Key recommendations from a report on Minnesota’s direct care worker crisis are moving ahead, with support from the Minnesota Olmstead Subcabinet. While much work remains to make the recommendations become reality, advocates are pleased to see progress.
The subcabinet, which oversees work to make Minnesota and its government agencies more inclusive to people with disabilities, approved a vital work plan November 26.
The plan is tied to the report, Recommendations to Expand, Diversify, and Improve Minnesota’s Direct Care and Support Workforce Workplan. The report, which has been under subcabinet consideration for months, was tabled in October so that the Minnesota Department of Human Service (DHS) could review the plan recommendations further and the implication of some action items.
Longtime disability communityadvocate Jeff Bangsberg, who served on the advisory committee that researched and drafted the report, thanked the subcabinet for moving recommendations ahead and expressed gratitude for the work state agencies put in during November to move the report along.
He spoke to the worker shortage and how it is affecting many people. “We need direct care staff to get us out of bed in the morning, and to help us with our activities and our daily lives,” he said. Bangsberg also agreed with state agency representatives’ call for more data on the workforce issues. “We really need the data to enable us to go to the legislature, and put our best foot forward in explain what the problems are.”
The recommendations were reviewed and amended before the November 26 vote. Staff from the Department of Human services (DHS) and Department of Employment and Economic Development (DEED) reviewed the work group’s proposals, with the state agencies delineating what each is responsible for.
The plan stated, “This workplan is designed to improve access to needed services and increase quality of life for people with disabilities by increasing the number of qualified direct care workers and retention of experienced workers who are needed to support people to live, work and engage in their communities. Having well-trained direct care professionals in place, leads to better health outcomes, more consistent care as turnover rates drop, and supports people to be fully participating and contributing members of society. The stakeholder working group which brought forth recommendations drew on research and expertise within Minnesota and nationally to understand the issues, and prioritize strategies to meet the challenges Minnesota faces with demographic changes that are contributing to the current workforce shortage.”
The plan goes on to state that there is a workforce shortage in all areas of commerce in Minnesota, not just in the area of direct support workers needed in long-term services and supports. It goes on to explain that while state agencies recognize their role, agencies cannot alone resolve the workforce challenges faced by people with disabilities. Others will have to help.
“The work plan is a living document that will be modified to reflect future legislation or other opportunities to collaborate on strategies,” it stated.
The plan’s strategies to expand, diversity and improve the direct care workforce don’t contract what the work group recommended. Instead, the recommendations were expanded upon and more direct actions and deadlines were spelled out.
The amendments approved in November don’t contradict the report recommendations that call for expanding, diversifying and improvement the pool of direct care and support staff workers. Instead, recommendations expand upon points made. Deadlines are also set in some cases.
One example is a recommendation to conduct analysis for a competitive workforce wage adjustment for direct care
workers providing Home and Community Based Services (HCBS), with options for a one-time increase in compensation and indexed adjustments every two years. This is to be based on the average of the Bureau of Labor Statistics Occupational Classifications (SOC) codes for similarly skilled/educated occupations and include total compensation.
“The expected outcome is that if acted upon through legislation, a competitive workforce wage and parity among workers will enable people with disabilities and providers of HCBS services to address current difficulties in attracting and retaining quality direct care workers to meet the health and safety, employment and community engagement needs of people receiving support across the state. More frequent adjustments will make HCBS rates keep pace with economic changes,” the amended work plan stated.
Analysis of this goal is to be given to the subcabinet by January 31, 2019. The original report stated that the analysis was to go to DHS.
A second task with the same timeline is to provide the subcabinet with analysis on personal care attendant (PCA) reimbursement rates to allow for differentiation of rates based on the level of training and care required by the person receiving services. “A report on what is required to adjust PCA rates to take into account higher levels of skills and training required to support people with greater and more complex support needs will be available to interested parties, including legislators, state agencies, providers, researchers, advocates and people who use services and their allies as they consider strategies to address workforce pressures.’ The report stated.
Deadlines are also outlined in following months for a survey of workers, a look at how to provide better worker benefits, technology, training and training gaps, hiring strategies and preparation of material and plans to mark direct care as a career path.
In some cases, steps are already being taken, said Alex Bartolic, director of disability services at DHS. One example is Direct Support Connect, a servicer which is meant to help workers and those in need of staff find each other.
Another study that is rolling is that of transportation. Legislators have authorized a study of the problems workers and their clients face. “It’s a big issue for everyone,” Bartolic said. Subcabinet members said they were pleased to see further analysis and fleshing out of issues. Mary Tingerthal, who leads the Minnesota Housing Finance Agency, chairs the subcabinet. She said the work group’s efforts and review and approval of recommendations has been a very thoughtful process.
“The recommendations don’t overpromise but hit on the fundamental points, if we are to make a dent in the workforce shortage,” Tingerthal said. Her hope is that DHS, DEED and the Olmstead Implementation Office bring forward the importance of the report and its recommendations in the months ahead.
The current subcabinet leadership has recommended to incoming Gov. Tim Walz that the subcabinet’s work continue. Regardless of that, a new subcabinet will have a learning curve and will have to get up to speed on issues including the workforce issue and the study.