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Huge staffing shortage leaves over 500 disabled Missourians waiting on services

Kim Ryu
As of January, 517 Missourians with disabilities are waiting on services from a strapped industry.

More than 500 Missourians with disabilities are waiting on services because of a caregiver shortage. Without proper staffing, many in-home and group home providers have stopped taking clients from the state’s waitlist. The list has doubled since July and continues to grow.

The coronavirus pandemic spurred a hemorrhaging of workers in an already short-staffed industry. In 2019, Missouri had a 50% turnover rate in the industry. The state Department of Mental Health is working on updating statistics, but a spokesperson said the pandemic only made turnover worse. And not enough new workers are waiting in the wings.

“Now it is a crisis on top of a crisis,” Joy Steele said on Friday’s St. Louis on the Air. She’s the CEO of Willows Way, a disability caregiving service in St. Charles.

People in the industry attribute the shortage to one main thing: a lack of competitive wages. Providers must often pay wages permitted by state-determined Medicaid reimbursement rates, and these days, fast food and retail chains often offer better pay than those rates.

Missouri Gov. Mike Parson proposed $375 million in additional funding for the fiscal year that starts in July. That would bring the starting wage for direct care providers to $15 an hour. Until then, direct care staff in Missouri start at $12.39 an hour.

Jessica Bax, the director of developmental disabilities for Missouri’s Department of Mental Health, said she hopes the legislature signs off on Parson’s proposal.

“We know that the market is very competitive right now for labor,” she said. “We feel like this is a significant increase and investment beyond what is being included in the rates today.”

But some providers wonder if Parson’s increase would even be enough. Through fundraising, Willows Way raised its wages to up to $18 an hour. Steele said she still has trouble attracting staff.

“I don’t think we’ve reached the magic wage,” Steele said.

Huge staffing shortage leaves over 500 disabled Missourians waiting on services
Staffing shortage leaves disabled Missourians without care

The shortage forced Willows Way to stop accepting new residential clients. And they certainly aren’t alone. Statewide, more than 2,000 vacancies for direct support professionals need to be filled, according to the Missouri Association of Rehabilitation Services. Some providers have had to close homes and end leases with clients, shuttering services. Some are relying on overtime and temp agencies to fill the gap.

Maddy Williams has waited for an independent supported-living placement for eight months. She’s 18 and has autism. Her mom, Angie, stays home to take care of her, but she said she needs to start working to provide for her family.

“You ask for help, and it’s simply not there,” Angie Williams said.

Whether it’s a group home or in-home services, these programs generally operate 24/7, 365 days a year. It’s a lot of hours to fill.

Steele said Willows Way needs to staff 1,000 more hours a week right now. To fill shifts, it's tripled overtime hours. Sometimes, Steele is the one covering shifts. She doesn’t see an alternative.

“We’re not an industry that can close,” Steele said.

Karen Mabins has worked as a direct support professional for 30 years. She’s seen firsthand how lack of pay hurts the industry, but still, she calls the job a blessing.

“I couldn't possibly pay you enough in order for you to treat someone well, in order for you to have a kind heart and be considerate and be concerned. There's no dollar value on that,” Mabins said. “But you would like to be compensated for it the best that you can.”

Mabins said she doesn’t want her clients to end up in a congregate living setting within a hospital or big institution, which she fears could happen if staffing shortages grow more acute. Mabins is convinced Missourians with disabilities belong in community homes.

“I don’t know who needs to sound the alarm and say how much of a precious entity this is,” she said.

St. Louis on the Air” brings you the stories of St. Louis and the people who live, work and create in our region. The show is hosted by Sarah Fenske and produced by Alex Heuer, Emily Woodbury, Evie Hemphill and Kayla Drake. Jane Mather-Glass is our production assistant. The audio engineer is Aaron Doerr.

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Kayla is a general assignment reporter at St. Louis Public Radio.