“Government leaders continue to advocate for expedited vaccinations and PPE. Masks, however, are less important if there are no staff to clock into provide support to persons with disabilities within those homes.” Robert Stack CEO Community Options
The consensus is hospital staff and the vulnerable must be first in line for the vaccine. Persons with disabilities have a 35% greater chance of dying from COVID-19 than the general population. Many live in small group homes supported by direct care givers.
Nonprofits were ordered to wait for guidance from state officials for inoculation of the disabled. While important, there is something equally as significant.
Agencies employing staff who provide care for persons with disabilities continue to struggle with staff retention.
Government leaders continue to advocate for expedited vaccinations and PPE. Masks, however, are less important if there are no staff to clock into provide support to persons with disabilities within those homes.
Since March, we have emphatically told government leadership that essential employees who care for the disabled are grossly underpaid given their exposure to the pandemic. The rates of payments are established by Medicaid on a state by state basis.
Last week, I witnessed a direct care staff reinforce mask wearing to a very energetic man with autism who tested positive. Now at the conclusion of a ten-hour day with close contact, the staff has no alternative but to go home to his family. He is told to self-isolate until he returns for his next shift. He could not spend time with his family because he could potentially infect his 62-year-old mother-in-law.
Staff endurance is losing momentum even with masks. Our turnover is over 45%. If there are no staff to wear masks to provide the care, we are in a very serious dilemma.
If the staff do not come to work and those individuals who test positive living within the community are left unsupervised, they could stop by the next-door neighbor with no supervision. Can you imagine the ramifications? Of course, the nonprofit will be blamed for mismanagement and negligence. In this instance it is the government that needs to help.
A simple solution to mitigate this exacerbated health risk is to keep the staff engaged. They need to be compensated at a hospital care level.
President-elect Biden pledged to secure this “front line” workforce and pay a fair wage. When the new President starts there is a simple temporary solution for those thousands of essential workers providing care.
In April of 2020, the Trump administration activated the deferred payroll holiday tax. This enabled nonprofits to manage cash flow and pay additionally for those subjected to COVID.
Many of our staff then and now who became sick have returned to their essential positions. This extra cash flow enabled us and many like us to maintain staff coverage during the last nine months. I essentially bonused staff if and when they returned with this additional revenue.
The Trump administration is forcing us to return this deferred pay back to the federal government. Once again, we will be forced into an untenable position.
We suggest that the new Biden administration offer an abatement for the payroll holiday tax program. This will keep funding within the economy and enable us to keep our essential direct care staff engaged until his cabinet comes up with a more permanent solution.
The long game is simple: Medicaid rates must reflect the care that must be provided.
Author: Robert Stack
President & CEO
Community Options, Inc. | El Paso, TX
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