New approach counters direct care shortage

New approach counters direct care shortage

It’s 7:30 a.m. Enrique Castaño, direct support professional at MSS St. Paul, an organization providing programs and support to people with intellectual and physical disabilities, is already hard at work, prepping for the day.

Today is a “programming day,” a new idea implemented by MSS to allow DSPs like Castaño to break from their regular routine and join different clients in alternative activities or design their own programming for clients.

Staff retention is a huge challenge for organizations like MSS. Partly due to rising demand and stagnant wages, as well as the common perception that this kind of work is temporary, organizations providing care and programming for adults with developmental disabilities experience high rates of staff turnover.

Castaño came to MSS through a fellowship program with Cow Tipping Press, a Twin Cities-based organization publishing work by authors with developmental disabilities and aspiring to change the way society views disability.

“Among the disability community and disability services, it’s well known that there’s a workforce shortage,” said Bryan Boyce, the founder and executive director of Cow Tipping Press. “Getting people to even to apply for positions can be tough.” Yet Cow Tipping Press might have the solution, or at least part of it.

In 2018, the Minnesota State Department of Human Services Direct Care/Support Workforce Initiative created a “strategic vision for tackling the crisis in the direct care and support workforce” with seven major recommendations. Recommendations include increasing wages, expanding the work pool, improving training, building job satisfaction, raising public awareness, better utilizing technological solutions and enhancing data collection.

Casual group around table
Cow Tipping Fellows gather at Five Watt Coffee to discuss experiences and readings from the month. Fellows pictured, from Left to Right: Ally Kann, Christina Brewer, Sohini Ghosh, Aarohi Narain, Enrique Castaño

Boyce took a more creative approach. He recently launched the Cow Tipping Fellowship, aiming to solve the problem by “reframing the role.”

It’s similar to an AmeriCorps model, recruiting employees by tapping into ideals of diversity and social justice, rather than hours and salary. Boyce finds this allows organizations to begin to attract a different profile of applicants.

In this first year of the program, Boyce successfully hired and coached five fellows – recent graduates from the University of Minnesota, Macalester College in St. Paul and Grinnell College in Iowa. Fellows work full time as employees of Cow Tipping Press partners MSS, Lutheran Social Services, and Rise, and meet monthly to discuss assigned readings on disability history and justice.

By providing an environment of support and camaraderie, Boyce hopes to fill in some of the gaps behind the low retention rates in the field. “I’m continuing to figure out how to partner with management at the sites to help them do an even better job leveraging the skills and talents the fellows bring to the table,” he said. The five inaugural Cow Tipping Fellows found great value in the program. “I’ve met fabulous people—both staff and the people we serve—and developed really important and meaningful relationships with them,” said Sohini Ghosh, one of the fellows.

Fellow Ally Kann said, “This work has also been really humbling. I’ve been sitting behind a desk writing papers for four years. In this fellowship, you realize that this work is something school never could have prepared you for but is just as challenging and just as important.”

The fellows also said that entering into organizations that have certain established norms, and trying newer, perhaps more just approaches to working with people with disabilities, can be hard. Cow Tipping Press, said Castaño, teaches person-centered work, and then “gives places like MSS an opportunity to work with younger staff who can model more person-centered work: allowing more choice and giving more voice to a person so they can have input in what’s going on.”

Man at cupboard with basket of items
Enrique Castaño gathers items from around MSS that he plans to use in a game with clients, based on the TV game show, “The Price is Right.” By helping clients learn what everyday items cost, he teaches them about pricing and budget.

Managers at the partner organizations have been impressed with their fellows’ performance, praising their “energy and dependability,” their “integrity and work ethic,” and describing fellows as “dedicated, passionate, and industrious.”

Castaño plans to pursue a career in the field. “I’ve enjoyed doing exercise classes with the MSS clients,” he said, “and, in the future, I plan to go into physical therapy, and specialize in working with people with disabilities.”

At the start of this second year of the fellowship, Cow Tipping press has hired 11 fellows, more than doubling the program. “I don’t think we’re a silver bullet to the problem, but we’re part of the silver buckshot. Systems are made up of people. New people help create new systems,” said Boyce.