Nonprofits concern future with out federal cash

Care providers for people with developmental disabilities across Florida are sounding the alarm as an important deadline for federal funding of their services approaches.

Both state institutions and private community-based providers rely on the work of “direct support professionals”, minimum wage workers who are entrusted with the care of patients with disabilities, whose tasks range from dressing rooms to administering medication.

Florida Governor Ron DeSantis’ new budget raised the minimum wage for government employees in institutions for developmental disabilities to $ 13 an hour, effective July 1.

However, proponents of nonprofit care services like The ARC of Alachua County say this pulls workers away from their organizations and institutionalizes those who rely on those care services.

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Mark Swain, the organization’s CEO, said community-based services like the ARCs provide care not found in government settings.

“Inpatient care is the worst care you can get at the highest price,” he said. “But that’s where the money goes.”

ARC cannot afford to pay DSPs the new minimum wage, the director says

The ARC can only afford to pay their DSPs less than $ 11 an hour, an amount that is influenced by state and federal funds. With the Florida Medicaid Support Percentage, 60% of community-brokered services are paid for by the federal government and the rest by the state.

Most recently, the American Rescue Act, a $ 1.9 trillion economic incentive passed by Congress in March, allocated $ 450 million in federal funds solely to community-based services in Florida.

But after requesting an extension this month, the state has until July 12th to accept that money before it goes away.

“It will literally cost Florida no more money,” Swain said. “But if they don’t, Florida will be more injured than ever.”

Swain said he got client referrals from across the state but couldn’t even consider them. The ARC has six open spaces in one of its group houses, but it lacks 55 employees, which makes the nursing service too thin to accept new customers.

“And we urgently need this income,” he said. “We can’t take them in – we don’t have the staff.”

Swain said these recommendations come from families of people with developmental disabilities traveling across the state to find a provider who can help.

“Right now people just float,” he said. “There is nowhere to go.”

Impact of the COVID Pandemic on DSPs

Swain said his DSPs have been working 100-hour-a-week shifts since the pandemic began, resulting in burnout and layoffs.

But this DSP shortage precedes the COVID-19 pandemic. Alachua County’s ARC was short of 24 workers before more left due to additional stressors during the pandemic. Swain said he needed 160 DSPs to run at full capacity, but it’s only 105 right now.

“It’s low wages and then COVID just makes it easy,” Swain said, clasping his hands together.

In the summer of 2020, the ARC gave DSPs $ 100 a week bonuses just to show up on their shifts.

In November, Swain managed to raise $ 250,000 in CARES Act funds from the Alachua County Commission to cover these costs.

Florida lawmakers set reimbursement prices for services, which means nonprofits cannot raise or lower the prices of their services, Swain said.

“There is nothing we can do,” he said. “Anything we do when we run out of time we have to do the best we can to raise wages and then we’ll just lose money and you can’t have a cake sale to make up for that.”

Ultimately, Swain said, that burden rests on the disabled who do not get the care they need.

“There are many families who depend on these services,” he said. “Families count on us.”

How community-based care providers differ from institutions

With government money flowing into institutions, the only hope of keeping community-based providers afloat is to get the state to accept federal funding. Any reservations Florida might have about accepting the federal money stem from state accountability, Swain said. He compared the situation to the Florida decision not to expand Medicaid.

“You want to make sure that there are no bad terms or anything attached that are not,” he said.

On June 29, Florida community providers met with disability officials and the governor’s office to come up with a two-year plan that would enable these nonprofits to meet the $ 13 hourly wage already promised for government employees.

Alan Abramowitz, CEO of The ARC of Florida, said 60 group homes across Florida will be closed between March and May 2021.

“I trust that the government will do what is best for the people who are among our weakest,” he said.

Even if all goes well, community-based vendors still have to convince their workers to keep going while promising to take on the raise the state has already given its workers. With labor shortages across the country, municipal providers also have to compete with higher wages in the service industry – McDonald’s now pays $ 12 an hour.

“(DSPs) really care who they serve and you know they want to stay, but it’s hard,” he said. “You also have a family and there are other jobs that do similar jobs in higher-income institutions. I mean, what is the person likely to do? “

Swain said federal funding would do exactly what it was supposed to do – stabilize community-based providers.

“We’d raise the pay for DSPs and hopefully get people back,” Swain said. “And then you hire more because these people deserve to make more.”

The DSP workforce consists mostly of women and women of color who have an average annual income of $ 19,000, according to a report by the Paraprofessional Healthcare Institute.

“It’s a systematic bias,” said Swain.

Gerald Simmons, now assistant production director for the ARC of Alachua County, joined the nonprofit seven years ago.

“It was very, very rewarding for me because I came from an environment of pristine evil and the people here are so innocent,” he said.

Simmons worked in forensic mental health at the North Florida Evaluation and Treatment Center for 30 years, where he said he worked with the “Ted Bundys” and “Jeffrey Dahmers”. Simmons was named Employee of the Month within four to five months of joining ARC.

“Whatever role I had to play, whatever I had to do to make sure we were successful,” he said. “Because this thing is bigger than us. It’s not about us, it’s not about the staff. It’s about the customers we serve. “

But without government cooperation to solve the low-wage problem, community-based services like the ARC could disappear.

“We’ve been here since 1966 and we’re about to get plowed,” said Swain.