Support staff turnover puts agency for disabled at risk

By CHELSEA SCHNEIDER - Associated Press - Friday, June 5, 2015

INDIANAPOLIS (AP) - When Barbara Jackson’s mom unexpectedly passed away in 2011, she became the caretaker for her twin sister Ann.

Ann’s disabilities require someone to be with her at all times. By caring for her sister, Jackson found a harmonious pairing of her professional and personal life.

At the time of their mother’s death, Jackson was an instructor for Arc of Evansville. The organization offers a wide-range of day services and job programs for people with intellectual and developmental disabilities.

Jackson stepped away from the position as Ann moved in with her and her husband, and the family learned to juggle their new routine. They received funding through Medicaid for Ann to attend Arc. The funding ensured her sister would venture out of the house and benefit from a social setting. The funding also allowed Jackson to return to Arc, and the job she loved.

Now both sisters go to Arc every weekday - Jackson as an instructor and Ann as a client.

“It’s very rewarding,” Jackson told the Evansville Courier & Press (https://bit.ly/1dJiMat ). “I just love when somebody learns to do something new that they never did before. Each day is never dull. Each day is totally different. Even from one minute to the next, it could totally shift.”

The sisters’ story is a unique one at Arc. But the role Jackson fills as a direct support professional is critical to the operations of agencies like Arc across the state. The Arc of Indiana is working to secure additional funding as a means to retain and increase wages for those workers who earn an average of $10.20 per hour in the state, said John Dickerson, executive director of the statewide organization.

“One of the critical issues we know both through research and stories of people with disabilities is the continuity and relationships they have with the people they work with is so important to the successes they make at becoming more and more independent,” Dickerson said.

But retaining workers is a challenge.

At Arc of Evansville, the average salary for direct support professionals hovers around $8.75. Staff turnover is 60 percent.

Direct support professionals at day programs, like the one hosted by the Arc of Evansville, oversee personal care for clients. They hand-over-hand feed during lunch. They help with toileting. And they lead instructional activities that teach a variety of interpersonal, safety and other life skills.

Ohio is taking steps to raise the wages of direct support professionals working in the state to $19 per hour. The goal in Indiana, Dickerson said, is to see wages for the workforce increase to a statewide average of $17.50.

One way money flows to not-for-profits serving the developmentally disabled is by clients qualifying for assistance through the Medicaid program. But each state controls the rates providers are paid for serving clients. And in Indiana, providers then have the power to determine the salaries they pay their staff, said Nicole Norvell, director of the state’s Division of Disability and Rehabilitative Services.

During the recession, Indiana cut some of the rates, though in the state budget beginning in July, lawmakers worked to restore some of those cuts. But Dickerson said organizations like Arc of Evansville won’t see as much impact from those dollars because they stand to benefit residential services more than daytime care.

“This was a very first step,” he said.

Indiana does not set a minimum wage providers must pay direct support professionals, Norvell said.

Norvell said salary ranges are comparable to certified nursing assistants, where issues also are seen with recruitment and retention.

“Some providers have very much taken the stance that they are choosing to pay their (direct support professionals) good wages to ensure they have staff on-site or they get to retain them.Again that’s really dependent on each provider and how they have chosen to handle the revenue they have,” she said.

Advocates for the agencies said the state needs to look ahead to create a long-term plan for the workforce. Calls for a plan come as more than half of direct support professionals are the primary wage earners of their homes. A recent survey also found 30 percent of the professionals work a second job.

Arc of Evansville faced cuts during the recession, its executive director Deidra Conner said, because of a change in funding methodology. Conner said the state switched from a daily rate to an hourly rate based on the attendance of clients. People come consistently, she said, but days where clients don’t attend, such as snow or sick days, hurt the organization’s bottom line.

Where more funding from the state would serve the greatest impact is in the salaries for direct support professionals, she said.

“It’s a difficult job physically,” Conner said, “but there’s also I would say, emotionally and mentally, it can be very draining.”

A challenge the field faces is the approximately 1,800 direct support professional positions currently open statewide, and that people can typically receive a higher salary at McDonalds and Wal-Mart.

“A lot of the people who leave us don’t leave us because they don’t like the work,” Conner said. “They leave because they need the money.”

“What you’re starting to see as the economy rebounds, there are a lot of jobs that are starting to really increase their entry level rates.”

State Rep. Vaneta Becker, an Evansville Republican, said the state needs to “wake up and recognize this need” because she worries it could cause the institutionalization of people.

“And that’s not our goal. That’s not what we want for the developmentally disabled because they can live much more independent lives and stay at home with the help and with these day programs like the Arc provides,” Becker said.

Jackson said she stays at Arc because it’s nice to help people, and clients teach instructors a lot as well. But she knows of some co-workers who work shifts at grocery stores and gas stations to make ends meet.

She also stays at Arc because it’s near her sister. Outside of work, the sisters have lived together for 34 out of their 35 years.

They attended the same high school, and Jackson took Ann along for some of her classes at the University of Southern Indiana as she earned her education degree. When Jackson moved out when she got married, the sisters remained close. Jackson checked on Ann and her mom every day.