The staffing shortages at IDD community-based group homes and the related closures have serious implications for the IDD population that resides in them.
More than half a million people with intellectual and developmental disabilities and related conditions (IDD) live in Texas. People with IDD often need assistance with learning, mobility, language, and self-care. Of the IDD population, about 15,000 people reside in either community-based intermediate care facilities for individuals with an intellectual disability or related condition (community-based ICFs/IID) or Home and Community-Based Services group homes (“HCS group homes”), and many thousands more are currently on interest lists hoping their name will soon rise to the top of the list. These 15,000 residents qualify for IDD-linked benefits under the state’s Medicaid program, which requires that they have only limited income and assets and display a certain level of need for care.
Direct support professionals (DSPs) at IDD community-based group homes are the people who work with the residents on a daily basis and ensure they are receiving the care they need. The wage rate for DSPs is set by the state at $10.60 per hour, although providers can vary the specific wages paid to workers. If an IDD community-based provider pays above the wage rate set by the state, it does so at a loss, because the state’s Medicaid program will not reimburse providers at a higher rate even if they spend more. Moreover, the work of DSPs is often stressful given the medical and behavioral challenges much of the IDD population faces, and benefits such as health insurance coverage and access to a 401(k) plan are not common.
This $10.60 base wage is not competitive with the pay for many entry-level jobs across the state, such as those at restaurants and grocery stores, many of which pay $15 or even $20 an hour, plus benefits. Strikingly, the $10.60 base wage is not even competitive within the same industry; the base wage for DSPs who serve residents with IDD in state-supported living centers (SSLCs) is currently $17.71 per hour, and is scheduled to rise above $19 per hour beginning September 2024. Moreover, as state employees, their health insurance coverage is paid entirely by the state.
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