Healthcare News

Turnover rate for those aiding disabled clients rivals retail, fast-food industries

By RITA PRICE, THE COLUMBUS DISPATCH

Although their chronically low wages showed modest gains last year, frontline workers who provide support and care to Ohioans with disabilities still left their jobs in droves.

A new survey by the Ohio Provider Resource Association found that employee turnover in 2017 climbed to 61 percent — a staggering rate that compares with the churn of the retail and fast-food industries.

“I hope some legislator will look at this and see what’s happening,” said Sandy Staton, a 63-year-old retiree who cares for a brother severely affected by cerebral palsy.

Staton would like to work less and hand over some of the duties to a direct-support worker. But she and her family have all but given up on finding dependable, long-term help.

“The problem lies in consistency,” said Staton, who lives in South Point, a Lawrence County village along the Ohio River in southern Ohio. “To get to know my brother, to understand him, is very difficult. It takes time.”

The task essentially dwarfs the compensation, Staton said, and many employees walk away.

The association received survey responses from private-sector agencies representing more than 8,000 direct-support workers and found that the average hourly wage rose by about 9.7 percent from 2015 to 2017, to $11.23 an hour, said Mark Davis, president of the provider association.

That’s good news, but it doesn’t appear sufficient to attract and retain desperately needed workers during a time of low unemployment. The spike in turnover was far greater, increasing some 20 percent over the same time period.

Davis and others are trying to analyze some of the ways in which a robust economy drains the pool of potential direct-support workers, many of whom are able to find different jobs that pay more and demand less.

“When times are good, they’re bad for us. When times are bad, they’re good for us,” Davis said of the seeming pattern. “You can make donuts and make more money than working with people with disabilities. Cage-cleaners at a zoo can earn more. That’s hard to hear, but it’s true.”

Few industries have turnover rates anywhere near as high, said Robert Gitter, an Ohio Wesleyan University economics professor who has written workforce reports for the Ohio Department of Medicaid. Since the recession ended and job-hungry Ohioans began to find better-paying work, “The story has gotten worse,” he said. “There’s evidence that turnover affects the quality of care.”

Gahanna resident Larry Koebel said the nonprofit agency that runs the residential center that is home to his 47-year-old son, Doug, sometimes has to turn to temporary staff to get by. “When you have heavy turnover, the new staff doesn’t know the routines,” Koebel said.

He was moved to complain in May after a temporary worker created a “terrible” situation. “I papered the world with letters,” Koebel said.

In a special report in April, The Dispatch wrote about the effects on employers, workers, people with disabilities and their families as Ohio and states throughout the nation grapple with a shortage of direct-support workers. Pay for those who provide community-based services to people with developmental and intellectual disabilities is largely tied to Medicaid reimbursement rates set by states, and increases over time have been modest and infrequent.

“If I had to work at $10 or $11 an hour, I could not, as a young person, do this and pay the bills,” Staton said.

To care for her brother without wrecking her own budget, Staton became an independent provider through Medicaid, which allows her to bill directly for several hours of her work each day. She’s grateful for the arrangement — it pays more because she doesn’t have to go through an employer agency — but Staton still would like to find a better option for some of her brother’s needs. She’s also doing her best to help care for their elderly parents.

“My brother weighs 150 pounds. I lifted him 16 times one Saturday when he was ill,” she said. Most nights, Staton said, her arms hurt so much that she can barely sleep.

It’s a labor of love that can’t last forever.

“All in all, we have a great state and great services,” Staton said. “But there are just some things that have to be looked at. Maybe someday someone will listen.”