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SupportingPeoplewithDevelopmentalDisabilities:TheImpactofLowWagesandtheMinimumWageDebateontheDirectSupportProfessionalsWorkforce
AJointPublicationof:
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SupportingPeoplewithDevelopmentalDisabilities:TheImpactofLowWagesandtheMinimumWageDebateontheDirect
SupportProfessionalsWorkforce
EXECUTIVESUMMARYNOVEMBER2015
Over110,000DirectSupportProfessionals(DSPs)arethelynchpinofthesystemofsupportsfor
peoplewithdevelopmentaldisabilities,with97,000workingfornotforprofitagencies.Thisreportincorporatessurveydatafrom131notforprofitagenciesthatemploymorethan64,000oftheseDSPs.
Thesehighlytrainedprofessionalsarewhymorethan100,000NewYorkersleadsafe,fulfillinglives.
Fundingforthesalariesoftheseprofessionals,whichcomesfromtheMedicaidprogram,isinsufficienttopaycompetitivewages,leavingtheseprofessionalsinchronicshortsupply.
Surveyrespondentsreportneeding5,300DSPstofillcurrentlyvacantpositionsthisrepresentsastatewidevacancyrateof8%.
TheshortageofDSPsresultedinaninordinatedependenceonovertimewithsurveyrespondentsreportingmorethan2.9millionhoursinoneyear.
TheStatesdecisiontoraisetheminimumwageforfastfoodworkersandstateworkerswithoutaddressingwagesofDSPswillmakeDSPwagesevenlesscompetitive,exacerbatingtheDSPshortageandjeopardizingthesupportsforpeoplewithdevelopmentaldisabilities.
Wageincreasesmustbeimplementedinanequitablefashionforallhumanserviceworkers.EquitablewageincreaseforDSPsmustbefundedthroughadequateproviderrateincreases.
WeapplaudGovernorCuomoformakingtheminimumwageapriority.Wesupportthehardworkingemployeesofthefastfoodindustryandstateworkforce,butourDSPs,whoareresponsibleforsupportingthelivesofsomanyspecialNewYorkers,deserveattentionaswell.
ShouldminimumwageincreasesleaveDSPsbehindmanywillconsiderchangingjobs,leavingthepeopletheycareaboutbehindtoworkinanotherfield.
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EXECUTIVESUMMARYNOVEMBER2015(Continued)
80%ofagenciessurveyedindicatethatDSPstaffturnoverandpoorretentionisalreadyaseriousproblem,withunattractivewagescitedasoneofthebiggestchallengestorecruitandretainworkers.DSPwagesturnoverisalreadycloseto20%peryear.
WeaskGovernorAndrewCuomoandthestatelegislaturetofundincreasesforproviderratestoincreaseDSPwagesandthewagesforotherlowwagedevelopmentaldisabilitysupportworkerssuchascooksandmaintenanceworkerswhosupportindividualsinthecommunity.
AlmostallofthefundingforprogramsservingpeoplewithdevelopmentaldisabilitiescomesfromtheMedicaidprogram.Unlikeforprofitbusinesssector,notforprofitagenciesdonothavetheabilitytoincreasepricesorreducethereturntoshareholderstoincreasewages.
The20162017statebudgetshouldincludeMedicaidfundingtoincreaseDSPanddevelopmentaldisabilitysupportworkerwagesacommensurateamounttothefirsttwostepsoftheCommissionerofLaborapprovedincreaseinthefastfoodminimumwagethatwillhappenonDecember31,2015andDecember31,2016.
FundingthesewageincreaseswillincentivizequalifiedandcompassionatepeopletopursueemploymentinaprofessionthathelpsmorethanonehundredthousandNewYorkerswithdevelopmentaldisabilitiesleadproductive,fulfilling,andsafelivesintheircommunities.
Specialeducationprovidersservingchildrenwithdisabilitiesfacesimilarobstacles;yearsofstatefundingfreezesorpaltryincreasesthatpreventsincreasingthewagesforlowpaidteacherassistantsandteacheraidsatspecialneedspreschoolsandschoolageprograms.Theseprogramsfacesimilarstaffingchallengestoovercomerecruitmentandretentiondifficulties.
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WHOAREDIRECTSUPPORTPROFESSIONALS?DirectSupportProfessionals(DSPs)assistpeoplewithdisabilitiestoleadproductivelivesandtoparticipatefullyintheircommunities.DSPsareemployedbyproviderorganizationstoprovidesupportservicestomanyofNewYorksmostvulnerablecitizens.DirectSupportProfessionalsworkingroupresidentialsettings,independentapartmentsandhomes,andinrecreationalandtherapeuticdaysupportsettings.Theyarecaringandcommittedindividualsworkinglonghourstoprovidenecessarycare,24hoursaday,toindividualswithdevelopmentaldisabilities.Theyfindtheworkthattheydosupportingtheseindividualsfulfillingandrewardingandofteneffectivelyserveaspartoftheirextendedfamily.DIRECTSUPPORTPROFESSIONALS(DSPs)ASSUMENUMEROUSRESPONSIBILITIESDSPshavetheresponsibilitytoensurethatpeoplewithdevelopmentaldisabilitiesaresafe,leadfulfillinglives,andreceiveattentionforcomplexmedicalandtherapeuticneeds.
DSPsprovidethesupervisionandcoordinationnecessarytomanagethedailyactivitiesofthepeopletheysupportsuchaseating,dressing,hygiene,employment,andrecreation.
ADSPsupportsthedeliveryofphysicalandbehavioralhealthservicesinbothroutineandcrisissituations.ThisrequiresDSPstonavigatethehealthcaresystemwhileworkingwithmedicalprofessionalstoadministermedicationsandattendtoavarietyofcomplexmedicalneeds.
DSPsteachindividualslifeskillssuchashomecareactivities,foodpreparation,personalcaremanagement,moneymanagementandsocialmanagementskills.
DSPsareadvisors,assistingindividualsinmakingcomplexdecisions.
DSPsserveascompanionslisteningtoandsupportingindividualsinsocialoutingsand
gatherings.Formanyindividuals,DSPsareacriticalpartoftheirextendedfamily.
BeingaDSPisphysicallystrenuouswork.Itofteninvolvestheliftingandmovingofindividualsintheperformanceofdailyactivitiessuchasbathing.DSPsprovidewalkingassistanceandhelppeoplewithlimitedmobilityandinwheelchairsgetaround.
DSPstransportindividualstomedicalappointments,therapeuticprogramming,jobs,aswellasrecreationalactivitieswithinthecommunity.
DSPsmustbeproficientinunderstandingandcommunicatingcomplexinformationtoothersviadailylogs,progressreportsandotherelectronicmechanisms.Theymustdealwithanenormousburdenofpaperworkessentialtoregulatorycompliance.
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DIRECTSUPPORTPROFESSIONALSMANAGECHALLENGINGSITUATIONSProvidingsupportservicestoindividualsisnotanentryleveljob.Itdemandsanexperiencedworkforcethatispatient,compassionate,andresilient.DSPshelpindividualsachievedignitybysupportingActivitiesofDailyLiving(ADLs).
DSPsassistinfeedingpeoplethatmayneedit.
Theyaddressandmayassistinmeetinghygienicneedssuchasbathing,teethbrushing,toileting,hairgroomingandhelpingindividualstogetdressed.
DSPsaretrainedtoknowhowtodealwithcombativebehaviorsthatincludescreaming,yelling,cryingandaggressivephysicalcontactandexpressions.
DSPshelppeoplewithdisabilitiesbuildrelationshipsincludingmoderatinganddeescalatingvolatilepeersocialinteractions,ensuringasafeandhealthyenvironment.
DIRECTSUPPORTPROFESSIONALSRECEIVEEXTENSIVETRAININGSANDCERTIFICATIONSInthewordsoftheNYSOfficeforPeoplewithDevelopmentalDisabilities(OPWDD)DirectSupportProfessionalsarethecoreofNewYorkssystemofsupportsforindividualswithdevelopmentaldisabilities.Theirjobsrequiretechnicalandvaluesbasedskillsthatmakelifechangingdifferencesinthelivesoftheindividualstheysupport.DSPsmustthereforereceiveveryintensivetraininginawidevarietyofcriticalareas.ThecorecompetenciesforDSPscanbefoundontheOPWDDwebsiteat:http://www.opwdd.ny.gov/opwdd_careers_training/training_opportunities/core_competencies.Afulllistoftrainingsrangingfromabusepreventiontoeldercareisavailableat:http://www.opwdd.ny.gov/node/3653.
CHECKSANDBALANCES:OVERSIGHTANDREGULATORYSYSTEMSCaringforandprovidingsupportservicestovulnerableindividualsissubjecttotheoversightofmanyentitiestoprotectthesafetyandwellbeingofindividualswithdevelopmentaldisabilities.DSPsandtheiremployersareheldtothehigheststandardsofaccountability.Thisrequiresthemtonavigatealengthyandcomplicatedjobapplicationprocess,includingacriminalbackgroundcheck.ThemultipleregulatorylayersmonitoringandoverseeingDSPsinclude:
Internalmechanisms
administeredbyproviderorganizations
Levelsofsupervisoryandmanagementoversighttoincludeaninterdisciplinaryteamofprofessionals
QualityAssuranceteams NewYorkStateOfficefor
PeoplewithDevelopmentalDisabilities
NewYorkStateJusticeCenterfortheProtectionofPeoplewithSpecialNeeds
AuditsandoversightbyavarietyofagenciesincludingtheInspectorGeneral,OfficeoftheStateComptroller,andNYSAttorneyGeneral.
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Trainingsinclude:
Annualtraininginmedicationadministration,firstaid,CPR,safebehavioraldeescalationandintervention,safety,andOSHAregulations.
TraininganddemonstrationonthejobinCoreCompetenciesadoptedbytheNYSTalentDevelopmentConsortium.TheCompetenciesarebrokendownintosevengoalscoveringallaspectsofanindividualslife.
TraininginaCodeofEthicscurriculumdevelopedbytheNationalAllianceforDirectSupportProfessionals(NADSP)tofacilitateandcopewithethicaldilemmasfacingindividualsconsistentwiththehighestprofessionalstandards.
DIRECTSUPPORTPROFESSIONALSAREDIFFICULTTORECRUITANDRETAINProvidingsupportservicesfor100,000NewYorkerswithdevelopmentaldisabilitiesandtheirfamiliesisanenormouschallengeforproviderorganizations.NonprofitproviderorganizationsrelyonDSPsforthehandsonsupport,withoutwhichtherewouldbenocare.ButtheintensedemandsofbeingaDSPleadtohighturnoverrates.ProviderorganizationsmustcompetewithotherindustriesinrecruitingDSPs,particularlythefastfoodindustrywhichhasrecentlybeenmandatedtoimplementa$15perhourminimumwage.Asthefollowingchartillustrates,thefastfoodindustryconstitutesahugeworkforcewithmanypotentialjobopportunitiesforthoseDSPswhofeeloverburdenedandunderpaid.
NYSFastFoodWageBoardDatawasusedtoestimatethattherearebetween101,700and124,000fastfoodworkersatchainrestaurants.
010,00020,00030,00040,00050,00060,00070,00080,00090,000100,000110,000120,000
NUMBEROFDSPs FASTFOODWORKERS(ChainRestaurants)
MagnitudeoftheDSPWorkforceinNYS
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Morethan80%ofagenciessurveyedindicatethatDSPstaffturnoverandpoorretentionisaseriousproblem.
HumanServiceprovidersarealreadyexperiencingsignificantchallengesrecruitingand
retainingstaffduetoanimprovingeconomyandatighteningjobmarket.
Agenciesreportedneedingmorethan5,300DSPstofillpositionscreatedbyastatewidevacancyrateof8%.
o
ThisshortageofDSPsresultedinmorethan2.9millionovertimehoursatthe131respondingagenciesduring2014.
Agenciessurveyedreportaoneyearturnoverrateof19%forDSPs,requiringaninvestmentof$5,000intrainingandothercostsforeachnewemployeehiredtofillthosevacancies.MajorimpedimentstorecruitmentandretentionofDSPsincluded:
o Wageandbenefitpackagesthatwerenotattractiveo
Insufficientnumbersofqualifiedapplicants
ArecentsurveybytheUniversityofMinnesotaindicatesthattheaverageturnoverratefor
DSPsinNYSis25%annually,amongmorethan130communitybasedprovidersofservicestopeoplewithdevelopmentaldisabilities.
DSPTurnoverImpactsSupportsforPeoplewithDevelopmentalDisabilities
VerySeriousProblem SomewhatSeriousProblem Other
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COMPENSATIONFORDIRECTSUPPORTPROFESSIONALSDirectSupportProfessionalsassumenumerousdailyresponsibilitieswhichtheymustperformaccordingtothehighestprofessionalstandards.Theyworkunderthestrictscrutinybymultipleoversightagencies.Theirworkiscriticaltothewellbeingandsafetyofthethousandsofpeoplewithdevelopmentaldisabilitiestheyserve.However,withoutpayingthemadecentwagerecruitmentandretentionissuesposeanenormousthreattothepeoplewithdisabilitieswhorelyonDSPs.AccordingtoCMSToolkit,CoverageofDirectServiceWorkforceContinuingTrainingwithinMedicaidPolicyandRateSetting,Linkingwageincreasestoworkersadvancementintrainingprograms(i.e.careerpathways,apprenticeships,credentialing,orcertificationprograms)representsanimportantcoordinatedstrategythatmaybeimplementedonthestatelevel(HarrisKojetinetal.,2004).OfferingbenefitpackagestoemployeesincludingDirectServiceProfessionalshasproventobeausefulrecruitingtoolinthepast.However,changesinhealthcarecoverageforallemployeeshassomewhatreducedtheeffectivenessofbenefitsasarecruitmentstrategyputtingmorepressureonbetterwagestorecruitandretainemployees.AsNewYorksminimumwageincreases,alongwithchangesinwagesfortheFastFoodindustry,itwillbemoreimportantthanevertoproportionallyincreaseDSPwagestoattractqualityprofessionals.
0%
5%
10%
15%
20%
25%
30%
NYSStudybyUofM ProviderSurvey
MultipleSourcesHighlightHighAnnualDSPTurnover
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GOVERNMENTSROLEANDRESPONSIBILITYOrganizationsthatprovideservicestovulnerablepopulationshavelittletonocontrolovertheirabilitytoincreaseDSPwages.Mostareheavilydependentuponfundingfromgovernment,especiallyNewYorkStatesMedicaidprogram.Infact,90%offundingforprogramsservingpeoplewithdevelopmentaldisabilitiesisMedicaid.Increasesinwagescanonlybeachievedwhengovernmentdecidestofundsuchincreases.Therefore,aminimumwageincreasedependsalmostentirelyonincreasesingovernmentrates,feesandcontracts.
NewYorkState,inconjunctionwiththefederalgovernmentwhichpays50%ofMedicaidcosts,hasanobligationtoprovidesufficientfundingsothatDSPscanmakeafairwage.
A2%COLAforDSPsequatestoapproximately20centsperhour.
Anincreaseintheminimumwageforonlyonesegmentoftheworkforcewillgivethefastfoodindustryaninsurmountablecompetitiveadvantageinattractingemployees.
0%5%10%15%20%25%30%35%40%45%50%
RecommendedIncreasein
MinimumWageforFastFoodWorkers
(NYC)
RecommendedIncreasein
MinimumWageforFastFoodWorkers(outsideofNYC)
TotalWageIncreaseFundingForDSPsOverLast
EightYears
FastFoodWageIncreasesWillLeaveDSPsBehind
2015
2016
2017
LastEightYears
BEYONDWILLOWBROOKTHEROADTOREALIZINGTHEDREAMThe1978WillowbrookConsentDecreeledtothesubsequentclosureofWillowbrookStateSchoolonStatenIslandafterthedisclosureofthehorrificconditionsatthatandotherinstitutionsservingpeoplewithdevelopmentaldisabilities.
TheaftermathofWillowbrookledtoarevolutionincareforpeoplewithdevelopmentaldisabilities.ItbroughtthemoutofinstitutionsandintocommunitiesthroughouttheStateandnation,restoringtheirrightsasfullcitizens.Todaythatrevolutioncontinuesthroughajointfederal/StateinitiativeknownastheTransformationAgenda.ThroughittheStatealong,withtheCentersforMedicare&MedicaidServices(CMS),haveidentifiedaseriesofsharedgoalstoimproveopportunitiesforindividualswithdevelopmentaldisabilitiesintheareasofemployment,integratedliving,andselfdirectionofservices.MeetingthegoalsofthisinitiativewillrequiretheservicesofahighqualityDirectSupportProfessionalworkforce,whichispaidafairwage.
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EvenexperiencedDSPswillfeelthepinch.Thedifferencebetweentheaveragesalaryandthestartingsalaryrepresentstheincreasesthatproviderscanpaytoemployeesastheygainexperienceandexpertiseovertime.Providersneedtonotonlybeconcernedwithhowentrylevelwagescomparetotheproposedfastfoodminimumwage,butalsomaintainingthespreadbetweenentrylevelwagesandaveragewagestomaintainthecareerladdersandincrementalpaydifferentialsthathavebeenachievedbymanyexperiencedDSPs.
Unlikeprivateindustry,notforprofitagenciesthatsupportpersonswithdevelopmentaldisabilitiescannotincreasethewagesofDSPswithoutacorrespondingrateincreasefromtheState.
0 2 4 6 8 10 12 14 16
AverageStartingDSPWAGENYCmetroareaAverageStartingDSPWAGE2014HudsonValley
Recommended2017FFMinimumWage(NYC)AverageStartingDSPWAGE2014Region3UpstateAverageStartingDSPWAGE2014Region4Upstate
Recommended2017FFMinimumWage(outsideofNYC)
FastFoodWorkersWillHaveSignificantlyHigherStartingSalariesThanDSPs
DSPs FFWorkers
10 11 12 13 14 15 16
$15FastFoodMinimumWage
Average2014DSPWageNYCMetropolitanArea
Average2014DSPWageHudsonValley
Average2014DSPWageRegion3Upstate
Average2014DSPWageRegion4Upstate
WithoutEquitableIncreases,EvenExperiencedDSPsWillFeelthePinch
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WHATCANBEDONE?FundingminimumwageincreasesfortheprofessionalswhosupportpeoplewithdevelopmentaldisabilitiesDecentpayforDSPsmustbeanobjectofintenseadvocacyinthefaceofchangestotheminimumwagefortheentireworkforceingeneralandfastfoodworkers,inparticular.WeaskGovernorAndrewCuomoandthestatelegislaturetofundincreasesforproviderratestoincreaseDSPanddevelopmentaldisabilitiessupportworkerwagesandincentivizequalifiedpeopleeagertotakeonthisintegralroleinsupportingourStatesneediestcitizens.The20162017statebudgetshouldincludeMedicaidfundingtoincreaseDSPwagesandthewagesofdevelopmentaldisabilitysupportworkerssuchasdrivers,cooks,andmaintenanceworkersacommensurateamounttothefirsttwostepsoftheCommissionerofLaborapprovedincreaseinthefastfoodminimumwagethatwillhappenonDecember31,2015andDecember31,2016.
CONTACTUSMargaretRaustiala KatieMayoALIA
AssociateExecutiveDirector(631)5211458 NYSACRA
[email protected] (518)4497551 [email protected]
BarbaraCrosier VP,GovernmentRelations BenGoldenCPNYS
Assoc.ExecutiveDirectorfor(518)4360178
[email protected] NYSARC,Inc.
(518)4398311J.R.Drexelius,Jr.
[email protected] DDAWNY
MichaelSeereiter(716)3167552 President/CEO [email protected]
NYSRA (518)4492976WinifredSchiff
michael@nysrehab.orgAssoc.ExecutiveDirectorforGovernmentalAffairsIACNY(212)[email protected]
SCHOOLSSERVINGSTUDENTSWITHDEVELOPMENTALDISABILITIES(4410&853)
Preschoolandschoolageprogramsforpeoplewithdevelopmentaldisabilitiesfaceasimilarworkforcestruggle.Asurveyof96providersthatservemorethan17,000studentsshowsagrowingvacancyrateforteacherassistantsand/orteacheraides(CFRcodes228,230,232,243,265).Thesejobstitlesrequireskilledindividualswhoareresponsibleforprovidingdaytodaysupportforchildrenwithcomplexneeds.Morethan60%oftherespondingschoolsindicatedthatretentionandturnoverofteacherassistantsandaideswasaseriousproblem.Manyagencieshavestartingsalariesthatareclosetothecurrentminimumwageandaveragewagesforsomejobtitlesareinthe$11to$13dollarrange.Theseschoolsarealreadystrugglingwithyearsofnearlyflatfundingthatdoesnotkeeppacewithcostincreases.Morethanhalfofrespondentsindicatedtheywillhavetoincreasestartingsalariesforsomepositionsasof12/31/15,despitealackoftuitionincreases,tomatchthenewrequiredminimumwageforfastfoodworkers.TominimallykeeppacewiththealreadyapprovedincreasesinminimumwageforfastfoodworkersinNewYorkState,tuitionreimbursementforthevariousteacheraide/teacherassistantpositionsmustbeincreasedacommensurateamount.
