Further Background - Intellectual/Developmental Disability Services, Workforce and Changes in the Medicaid Program:
By assisting individuals with intellectual and/or developmental (I/DD) with their employment, daily care, social outings, medication and other health needs, I/DD services facilitate individuals’ active and engaged lives in the community, near their loved ones and friends instead of segregated state-run institutions. These services are offered across individuals’ lifespans and are almost entirely funded by Medicaid. In the Medicaid federal-state partnership, the federal government covers a share of the budget laid out by state, and states set fix reimbursement rates that I/DD service providers cannot negotiate. Currently, Medicaid rates are too low for service providers to be competitive employers. The resulting low wages are the lead cause of a workforce crisis in the direct support occupation, with a 45 percent turnover rate nationally.
This means individuals’ needs are unmet because there are not enough direct support professionals to staff them, leading to waiting lists across states. Individuals can wait for years to receive supports, which can take a large toll on their and their families’ well-being. Because the Bureau of Labor Statistics has identified demand for this occupation as one of the fastest-growing in the country, the seriousness of the crisis is unlikely to subside. Providers want to be able to employ more staff, but changes to Medicaid funding could affect their ability to do so and exacerbate the work crisis if proposals do not take into account providers’ need to strengthen the workforce.
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Photos courtesy of ANCOR member PAR's "Fix the DSP Crisis" campaign video. PAR represents Pennsylvania providers statewide. To learn more and see the video, click on the images.