March 2023 Disability Task Force Meeting: Impact of the Workforce Crisis

On March 9, 2023, the Disability Task Force (DTF) met to discuss the impact of the workforce crisis.

Maura Sullivan from ARC MA gave an update on legislative approaches to help address the workforce crisis. Legislation includes the following:

• An Act relative to rates for workers providing supports and services for individuals with disabilities S83, H171 (Sen. Finegold, Rep. Garballey and Rep. Cataldo). This Bill addresses severe workforce shortages for direct support staff, program managers, and clinicians such as nurses. The bill provides for a minimum salary benchmark of the 75th percentile based on the state’s bureau of labor statistics.
• An Act establishing a fund to further educational opportunities for caregivers to adults with disabilities S812,H1285 (Sen. Barrett and Rep. Rogers), which creates a pilot to provide free community college to direct support staff with two years of service.
• An Act relative to family members serving as caregivers H1232, S775 (Rep. O’Day and Lovely).  This bill allows guardians, caregivers, and others with legal standing to be paid for providing Adult Foster Care (AFC) and Personal Care Attendants (PCA) services.

She talked about the budget that was released by the Governor that will help address some of the hiring issues.  Examples include: $200 Million for MassHealth day programs, $54 Million increase for chapter 257 rates, $21 Million boost for Turning 22 (students needing adult services), $10 Million increase for adults with autism, $7 Million boost for families in need (Family Support), and finally a $270 Million increase in residential services including a boost for state operated programs to address the backlog of need for residents.

(See slides here)

The meeting then focused on a discussion by DTF members about the impact of the workforce crisis on each of their organizations, and any effective strategies utilized to address this crisis.   A summary of the discussion is provided below.

Impact of the workforce crisis

• Programs are being impacted for almost everyone; some programs are closing due to lack of staffing.
• There is a high demand for community supports, but programs are having a hard time filling staff vacancies and creating wait lists. Since clients are not getting the services they need, there is consequently a lot of regression experienced by some clients.
• Direct care providers are needed. This has been the hardest hit area and some clients are being asked to leave group homes due to dysregulation since there is no support. More individuals are going into hospitals and then are stuck there since there is no staff to support them in the residential placement. Having few residential school placements available even if the school is willing to pay has also been very challenging.
• Mental health clinicians are hard to find.
• It has been hard to hire interns, and there is a decrease in those taking Human Service courses in college due in part to the lack of competitive salaries.
• Physicians and others in the medical field are retiring and are burnt out, and there are not a lot of people to fill the gaps.
• Having to push off start dates for clients due to insufficient direct care staff can cause regression.
• Wait lists for special education evaluations are over a year long, and staff are working over-time to get people off the wait lists.
• Many members of the disability workforce are women and people of color, who are being offered inadequate and inequitable wages.

Effective strategies

• Coalitions of providers, agencies, and disability community to increase wages through legislation.
• Negotiated a bonus as an incentive for staff employed for over 5 years to help retain staff.
• Shifting the housing model for support staff away from 1:1 staffing.
• Need to address immigration barriers, as a lot of the employees providing direct care to clients before Covid were immigrants.
• Need to expedite the hiring process, or else candidates will obtain other jobs in the competitive hiring market.
• Utilize AARPA recovery funds to provide employment supports for individuals with disabilities.
• Partner with other organizations and attend resource fairs focusing on human service options to create interest in the field.
• Grants and donations focused on the need to raise funds to increase pay for providers (unrestricted funds).
• BMC launched a short-term behavioral clinic for those unable to access therapies, and one of the BCBA’s ran a zoom clinic for caregivers.
• Creating formal partnerships with schools to get more student interns. Offering hybrid or remote options for international interns.
• Loan forgiveness programs for individuals who work in the non-profit sector.
• Being creative, job sharing and hiring part-time staff when necessary.

After panel presentations, there was a Q&A and discussion with DTF members.