FROM THE COMMUNITY: Many partners will solve direct support workforce shortage

By Claire Wilson, Alex Bartolic

DHS, along with other state agencies, is playing a significant role in implementing the plan and also has been working for years on strategies to ensure people with disabilities live, work and enjoy life in ways most meaningful to them.

Increasing worker wages and benefits is the first strategy listed in the plan. This action would require legislative action with support from people with disabilities, advocacy organizations, providers and direct support professionals themselves. DHS and our partners are laying the groundwork for discussions in two ways. We are analyzing compensation of occupations with skills and education backgrounds similar to those of current direct support workers. We are also looking at how provider rates could better match different levels of worker training and care required by different people receiving services. An enhanced rate for some PCA services began last summer; the current analysis may support other rate changes to more closely match people’s individual needs.

Another effort to explore possible wage and benefit adjustments is the statewide survey of providers on direct support worker wages and benefits. DHS, the University of Minnesota Institute on Community Integration and provider trade organizations have partnered on this survey with advocate support. While this work is underway, we are also pursuing strategies with potential to better meet individual needs, give direct support workers more attractive, flexible work hours and to free up time for critical hands-on support.

We must be creative and open to new service delivery options to ensure the people get the appropriate level of quality care when, where and how they need it. Viewing technology as a first option, for example, can help to promote independence of the person served and free up workers to be in places where they are critically needed for hands-on care. When in the home of a person who agrees to use it, an automated medication dispenser, for example could potentially free up time of a skilled nurse who might otherwise have to visit daily to administer medications.

Use of remote monitoring technology can allow providers to assign fewer overnight on-call staff to monitor several people who live close to each other instead of having a worker sleep at each person’s home in case it is needed.

Similarly, the new Individualized Home Support service available across Medical Assistance disability waiver programs allows people to get help intermittently as they go about their day, at home, at work and in the community. A key difference between this service and previous reimbursable support services is greater flexibility in billing for this service and in providing the services—either in person or remotely by phone, text or video-conference.

Flexibility can make direct support work more attractive to people who may want to work around another job schedule, in semi-retirement, while their kids are at school or only within their neighborhood.

Direct Support Connect, Minnesota’s dedicated online job board and hiring resource for direct support workers and people who hire them, began an advertising campaign last summer that highlights flexibility as well as the intangible rewards of a job with meaningful personal interaction. The potential benefits for the person receiving services is to manage their own services and connect with someone with the skills and availability they need. While Direct Support Connect represents only one of many needed strategies, we are encouraged by initial results of a social media campaign over last summer and fall, which more than doubled the number of profiles for both direct support workers and people looking to hire and self-direct their own services in the same time period. Another campaign is now underway and enhancements to the website continue to be made.

The direct support worker shortage is a national problem requiring many approaches and collaboration among a host of stakeholders to make progress. We are committed to working with partners throughout Minnesota to improve the situation so people can get the services they need.

Claire Wilson is deputy commissioner for policy at DHS. Alex Bartolic is director of the Disability Services Division at DHS.