California faces ‘unprecedented’ shortage of professional caregivers
SACRAMENTO — Before the pandemic, David Katz had his own home with supported living services in Rocklin, a 12minute drive away from where his parents live in Roseville.
He had been living there since 2016 with direct support professionals funded by the regional center.
David, 39, wanted to live on his own instead of with his parents, but he needs 24/7 supervision because, due to various aspects of his autism, he cannot be at home alone safely, according to his mother.
The workforce for people with disabilities includes personal assistance, home care workers and direct support professionals, who provide services for individuals to lead full and independent lives. Direct support workers help David learn how to manage his own home, go grocery shopping and cook. Some things, like using a hot oven, David will always have to rely on others to do for him.
As the pandemic took hold, many families grappled with a shortage in the direct care workforce caused by decades of subminimum-wage rates. The average annual turnover rate for the direct support professionals workforce was 45% even before the pandemic, according to The Arc, a national organization advocating for people with intellectual and developmental disabilities.
The shortage made it difficult for David’s parents to find enough staff to fill shifts throughout the week.
“It started with just Tuesday,” said Betsy Katz, David’s mother. “And then he was coming home Saturday morning to Sunday evening, and then it actually expanded that he was coming home Tuesday plus Friday through Sunday.”
Soon enough, David was living at home for half of the week, every single week for three months. He was in direct contact with four staff members and a supervisor, all of whom interacted with other clients with supported living services. And then he’d come home, where both of his parents are at heightened risk of severe illness from COVID-19.
“It was very, very difficult,” Katz said. “We were observing precautions quite religiously.”
Many care professionals take issue with those who call the workforce shortage a crisis.
“We refuse to call it a crisis. It’s a systemic failure,” said Joseph Macbeth, the CEO of the National Association of Direct Support Professionals. “This has been going on for 30 years or more.”
According to Macbeth, it’s too soon to know precisely how much the pandemic has affected the workforce turnover rates.
Data from The Century Foundation shows that employment in nonresidential services for the elderly and people with disabilities is down 3% from pre-COVID19 times, and residential employment is down 10%. But anecdotal evidence from service providers highlights the severity of the shortage.
“Less and less people are coming to do this work. That is clear,” Macbeth said. “And that’s consistent with a lot of other low-wage jobs. The service industry, the retail industry, they can’t find people either, post-pandemic. So we are in that same bucket.”
The Bureau of Labor Statistics does not designate a specific occupational category for direct support professionals who work with people with intellectual and developmental disabilities. Instead, they fall into occupational categories like personal care assistant, home health aide and nursing.
As such, the Bureau of Labor Statistics may undercount direct support professionals, according to the NADSP.
This is “extremely problematic,” said Nicole Jorwic, the senior director of public policy at The Arc, because states aren’t required to collect data and examine wages for those workers.
For Turning Point Community Programs, a nonprofit in Northern California providing support for adults and children with intellectual and developmental disabilities on an outpatient basis, their current labor shortage is 30% higher than anything they’ve seen before.
“The shortages we’re experiencing now are really unprecedented,” said Diana White, the chief operations officer at Turning Point.
Service providers and workers agree that systemically low wages are the primary cause of workforce shortages.
In August 2020, shortages forced Janet Brandon to close her adult development program serving the greater Sacramento area.
“I can’t run my business at full capacity,” Brandon said. “I don’t have enough staff to cover all my clients.”