A staffing “emergency” is forcing major changes in Twin Cities’ group homes

Imagine being told that you suddenly have to move up the mess and leave your home. It is not clear how long you will be living in your new place. It can be months – or longer.

Earlier in the winter, residents of some of over 30 group homes drove past Mount Olivet Rolling Acres (MORA) – a 50-year-old nonprofit dedicated to serving people with intellectual and developmental disabilities or behavioral health issues – was told that severe staff shortages meant they had to move, either home with their families or temporarily. accommodation in other group homes.

The move was necessitated by concerns for the safety of residents and workers, explained Tracy Murphy, MORA president. Without enough staff to keep all their homes running, the leaders of the nonprofit organization decided that they should move residents to other places until they were able to hire enough staff – or adjust the number of people they can accept in their programs.

“It breaks my heart that we have to make these decisions,” Murphy said. “But my top priority is to keep everyone safe.”

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For residents, many of whom are nonverbal or lack the intellectual ability to understand why they have to leave their homes, the move has been particularly difficult to take. “We all thrive on a routine,” Murphy explained. “If these people are to move out of their homes, their routine is extremely disrupted.”

Tracy Murphy

Tracy Murphy

The intricacies of staff shortages and federal safety requirements can be difficult to explain to a person with an intellectual disability, she added: “They may not understand why their routine is disrupted. For many residents, it can lead to increased behavior, to stress and anxiety.”

The range of disabilities that MORA clients face only increases this stress: “Imagine you do not have the autonomy to make your own decisions,” Murphy said. “How will you deal with that stress when you’re told we’re changing your routine?”

Stephanie Kohl

Stephanie Kohl

Stephanie Kohl, program director for MORA’s therapeutic services, said the movements have been “life-threatening” for some people. “The way to put it in the context of outsiders is like being displaced by a fire or a hurricane and you suddenly have to leave your house and you never know when you will be able to come back.”

‘This is an emergency now, no longer a crisis’

After several years of boiling, staff shortages in Minnesota’s long-term care programs has reached a full boil, Murphy said. Even before COVID hit the state, group housing like those run by MORA had struggled to fill all vacancies, but by March 2020, as the world was turned upside down, it became even harder than ever to retain and attract new workers.

“With Great Resignation, the nonprofit sector has been hit particularly hard, ”Murphy said. At MORA, it has been especially difficult because there is only so much that can be done: “So many employers are trying to put in new services to attract and retain people. But it’s just like putting icing on a rotten cake. What needs to happen is to bake a new cake. ”

The truth is, Murphy explained, people in her industry had known that something like this would happen for years. Population models predicted a staff crisis, with not enough workers to fill all open jobs. As the predictions turned out to be true, employers began to realize that in order to serve their customers, a real change had to happen.

“This is an emergency now, no longer a crisis. We have been in crisis since 2010.”

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The numbers are sharp. At MORA, it would take about 500 full-time and part-time employees to be fully staffed. “Right now, we have 360 ​​people working for us, between part-time and full-time employees,” Murphy said. “We have 25 percent of our positions open.”

State and federal vaccine mandates have also put pressure on the care sector because some workers are reluctant to get a COVID vaccine. “The overall reaction when we talk to them about vaccination mandates is, ‘I’m just going to work at Target,'” Murphy said.

Under new federal COVID vaccine requirements, MORA must have 100 percent of its employees fully vaccinated by the end of March. “We also need to prove that we are making a good faith effort to achieve this goal along the way,” Murphy said. “80 percent of staff must be fully vaccinated by January 26.”

As of January 5, she added, 79 percent of staff have been vaccinated.

While Murphy believes vaccines are an important tool in controlling the pandemic and ensuring the health of residents, she has advocated extending state mandates; not having enough staff to take care of the residents also puts their health at risk, she believes.

“If I lose another 25 percent of my employees … I’ll be down to less than 300 employees when I should have 500.”

It is the same situation with other care providers for people with intellectual and emotional disabilities, Murphy added. “Every other Wednesday we are in conversation with DHS and MDH. Every single person on that call makes the same difficult decisions that I do. ”

In addition to vaccination reluctance, another reality that makes it difficult to attract and retain employees is pay. Such facilities are funded primarily through public dollars – often from Medicaid or through government funds for low-income people – which means that the average hourly wage for these challenging jobs remains low.

“Jobs at Mt. Olivet Rolling Acres are all national minimum wages,” Kohl explained. “We’ve been able to improve it a little bit to make it more competitive, to like $ 14 an hour, but Amazon, McDonald’s still beat us.”

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Consequences for the residents

For residents of MORA group homes, a visit to the Pearson Center in Victoria is often the highlight of their week. The center is a year-round recreation and community center where people of all levels can connect and find healthy activities, “a gym, a computer room, an activity room with a large-screen TV, video games, a reading nook, a sensory room and a mini kitchen,” explained Nate McKenzie, supervisor of MORA recreation and therapeutic services.

At the beginning of the pandemic, the number of clients who could go to the Pearson Center was severely limited, and many programs switched online. But this summer, as lower case rates meant some restrictions on social distance were eased, customers were allowed to return to participate in some popular activities. Then the staffing crisis hit, which meant that often there were not enough people working in the homes for the residents to be transported to the center.

This setback hit some people particularly hard. “We know someone who has been to our dance program every Monday for five years,” McKenzie said. “Suddenly they don’t come here anymore. … For reasons beyond their control, they can not do anything they love. It would have a negative impact on everyone’s quality of life. ”

While McKenzie and other recreational and therapeutic services staff were able to relocate some activities to Zoom, the number of participants in these programs has declined. Virtual programming does not build relationships in the same way that personal experiences do, he said, and many people with intellectual disabilities have difficulty making connections in a remote environment.

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Murphy agreed. “We’ve done yoga over Zoom,” she said. “We did our Halloween dance over Zoom. We can offer virtual activities, but many of the people we support have a physical disability and an intellectual disability, which makes their ability to use technology and to connect in that way really difficult. The people we support do much better personally with touch and to look people in the eye. ”

McKenzie said he and his colleagues are working to address staff shortages by picking up residents in their group homes and driving them back to the Pearson Center for Activities. This gives group home staff some respite – and the residents an activity that gets them out into the world.

It’s good when people can do things they enjoy, ”McKenzie said. “Given the current situation, I think it’s important that this opportunity is there for people to at least just get out of the house.”

An honorable salary for an ‘honorable’ job

What does it take to attract more workers to Minnesota’s long-term care programs? Murphy believes that long-term improvement requires, “dramatic and immediate” change. “The systems we have created are not sustainable now. We know what we need to do, but we need to rebuild it to get there.”

Such a change requires a major adjustment in how society values ​​work on care services, said Sarah Smith, head of quality improvement at MORA’s housing department. “If there is one thing we can do for those who work as caregivers in disability services, it is to compensate them fairly and provide a living wage.”

Smith said she has been working in the field for a decade and has known many support staff who, due to the low wage rate, have to work “around the clock at several jobs” just to make ends meet.

“We should value those who are willing to sacrifice so much to care for those who cannot take care of themselves and show that work is valued through reasonable compensation given our current economy. Caring is an honorable job and should be seen as such across society. ”

If the government and lawmakers made this issue a priority, she added, “they would know we need to find the means to increase those hourly wages.”

Natasha Merz, Minnesota Department of Human Services, director of disability services, said her department believes “it is extremely important to ensure qualified, compassionate care for people with disabilities.”

Because of this, she added, “The Minnesota Department of Human Services worked with the Legislative Assembly in 2021. to approve rate increases for critical services that support people with disabilities. We have implemented cost reporting to monitor provider costs compared to Medicaid rates and have used enhanced federal funding to support the critical, direct support professional workforce. ”

But she admits there is more to do: “We recognize that there is a lot more work ahead for DHS and others to further meet these critical needs. ”

Murphy said she believes it may be too late that it may actually require a complete reconsideration of the way her nonprofit and others like it perform their work in order for them to continue to care for their client base. in the future.

“This is not just a disturbance, but a much-needed dismantling,” she said. “We disassemble the system and hopefully put it together in a different way.”

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