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Our debt to direct-care workers

LAST YEAR the forces for good in this city rallied to the cause of janitors who wanted to earn $12 an hour for their labors and won. Now we must bring the same forces to bear for an even greater good -- social justice for direct care workers supporting individuals with mental retardation.

Recent reports in the media hit the mark in describing the inadequate salaries and benefits of direct-care workers employed by nonstate-operated community programs supporting people with mental retardation.

In Massachusetts in FY02 (the last year for which data is available) the first level of direct-care worker in nonstate community services earned an average wage of $19,606. The same level worker in a state-operated program earned an average wage of $26,148.

This gap increases as one moves up the direct-care job classification levels.

This situation must be addressed. With the lowest paid workforce in human services, each stakeholder in the system of community supports suffers. High turnover and vacancy rates, particularly in residential programs, jeopardize consumers, workers and providers.

Families and consumers want consistency in care and support from well-trained staff that they know, and who know them. A constant stream of new faces produces the direct opposite of what consumers define as quality.

The harm to workers is obvious. To earn close to a living wage, they must work two or three jobs. Working that many hours makes them more vulnerable to mistake and personal injury. It also sends the unmistakable message that their work is not valued. Even though they are "first responders," the essential personnel that don't get to home on snow days, direct support workers earn less than $10 and hour.

The boards of directors and leadership of community agencies too are impacted by the workforce crisis. An agency's work is labor intensive. Seventy percent of the cost of providing services is in personnel. Excessive turnover and vacancy rates waste scarce resources by increasing recruitment and training costs, paying overtime and relief expenses. When mistakes happen, the agency's reputation is tarnished.

Adding to the need to solve the problem is the growing demand for community supports. The Supreme Court's Olmstead decision affirmed the right of people with disabilities to live in their communities rather than institutions.

In Massachusetts the Boulet and Rolland lawsuits require the Department of Mental Retardation to serve people on the waiting list and to move them from inappropriate placements in nursing homes.

The plight of direct-care staff who support people with mental retardation is so profound that members of Congress have filed concurrent resolutions to highlight the crisis. Groups in other states have filed lawsuits to address the injustice.

In Massachusetts, we have a legislative remedy at hand. Senator Susan Tucker of Andover and Representative Antonio Cabral of New Bedford, chairs of the Joint Committee on Human Services, have filed legislation that will address the inequity. H. 3166 and S. 823, if passed and funded, will establish a plan that over a five-year period will eliminate the disparity in salary and benefits between direct-care workers in community agencies and their counterparts in state-operated programs funded through the Department of Mental Retardation.

Additionally, the House bill requires that recommendations for workforce training and development standards for community providers be developed. Similar legislation passed and has been funded in Maryland for the past two years.

The workforce crisis must be resolved. The state, providers, and workers must be able to assure individuals with mental retardation and their families that that we have the stable, uniquely trained and equipped workforce to offer the lifelong support that allows each individual with mental retardation to maximize his/her potential.

Each stakeholder in this system deserves no less.

Grace G. Healey is executive director of the Association of Developmental Disabilities Providers.

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