Disability care crisis

People with disabilities receiving home and community-based services through the Pennsylvania Department of Human Services like me are facing a crisis.

The problem is two-fold: agencies are not receiving adequate rates. Therefore, the wages paid to direct care workers are too low. Second, there is a shortage of direct care workers. This is largely due to inadequate wages.

Many people with disabilities in northeast Pennsylvania receive services through Medicaid waivers and the state funded Act 150 program. Both help with tasks such as bathing, dressing, grooming, feeding, and other activities of daily living. The programs enable thousands of Pennsylvanians to live in the community, avoiding unnecessary warehousing in a nursing facility which is more expensive.

During the COVID nightmare, people who provided in-home assistance were designated “essential workers.” One significant problem that still plagues quality services is that essential is not synonymous with steady. We still compete with fast food restaurants, coffee shops, convenience stores, retail, warehouses, and other part-time gigs for the same candidate pool. The pandemic exacerbated a problem that already existed. People can earn more money elsewhere.

We know that home and community-based services are far less expensive to provide than nursing home and institutional care. Most important, people with disabilities want to live at home. Program rates for providers range between $17 and $23 hour while the direct care wages are between $10 and $17 hours after administrative costs and staff trainings.

It’s time for a commitment from the administration and legislature to increase funding for home and community-based services in fiscal Year 2025-26. People with disabilities have waited long enough.

Keith Williams, Manager

OVR Grant and Advocacy at MyCIL