Home > Uncategorized > Staffing shortages and low pay affecting care in DDS group homes

Staffing shortages and low pay affecting care in DDS group homes

As the Department of Developmental Services (DDS) system in Massachusetts emerges from the COVID crisis, a number of systemic problems are lingering, including reports of staffing shortages in group homes.

The staffing shortages may not be directly due to the pandemic, but the pandemic may have brought matters to a head.

Staffing shortages have long been a potential result of the low pay provided to direct care workers in the DDS system compared with high salaries provided to executives managing the nonprofits operating most of the group homes.

Even with a $4.2 billion surplus in state budget revenues projected for the current fiscal year, there appears to be no sign of urgency on Beacon Hill to address the direct care wage problem. Legislation (H.4171) that would have boosted minimum direct care wages in the DDS system to $20 per hour died at the end of the previous legislative session last December, and apparently hasn’t been revived.

We sent an email query on July 13 to state Health and Human Services Secretary Marylou Sudders and DDS Commissioner Jane Ryder, seeking confirmation of the staffing shortages and reasons for them. We sent a similar query to the Legislature’s Children, Families, and Persons with Disabilities Committee.

In our emails, we asked whether there are legislative efforts underway to boost direct care pay in the DDS system in order to recruit more caregivers and prevent others from leaving the system.

Neither Sudders nor Ryder has responded to our query.

A staff member of the Children and Families Committee did get back to us last week, saying a bill has been proposed for the second year in a row that would gradually raise the pay of direct care workers employed by DDS providers to the level earned by similar workers employed by the state.

Unlike last session’s bill, which would have raised direct care pay to $20 per hour, no actual hourly payment amount is specified in this year’s bill, H.237. The measure was referred to the Children and Families Committee on March 29.  A “tentative” vote on the bill isn’t scheduled by the Committee until this coming fall.

In response to a separate query we sent earlier this month to our membership, a number of family members maintained that staffing shortages exist and have caused problems in their loved ones’ residences. One parent said a DDS regional director had confirmed to her that “there is a staff shortage statewide and they are working to recruit people.”

In one case, a DDS official emailed a parent of a state-operated group home resident, saying DDS was “in touch with (the group home management) …to ensure proper staffing ratios are being met at all times.”

But a number of family members said they did not believe staffing has lately been adequate in the residences. One parent said her son needs two staff to assist him. She said, however, that there were only two staff available per shift in the entire residence, whereas there used to be five staff per shift. The parent termed the staffing situation “potentially dangerous.”

Another parent said several staff in her son’s residence were either on vacation, had resigned, or were in training elsewhere. She said the situation resulted in a recent incident in which a resident of the home left the residence unnoticed and was eventually found outside and brought back by staff.

Affecting quality of care

The parent cited above added that the shortage of staff in the residence has been accompanied by a shortage of hygienic supplies such as disposable wipes and body wash. “The lack of good personal hygiene is neglect,” the parent said.

Use of temporary employment agencies

Two family members said the providers running the group homes were using temporary staffing agencies to fill full-time positions. “They come into the house,” said one parent, “turn on the TV and sit down.” The parent said the temporary staff are not allowed to drive, so her daughter “is stuck inside the house all day, sometimes day after day, which is contributing to her health issues.”

A parent of a resident in a state-run group home said a number of the group home Occupational Therapy and Physical Therapy staff were also working in provider-run homes in order to supplement the staffing there.

Need for higher pay for direct care workers

A number of parents pointed out the connection between the staffing shortages in the group homes and low pay for direct care workers.

As one parent put it in an email to us, “Since the governor has a $4 billion surplus, maybe he could give DDS money,” specifically to increase group home staff wages.

A state budget fund was created a number of years ago, in part, to boost direct care wages. The problem is that while the fund has generated surplus revenues for many providers in recent years, little of the money has apparently gone to boost direct care pay.

In 2018, Governor Baker did sign legislation to raise the minimum wage of direct care and other workers to $15 an hour; but the minimum wage won’t reach that amount until 2023. In 2017, the Legislature rejected efforts to raise direct care wages to $15 as of that year, and rejected a bid in 2019 and again last year to raise direct care wages to $20 per hour.

EOHHS no longer tracking staff vaccinations

Also possibly due to the staffing shortage, the administration is not only not requiring working staff to be vaccinated for COVID-19, the administration is no longer tracking the number of staff who are vaccinated. EOHHS said it has never tracked the number of staff refusing vaccinations.

In a response to a June 28 Public Records Request we submitted for the latest numbers on residents and staff in the DDS system who have been vaccinated, EOHHS said they stopped tracking that information as of April 23. That was the last time they provided that information to us.

On April 23, EOHHS gave us information from early that month, indicating that about 50% of staff in DDS-funded group homes had been vaccinated, and 75% to 90% of residents in group homes had been vaccinated. So apparently with only half of the staff in the system vaccinated, EOHHS decided to stop tracking it.

Perhaps given the fact that the administration doesn’t require DDS staff to get vaccinated, the administration decided it isn’t necessary to know how many staff have actually done so. That seems to be a risky approach.

It also seems one of the administration’s biggest fears has been that the COVID crisis would lead to staffing shortages. As a result, the administration was slow to require testing of staff for COVID-19, and has declined to require that staff get vaccinated.

Despite that fear, the administration and Legislature apparently don’t seem to want to do the one thing that would go furthest to prevent staffing shortages — that is, ensure that direct-care staff are adequately paid for the difficult and important work they do.

  1. tom rickels
    July 19, 2021 at 10:54 am

    Hi Dave,

    Good article. After money, I think a problem no one is addressing is that we may have just created a system we cant sustain. This problem started to become more noticeable as the first wave of boomers ( the most work obsessed group ever) started to retire (we are retiring at a rate of 250,000-350,000 per year). No criticism of Millennials and Gen X’rs but they aren’t as inclined to take these jobs. Downsizing has created the need for more staff, not less and we are at the breaking point.

    Liked by 1 person

    • Valerie Loveland
      July 19, 2021 at 11:14 am

      Tom

      It’s not just the retiring boomers with a good work ethic creating a worker shortage, but these people pay taxes, and that will also change when they retire. It’s a double whammy if you will. Couple that with nearly record number of adults with autism aging out of the educational system, and that’s the recipe right there! The state NEEDS to address this and it can no longer wait! I was posting this very issue a decade ago and was called “crazy”. Diagnosis rates have more than doubled. In 2000, my son was diagnosed it was 1:150. Now it’s 1:35….what will happen in 20 years from now? We are only seeing the beginnings of it.

      #directcareworkers #livingwages #betterpay #morestaff #morediagnosis #autism #autismadocate #advocate #speakup

      Like

  2. Valerie Loveland
    July 19, 2021 at 11:09 am

    Well this is a huge problem!

    Lack of funding for workers, lack of workers, lack of vaccinations to work directly with immune compromised population. Vaccination or not, this population is still subjected to catching covid. It’s a law suit waiting to happen!

    #vaccinationrequirements #autism #immunecompromised #lackoffunds #lackofstaff #dds #stateofmassachusetts

    Like

  3. July 19, 2021 at 11:19 am

    This is strange. I thought I read Gov. Baker put back the money he originally was going to decrease for residential. Makes you wonder where the money went. Perhaps if they were paid decent they’d get more qualified help.

    Like

  4. Anonymous
    July 19, 2021 at 11:25 am

    As a mother of a special needs daughter who has been in a Group Home for several years, I so appreciate COFAR and David for all they are doing to make sure that our daughters and sons are being taken care of in every aspect of their lives safely and in a meaningful way. God Bless.

    Like

  5. Andrew Allen
    July 24, 2021 at 5:09 pm

    Staff are being taken from other group homes and put into other homes that are seeing staff forced triple shifts. Like we are just scabs. These staff do not know the residents or their complex needs. Yet people with higher salaries that work in their office, or still from home do a weeks worth of work in one or two days. I am a dsw for dds that works in a great home. But there are so many homes that are becoming rotten by mismanagement and the ever increasing work load put on staff by middle management and the departments within dds.

    Like

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