“If you had to hire someone to provide essential care for your disabled child or parent, do you think that you could find anyone you could trust for $10.60/hour?”

FOR IMMEDIATE RELEASE

August 13, 2024

Contact: [email protected]

AUSTIN, TX – In case you missed it, last week advocates from across the state made their voices heard during the Texas Health and Human Services Commission (HHSC) public comment period on the agency’s rate methodologies, including those that impact reimbursement rates for direct support professionals (DSPs) serving Texans with intellectual and developmental disabilities (IDD). The advocates made clear that HHSC’s flawed methodology in calculating how these facilities and their staff are reimbursed for services has not kept pace with inflation, leading to an untenable wage reimbursement rate of $10.60 an hourthat has led to a full-blown workforce crisis among those who serve Texans with IDD in community-based settings.

Texas-based advocates voiced their concerns and called for reform during public commentsessions hosted by HHSC on Thursday, August 8th, and through letters that highlighted the urgent need to reform the agency’s flawed rate methodology to help address the ongoing DSP workforce crisis:

“Is there any job you would do for $10.60/hour? If you had to hire someone to provideessential care for your disabled child or parent, do you think that you could find anyone you could trust for $10.60/hour? You know that the answer to both questions is no. Not maybe. Not hopefully. It’s no.” 

– Mark Olson, President & CEO, LTO Ventures

“It’s just, it’s heartbreaking, it’s disappointing because you wait so many years to get the Cadillac of waivers only to find your loved one still has to remain in the home. And to find direct staff to support you in the home at the reimbursement rates currently offered, it’s not sustainable.” 

– Leslie Russell, Parent to a Child with IDD

“I’m proud to be a Texan, but this is shameful to me…I go to my donors to make up the difference. The state pays for about 60% of my actual cost. I go to my donors…the donor shouldn’t have to make up the difference…It’s the obligation of the state. The state needs to be doing this, but we cannot do it with the current rates.” 

– Debra Caudy, Founder & CEO, 29 Acres

“The current rates and the assumptions behind them have imposed unsustainable cost burdens on providers, negatively impact the retention and recruitment of DSPs, nurses, and other essential staff, and threaten the viability of our service system. This situation endangers the IDD population and risks the health and safety of our state’s most vulnerable residents.”

– Rolando B. Pablos, Former Texas Secretary of State

“People with IDD, their families and advocates fought hard for their right to live in the community, in the least restrictive environment. To now see families and advocates of people with IDD increasingly supporting their admission to an institutional setting simply because of a lack of options is tragic…People should not be at risk of being institutionalized simply because community providers are unable to hire or retain staff due to an inadequate funding methodology.”

– Ken Winston, Director of IDD Services, Integral Care

“My greatest concern is about the insufficient rates that we’re having to use, and because of the insufficient rates, it’s making it very difficult for us to recruit and retain direct support professionals, supervisors, quality assurance staff and nurses…Six years ago, we had six intermediate care facilities. We’re now down to one. And the reason for that – the main reason for that – is the fact that we were not able to recruit and retain direct support professionals, which are needed to be able to support the individuals in our home.”

– Sandra Taylor, IDD Director, Community Healthcore

“We have a workforce shortage that is affecting the quality of life of the people that we support across the state, and putting an undue burden on law enforcement, because that is the only option, in some cases, for a staff who’s at a home with four people to deal with an issue when one of them runs out the door. So, I don’t think Texas is benefiting from the fact that we’re not paying HCS providers enough to pay their direct support staff a living wage. I would be interested to see the increase in law enforcement involvement in these cases over the last three years. The outdated rate methodology and the failure to adjust for inflation and increased cost in wages, food, gas, property, vehicle maintenance, result in inadequate funding for necessary services and resources to give people with intellectual disabilities a minimal quality of life.”

– Sheryl Baker, Chief of Aging and Disability Operations, StarCare Lubbock

“I’m not going to say much about the wages. Everybody knows that you can flip hamburgers for $8 more than the wages… I’m 70. My husband is 77, and every year, wehave to do more lifting of our quadriplegic daughter instead of less because of the wages…Group homes are closing, and they have a very short fuse for behaviors, and so our families are getting kicked out of group homes, and sometimes the way they do it is to call the police. And that puts them in jail, and that means that they languish in jail until they can wait, not a week, not a month, but years for competency restoration, which is a required program before you can have your hearing. So this group home closure is triggering a much larger problem.”

– Linda Litzinger, Public Policy Coordinator, Texas Parent to Parent

“For starters, the rates are simply insufficient and do not allow for a livable wage for staff…Providers are facing extreme difficulties recruiting a full roster of DSPs, supervisors, nurses…and we are struggling to retain those that we do have. This issue is further exacerbated as the cost of living rises, while the rates have not been updated to reflect this change. A shortage of staff, specifically qualified staff, hinders the quality of care for individuals served who are at the heart of all of this, and it also destabilizes their daily routines as individuals are continuously having to reacquaint themselves with an ever–changing staff roster.”

– Alison Petro, Business Finance Manager, Sevita Health Texas

“Our staff deserve increased wages and funding at appropriate rates. In addition, if we can’t hire them, we also are having difficulty retaining them. It is crucial for ensuring health and safety of people with IDD that we have experienced staff with years of expertise working with them. Experienced staff in our field are fleeing in droves to opportunities that pay enough to support their family. We recommend that you model compensation, including benefits, on state supported living centers where staff qualifications and responsibilities are very similar.”

– Kathy Griffith, Director of Government and Regulatory Affairs, Caregiver, Inc.

“The existing rates are insufficient to recruit and retain DSPs, supervisors, quality assurance staff, and nurses. This results in a severe workforce shortage that destabilizes care for individuals with IDD and compromises service quality.”​

– Katherine Morrow, Founder, Paul and Katherine Morrow Family Foundation

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“As a concerned Texan, I urge you to take immediate action to address these critical issues with current rates and rate methodology. It is essential to better support community-based services and the DSPs who provide indispensable care for many of our fellow Texans who cannot care for themselves.”

– Henry B. Gonzalez III, Partner & Lawyer, Gonzalez Chiscano Angulo & Kasson PC

“Recent updates to the labor laws…such as the new federal overtime rules, have introduced additional costs that current reimbursement rates do not cover, which is why these rates urgently need an update to account for these new financial burdens…We’re a nonprofit, and we’re struggling to make up the difference between what we’re paid for by Medicaid. And my question is…why philanthropists in the state of Texas have to take up the slack in our own state Medicaid waiver program? Our lawmakers will not appropriately fund this program to pay for the most vulnerable in the state of Texas.”

– Lisa Brodsky, CEO, Community Homes for Adults, Inc. Dallas

“Understanding that Direct Support Professional task responsibilities are the same in the State Hospitals and State Supported Living Centers as those in the ICF/IDD and HCSprograms that are suffering from the same recruitment and retention problems, why hasthe State of Texas chosen not to offer the same solution with provider rates that allow forpayment of the higher salaries of $17.50 to $21.00 per hour in those programs?”

– Toby Summers, Former CEO, Mission Road Ministries

“HHSC is out of touch with the IDD community-based services. These rates are fueling this crisis. Providers are closing their doors or reducing capacity. Many across the state are considering closing altogether. Texas is neglecting the community-based IDD population…HHSC was able to determine adequate rates to meet the current inflationary and economic climate facing the state-supported living centers. It’s past time to do the same for the community-based IDD providers.”

– Larry Hill, CEO, Hill Resources

“HHSC has, in fact, failed families, people with IDD and providers within sufficient rates the last 20 years, and thus have failed to protect the opportunity for people with IDD to thrive in the community…HHSC seems to be begging for another lawsuit for ignoring the needs of not just people with IDD, but seemingly all people with disabilities needing supports from the state system. Why not forgo the time and cost of a lawsuit and just fund the program so people with IDD and other disabilities can actually thrive in the communities in which they live with, the friends they’ve come to love and with provider staff with which they can build a long–term relationship.” 

– Carey Amthor, Division Director of IDD Services, Heart of Texas MHMR Center

“We’re having a hard time as providers, providing the care to these individuals that they (a) deserve and (b) need…The cost of food, the cost of transportation, the cost of utilities, you name it, all across the board, has gone up to the point to where the reimbursement that we’re getting is just not sufficient…It’s just a dire situation… we could definitely use some kind of change in the methodology to raise our reimbursement rates so that we can pay the staff to adequately care for the individuals that we serve.”

– Jay Shannon, Administrator, Trinity ICF

“The low rates have a direct (negative) impact on both residents and staff, but in addition to that, these low rates are directly and indirectly increasing costs for the Commission as well. State government directly pays out millions of dollars by way of assistance but indirectly is spending millions of dollars investigating these extremely high abuse and neglect cases, as well as oversight for providers unable to meet standards due to workforce shortages. By increasing rates three things will happen: Texans needing services will be safer and able to live life abundantly; Texas providing services will be fulfilled and able to make ends meet with less reliance on government assistance programs, and state government will be able to spend money on more focused and positive outcome programs as good stewards of taxpayer dollars.”

– Melissa Perkins, Executive Director, Breckenridge Village

To learn more about the Time to Care coalition and the urgent need to deliver competitive wages for community-based DSPs serving Texans with IDD, please visit www.timetocaretx.org. 

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