Direct Service Workforce Shortage

	The Issue	The Latest Scoop	Action Steps	Lead Contacts	More Information

The Issue

Our community support system has been under-funded for years. The cost of providing day-to-day support exceeds the rate of funding available from the state. This results in pressures to limit wages and benefits for direct service workers and increase the risk that counties and providers will be pushed to water down services in ways that contradict common advocacy principles of choice, individualized support and inclusion. A 2003 Wisconsin Council on Developmental Disabilities (WCDD) survey of direct service agencies showed that the first steps in remedying the direct service workforce crisis include:

1. An increase in the daily rates for CIP Medicaid waiver programs-and comparable increases in reimbursement rates for Medicaid personal care-to support improved wages and benefits and more stable provider agencies. Build in a mechanism for cost of living increases.
2. Health insurance reform that results in increased access and affordability of coverage for direct service workers.
3. Funding to retain a committed workforce through training, supportive supervision, recognition and increased status.

The Latest Scoop (Updated: 10/17/2005)

WCDD’s State Plan identifies three objectives for improving the status of direct service workforce. Here is a summary of our current activities and priorities.

1. Improve wages and benefits. There is a need to reform the policies and practices that contribute to sky-rocketing health insurance premiums, deductibles, and co-payments. As various proposals are introduced, we will analyze their likely impact on direct service agencies. For more information contact Chris Thomas-Cramer at WCDD, ThomaCM@dhfs.state.wi.us
   
   The Survival Coalition of Wisconsin Disability Organizations continues to advocate for increased Medicaid waiver rates so that workers can be paid fair wages.
   
2. Improve retention of direct service workers. WCDD in partnership with the Bureau of Developmental Disabilities Services (BDDS) has developed a series of trainings targeting workers and the agencies that employ them.
   
   Training modules on “Good Work” and “High Reliability Organizations” are examples. WCDD and BDDS worked with John and Connie O’Brien and others to develop several modules aimed at improving the workplace culture to foster workers’ long-term commitment. For a summary of these trainings and an evaluation report, see Melissa Mulliken’s report, An Evaluation of the Wisconsin Council on Developmental Disabilities Workforce Trainings. For information on the availability of future trainings, contact Marcie Brost, DD Section, BrostMM@dhfs.state.wi.us.
   
   Workshop on Power and Control. The workforce project also presents a training on the dynamics of power and control in the relationships between direct service workers and the people they support. For information on the availability of future trainings, contact Marcie Brost, DD Section, BrostMM@dhfs.state.wi.us.
   
   Other Training. WCDD is interested in exploring the value of internet-based skills training for direct service workers. One option is the College of Direct Support. For more information, contact Jennifer Ondrejka, OndreJM@dhfs.state.wi.us.
   
3. Recruitment. WCDD is interested in piloting an internet-based method of linking prospective direct service workers with the provider agencies. One promising model is Rewarding Work.
   
   This model markets the positive and rewarding opportunities associated with direct service work and provides the internet technology to link workers and agencies. For more information, contact Jennifer Ondrejka, OndreJM@dhfs.state.wi.us.
   

Action Steps

1. Visit or write your state and county elected officials. Help them understand the importance of this work and the need for better wages and benefits.
2. Write a letter to the editor of your local paper.

A 2003 WCDD survey of direct service agencies showed that:

• Frozen funding of the CIP Medicaid waiver program results in low wages and eroding health insurance benefits for direct service workers.
• Low wages and eroding health benefits contribute to high worker turnover rates.
• High turnover rates impact the continuity, safety and reliability of support that vulnerable people with developmental disabilities rely on.

Solution:

1. Increase CIP rates now and build in a mechanism for automatic cost of living increases for the future.
2. Reform health insurance so that it is affordable and available to direct service workers.

Lead Contacts

Nancy Leipzig
CAPOW/Clarity Care
424 Washington Ave
Oshkosh WI 54901-5044
920/236-6560
nancy.leipzig@claritycare.org

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More Information

• Plain Talk:
  
• Advocacy Resources:
1. Workforce Advocacy Poster
   
• Background Papers:
  
  1. Little Papers, Peter Leidy and Phoebe Hefko, 2005
  2. Wage and Benefit Report, 2003
  3. Holding the 10,000 Details: Productive Relationships Between Parents of People with Developmental Disabilities (Link to PDF and/or printed copy), 2001
  4. Wisconsin Wage/Benefits of Direct Support Workers, February, 2004
  5. Staff Retention Among Direct Support Workers in Wisconsin, July 2002
  6. Op Ed article by Gerry Born, August, 2003
  7. Survival Coalition position on direct service workforce, December 2002
  8. Common Understanding of the Workforce Crisis (Link to PDF and/or printed copy), 2002
  9. The Workforce Riddle in a Rural County (PDF). Gaye Wenger, DD Network, March 2002.
  10. The Workforce Riddle for Counties (PDF), Charity Eleson, DD Network, March 2002.
  11. Relationships and Change (PDF), Kim Turner, DD Network, March 2002.
  12. Experiencing Loss in Unexpected Places, K. Turner, M. Brost, A. McGrath, WCDD, March 2002.
  13. Health Reforms: An Absolute Necessity, Wisconsin Council on Developmental Disabilities, August 8, 2001
  14. Business Initiatives to Expand Health Coverage for Workers in Small Firms, by Commonwealth Funds, November, 2001
  15. An Unaccounted-for Workforce Cost, Thomas Cook
• Fiscal Information:
  1. CIP 1B
• Stories of Wisconsin's citizens with disabilities:
  
• Links to relevant disability information: