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Do Not Decrease Rates for Direct Support Providers

James is 35, has Down Syndrome, and lived with his sister until he moved into a group home last summer with two other people. He has a part-time job, but the direct support professionals who work in his group home helped him fill out job applications, provide his transportation to and from work, and offer cues to help him live more independently. His direct support staff are responsible for knowing all of his medications, allergies and adverse reactions. The same direct care staff help one roommate with eating, bathing, toileting, and administering medication and implementing a complicated behavior management plan for another roommate.

James, his roommates, and more than 45,000 other individuals with intellectual and developmental disabilities in Texas rely on dedicated caregivers to help them lead independent lives in the community and to help meet their most basic needs. Direct support professionals, or DSPs, play the role of special education teachers, job coaches, counselors, social workers, nurses, cooks, chauffeurs, and attendants. They work in a variety of settings and assist with everything from medication adherence to daily living needs to job coaching. In group homes they offer 24-hour supports and supervision.

DSPs are nothing short of miracle workers. Throughout the pandemic and Winter Storm Uri, these fearless DSPs have prioritized the health, safety and wellbeing of the individuals they serve above their own. They’ve shown incredible dedication—and they’ve done it all for wages starting at $8.11 an hour. Unlike other long-term care settings, staff redundancies don’t exist.

Many DSPs have chosen this profession because they are committed to helping others. But working with one of Texas’ most vulnerable populations also comes with many challenges.

Over the years, recruiting and retaining the qualified, compassionate DSP workforce needed to support Texans living with disabilities has not been easy. Below market wages paid to DSPs, which are set by the legislature, have been a leading factor in Texas’ caregiver shortage and high turnover rates.

Even before COVID-19 it was a common enough story for newly hired DSPs to abandon the industry in favor of easier, more lucrative jobs in fast food. When we have an unstable DSP workforce, we have an unstable service system. With such a vulnerable population, we cannot afford to have an unstable service system…period.

That’s why the Texas legislature must act now to ensure we can effectively recruit and retain the DSP workforce we need to continue supporting individuals with disabilities. And it starts with passing HHSC Article II Rider 109 this session, which would ensure rates will not be reduced for services provided to people with IDD.

Secondly, the legislature and Health and Human Services Commission should accept additional federal relief funds targeting home and community-based services and use that money to incentivize people to enter and remain in the DSP workforce. This would go a long way in ensuring our industry is operating on solid ground, not just today but in the years to come.

Like all frontline health care workers, Direct support professionals deserve a living wage for the tremendously important care they provide. And service recipients with IDD living in group homes deserve a workforce compensated for the hard work they provide.

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