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Programs for adults with IDD: Handcuffed and drowning in a staffing crisis

Other programs have a competitive edge in addressing their staffing crisis: they can raise wages. If we cannot at least pass HB 661 and SB 684, the crisis in programs serving adults with IDD will only worsen.

As education, childcare, and home health care programs crawled slowly out of the chaos wreaked by COVID, they faced another problem: staff had left the workforce in droves, and no one seemed ready to fill the jobs they left behind. This general staffing crisis has been cited by officials from the Department of Human Services (DHS) as a major reason for the current shortage of Direct Support Professionals (DSPs) for adults with Intellectual or Developmental Disability (IDD). But DHS officials left out a key fact: every program offering education or childcare - and many that support seniors - can try to ensure that needs are met by increasing wages and passing costs off to users… except for programs serving adults with IDD. While others can stay afloat during the crisis, those relying on DSPs are sinking, handcuffed by state regulators.

Some background… For years, analysts have been sounding alarm bells about the pending staffing crisis that lay ahead for the types of programs listed above. As the last of the baby boomers approach retirement, analysts predicted that every sector of this economy would find vacancies increasingly difficult to fill. This same aging population would itself need more care, increasing growth in support for seniors just as the number of workers decreased. With vacancies increasing across almost every other sector, the traditionally lower-paying jobs in education, childcare, and home/health care would become less attractive to a working-age population with plenty of other easy and more lucrative choices.

COVID simply accelerated all of these trends as more adults chose to leave the workforce earlier, or for better paying or less stressful options. This was especially true for those providing direct services to individuals, who were under pressure to continue to deliver services while complying with ever-changing protocols and coping with high rates of absenteeism as colleagues were exposed or sickened. Most people know - and appreciate - the truly heroic efforts of those who kept hospitals, Fire/ Police / EMS services, and senior living facilities operational throughout COVID. But those who kept hospital and residential programs for those serving individuals with IDD open throughout COVID were also heroic. They are now not only exhausted, but frustrated by wages that have not kept up with inflation.

Post-COVID vacancy rates in education, child-care, and other health sectors confirm these trends, as evidenced by news reports statewide. Consider the teacher shortage being documented from Philadelphia to Pittsburgh, and from Mifflin to Cumberland County. Higher educators report that phe pipeline of teachers has shrunk by 67% since 21011, and in 2020-2021 Pennsylvania issued more emergency teaching permits than new teacher certifications. The emerging gaps are likely to worsen already troubling inequities in accessing a quality education in places like Philadelphia.

Each one of these other sectors has a path to address vacancies by increasing wages. Though painful for parents, childcare providers can pass the costs of wage increases to them. Schools can raise taxes - and indeed are obligated to do so in the case of special education, to ensure that individual student needs are met under IDEA. But those paying the wages of DSPs cannot, because of artificially low rates set by state regulators. When given a choice between already low wages diluted by rising inflation and an opportunity to earn more doing potentially less stressful work, is it any surprise that the workforce serving adults with IDD is sinking?

As more entering the workforce chose to work in education or childcare, the DSP staffing crisis will worsen. The least we can do is to temper this trend by passing HB 661 and SB 684 to keep the wage gaps from widening. The best option? A timely, transparent, market-based re-evaluation of wages to ensure the kind of reasonable and equitable access to services required under federal law, especially in the light of persistently high vacancy and turnover rates and long waiting lists here in Pennsylvania.



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