Over 40 providers of services for individuals with intellectual disabilities and autism (ID/A) have co-signed a public letter calling on the Pennsylvania General Assembly (“GA”) to increase funding for home- and community-based services (HCBS). Their editorial opinion, published in several papers, outlines the need for increased financial support. It also details the advocacy efforts they’ve undertaken to convince the GA to increase HCBS funding as they complete 2022 budget work. Here, we take a look at their reasoning, advocacy efforts, and specific recommendations, as well as the result of their efforts.
Core Funding Need
The opening of the letter makes clear the core need for increased funding: a crisis around hiring and retaining direct service professionals (DSPs):
“As leaders of intellectual disability and autism (ID/A) services, we have been raising our voices about the unsustainable staffing/direct support professional (DSP) crisis in our community.”
This issue impacts those with ID/A and I/DD (intellectual and developmental disabilities) and is not unique to Pennsylvania. It has been identified as a national crisis, particularly as a result of the COVID-19 pandemic. One commonly identified issue for a crisis-level turnover rate and staffing shortage: wages that are too low. According to a whitepaper from the University of Minnesota:
“All the progress toward community living that has been made in services for people with IDD over decades is now in jeopardy — because of catastrophic labor shortages and pervasive high turnover rates in the workforce that supports them, direct support professionals (DSPs).”
Although the national average for DSPs is $11 per hour, a rate that is based on federal and state funding, some Pennsylvania providers have used emergency funds (such as those provided via ARPA) to raise their rates to $15.50 per hour. Their hope: that the higher compensation will increase retention rates.
Advocacy Efforts
The providers’ public letter cites advocacy efforts they and others have taken to ensure the GA provides adequate funding for DSPs as they consider budgeting for HCBS. They highlight the efforts of parents who have spoken to legislators about the emotional, physical, and financial strain put on their families due to lack of DSP availability.
They also highlight their own efforts to enact change, wherein various providers have met with legislators to share stories of those impacted by the crisis, including:
- Individuals with I/DD who cannot access the support they need due to staffing shortages;
- DSPs who continued to work through the pandemic, despite the emotional and financial burden it placed on their families;
- A shift from having dozens of applicants to choose from each hiring round to experiencing a dearth of qualified candidates;
- Seeing more than 60% of DSPs leave during the first year on the job because the pay is too low to be sustainable for their families.
In the wake of these advocacy efforts, public support has been strong. In fact:
“In the last year, almost 170 feature stories, editorials, and op-eds have been published by news outlets drawing attention to this crisis and how this budget could bring stability to this area.”
Funding Recommendations
The funding recommendations outlined by the providers for the Pennsylvania GA are as follows:
- Increasing state funds by $65 million to ensure DSPs working in the community can be compensated at the same rate as DSPs employed by the state; and
- Committing to keeping compensation rates current with inflation through the creation of an annual index.
The Result
Although falling after the intended June 30 deadline, the Pennsylvania GA has approved a budget in collaboration with the Governor. Two positive outcomes include:
- An investment in the Property Tax/Rent Rebate Program, which will allow Pennsylvania residents with a disability to access a rebate that can offset their tax or rent payments by $200-$650, depending on their income.
- An investment in Recurring Medicaid Funding, which can be combined ARPA dollars to support “vulnerable seniors, frontline caregivers and long-term care providers throughout the commonwealth.”
Although not every suggestion or recommendation provided by advocates was enacted, Rehabilitation & Community Providers Association (RCPA), an advocacy group located in Harrisburg, PA ultimately provided an optimistic view of the budget outcome, saying “…the funding boosts we did receive will help human service providers that have faced chronic underfunding for years.”
Even more importantly, they see the success of providers’ efforts as a stepping stone to future changes and legislative wins. For their full wrap, including specific budget priorities, click here.