One In Six DD Jobs in RI Goes Unfilled; Raises Would Ease Crisis and Improve Service Quality

image by capitol tv 

image by capitol tv 

Kevin Nerney of the Rhode Island Developmental Disabilities Council, left, and Maureen Gaynor, second from right, share pleasantries just before their testimony before the House Finance Committee on Feb. 8. Looking on are Gaynor's support worker, Melanie Monti, and Emmanuel Falck of the Service Employees International Union State Council.  Image by RI Capitol TV. 

By Gina Macris

Raising the pay of Rhode Islanders who serve adults with developmental disabilities is not only about helping these poverty-level workers pay their bills, according to testimony before the House Finance Committee Feb. 8.

The proposed raises also will reduce staff turnover and, in turn, improve the quality of life for some of the state’s most vulnerable citizens, Donna Martin, executive director of the Community Provider Network of Rhode Island (CPNRI), told the legislators. 

Kerri Zanchi, the new director of the Division of Developmental Disabilities, agrees with Martin’s assessment. Zanchi says the pay hike is not only an “investment in the direct service professional, but an investment in our community" and in high quality services.  

She estimates that the wage increase will amount to an average of 42 cents an hour, and says that provider agencies are now experiencing a staff turnover rate of about 33 percent.

Carol Dorros, the mother of a 21-year-old man with behavioral issues and other complex problems, knows firsthand the value of support staff retention. When her son was still in high school and receiving some adult services from a private agency, his support worker changed four times during a single academic year. As a result, he made “no progress” from September to June, Dorros said.

 Maureen Gaynor rolled up to the speakers’ table in a power chair and used a computerized voice to speak the text she had written with a “headstick,” a pointer attached to a band around her head.

These people deserve higher pay, Gaynor said, explaining that support staff sometimes must help with the most intimate care, such as bathing, dressing and using the toilet.

And she reminded the legislators that she would not have been able to attend the hearing without an aide willing to drive her to the State House and get her to the basement hearing room.

After she spoke, Kevin Nerney of the Rhode Island Developmental Disabilities Council reinforced her remarks:  “When you help someone eat, drink or bathe, you need to have a really good relationship with that person. We’re not talking about folding shirts at the Gap or flipping burgers at McDonald's,” said Nerney.

At AccessPoint RI, a service provider, the starting salary is $10 an hour, or $22,000 a year, said the agency’s executive director, Tom Kane. The average pay was $10.82 an hour until the current fiscal year, when the General Assembly set aside $5 million for raises for developmental disability workers – the first pay increases since 2006, Kane said.

The added funding resulted in a 36-cent hourly increase, raising the average to $11.18, according to calculations made by service providers and others.

When Kane reviewed the the roster of employees at the time his agency processed the raises last fall, he said he was heartbroken to find a 30-year employee who was to receive a total of $13.10, with the pay bump.

Kane and others indicated they believe that a “15 in 5” campaign to raise the pay of direct care workers to $15 in five years (by July 1, 2021), is simply not enough.

Kane alluded to a drive launched by State Sen. Louis DiPalma, D-Middletown, last fall when he asked Governor Raimondo to include a raise for direct care workers in her budget proposal for the next fiscal year.. While she has done so, her $6.2 million set-aside for wages is about $$600,000 shy of what DiPalma requested.

Kane said raises should not only be based on a percentage increase.

 “A four or five percent increase on an insufficient wage is an insufficient increase,” he said.

If the minimum wage increases to $10.50 an hour, as Governor Raimondo has proposed, “and we give 5 percent” raises, Kane said, “we’re paying minimum wage again.”

Kane took issue with figures presented by Linda Haley of the House Fiscal Staff that the raises in the current budget also bumped up pay for supervisory personnel.

He said the raises all went to direct care workers, (as stipulated in current state budget.)  Some agencies, including AccessPoint, used other funding sources to provide raises or bonuses to supervisory employees.

At AccessPoint, Kane said, front-line supervisors spend half their time doing direct care anyway.

“It is incredibly important that this bill passes, hopefully with more money in it,” to support not only those providing direct care but people who perform other important tasks, like writing clients’ state-mandated individual support plans, which are akin to road maps for services that are specific to each client. Most of these employees “have not had a raise in 11 years,” he said. “I don’t know why they stay.”

Emmanuel Falck of the Service Employees International Union (SEIU) State Council represents 270 workers at the Arc of Blackstone Valley. One of them, a 52- year-old woman with 20 years’ experience in the field, used to be able to make ends meet by working 60 to 65 hours a week, he said.

But after an 18-month bout with cancer, the most she can now work is 20 hours a week. And the last vacation she had was three days in Washington, D.C., in 2000, Falck said.

He said the proposed 42-cent increase to the hourly rate would be much appreciated, but the state needs to move faster to raise workers’ pay to a living wage.

“I urge this committee to bump it up as fast as possible,” he said, proposing a $15 hourly wage by 2019 instead of 2021. As it is, direct support workers living in Rhode Island will be able to cross the state line to neighboring Massachusetts and do the same work for $15 an hour on July 1, 2018, Falck said.

Donna Martin, the CPNRI director, said that developmental disability service providers face a “tremendous crisis” in competing for the same pool of workers who serve elderly clients, thanks to a growing number of aging baby-boomers.

On average, the 27 providers belonging to CPNRI cannot fill one in six job openings, creating a vacancy rate of about 16 percent, she said. During exit interviews, workers say that they love their jobs but can’t feed their families with what they are paid, according to Martin.

As a result of the vacancies, employers are forced to spend money on overtime that they would rather put into worker pay and training, Martin said.

“I appreciate your sensitivity to the struggles of our staff,” Martin told the finance committee members.  “They are where the rubber meets the road when it comes to quality.”

Chris Semonelli of Middletown, the father of a 14-year-old girl with autism, put some historical context around the discussion of the wage proposal.

From 2006 through 2011, the budget for developmental disability services was reduced 20 percent, Semonelli said, quoting a profile of the system written by the Sherlock Center on Disabilities at Rhode Island College in 2013. And the services are not designed with an eye toward results. In the current design, more money gives more of the same service, he said.

That said, Semonelli said he strongly supports Governor Raimondo’s proposed wage increase in the next budget, as well as the “15 in 5” campaign. The governor’s plan for the next fiscal year “is a start,” said Semonelli, who also is co-director of an advocacy group called Friends of the Disabled on Aquidneck Island.

Although Wednesday’s hearing sounded like a budget discussion, it focused only on Article 23 – one of 24 chapters in the overall fiscal package Raimondo has submitted to the General Assembly.

The provision would require a one-time increase in the base pay of direct care workers, “in an amount to be determined by the appropriations process” and also require the Office of Management and Budget to perform an audit to ensure that the raises go only to those workers. 

RI Official Describes How Nearly $12 Million in DD Budget Responds to Consent Decree

By Gina Macris

Rhode Island is poised to offer financial rewards to agencies that meet certain performance goals in delivering supported employment services to adults with intellectual and developmental disabilities, according to the Deputy Secretary of Health and Human Services.

At a meeting of the Employment First Task Force on Aug. 9, Jennifer Wood explained how the state will use a total of nearly $12 million in funding authorized by the General Assembly in the current budget to implement the two year-old federal consent decree which mandates that adults with developmental disabilities have access to regular jobs in their communities.

A total of $6.8 million will be set aside for the supported employment bonuses –an estimated average of $15,750 after a client has been employed for six months. An additional $5.1 million has been earmarked for modest wage increases to about 4,000 agency staff who work directly with clients.

Ultimately, it is up to Judge John J. McConnell, Jr. of U.S. District Court to say whether these measures conform with a detailed order he issued in May requiring Rhode Island to lay the groundwork for long-term compliance with the consent decree, which remains in effect until Jan. 1, 2024.

At some point, the independent court monitor in the case, Charles Moseley, is expected to report to the court on whether he believes that state’s latest compliance efforts meet the requirements of the court order.

The May 18 order said that by Aug. 1, the state had to:

  • implement performance-based contracts for supported employment services
  • implement a flexible reimbursement model that pays service providers for the actual cost of providing services
  • implement individual financial authorizations for clients receiving services that include specific allocations for supported employment services 
  • increase salaries, benefits, training, and supervision for direct service workers and job coaches.s

The Task Force, made up of representatives of individuals with developmental disabilities, their families, and community organizations, was created by the consent decree as a bridge between government and the community. It met in the offices of the Community Provider Network of Rhode Island on Jefferson Boulevard in Warwick, 

Wood told Task Force members that the private agencies employing the workers will get lump sums for raises retroactive to July 1, but she could not say exactly when that will happen. Figuring out the payments has been a huge mathematical exercise, she said, and still requires changing the programming on state computers.

Based on current average pay of $11.55 an hour, the raises would be an average of $.30 an hour, Wood said, although actual salaries vary from one agency to another.

In a report to the court on July 29, the state said that it will require service providers to show that the money went to workers who have direct contact with clients, as the General Assembly intended.

Wood told Task Force members that state officials have been working with private service providers on the incentive program.

The July 29 report to the court said the incentive program will be implemented from August through next June, although the state has not yet begun taking applications from service providers. The program will serve a minimum of 200 clients with developmental disabilities. according to the filing with the court.

These clients will receive specific allocations for supported employment services as part of their individual financial authorizations from the Department of Behavioral Healthcare, Developmental Disabilities and Hospitals (BHDDH), Wood said in a brief interview after Tuesday’s meeting.

Others served by BHDDH who are not part of the supported employment incentive program will not be affected. That means that if they want supported employment services, they must continue to trade in hours from another category of daytime support.

The bonuses will be paid in stages; when a client gets a job and after three months and six months on the job respectively, according to the report to the court. It also said the dollar amounts and numbers of incentives may be adjusted.

Wood told the Task Force that the experience of the first six months of the program would be used to make improvements for the second half of the fiscal year.

After the meeting, she said the incentive program would be an added “layer” over the current reimbursement model, which requires agencies to document clients’ face-to-face interaction with direct service workers in 15-minute increments during the day. 

That “unit service model” will remain in place, she said.

Because the reimbursement system does not pay an agency when a client is absent, for whatever reason, the provider cannot collect the full amount of the client’s authorization for daytime activities.

The consent decree found fault with this method of payment. It required the following change:

“The State will ensure that its reimbursement model for day activity services is sufficiently flexible to allow providers to be reimbursed for costs (e.g. transportation to the job site, employer negotiation, counseling clients by telephone) that are: (1) directly related to providing Supported Employment Services to individuals in the Target Populations, and (2) provided when service provider staff is not face-to-face with a client. “