Some insurance companies may be pocketing money meant for raises to alleviate a critical shortage of home care workers.
To comment: TULETTERS@TIMESUNION.COM
New York has a desperate shortage of home care workers to take care of sick, disabled, and frail people. Recognizing that dire situation, state lawmakers and Gov. Kathy Hochul put $7.7 billion in the state budget for wage increases to help retain and attract these vital employees.
But now it looks like hundreds of millions of dollars of that money may end up going to insurance companies that are keeping it for themselves.
It’s a level of greed and opportunism in the face of a crisis that ought to shock the sensibilities of the governor and Legislature. And Attorney General Letitia James should look into whether there’s a civil or criminal case to be made here. Even it it doesn’t rise to criminality, it’s as offensive an abuse of public funds as the rampant fraud we witnessed in the false claims for unemployment benefits early in the COVID-19 pandemic.
As the Times Union’s Rachel Silberstein reports, the money was supposed to support minimum-wage increases of $2 an hour this year and $1 an hour next year. The increases were slated to start Oct. 1.
But some private insurance companies, in negotiations with home care agencies, are offering only 20 cents to 50 cents more an hour in reimbursement rates. The New York State Association of Health Care Providers says that as of last week, the vast majority of home care agencies reported no insurance companies even talking to them about raising reimbursement rates. Some even want to decrease rates.
The result, then, would be even worse than if the state had offered no new money at all. Because providers would have to pay more per hour but not be made whole by the insurance companies, they’d likely have to cut staffing and overtime pay and turn away clients insured by companies that won’t cover the wage hikes.
Certainly this sounds immoral, and it may not be legal. The state Department of Health says that under federal rules concerning how much money from premiums insurers and managed-care organizations have to spend on direct care, they can’t keep the state funds. The department intends to reinforce that message.
State leaders should deliver a message of their own — that keeping these public funds from getting to the workers is an egregious breach of trust. It’s not just about the pay, but about the health of an industry that so many vulnerable people depend on. Insurance companies are not just shortchanging the providers, they’re thwarting an important public health initiative.
Capital Region lawmakers — state Sen. Neil Breslin, D-Delmar, who heads the Senate Insurance Committee, and Assemblymen John T. McDonald III, D-Cohoes, and Phil Steck, D-Colonie, both members of the Assembly Insurance Committee, should call on their respective committees to convene and demand insurance executives come to Albany and explain themselves. And they should work with the Hochul administration to develop, if necessary, any new laws to force insurers to pass the money on, and retroactively pay anything they failed to do. And a penalty, if possible, might help drive home the point.
In the meantime, we offer some simple, clear, nonbureaucratic advice to the insurance industry: Do the right thing.
Article from Albany Times Union, Friday, September 30, 2022
Experts: All $7.7B from state for home care staff won’t reach paychecks
By Rachel Silberstein
ALBANY — Hundreds of millions of dollars in state funding set aside to raise the pay of home care workers are likely to end up in the pockets of private health insurance companies, industry experts say.
After years of campaigning for better pay, home care workers in New York state won $7.7 billion for wage increases in the state budget approved in April.
The money is intended to help end New York’s worst-in-the-nation home care shortage. The funding is for a $3-per-hour minimum wage increase — $2 this year, $1 more next year. Workers and advocates are calling on the state to compel insurance companies to pay their fair share.
But private insurance companies, who negotiate reimbursement rates with home care agencies, are offering pay bumps as low as 20 cents or 50 cents per hour, according to offers from two insurance companies shared with the Times Union with the company name redacted.
According to Bryan O’Malley, executive director of the Consumer Directed Personal Assistance Association, talks with insurance companies can hardly be classified as “negotiations,” as home care agencies have little leverage.
“The only way we can force any kind of negotiation is if the Department of Health gets involved,” which is rare, O’Malley said.
According to a survey by the New York State Association of Health Care Providers conducted last week, 87 percent of home care agencies say they have had zero insurance companies reach out about the rate change. Of those that did hear from insurers, 61 percent reported being offered decreased rates. Most respondents said that the insurance companies are actively putting up roadblocks to even discussing a new rate.
“The only way we can force any kind of negotiation is if the Department of Health gets involved.” — Bryan O’Malley, Consumer Directed Personal Assistance Association executive director
The home care raises are set to go into effect Oct. 1 — so if the state doesn’t step in immediately, private insurance companies could keep 80 percent of the money intended for low-income home care workers, advocates say.
The added cost to home care agencies could trickle down to workers in the form of reduced hours and overtime pay and turning away consumers with certain insurance plans, O’Malley said.
A state Department of Health spokesperson said that insurance companies, or managed care organizations, can’t keep the state funds due to federal “medical loss ratio” requirements. The medical loss ratio refers to the percentage of premium dollars that a health plan spends on medical claims and quality improvements versus money spent on overhead costs.
“The department informed plans that they should start coordinating with their provider network to make the necessary provider contract updated on Aug. 16 when we delivered the updated per hour amounts and rate schedules,” Monica Pomeroy said. “Additionally, on Sept. 12, the department organized a second webinar where we reiterated this information with MCOs and providers.”
The health department will keep reiterating its previously released guidance with health plans to ensure statutory compliance, she added. Providers are urged to connect with their contact at the Department of Health if they feel the plans are being unreasonable.
“The new per-hour values, which include all elements of the home care worker wage, are sufficient and actuarially certified to meet the new state statutory requirement as of Oct. 1, according to all the interactions and input we have had to date from both MCOs and providers,” Pomeroy said.
The New York Health Plan Association, a member organization of health care providers in the state, issued a statement Thursday calling on the state to “finalize rate packages to bring clarity to the process” of distributing the wage increases.
“Fair wage funding should be utilized to increase worker salaries, and health plans have been working diligently to adjust their rates to providers to reflect the changes included in the FY23 State Budget,” Eric Linzer, president and CEO of NYHPA, said in the statement. “Unfortunately, in some cases, the funding made available to health plans is not enough to support increases of the magnitude that providers are seeking, while in others some providers are not seeking the funds for workers but rather for profit.”
Letter from ENYDDA, NYC Fair, DDAWNY,LIANDD, SWAN, GROW, SOYAN, NYADD and New York Self Determination Coalition
Dear Governor Hochul,
We are independent consumer and family advocates across NYS, and we want you to know: We remain opposed to Managed Care Support Services for People with Intellectual and Developmental Disabilities (I/DD). Managed Care for I/DD services will not save money, will not provide better care and will not address issues of equity and access to services.
The OPWDD service system faces many challenges. Growing demand, problems with supply and quality, and an on-going work-force shortage have amplified those challenges. Following more than a decade of system transformation and exploration, we are hearing a repeated message from some, that Managed Care for I/DD is the solution. This narrative creates the impression that a transition to Managed Care for I/DD services is inevitable.
Managed Care promises to improve access by leveraging its provider networks. It promises to improve quality by instituting value-based payments and risk sharing. It promises to bring more innovation, and many, many more promises. These promises sound too good to be true for a very simple reason – they are too good to be true.
We reject the unproven aspirations of managed care for I/DD support services. Instead, we want to focus on making improvements that have a direct and positive impact on people’s lives, starting now. As the exploration of Managed Care for I/DD services continues, we will continue to challenge it. Managed Care for I/DD services is not here, is not inevitable, and is not a good idea. This is the first of a series, ‘Debunking the Myths of Managed Care’. Please reach out to any one of us to discuss this issue.
Thank you,
Respectfully submitted on behalf of;
Families and Self-Advocates Representing People with Intellectual and Developmental Disabilities across New York State
CC: Dr. Mary Bassett, Department of Health
Kerri Neifeld, Office for People With Developmental Disabilities
Jihoon Kim, Deputy Secretary for Human Services and Mental Hygiene
Thirty-five years ago, on this day, the Willowbrook State School was shuttered, signaling a new day for people with developmental disabilities. It was the courageous reporting of Geraldo Rivera, aided by a brave young named Bernard Carabello, that led to its closure by exposing the failure of a system that relied heavily on mass institutionalization of people with disabilities. Mr. Rivera’s expose 50 years ago launched a multi-year effort to change the service delivery system, leading ultimately to the closure of 20 institutions across New York State over 30 years in favor of community living.
The history and the mission of the Office for People With Developmental Disabilities is irrevocably intertwined with the history of the Willowbrook State School. This agency was born out of the strong and heroic advocacy of family members and people with developmental disabilities to ensure better treatment and better services for people within their communities and ultimately led to the end of institutionalization.
The opening of the Willowbrook Mile today preserves this history for future generations so that we may never forget what happened, nor take for granted the actions that led to the school’s eventual closure and, ultimately, the integrated and community-based living opportunities that exist for people with developmental disabilities today.
As we continue to remember Willowbrook, we are reminded of how very important our ongoing advocacy is. We need continued advocacy from people with disabilities, their families, our provider partners and those of us working in state government service to keep our system safe, accountable and responsive to the needs of people with developmental disabilities.
So, as we reflect on this Anniversary and the opening of the Willowbrook Mile, I ask that you join me in remembering our history and continuing to use your voices to help pave the path forward. While we have come a long way, there’s so much further we can go. Let’s work together to secure the support and the funding we need to ensure that all the people we support can live rich lives and realize their full potential. Bernard, the many brave families who fought to close Willowbrook and similar institutions and so many others who have followed in their footsteps have shown us what is possible. It is up to us all to continue pressing forward to achieve what is possible for people with developmental disabilities both now and in the future.
Revised Protocols for the Implementation of Isolation and Quarantine of Individuals in OPWDD Certified Facilities Following COVID-19 Exposure or Infection
Dear Colleagues and Friends,
In accordance with Governor Hochul’s announcement lifting the requirement for masks to be worn in certain facilities, OPWDD is revising its COVID-19 guidance.
As of September 7, 2022, OPWDD will no longer be requiring masks to be worn in its certified or operated facilities, with the exception of Specialty Hospitals. Masking is also no longer required during transport. As set forth in the attached guidance, masking may still be required in certain individual circumstances, such as when a person or staff is recovering from COVID-19 or is suspected of having COVID-19.
This guidance also more clearly explains OPWDD’s isolation and quarantine guidance and its applicability in OPWDD’s various certified settings.
This guidance will supersede the following guidance documents:
Post State of Emergency COVID-19 Guidance for OPWDD Certified, Operated, and/or Funded Facilities and Programs – Issued September 15, 2021;
Frequently Asked Questions (FAQ) About OPWDD’s Emergency Regulation 14 NYCRR Section 633.26 Mandatory Face Coverings in OPWDD Certified Services and Facilities – Issued September 24, 2021; Revised June 30, 2022
Revised Protocols for the Implementation of Isolation and Quarantine of Individuals in OPWDD Certified Facilities Following COVID-19 Exposure or Infection – Issued July 8, 2022.
Thank you for your continued partnership as we continue to ensure health and safety for all.
Low pay and difficult working conditions are exacerbating the widespread closure of facilities that serve disabled individuals
ALBANY — A staffing crisis at residential facilities that serve those who are intellectually and developmentally disabled is costing more than $100 million a year to handle the fallout from the flood of individuals leaving those jobs, according to a recent survey conducted by New York Disability Advocates.
The survey captured more than 50 percent of the industry’s stakeholders, confirming that low pay and difficult working conditions are exacerbating the widespread closure of facilities, including many run by the state Office for People with Developmental Disabilities.
“The statistics are rather sobering,” said Erik Geizer, CEO of the Arc New York, the state’s largest nonprofit organization serving people with intellectual and developmental disabilities.
Geizer noted that there is a 35 percent annual staff turnover rate and that is being compounded by the roughly 20 percent vacancy rate for the “direct support professionals” who provide the unique services.
In addition, 40 percent of providers have closed or reduced programs in the past several years.
“That’s pretty sobering because the number of people with intellectual and developmental disabilities is pretty stable. It’s not going down,” he said. “This is as bad as I’ve seen the field. I’ve never seen things so bad.”
Geizer said the quality of care is also suffering as a result of the labor shortage — in an industry where clients do better when the workers helping them are familiar faces. The program shutdowns also have led to many parents and caretakers of developmentally disabled individuals needing to quit their jobs to care for their loved ones.
With so many workers leaving the industry — where the rate of pay is in line with fast-food restaurants and retail stores — the additional costs of retraining new workers, including many of whom may not remain the jobs, is depleting the limited amount of money set aside for caregiving.
“We don’t often talk about the actual cost of our staffing crisis,” said Tom McAlvanah, president of the New York Disability Advocates and executive director of the Interagency Council of Developmental Disabilities. “Provider agencies are spending millions of dollars to combat turnover of direct support staff. Investing those resources into competitive wages and workforce initiatives that promote retention of essential staff would help stabilize our system of supports and ensure continuity of care for New Yorkers with I/DD.”
In January, Gov. Kathy Hochul’s administration announced it had applied for $2.2 billion in federal aid to strengthen the home care workforce, including implementing a “data-driven” strategy for recruiting OPWDD workers.
According to the Public Employees Federation, OPWDD’s civil service workforce declined by more than 10,000 workers — to just under 20,000 — between 1990 and last year. But most of the care in that industry is provided by non-profit service agencies.
OPWDD has recently acknowledged that “like most human services organizations across the country” it is facing “a workforce shortage of crisis proportions worsened by the COVID pandemic.”
The agency said it has needed to implement “emergency measures to ensure the safety of people living in a small number of group homes that are unable to retain or recruit sufficient staffing levels.”
In the past three years, 130 OPWDD-operated group homes across the state were “temporarily suspended” due to staff vacancies, the agency said. The non-profit organizations providing those same services have been forced to implement similar shutdowns and suspension of programs.
Group home workers have said mandatory overtime has contributed to additional departures — retirements and resignations — and it’s not unusual for some employees to be required to work shifts of more than 30 hours.
In addition to paying out more than $1 billion in bonuses to workers employed by nonprofit providers — money from the American Rescue Plan Act — the state agency also has added a 5.4 percent “cost-of-living adjustment for non-profit provider agencies to address inflation and other fiscal pressures, such as the need to enhance direct care, support and clinical staff compensation.”
But stakeholders in the industry say those measures have not led to any significant shifts in the workforce crisis.
Brendan J. Lyons is a managing editor for the Times Union overseeing the Capitol Bureau and investigations. Lyons joined the Times Union in 1998 as a crime reporter before being assigned to the investigations team.
Three-year Agreement with National Alliance for Direct Support Professionals to Expand Opportunities; Professionalize Workforce
Partnership to Help Address Ongoing Worker Shortages in the Developmental Disabilities Field
Governor Kathy Hochul today announced that the New York State Office for People With Developmental Disabilities has entered into a $10 million partnership with the National Alliance for Direct Support Professionals to expand opportunities for professional credentialing for direct support professionals in the developmental disabilities field throughout New York State. The three-year agreement will help professionalize the direct support professional workforce and address worker shortages.
“Workforce shortages are putting a tremendous strain on our dedicated direct service professionals, and in response New York is taking action to provide career advancement and growth opportunities in this crucial field,” Governor Hochul said. “This $10 million partnership to expand credentialing will prove critical in providing support for training, education and expanded recruitment and retention efforts – an important step in meeting the needs of New Yorkers with developmental disabilities.”
OPWDD’s partnership with the National Alliance will provide access to three levels of direct support professionals credentialing and its frontline supervisor certification through participation in its E-Badge Academy. The project is supported by federal funds OPWDD is receiving through the American Rescue Plan Act of 2021.
The National Alliance credential is competency-based and modeled on the Centers for Medicaid and Medicare Services’ Direct Service Workforce Core Competencies and the National Alliance Code of Ethics.
Founded in 1996, the National Alliance for Direct Support Professionals’ mission is to enhance the quality of support provided to people with disabilities through the provision of products, services and certifications which elevate the status of direct support workers. The organization strongly promotes recognition and identity of direct support professionals to spur meaningful public policy investments, while also advancing the knowledge, skills, and values of this occupation.
In the coming weeks, the National Alliance will release a request for proposals for eligible home and community-based service provider organizations to participate in the grant and claim seats in the E-badge Academy for staff. The National Alliance will provide credentialing or certification for about 2,442 direct service professionals and frontline supervisors over the length of the three-year contract.
The project will provide bonuses for participating direct service professionals. In addition, the project will reimburse employers for training hours undertaken by their staff.
Office for People with Developmental Disabilities Commissioner Kerri Neifeld said, “Expanding access to this industry-recognized credential will improve the competence and skills of our workforce and ultimately increase retention rates. It will provide our dedicated frontline staff who have been working tirelessly to meet the needs of New Yorkers with developmental disabilities under tremendous pressure the professional advancement and career opportunities they so well deserve. And, most importantly, it will help to ensure that thousands of New Yorkers those who need caring, expert direct service professionals to show up every day ready to meet their needs will receive the services they need to pursue their personal best and live their most fulfilling lives.”
Representative Kathleen Rice said, “Direct Support Professionals provide critical patient care and allow the most vulnerable New Yorkers to live independent, meaningful lives, but rarely do they receive pay, benefits, or training commensurate with the importance of their work. In Congress, I lead the Recognizing the Role of Direct Support Professionals Act to help the federal government understand and address the needs of this workforce, and I’m grateful for Governor Hochul’s actions to expand career opportunities for DSPs and reduce the shortage of homecare workers in New York.”
State Senator John W. Mannion said, “Direct Support Professionals need our support because the workforce crisis is having a profound impact on the ability to deliver services and necessary care. Expanding training and credentialing will allow DSPs the ability to advance professionally while helping to recruit and retain more compassionate New Yorkers into the care economy. This is an important step towards providing some relief for our overwhelmed and unfairly burdened DSPs. Governor Hochul has been a partner in addressing the workforce crisis and I look forward to working together to deliver additional solutions to this long standing problem.”
National Alliance for Direct Support Professionals President and Chief Executive Officer Joseph MacBeth said, “We are proud to be working with OPWDD and the New York provider community in demonstrating the value of direct support professional credentialing by providing access to the E-Badge Academy for nearly 2500 direct service professionals and frontline supervisors. The workforce crisis is a long-standing and complex issue that requires interventions in many areas. Recognizing the demonstration of skills and providing financial incentives for high-performing direct support professionals and frontline supervisors is an important first step to being recognized as a profession.”
New York Alliance for Inclusion and Innovation President & CEO Michael Seereiter said, “The NY Alliance for Inclusion and Innovation applauds the National Alliance for Direct Support Professionals in working together with OPWDD to administer a rigorous credentialing program for direct support professionals that will allow direct service professionals to advance their knowledge, values, and skills by obtaining certification. It offers a path to a career ladder and aides in addressing the DSP workforce shortage in addition to supporting DSPs to continue providing quality supports and services for individuals with intellectual and developmental disabilities.”
This initiative is part of a greater effort to enhance, improve and transform key aspects of the OPWDD service system using COVID-19 relief funds awarded by the federal CMS. These funds are targeted to specific activities across a wide range of OPWDD programs and provide a timely opportunity to address critical challenges. OPWDD’s plans for all of its ARPA funds can be found at: https://opwdd.ny.gov/american-rescue-plan-act-arpa.
Saratoga Bridges’ day habilitation program in Clifton Park is latest to face shutdown amid a staffing crisis plaguing facilities that serve those with disabilities
CLIFTON PARK — A staffing crisis that is crippling care programs for individuals with disabilities is forcing Saratoga County’s largest nonprofit human services agency to temporarily “pause” a day habilitation program in Clifton Park.
For some of the roughly two dozen families affected, the looming decisions include whether a parent might have to quit their job to care for their loved one during the day.
“At that particular site we felt that it’s not safe to do the day program with as many individuals, with the staffing shortages that we have,” said Jane Mastaitis, chief executive officer at Saratoga Bridges, one of 36 chapters of The Arc New York, the state’s largest nonprofit organization serving people with intellectual and developmental disabilities. “We’re just so short of staff; it’s just a decision that we made as team … for the safety of the individuals.”
Mastaitis said the temporary closure is scheduled to begin Aug. 15 at the facility on Clifton Park Center Road.
It is among dozens of closures of similar residential and day habilitation programs by state-run and non-profit agencies that have been unfolding across the state. Although New York increased the wages it pays workers in state-run facilities, the private sector — especially non-profit organizations — account for about 80 percent of the services provided to intellectually and developmentally disabled individuals. But the average wage for care workers in that sector is still under $15 an hour.
Joseph Pisacane, 61, a Waterford resident who is the sole caretaker of his 31-year-old son, said the temporary closure of the Clifton Park program is likely to force him to quit his job. During the pandemic, he said, he had to leave his job for more than a year because of the lack of services available for his son, a situation exacerbated by COVID-19 shutdowns.
“My son has a seizure disorder from birth and he’s totally disabled,” Pisacane said. “He is mobile, but for how much longer I don’t know. He wears a diaper and doesn’t communicate. I’m a single dad trying to do this on my own for the last 13 years. I’m really struggling and I don’t know what to do anymore.”
He’s not alone: Families across the state — and nationwide — are facing similar crises as group homes and facilities that serve disabled individuals are facing closure due to an unprecedented staffing crisis brought on, in part, by low wages and other factors impacting the industry.
Laura Styczynski, whose 30-year-old son attends Saratoga Bridge’s day habilitation program, said she also may be forced to take a leave from her job at a school in order to care for him during the closure.
“They said that it’s for an indefinite period of time, and they said when day-hab reopens it may not reopen for us here in Clifton Park,” Styczynski said. “I work in a school, so come Labor Day I need the situation to be resolved so that I can go back to work to carry some of the benefits for our family as well as the income needed to help provide for all three of our children. … I can’t go to my job, which means the school system that I work for is going to be short-handed. It’s a very stressful situation for families.”
Styczynski said she does not fault the workers whom she said “break their backs every day” but in many instances could receive more pay working for a chain restaurant.
“They need to pay the staff more,” she said. “These people work so hard and are so dedicated to these individuals that it’s just a shame for everyone that they’re struggling this way.”
Kate Geurin, a spokeswoman for The Arc New York, said that government-funded one-time bonuses distributed to employees this year helped retain workers in the private sector but had little impact on recruitment.
“We’ve found that what’s much more effective is increases in base pay, and also the retention bonuses are ending so we have some concerns that we’ll actually lose staff once that’s played out,” Geurin said. “It was a real stopgap solution. So we did get COLA (cost-of-living-adjustment) funding and some providers are able to increase wages using those funds, but it’s really still not enough to remain competitive.”
Geurin added the organization is “very, very cognizant of the problems that it causes for families” when services are suspended, “but we need to know that we’re bringing people into a safe environment.”
Mastaitis said Saratoga Bridges — which also operates day habilitation programs in Malta, Wilton and Saratoga Springs that will remain open — used to compete for workers with other non-profits that provide similar services. Now, she said, they are competing with all employers — including fast-food restaurants and retail stores vying to hire the workers who are willing to fill vacant jobs.
“In fact, prior to COVID we served over 400 people in our day program, and right now are serving about half of that because of staffing,” Mastaitis said. “I don’t know where the workforce went. … It’s hitting families hard. … It’s very, very difficult to make a decision like this. Everybody is out of staff.”
Saratoga Bridges is seeking alternative programs for the families who will be effected by the closure of the Clifton Park day program, though it’s not clear how many options there are; it may require some to travel longer distances.
Rural areas of the state, especially in the Finger Lakes region, are among the regions hard-hit by the “suspensions” of residential services that have resulted in many developmentally disabled people being forced to move into new group homes or care facilities, sometimes long distances away from their families.
In January, Hochul’s administration announced it had applied for $2.2 billion in federal aid to strengthen the home care workforce, including implementing a “data-driven” strategy for recruiting workers for the state Office for People with Developmental Disabilities.
According to the Public Employees Federation, OPWDD’s civil service workforce declined by more than 10,000 workers — to just under 20,000 — between 1990 and last year.
OPWDD officials said they have been implementing salary increases since March to improve recruitment and retention. The first phase of that, which increased pay to more than $20 per hour for the state workforce’s “direct support assistants,” resulted in more than 4,000 workers receiving an increase. They are also increasing salaries for higher-level clinical workers as well as nurses.
The agency said it has needed to implement “emergency measures to ensure the safety of people living in a small number of group homes that are unable to retain or recruit sufficient staffing levels.”
In the past three years, 130 OPWDD-operated group homes across the state were “temporarily suspended” due to staff vacancies, the agency said. That does not include facilities operated by non-profit agencies, which provide most of the state’s care.
As of the end of March, OPWDD was seeking emergency residential placement for 1,059 people who were either “homeless or in imminent danger of being homeless.” There were 2,270 people seeking residential placement in a “substantial need category, which includes people at an increasing risk of having no permanent place to live, such as someone whose family or other caregivers are becoming increasingly unable to continue to provide care for the person.”
An additional 2,159 people were seeking residential placement but were not considered to be in “emergency” or “substantial need” situations.
An official with the New York Disability Advocates recently told a state Senate committee that there had been a roughly 25 percent vacancy rate for direct care workers, which was about 75 percent higher than before the
Rural areas are being especially hard-hit by the “suspensions” of services in facilities that care for developmentally disabled individuals
ALBANY — A staffing crisis at residential facilities operated by the state Office for People with Developmental Disabilities is continuing to drive closures of the facilities, with labor groups and families who rely on the group homes worried there is not enough being done to recruit new workers.
Rural areas of the state, especially in the Finger Lakes region, are among the regions being hard-hit by the “suspensions” of residential services that have resulted in many developmentally disabled people being forced to move into new group homes or care facilities, sometimes long distances away from their families.
“They’re not doing a good enough job trying to recruit new people in a very rural area,” said Karen Duboy, a Wyoming County resident whose 30-year-old son Matthew, who has Down Syndrome, was uprooted in December from the group home where he had lived comfortably for years. “I just think the state has really let a lot of people down with continuing the services that we’ve all looked for.”
Duboy’s son was among a group of dozens of disabled persons who were initially going to be moved to a day center in the Finger Lakes region last November where cots were being set up in a gymnasium. That plan was quickly abandoned that month after the Times Union contacted Gov. Kathy Hochul’s office about it.
Duboy said that after the state closed her son’s longtime residence, where he had lived with four other residents, he was among 11 residents who were moved into another home with 11 other residents, many of whom used wheelchairs.
“The whole dynamics changed for both houses. So now you have 22 people that have been really disrupted,” she said. “The staff did very well helping people to adjust. … At the time Matthew was there, I feel that he got cared for — but the quality may not have been what it was in a smaller house. Again, it’s no disrespect to the staff: They did the best they could with what they had.”
In January, Hochul’s administration announced it had applied for $2.2 billion in federal aid to strengthen the home care workforce, including implementing a “data-driven” strategy for recruiting OPWDD workers.
According to the Public Employees Federation, OPWDD’s civil service workforce declined by more than 10,000 workers — to just under 20,000 — between 1990 and last year.
Earlier this month, Wayne Spence, PEF’s president, delivered remarks at one of multiple public forums the agency is conducting across the state to get input on its new five-year plan that’s schedule to go into effect next year.
“It is regrettable that the agency purposefully excluded our members and our union from active participation in the development of this draft strategic plan,” Spence said at the forum in Rochester on July 18. “We also remain concerned that this strategic plan continues to advance the flawed policy approach that private providers can provide appropriate, long-term care for the most profoundly disabled at lower cost and with the same quality of care provided by the state’s residential and other programs.”
In response to a series of questions, OPWDD issued a statement saying that “like most human services organizations across the country” it is facing “a workforce shortage of crisis proportions worsened by the COVID pandemic.”
The agency said it has needed to implement “emergency measures to ensure the safety of people living in a small number of group homes that are unable to retain or recruit sufficient staffing levels.”
In the past three years, 130 OPWDD-operated group homes across the state were “temporarily suspended” due to staff vacancies, the agency said.
Tough conditions
Statewide, OPWDD said it has nearly 3,000 full-time staff vacancies from its 2023 budgeted allocation. The agency said that in “rare circumstances” it has needed to mandate overtime that results in staffers working more than 30 consecutive hours to maintain minimum staffing requirements for those they serve.
“The agency works to provide staffing relief as quickly as possible and will work with the employee to allow for periods of rest/meals,” the agency said.
Three years ago, there were more than 7,600 people being cared for in group homes and other 24-hour care facilities run by OPWDD. But staffing shortages that began before the pandemic have decimated that workforce, which state officials have acknowledged are underpaid for often challenging working conditions.
But waiting lists continue to remain stacked with thousands of individuals whose families or caregivers are seeking residential care.
As of the end of March, OPWDD was seeking emergency residential placement for 1,059 people who were either “homeless or in imminent danger of being homeless.” There were 2,270 people seeking residential placement in a “substantial need category, which includes people at an increasing risk of having no permanent place to live, such as someone whose family or other caregivers are becoming increasingly unable to continue to provide care for the person.”
An additional 2,159 people were seeking residential placement but were not considered to be in “emergency” or “substantial need” situations.
Group home workers interviewed for this story said the mandatory overtime has contributed to additional departures — retirements and resignations — and it’s not unusual for some employees to be required to work shifts of more than 30 hours.
“The continued outsourcing, consolidation and closure of programs and services operated by (various state agencies) — coupled with the reduction of staff and the physical beds dedicated to help the mentally ill, the developmentally disabled and those who suffer from co-occurring disorders — are disproportionately harming low-income, uninsured, underinsured, undocumented and severely handicapped New Yorkers who suffer from acute mental illness, developmental disabilities or addiction, as well as those who suffer from co-occurring disorders,” Spence said on July 18.
Duboy, whose son moved into a home earlier this year run by the ARC that serves Geneseo, Livingston, Orleans and Wyoming counties, questioned the five-year plan being proposed that she said “looks good on paper” but has not resulted in a more immediate effort to recruit workers.
“The staff that are there do really enjoy helping our loved ones on daily skills and working with them, but the future of that type of commitment is not there,” she said. “The staff feel like they’re under-appreciated. It’s just really hard. I think (the state) lost touch with families. I want Matthew to be cared for to the best of his loving care when I’m gone.”
Pay raises
PEF officials contend the state doesn’t appear to have a plan to quickly address the staffing shortages and ongoing closures despite providing supplemental benefits and bonuses for the private not-for-profit agencies that are handling many of the residents.
Randi DiAntonio, PEF’s vice president, told a state Senate panel last year that the staffing shortages were exacerbated by the pandemic — when many people quit their jobs — and also by years of handing over services for those with intellectual and developmental disabilities to private providers in an effort to cut costs.
“The state of New York has embarked on a long-term effort to reduce funding and staffing at all of its agencies. OPWDD has seen some of the most dramatic reductions in staffing overtime,” DiAntonio said in a written statement provided to the panel, noting that the agency had its workforce cut by 16 percent — nearly 3,800 employees — between 2011, when Gov. Andrew M. Cuomo began his first term, and 2020.
“This reduction in staff is directly attributable to the imposition of ‘bare-bones’ budgeting at all of the state agencies that has been in place for years so the state can remain under the arbitrary 2 percent annual state spending cap,” she added. “This budgeting approach left the state ill-prepared to address the (COVID-19) pandemic and has hampered the ability of the state to meet its ethical obligations to maintain the continuity of quality and accessible services for many at-risk New Yorkers, including individuals with developmental disabilities.”
DiAntonio, under questioning from the panel, had said nurses and other health care professionals were “leaving in droves,” and low morale and burnout in the industry were at all-time highs.
“The number of people with disabilities is not shrinking … and the needs for people with children with autism are exponentially larger,” she said. “The waiting list for services has not gone down. … We’ve closed almost 5,000 beds.”
An official with the New York Disability Advocates told that same Senate committee that there had been a roughly 25 percent vacancy rate for direct care workers, which was about 75 percent higher than before the pandemic.
Among the measures the state has undertaken to try and stem the staff shortages: allocating bonuses of up to $3,000 “for both state and nonprofit health care and mental hygiene staff, which are in the process of being effectuated.”
In addition to paying out more than $1 billion in bonuses to workers employed by nonprofit providers — money from the American Rescue Plan Act — the agency also has added a 5.4 percent “cost-of-living adjustment for non-profit provider agencies to address inflation and other fiscal pressures, such as the need to enhance direct care, support and clinical staff compensation.”
Additionally, the most recent state budget allows OPWDD to pay increased overtime rates of 2.5 times the rate of base pay.
Brendan J. Lyons is a managing editor for the Times Union overseeing the Capitol Bureau and investigations. Lyons joined the Times Union in 1998 as a crime reporter before being assigned to the investigations team. He became editor of the investigations team in 2013 and began overseeing the Capitol Bureau in 2017. You can reach him at blyons@timesunion.com or 518-454-5547.
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