The intellectual disability health care field is experiencing a shortage of direct support professionals that approaches crisis proportions.  Direct support professionals are those individuals who work directly with adults and children who have intellectual disabilities, assisting them with achieving their highest levels of independence and integration.  Fueled largely by a sub-living wage of about $11.50 per hour, the field is plagued by high turnover (26 percent per year) and high vacancies (12 percent).  These low wages qualify many direct support professionals for significant levels of public welfare support, in some cases as much as $15,000 per year.

This staffing crisis negatively impacts program continuity, use of overtime, and the quality of life for supported individuals who have intellectual disability.  At the same time, the demand for direct support professionals is increasing due to the growing needs of the baby boomer generation as they age and their support needs increase, and this will only heighten the staffing shortage.

The crisis occurs in the midst of a national movement to increase the minimum wage for all jobs.  The direct support professional staffing crisis, combined with the national minimum wage movement, prompted three Pennsylvania provider associations (The Alliance of Community Service Providers, Pennsylvania Advocacy and Resources, and Rehabilitation and Community Providers Association) to fund a research project to estimate the impact of increasing Direct Support Professional wages to $15 per hour.  Using data from a 2016 Pennsylvania wage survey of direct support professionals in the intellectual disability field, researchers were able to estimate that the potential benefit to Pennsylvania could be as high as $199 Million annually in savings.

While the initial front-end cost of the wage increase would cost Pennsylvania approximately $237 million per year, this cost would be offset on the back-end by savings from reduced overtime use, reduced recruitment/retention expenses, and reduced reliance on various forms of public welfare by direct support professionals.  In addition to the fiscal offsets, the study anticipated that the higher wages would attract higher skilled individuals to the field and enhance program continuity by reducing turnover.

The study concluded that it is unconscionable to pay poverty-level wages that require direct support professionals to rely on public assistance.  It should be recognized that with the excessive overtime they work (required to ensure safety) and the reliance of direct support professionals on various forms of public welfare, society is already paying well more than the $11.50 wage, in terms of wages combined with public welfare benefits.  Shifting funding to wages would improve program quality and enhance the dignity of workers.

Recently, this study was presented before the Pennsylvania House of Representatives Human Services Committee as part of a hearing that focused on the direct support professional workforce crisis and the need for increased wages.  Additionally, the Philadelphia Inquirer's, "Falling off the Cliff," series has highlighted this important issue.  Hopefully these efforts will continue to raise awareness about the importance of supporting this critical workforce and our most vulnerable citizens in our health and human services system.

Tine Hansen-Turton, Scott Spreat, and Kristen Farry are with Woods.  Nick Torres is with Social Innovations Journal.