Dear Governor Walz (Caregivers Stabilization Act)

Dear Governor Walz,

I know there is talk about funding more oversight technology for Minnesota’s disabled population. Medical and caregiving technology is a great thing, but it doesn't solve every problem.

The type of people with disabilities we care for at ACR Homes have complex needs that cannot be met through technology alone.

A typical client of ACR:

· is non-ambulatory and requires an accessible home and 24/7 care

· has 7-15 diagnoses

· needs 30-80+ medications and treatments each day

· has 40-80+ doctor’s appointments per year

Many of the people we support have seizures that won't stop without medical intervention such as oral or rectal Ativan. If a powerful sedative like this is used, the client's vitals must be monitored carefully for respiratory distress. Many of our clients seizure silently, and some benefit from video monitors in their rooms to alert staff to unexpected movement. Pressure alarms, sound monitors, and call systems all improve safety for our clients, but that care must be on-site and awake 24 hours a day.

Our overnight awake staff stay busy repositioning clients, changing or assisting them to the toilet, administering medications or tube feedings. This is also the time we catch up on house cleaning and do initial meal-prep. Day hours are spent doing therapies as assigned by PT, OT, ST, and caring for the complex needs of people who often have g/j tubes, catheters, require oxygen, nebulizers or vest treatments, some have ostomies or diabetes, preparing meals for modified and specialized diets, working on goals to improve client's skills, and activities for leisure, social, spiritual and recreational needs. Our staff are so busy, sometimes it's hard to find time for lunch.

Caring for these people is complex, and making an error can result in a staff losing their ability to work with any vulnerable population. More and more new-hires are unable to pass the competency tests to care for these clients. Those who do make it through are not as resilient as staff in the past, and they tend to leave when things get hard. Our retention rate dropped from our long-term average of 75% to 51.6% in 2021. In 2022 it dropped to 45.7%.

Here are some data points you may find interesting:

· Since Sept 2021 we’ve had 2300-5,000 hours open per week – that’s 40-90 shifts per day

· We need 1,150 DSPs to be fully staffed. We are 250 staff short (25%)

· In 2021, ACR hired 519 employees but 703 termed. In 2022 we hired 570 and 627 termed.-Retention suddenly dropped from our long-term average of 75% to 51.6% in 2021. In 2022 it dropped to 45.7%

· Statewide data shows that two out of three DSPs leave the job in less than a year

Because the training is hard, the work is hard, the risks are high, and McDonald's pays more, we are having a hard time keeping staff. We need more bright and careful workers in MN and we need a livable wage. We also need the profession to be something to which people aspire to, not settle for.

You may know that providers across MN are reducing capacity.

· Data from our trade association shows 40% of provider organizations temporarily or permanently closed residential programs or facilities

· 23% of provider organizations reduced waiver residential capacity, which may lead to permanent closures and license surrenders. An unfilled bed is still a licensed bed, so the DHS data can be misleading.

· DHS reported a NET LOSS of 16 licenses in Q2 2022 (a lagging indicator as providers try many other strategies before surrendering a license).

· The average net change in the number of CRS licenses was 18.4 for 2019-2021, and was -2.3 through the first 3 quarters of 2022

Since 2018, ACR Homes has been forced to close 15 sites due to the workforce shortage and lack of competitive wages. This resulted in 51 of our clients being displaced. We hope this is enough and that we won't have to close any more homes, but the staffing situation is still untenable.

Please Support The Caregivers Stabilization Act (SF7/HF32) to inject critical funding into the DWRS. This bill will:

· Fully fund the Competitive Workforce Factor to help make wages competitive with similar jobs.

· Use current data for Disability Waiver Rate System (DWRS) adjustments. (DWRS sets uniform rate–determination methods and standards for all disability-related services in Minnesota.) Current law determines DWRS adjustments based on data that is 30 months and 1 day old. This bill uses the most current available data from the Bureau of Labor Statistics and Consumer Price Index.

· Increase funding for ICF/ID providers so they can increase staff wages. Service rates have been largely untouched for 20 years.

 

Your attention to this matter is greatly appreciated,

 

Deb Nygaard

Director of Development

ACR Homes