Service agencies struggle to find care staff

HUDSON–“The turnover is insane, not only in direct support professionals but also in management. Our jobs have always been stepping stones to other careers. Staff turnover and vacancies are a challenge,” Melanie Brodowski, program manager of Coarc told the Columbia County Community Services Board (CSB) at the board’s April 24 meeting.

Coarc, the non-profit organization that provides services for people with disabilities, is not alone in facing staffing shortages. The meeting focused on issues arising from staff inconsistency, state funding cuts and managed care and was one of two county meetings in two days at which the problems came up.

It is said that “for every 10 openings, you have seven bodies,” said Michael Cole, the county’s director of the Community Services.

To get more staff, Coarc has just started hiring high school students as part-time junior direct support professionals to “do the fun stuff,” such as accompanying clients to the movies and shopping, Ms. Brodowski reported. But how many will stay on after completing school is a question. Direct support professionals earn about the same hourly pay as workers in McDonald’s, but they have a lot more responsibility, Ms. Brodowski noted.

Another challenge in finding people to fill the jobs is the attitude of people entering the job market. “When I started, I worked 80 hours a week,” Ms. Brodowski said. “Now rules limit us to 60 hours a week. But they don’t want to work even 60 hours a week. They want to hand pick their hours.”

“In human services, you can’t work from home,” added Amanda Pierro, director of the Apogee Center.

In addition, Ms. Pierro noted that the Hudson City School District gives all students in lower grades regular sessions in its new STEAM (science, technology, engineering, art, and math) lab, but not regular sessions simulating hands-on human services. At that early age, they get the message that the best and ideal careers are in STEAM, she said.

Beth Schuster, executive director of Twin County Recovery Services and chair of the CSB, indicated that some of her employees dress inappropriately for their jobs.

“You need a [wage] rate increase. But what is new is that state aid is shrinking” said Mr. Cole. The state gives the agency a certain amount of money, and although the agency has discretion as to what it pays its employees, total salaries plus other expenditures must stay within the budget.

As for alternate funding, “We’ve tried the for-profit route, and it hasn’t worked,” reported Ms. Brodowski. Coarc runs Tradewinds, a non-profit gift shop on Hudson’s Warren Street, some of whose merchandise is “crafted by” Coarc clients with disabilities, according to Tradewinds’ website. But though it provides “wonderful services,” it is barely breaking even, said Ms. Brodowski. In addition, she said, “We feel funny” doing something for profit “rather than our clients.”

Like other local agencies, Ms. Schuster said that at Twin County Recovery Services, “We’re getting more referrals but less money for treatment.”

Ms. Brodowski also provided an update on Coarc’s conversion to managed care. Consequences include that all clients need new life plans and care managers. The deadline for the new life plans is December 31 of this year, an extension from December 31 of last year. The care managers replace Medicaid service coordinators. Medicaid service coordinators were “within our organization, part of the team,” said Ms. Brodowski. But care managers work for private agencies. Ms. Brodowski reported that initially, some clients did not know who their new care managers were. Some feel that they are less accessible than Medicaid service coordinators were, even when in the same building. And some clients do better if their care coordinator stays the same. In addition, the computer systems have not yet been able to communicate with each other as much as they could with the old system.

Whatever they are called, care coordinators should be there “because somebody asked for help, not to support a managed care company,” Coarc Chief Quality Officer Carolynn Anklam had said the previous day at the meeting of the CSB’s Intellectual and Developmental Disabilities Subcommittee. At that meeting she said the bulk of Coarc’s Care Managers now come from Care Design New York, whose website describes it as “a care coordination organization/health home for individuals with intellectual and developmental disabilities.” Its membership consists of organizations with “affiliate agencies” that service people with such disabilities.

At that meeting a Courtney Ortiz, director of Public Relations for Care Design, asked, “What’s your biggest problem?”

“Lack of continuity in the workforce,” responded Mr. Cole, saying that the problem includes an individual’s care coordinators changing.

The next meeting of the full CSB will take place Wednesday, May 29, at noon, at 325 Columbia Avenue in Hudson. The CSB’s Mental Health/ Substance Abuse subcommittee will meet Wednesday May 8 at noon, and its Intellectual/ Developmental Disability subcommittee will meet Tuesday, May 28, at 4:30 pm, at the same place.

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