direct support workforce initiative 2019-2025...jan 15, 2019 · •domino's pizza - boston,...

Direct Support

Workforce Initiative

2019-2025 Presented by: Leo Sarkissian

January 2019

arcmass.org

About The Arc of Massachusetts

The mission of The Arc of Massachusetts is to enhance the lives of people with intellectual and developmental disabilities, including autism, and their families. We fulfill this through advocacy for community supports and services that foster social inclusion, self-determination, and equity across all aspects of society.

2 | ARCMASS.ORG/WORKFORCE

2

Crisis in the

Workforce

• 72 % of Mass. human

service providers report

that it has become

increasingly more

challenging to fill job

openings over the past

three years.

• Families rely on the

direct support

workforce for daily

routine, respite,

employment support

and avoid caregiver

fatigue.

| ARCMASS.ORG/WORKFORCE 3

STATE OF AFFAIRS

Section 01


Crisis for Families* & Agencies

• Individual w/disabilities & Family Caregivers face challenges in hiring staff for in-home services whether for care attendants, respite or nursing.

– 92% of Caregivers indicated difficulty with finding Direct Support Professionals (DSP) in recent FINDS Survey.

• The annual national turnover rate for the DSP workforce is an estimated 46% with a majority leaving within 1 year of employment.

• Massachusetts ranked 35th in the country on how well its Medicaid program serves people with I/DD.


The Commonwealth of Massachusetts

The Massachusetts unemployment rate continues to remain low at 3.5 percent.

Unable to recruit college graduates burdened with high college loans.

Our state is the 3rd highest costly to live in & median price of home in Boston is 70% above national average.


Job Market Values and Realities

Mean wages of DSPs are below those of janitors, clerks and others:

• Nannies $17.66 • Janitor $16.97 • File Clerk $17.53 We want to attract

committed, long-term DSPs who value their work with people with disabilities and families.


How does a $8.85 - $14.08/hour DSP salary

compare to a local Domino’s Pizza Delivery

Driver?

• Cash Daily - Pizza

Delivery - SIGN ON

BONUS!!

• Domino's Pizza -

Boston, MA

• $15 an hour - Full-

time, Part-time


https://www.indeed.com/cmp/Domino's

MASSACHUSETTS WORKFORCE

AT A GLANCE

Section 02


Workforce at a Glance Roles of DSP Staff…

• Teach instrumental activities of daily living -such as mobility, dressing, toileting, shopping or banking

• Provide employment assistance

• Build bridges to community activities, clubs and new relationships

• Ensure safety


Addressing the Entire Workforce

The Workforce is hired by:

• Individuals with disabilities

• Caregiver families or neighbors

• Providers

• Public Sector authorities

DDS or MassHealth line items or programs affected include, e.g.:

• Family Support

• Employment/Day

• Residential

• DESE-DDS

• Autism Child Waiver and Autism Omnibus

• Day Habilitation

• Adult Family/Foster Care

• Continuous Nursing

• Personal Care


Responding to Medical, Behavioral &

Other Conditions requiring

Specialists

•Consult to family and other caregivers,

agency services & generic practitioners

•Address complex medical or behavioral

conditions, communication needs

•Develop assistive technology strategies


MA Clinical/Professional

Workforce Challenges

• In-home nursing rates have not kept

pace with medical settings and nurses

aren’t often prepared for community

care

• Lack of specialists, high use of

emergency rooms, lack of knowledge

• Inadequate regional capacity for

consultation and problem solving


Individuals, Families and Providers

Need Staff Over 70% of caregivers are

family members – when

families don’t have support,

jobs suffer or are lost.

Staffed Homes w/vacancies

mean more safety risk and

disruption.

A nuanced response will result

in pay/benefits tracking with

health and education sectors

and access to clinical support

to decrease unnecessary use of

all types of hospitals & ER.


MASSACHUSETTS WORKFORCE

PROPOSAL: FOUR STRATEGIES

Section 03



4 Strategies The Executive Office of Health & Human Services adopt a planning process with Stakeholders to develop a specific

plan that reviews the following Recommendations & additional input while investing initial funding in FY’20.

WORKFORCE PROPOSAL

FOUR STRATEGIES

Workforce Investment

Innovation and System Design

Clinical Teams and Trained Staff

Building Human capital


STRATEGY 1




Significant investment is needed over the next few years to

achieve the entry & mean salary levels and improved

benefits to recruit and retain a stronger, more qualified

workforce and reduce high turnover costs.

Strategy 1:


Strategy 1: Workforce Investment

$17/hour entry

salary

FY’20 –

Jump start

competitiveness

in the market for

employees

Fund increases

for staff above

entry who earn

less than

$75G/year to

address

compression

Employee and Contract Staff Salaries


Strategy 1: Workforce Investment

Example Wage

Targets by 2025

• Three target examples

of workforce positions

to increase wages are

Direct Support

Professional, Frontline

Manager and Nurse RN

tied to health care and

education sectors.

Role Entry Mean

Direct

Support

Professional $24 $32

Front Line

Manager $36 $40

Registered

Nurse – Day

or Block $36 $42


Strategy 1: Workforce Investments

Employee Benefits

– Tuition or loan forgiveness.

– Initiatives to fund tuition credits at public colleges, universities, and technical schools to recruit younger workers.

– Room and board, child care, discounts at local retailers, and transportation benefits.

– Tax credits to allow retirees to receive an increased benefit from employment in the human services industry.

– Address legal immigration barriers (H1B) on a national level.


STRATEGY 2

Innovation and System Design Improvements


Strategy 2: Innovation and System Design

Improvements

1. Individuals and Families First: Offer packages to maintain family life while addressing adult needs (incl. guardians).

2. Provide care management.

3. Enhance resources for supported and/or shared-living; job & life coaching.


Strategy 2: Innovation and

System Design Improvements.

4. Transition those in institutions to home

and community.

5. Implement technology for individuals’ advancement and service system improvements.

6. Review regulations.

7. Task Force to address DESE/LEAs preparation of students with I/DD for adult life.


STRATEGY 3

Address Lack of Clinical & Specialists Teams


Strategy 3:

Address Lack of Clinical & Specialists

Teams

Assist Families &

Service Providers

Expand to five regional

consultant teams.

Collaborate with

practitioners to support

families and agencies to

manage complicated

situations or urgent need

cases.

Assist Practitioners

Provide communication to

& consultation for

medical, behavioral,

dental or other issues.

Possible model: The Arc’s

Operation House Call.

Short-Term Utilization

Specialists “live” or by

telehealth (short-term basis)

to address specific conditions

or prevent unnecessary

emergency room visits.


STRATEGY 4

Human Capital Development


Strategy 4: Human Capital Development

Increase rates for recruitment, onboarding,

retention, and training

1. Review existing allocations for onboarding and staff

training.

2. Pilot a regional or other employment collaborative for

workforce recruitment for individuals, families &

providers.

4. State to facilitate high school and college preparation

for our field.

5. Ensure accountability for staff training.

6. Develop career paths and consider alterative

certification.


In Conclusion…

The Commonwealth of Massachusetts has long been the leader of the nation when it comes to supporting people with I/DD in public education and community integration. Once again the Commonwealth can be a trailblazer for the nation, this time as it resolves the workforce crisis.


“The link between interest group activity and spending can be powerful…” Your commitment to the Workforce campaign and advocacy is essential! Visit our webpage: https://thearcofmass.org/workforce/


Bibliography United Cerebral Palsy and ANCOR, January 2019. The Case for Inclusion. The Providers Council. February 2017. Who Will Care? The Workforce Crisis in Human Services. 2018 Disability Data Digest (Rep.). (2018). Rochester, NY: MediSked. Workforce turnover cited https://cl.ici.umn.edu/node/6 (ICI at the Univ. of Minnesota, Workforce report in partnership with ANCOR) Dept. of Labor and Workforce Development (DLWD). Scott Cohn, CNBC, July 10, 2018. The most expensive places to live in America. From Life in the Community Summary Statement. Obtained from Bureau of Labor Statistics, https://www.bls.gov/oes/current/oes_ma.htm#21-0000 A. E. Hewitt et al., Minnesota: Research and Training Center on Community Living, Institute on Community Integration, University of Minnesota, FINDS Community Report 2017, Minnesota, https://www.thearc.org/FINDS. State of the States in Intellectual and Developmental Disabilities; Data Brief 2018; A. Lulinski et al; Coleman Institute for Cognitive Disabilities, University of Colorado and The Arc; http://www.stateofthestates.org/images/documents/SOS-Brief-2018_2_Rebalancing.pdf (IBID, 2005 Issue on Civil Rights and Advocacy) Google Images


http://caseforinclusion.org/application/files/1215/4653/0255/UCP_Case_for_Inclusion_Report_2019_Final_Single_Page.pdf

http://providers.org/reports/entry/who-will-care-the-workforce-crisis-in-human-services



https://cl.ici.umn.edu/node/6

http://lmi2.detma.org/lmi/News_release_state.asp

https://www.cnbc.com/2018/06/28/these-are-americas-most-expensive-states-to-live-in-for-2018.html

https://www.thearc.org/who-we-are/position-statements/life-in-the-community

https://www.bls.gov/oes/current/oes_ma.htm#21-0000



https://www.thearc.org/FINDS

http://www.stateofthestates.org/images/documents/SOS-Brief-2018_2_Rebalancing.pdf





Contact Information

• Leo Sarkissian, The Arc of Massachusetts

Executive Director

• Phone: 781-891-6270, ext. 106

• Email: [email protected]


direct support workforce initiative 2019-2025...jan 15, 2019 · •domino's pizza - boston,...

Documents