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Adults with IDD were let down by Pennsylvania's policies and then left behind by inflation

Struggling to keep up with rising costs this year? Support staff working with adults with IDD have struggled for more than a decade. And there is no end in sight, unless we pass HB 661 and SB 684.


We have all seen the headlines - prices for everything have continued to rise. The Consumer Price Index in the Mid-Atlantic region increased by 5% between April 2022 and April 2023. And this is good news compared to almost 13% increase experienced between the onset of COVID in March 2020 and April 2022. Consumers had not seen comparable inflation rates for more than 40 years. But after a rocky ride, the labor market has started to correct itself, and increases in wages have closed the inflation gap everywhere.... unless you are someone providing direct support to adults with Intellectual and Developmental Disabilities (IDD).

No such correction has occurred for families and professionals struggling to serve adults with IDD. In fact, wages for front-line IDD staff - the Direct Care Professionals (DSPs) - have barely budged since 2011. While federal policy regarding the Medicaid waivers used to pay service providers recommends that the rates paid to providers be periodically reviewed and updated in the light of inflation and other factors, it does not require this. And so Pennsylvania's Department of Human Services (DHS) - responsible for administering waivers intended to help people with IDD - has not done so regularly.


Part of the current crisis can be traced back to 2011, when DHS implemented sweeping changes to its payment system, the net effect of which was that wages paid DSP's were cut from $16/hour to $10/hour for a position with benefits. Twelve years later, adult service providers are reporting to us that some of their DSPs now earn... $16/hour, and not necessarily with benefits. Other changes to the system of payments resulted in cuts to other services these providers offered, with the result that many report having to raise 10-20% of their operating budgets from private donors just to make ends meet.


DHS has sought to mitigate COVID's impact with supplemental pay (included in the rates described here), and recently elected to extend this. But this did little to address more than a decade of neglect. And for agencies, this came nowhere close to making up for the tremendous expenses they incurred to keep their doors open throughout COVID. Taken together with increasing labor shortages in the education and human services, DHS' supplemental pay it is like a bandaid for gangrene.


Advocates have been pushing for years to close the ever-widening wage gap, and most recent estimates place the cost of catching up at now more than $400M. Though Governor Shapiro completely failed to address this gap in his proposed budget, legislators have stepped in with proposals to at least slow the spread of the gangrene. HB 661 was introduced in the Human Services Committee in March by a bipartisan group of legislators, with a companion bill in the Senate (SB 684) introduced by Democrats in May, These bills would require that rates paid to Direct Support Professionals - the backbone of IDD Waiver-funded workforce - be adjusted on July 1st every year to keep up with inflation. In 2023, this would likely result in a 4 to 5% increase.


HB 661 and SB 684 will not close the wage gap, but at least they will prevent it from widening. Urge legislators on the Human Service Committee in the House and in the Senate to move these bills out of committee to the floor for a full vote. We think that the legislature WILL pass these if given the chance. If we cannot begin treatment, we can at least stop the bleeding.

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