities live dignified lives.

“The role of a DSP is so unique,” Combs said. “It’s much different from a nursing facility. You’re walking with people through their lives to fulfill their wishes and what they want for themselves. We hope increased visibility of people with physical or developmental disabilities brings more awareness to this field.”

That lack of awareness means that many people don’t know that these jobs are available.

“There’s this belief that the DSP as a job is not a career path. And we want to challenge that greatly. There is an opportunity for upward mobility,” Combs said.

Both Combs and Schlater started their careers as support professionals themselves.

“The individuals we serve are in your neighborhoods,” Schlater said. “All over the Miami Valley there are individuals in group homes blending into the community. The reality is, people don’t realize jobs are in their own neighborhood.”

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