Oregon’s Growing Wage Gap


BY ERIN J. BERNARD

Wage gaps and workforce shortages are threatening the quality of care and supports to Oregonians with intellectual and developmental disabilities. Who’s caring for those who care for our most vulnerable residents? 

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BY ERIN J. BERNARD

Wage gaps and workforce shortages are threatening the quality of care and supports to Oregonians with intellectual and developmental disabilities. Who’s caring for those who care for our most vulnerable residents? 

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Life presents unique challenges to each of the 38,000 Oregonians living with Intellectual and Developmental Disabilities (IDD), from managing complex medical and mental health challenges and interacting safely with the community to shopping for groceries and preparing dinner. 

For help with these tasks, this vulnerable population depends on a dedicated segment of the direct care workforce known as Direct Support Professionals (DSPs). 

Oregon’s 14,000 DSPs provide crucial daily support, training and assistance in skill development to people with complex, challenging needs, and they do their work through community agencies offering everything from 24-hour residential or in-home care and crisis management to support for employment, education and socialization services. 

This is not an easy gig, says Oregon Rehabilitation Association Executive Director Chris Burnett: “You have to have the right makeup for it. You have to be a very compassionate, patient and intuitive person.”

ORA, a statewide association of community providers of services to individuals with IDD, educates and advocates for 67 agencies across Oregon, says Burnett: “Our role is to collect the issues being raised by members and carry that forward in the aggregate. We help members prioritize, sort and filter.”

ORA also brings agencies together with state decision-makers at a variety of regular events from major conferences to roundtable meet-ups to discuss issues affecting quality of care, and it has lately tracked one particularly alarming trend: demand for DSPs is growing, but agencies just can’t fill the vacancies. 

Agencies depend on DSPs to provide the specialized, 24-hour care individuals with IDD can require, and that job demands great resiliency, says Maren Gibson, a 12-year veteran of the profession who works at Monmouth-based Partnerships in Community Living (PCL). Gibson might spend her morning at the movie theater and her afternoon helping someone who uses a gastronomy tube to eat lunch. She might offer complex relationship advice, or use body language to interpret basic needs.

In addition to being skilled communicators, DSPs must understand a broad range of disability types, from autism to emotional disturbances to speech and language disorders. They must administer medication and treatments and also confer with families, medical care providers, and the justice system as needed.

“It all depends on what the person in front of me needs,” says Gibson. “There’s not really a clear beaten path.”

Where have all the DSPs gone? 

Dedication and talent may be essential to this specialized calling, but low wages persist. Oregon’s providers are reimbursed at a rate of $10.80 per hour worked by a DSP — about $22,000 per year. There’s been no cost-of-living adjustment since 2009, so funded pay hasn’t kept up with economic growth. And if an individual requires more support hours than state funding covers, agencies must make up the unfunded difference. 

Fail to compensate the workforce that supports people with IDD, Burnett warns, and the entire system could crumble. Cracks are already appearing as DSPs decamp en masse to become Personal Support Workers. PSWs are hired directly by individuals, have minimal training requirements, supervision or oversight, and command an hourly state-funded minimum wage of $13.75 an hour. This will increase to $14 an hour in January 2016 and $14.50 in February 2017. 

Other DSPs are taking jobs in foodservice and landscaping, which doesn’t surprise Jeanne Farr, President of Disabilities Services and Strategic Projects for Albertina Kerr: “They can go to Whole Foods and work as dishwashers or in maintenance and make more,” she says. “They can go to McDonalds and make more. People end up leaving because of financial need, not because they want to leave the field.” 

This exodus has left many Oregon provider agencies chronically short-staffed, constantly onboarding new hires, and scrambling to cover labor costs with hard-to-come-by fundraising dollars. 

Partnerships in Community Living prioritizes higher-than-minimum wages for DSPs, says Associate Director Joanne Fuhrman, but agencies can only do so much: “As a private non-profit, we’re obligated to use resources we have to provide services to people. Providers have to work really hard to be creative.”

It takes $11,000 and three months for PCL to train a DSP—a big investment in someone who could leave within months. 

“We end up with people in a transitional point in their lives, people who are new to the workforce and college students as our DSP workforce,” she says. “All of whom are great DSPs, but they don’t stay…that means that someone we support has to get to know someone new who comes into their life seven, eight, nine, or ten times a year.”

Turnover makes everything trickier, agrees Gibson: “You can’t provide general training on specific people. Your training is your interaction with that person every day.”

Gibson recalls a man who regularly assaulted himself and others when PCL began supporting him. It was his only way of communicating needs until staff started teaching him American Sign Language. Today, the man is calmer, more communicative, and fully employed. 

When providers’ faces change constantly, notes Farr, it’s hard to gain the trust required for such transformations: “We serve people requiring immense personal care who need assistance in all their daily activities…Can you imagine being in that vulnerable state and looking up and seeing a stranger?” 

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Championing Change

Oregon’s making sweeping changes to how it administers programs for people with disabilities as demand grows and a more community-oriented model of care gains traction, says Burnett.

Implementing the flood of directives isn’t easy for agencies already stretched thin, so ORA educates its members on lynchpin policies and issues, and it trains them to become their own advocates, capable of educating state decision-makers in turn. 

If Burnett wielded a magic gavel, she’d order the state to pay DSPs a competitive living wage with regular cost-of-living increases. 

“It would allow staff to see, “This is viable; I can make a career of this, I can support myself and my family,” she says. “Those two things would dramatically result in more stability, higher-quality services, and more sustainable services.” 

Last legislative session, ORA took steps toward that future by backing “Value the Work, Raise the Wage,” a campaign that aimed to bring DSP wages to parity with PSW wages. Despite vocal advocacy from desperate agencies, the legislature only approved a four-percent, 23-cents-per hour pay increase, with DSPs still earning less per hour than others doing the same or similar work.

It’s not nearly enough, says Burnett, and an indication that state decision makers truly don’t appreciate the gravity of the direct care workforce crisis.

Gibson vowed at the start of her career to work tirelessly to enrich the lives of people living with disabilities. She’s kept that promise, despite pay so low she can’t qualify for a home loan, but it’ll take more than a few extra pennies an hour to keep this workforce strong for the long haul.

Ultimately, taking better care of those who care for people with disabilities isn’t just a social imperative, says Burnett; it’s a sound investment in our own futures. 

Provider agencies are often major community employers who spend millions of dollars on goods and services at local businesses. 

We are all likely to directly encounter disability at some point in our lives, Burnett points out: “Most people have some knowledge or association with somebody with a disability, whether it’s mental illness, Down Syndrome, autism, or an aging parent who has mobility issues or Alzheimer’s. It behooves all of us to take a look at this and say, ‘How are we going to manage this and fix it? How are we going to make sure the people we love receive support when they need it?’” 

DSPs, says Gibson, are the answer: “We are the in-between step before the hospital, before the police officer, before crisis or death happens. We [as a State] get so involved in reactive strategies that we’re not noticing that the people in the middle can make a big difference.”