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2016 Executive Budget

A salary increase for direct support workers is in play and it won’t happen unless advocates can convince their legislators to do what the Governor has not done.

How could you support legislation for a $15 per hour minimum wage and not include a wage increase for direct care workers- workers paid through the state’s own Medicaid program? How could you mandate private businesses in the fast food industry to pay a $15 minimum salary and not support agencies like Camp Venture who provide essential care to our most vulnerable citizens with the funding to do the same for their staff?

It makes no sense and we can only hope that this glaring inequity can be addressed before the 2016 State Budget is finally passed. Even if the minimum wage law does not pass in the legislature something has to happen with the direct support wage or there will be no direct support. What it will take to make this right is an avalanche of phone calls, emails and meetings with individual representatives so that our state elected official in the Senate and the Assembly really get the message. Anyone who cares can not afford to sit this one out, especially not this year, or it just won’t happen.

Our state economy has come a long way since the economic collapse of 2007. Unfortunately, the people who provide care and support to our state’s most vulnerable citizens with developmental disabilities have not. Medicaid cost in the past several years have risen by about 3.7% a year but direct support salaries have barely risen that much since the Governor took office. For these dedicated and hardworking staff, the wage has been stagnant, the work has gotten harder, the professional demands and personal liability have increased and the recession (for them), continues. It is an unaddressed problem with potentially serious implications for our state’s system of care.

Direct support professionals are, just that, professionals. They are required to master a range of complex tasks in order to ensure the care of the people entrusted to them. They include, the teaching of self care, managing behavioral interactions according to a clinical prescription, involved health care interventions which they perform under a Registered Nurse’s license, along with anything and everything that might be required to ensure every aspect of an individual’s personal care. They drive, promote personal relationships, administer medication and engage people in their community. They are at once, teachers, nurse’s assistants , social workers, mentors and friends. They work with the very young and the very old and are with them until the time of their death. They work in community homes and in formal and informal settings and, often they work with little or no direct supervision.

Direct support professionals are also responsible for the accuracy of Medicaid billing and they are subject to oversight not only by the organizations and governmental bodies that they work for, they are also accountable to the Justice Center and the Medicaid Inspector General. In either case, consistent with the expectations of a profession, if they make a mistake with either the care and supervision that they render to vulnerable persons or with their billing, they can be subject to felony criminal prosecution.

It’s a difficult and demanding job and yet, most direct support professional have a starting salary of just $11.00 per hour. And, though there was a salary increase in 2015 for these staff, it was the first since 2006 and, in that sense, their wage in real dollars has declined.

Today our system of care is at a crossroad. With increasing demands from the federal government to develop more independent alternatives for people with intellectual and developmental disabilities, the requirement is for a more professionalize workforce with increased sophistication in their skill development and behavior management ability. What is required is not in the realm of an $11.00 per hour job. And, in the context of an increasing minimum wage in other areas of the economy, our citizens with developmental disabilities who rely of these staff professionals, face a potential crisis.

People who work in service to their fellow man often do so out of a sense of mission and responsibility but ultimately under-paid and over-worked people are compelled to make hard choices just as governments and corporations do based on economic reality. If the wage does not feed your family or pay to put a roof over your head, you have to make a change and the concern is that many of these workers, especially the best of them, will leave as changes in other areas of the economy bring better wages.

The fastest growing occupation in the United States is Home Health Aid. We are an aging population and the need for qualified care givers and, most especially professionals who have the ability to work with people with Autism, behavioral challenges, complex medical conditions and other potentially life-threatening issues, is increasing. Securing the welfare of our most vulnerable people starts and ends with our efforts to maintain a workforce. Indeed, it is not simply about these workers and their sustainability, it is about the quality of life of the people they serve that we must consider. Effective care comes from a well-trained and professional workforce that have the requisite competence, motivation and compassion to help people to live lives worth living.

The time is now to address the very pressing issue of the direct support wage. Keeping good people in their jobs is more cost effective that an effort after the fact to fix a broken system. Leadership now will put us on the road to the sustainable future that the vulnerable citizens of our state need and deserve.

A mistake is not a mistake until it is irreversible and this oversight can still be changed by an amendment to the state budget. We can only hope that our leaders take this opportunity to lead. Justice that is not for all is not justice at all. This is public policy that we just can’t afford not to get right.

To get involved and find contact information for your legislators visit the IAC lobby page at this link:

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2008 Rockland County Autism Symposium Venture Foundation Address
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