Families, providers say $12 an hour for workers isn’t enough to keep Texas disability services afloat

From KERA News:

Today, Chris Sanderson is looking for someone to train his dragon.

The dragon, Daisy, is the star of Sanderson’s TV show, and she needs a new trainer STAT. Three dragon experts are competing for the gig, and they’ve come to show Sanderson their skills.

Daisy is a huge plush dragon toy that Jim Hanophy brings out on a leash. This is improv class, and Hanophy, the instructor, nudges his students to teach Daisy some new tricks: shake, speak, and of course, fetch. For that one, one of the wannabe trainers chucks a glue stick, and his audience applauds.

Improv class is a weekly event at Ability Connection in Irving, an organization that serves people with intellectual and developmental disabilities, or IDD.

“It seemed like a great way to get people comfortable practicing skills like communication and teamwork, without actually being told they’re practicing communication and teamwork,” Hanophy said.

Sanderson is one of Ability Connection’s approximately 1,000 clients. He lives in a group home, he said — a type of residence where people with disabilities can live with housemates and 24/7 care.

“I like coming here, and I like going on outings, and I like watching TV and reading, and I like doing projects down there, and doing improv, and doing music class, and doing exercises and doing activities, and I like Bible study,” Sanderson said.

All that is possible because of Medicaid, the joint state and federal health program.

Medicaid reimburses organizations like Ability Connection for running group homes and day programs. The state legislature is in charge of setting the base wage for the workers who care for clients.

Right now, that base wage is $10.60 an hour. Providers say the low base wage for workers is driving a staffing crisis that is forcing them to shut down some services and rethink the future of their organizations.

The legislature is currently in session, and the proposed state budget in both chambers would give them a raise to $12 an hour.

Advocates say that’s still not enough. Time to Care, a coalition of providers pushing for a raise, wants a $17.50 base wage.

“We can barely get somebody to show up for $15 an hour,” Hanophy said.

Hanophy isn’t just the improv teacher at Ability Connection. He’s also the president and CEO. His organization used to have eight group homes, but it’s down to four. He blames the worker shortage.

“Staffing in those homes was just such a nightmare,” he said. “We were constantly paying overtime and people were working 50, 60 hours a week. And it was just killing us.”

Ability Connection isn’t alone.

A survey from group home advocacy organizations found that from January 2023 to February 2024, 229 group homes in Texas shut down. Operators anticipated the closures of 126 more in March 2024 and beyond.

“An exodus of providers from the system has already resulted in loss of access to care and increased utilization of high-cost institutional settings, including state psychiatric hospitals and State Supported Living Centers,” the survey reports.

State supported living centers are the large, state-run institutions for people with disabilities – particularly people who have medical or behavioral challenges, according to the state.

Without a raise in the base wage, Hanophy said he doesn’t know if Ability Connection will be around long-term. They fundraise to make up for what Medicaid doesn’t pay, but nonprofits are all fishing out of the same pond, he said.

Medicaid waivers are a family’s ticket to disability services. Waivers help them pay for help like an at-home attendant, or a spot in a group home. But the wait to get a waiver can last more than a decade. Some people die waiting, according to state data.

“I’ve had conversations with people from other states who have called and said, ‘You know, we’re thinking of taking a job in Texas. My son has a disability. How long would it take to roll over into your program?’ I’m like, don’t come,” Hanophy said. “If that’s your priority, don’t come.”

Allana Banks did come to Texas. She moved here from Missouri with her daughter Ariana and her son T.J., whose disability means he’s nonverbal and dependent on others for care.

T.J. has a Medicaid waiver that Banks uses to pay for caregiving at their home in Haslet. He waited about seven years before he got an emergency slot, Banks said.

But she has found that having the waiver almost doesn’t matter, because staffing problems extend outside of group homes, too.

“Either they will no-call, no-show, or the rate of pay isn’t enough,” Banks said. “They’ll say they take the job, but then they may have found something else that pays more, and they don’t come back.”

When a worker doesn’t show up, “My day is ruined,” Banks said. She works full-time, and any scheduling snafus can put her job at risk.

“I am actively looking at this moment to find a qualified, dedicated caregiver. Our lives depend on it. My family’s livelihood depends on it,” she said.

The state has bumped the base wage for direct care providers at state supported living centers to $17.71 an hour, according to Time to Care. The state reports the wage boosts have helped fill staff vacancies and improved turnover rates.

Advocates say a similar pay raise could have the same effect outside large state institutions. Direct care providers who work in the community say their pay needs to reflect the demands of the job, and the passion it requires.

LaWanda Williams has been a direct care provider for 25 years, she told the Texas Senate Committee on Finance at a hearing on Feb. 4.

“A pay increase from the state is not merely a financial adjustment. It is a testament to the value that we bring to those that we serve,” she said. “By investing in us, you are ultimately investing in the quality of life for those that we serve.”

The system is set up to give families and people with disabilities a bigger set of choices. State supported living centers might not be the best choice for everyone. Maybe at-home care, or a small group home, is better.

When disability services providers shut down group homes, those options dwindle.

Community Healthcore, a disability services organization in East Texas, has closed all but one of its group homes in the last five years, according to IDD director Sandra Taylor.

The last one could close too, depending on what the legislature does this year, she said.

“It’s like a train wreck. It’s almost like, okay, so we’re being literally forced out of a business that we really want to be in, but can’t afford to be in,” Taylor said.

Taylor said she can’t imagine her own sister, who has IDD, not having a choice about where to live. Her sister still resides with their 85-year-old mother in a small town outside Temple.

“She has the option of being able to live in her community. She loves the church that we all were raised in, so she attends church. Everyone in the community knows my sister,” Taylor said.

Choices are what Marcus Bowden says he likes about his services. He’s an improv class student at Ability Connection, and he lives in a group home, he said.

“I like having my own place,” he said.

Bowden has been with Ability Connection for more than 15 years. He manages the food cart there, going around with chips and cookies. Staff members keep money on hand to buy treats from him.

“It gives me the freedom to do what I want to do,” he said of Ability Connection. “I like helping people as much as I can.”

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