Care providers for those with developmental disabilities across Florida are sounding an alarm as a major federal funding deadline for their services approaches.
Both state institutions and private community-based providers rely on the work of “Direct Support Professionals,” minimum-wage workers who are tasked with the care of patients with disabilities, with responsibilities ranging from helping patients dress to administering medication.
Florida Gov. Ron DeSantis’ new budget raised the minimum wage for state workers at developmental disability institutions to $13 an hour, effective July 1.
But advocates at not-for-profit care providers like The ARC of Alachua County say this will draw workers away from their organizations and leave those who rely on these caretaker services to be institutionalized.
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Mark Swain, the organization’s CEO, said community-based services like the ARC’s provide care that isn’t matched at state institutions.
“Institutional care is the worst care you can get at the highest price,” he said. “But that’s where the money is going.”
The ARC can only afford to pay its DSPs less than?$11 an hour, an amount influenced by state and federal funding. Through the Florida Medicaid assistance percentage, 60% of services arranged by community-based providers are paid for by the federal government, with the remainder paid by the state.
Recently through the American Rescue Act, a $1.9 trillion economic stimulus passed by Congress in March, $450 million in federal money was earmarked solely for community-based services in Florida.?
But after filing for a deadline extension this month, the state has until July 12 to accept this money before it vanishes.
“It literally will not cost Florida any more money,” Swain said. “But if they don’t do it, Florida is going to be in more of a hurt than they’ve ever been in.”
Swain said he gets client referrals from all over the state but isn’t able to even consider them. The ARC has six open slots in one of its group homes but is down 55 staff members, making the care provider stretched too thin to take on new clients.
“And we desperately need that revenue,” he said. “We can’t take them — we don’t have the staff.”
Swain said these referrals come from families of those with developmental disabilities who are travelling across the state to find a provider that can help.
“There’s people just floating right now,” he said. “There’s no place to go.”
Swain said his DSPs have been working 100 hour-a-week shifts since the pandemic began, which led to burnout and people quitting.
But this DSP shortage predates the COVID-19 pandemic. The ARC of Alachua County was short 24 workers before more started leaving due to added stressors during the pandemic. Swain said he needs 160 DSPs to run at full capacity, but only has 105 at present.
“It’s low wages and then COVID just doing this,” Swain said, clamping?his hands together.
In summer 2020, the ARC was giving $100-a-week bonuses to DSPs just to show up for their shifts.?
In November, Swain managed to get $250,000 in CARES Act money from the Alachua County Commission to help cover those costs.
The Florida Legislature fixes reimbursement prices for services, meaning not-for-profit providers cannot raise or lower the prices of their services, Swain said.
“We can’t do anything,” he said. “All we do when time gets tough, we’ll have to do raises as best we can and then we just lose money to do it and you can’t have a bake sale to make it up.”
Ultimately, Swain said, this burden falls on the disabled, who won’t get the care they need.
“There’s a lot of families that depend on these services,” he said. “Families count on us.”
With state money funneling into institutions, the only hope to keep community-based providers afloat is getting the state to accept the federal funds. Any reservations Florida might have about accepting the federal money come from the state’s accountability, Swain said. He compared the situation to Florida choosing not to expand Medicaid.
“They want to make sure there’s no bad strings attached or anything like that, which there’s not,” he said.
On June 29, community providers across Florida met with disability agency heads and the governor’s office to provide a two-year plan that would allow these not-for-profits to match the $13 hourly wages already committed to state workers.
Alan Abramowitz, CEO of The ARC of Florida, said 60 group homes across Florida closed between March and May 2021.?
“I have faith the administration will do what’s best for the people that are some of our most vulnerable,” he said.
Even if all goes well, community-based providers still have to convince their workers to stay on while promising to match the raises that the state will already have given its workers. With a worker shortage across the country, community providers also have to compete with higher wages in the service industry–McDonald’s now pays $12 hourly wages.
“(DSPs) really care about who they’re serving and, you know, they want to stay, but it’s hard,” he said. “You’ve got a family too and there’s other positions that do similar work in institutions that pay more. I mean what is the person likely to do?”
Swain said the federal funds would do exactly what they are intended to do — stabilize community-based providers.
“What we would do is increase pay for DSPs and hopefully get people back,” Swain said. “And then hire some more because these people deserve to make more.”
The DSP workforce is made up primarily of women and women of color who earn an average annual income of $19,000, according to a report by the Paraprofessional Healthcare Institute.?
“It’s a systematic bias,” Swain said.
Gerald Simmons, now serving as The ARC of Alachua County’s assistant manager of production, started at the not-for-profit seven years ago.
“It became very, very rewarding for me because I came from an environment of unadulterated evil, and the persons here are so innocent,” he said.
Simmons worked for 30 years in forensic mental health at the North Florida Evaluation and Treatment Center, where he said he worked with the “Ted Bundys” and “Jeffrey Dahmers.” Within four to five months of starting at the ARC, Simmons was named employee of the month.
“Whatever role that I had to play, whatever I needed to do, to make sure we’d be successful,” he said. “Because this thing is bigger than us. It’s not about us, it’s not about the staff. It’s about the clients that we serve.”
But without state cooperation to solve the problem of low wages, community-based services like the ARC could start disappearing.
“We’ve been here since 1966 and we’re about to get plowed,” Swain said.