The Ohio Department of Developmental Disabilities has proposed a new policy that would prohibit independent providers employed through Medicaid from working over 40 hours a week and receiving overtime pay.
This change comes a year after the U.S. Department of Labor required all health care workers be paid overtime, and it has raised questions about how the care for people with disabilities will be impacted.
The proposed policy the DODD said it expects to accept at the end of March is supposed to cut down on “excessive overtime pay,” but critics are worried it could negatively impact DODD service.
“I can’t get dressed, get in the shower, get in and out of bed, get in and out of the bathroom without the help of an independent provider,” Justin Martin, who has cerebral palsy, said at an Ohio Department of Developmental Disabilities meeting last week. “We still routinely have issues trying to find providers.”
Joe Russell, policy and advocacy director for the Ohio Association of County Boards of Developmental Disabilities, said much of the concern surrounding misuse of the disability care pay system is from independent caretakers making overtime wages for time that is not necessarily spent working. He said family members or friends who provide independent care for someone will sometimes try to receive compensation for personal time spent with the person in their care.
The average disability service worker in Ohio earns about $11 an hour. This is not always sufficient pay, especially without the added bonus of overtime for the many hours they are typically required to work, Ohio Provider Resource Association Director Mark Davis said.
The issue has become common enough that the Ohio Provider Resource Association, a statewide group of service providers, has programs in place to provide food, transportation and child care to disability care workers who qualify as low income.
The issue of low pay is worsened by an insufficient workforce within the disability service industry, which creates an overwhelming demand for the employees already in the field.
“We struggle with that every day, to meet the needs of the people who need these services,” Davis said. “I don’t know how much this change could add to that or subtract from that. It could be helpful in terms of providing substitute care and some things we haven’t thought of yet, or it could create higher demand for workers.”
One of the possible contributors to the disabilities workers shortage is increasing competition from other industries that demand the same amount of skill for equal or more pay, Russell said.
“Over the past 10, 15, 20 years the skillsets have increased in the private marketplace. Essentially, low-skill positions like the fast food industry compete directly with the health care industry. That’s made it very difficult for agencies to recruit providers and keep providers because it’s a much more complicated job than flipping burgers,” Russell said.
Although additional training is needed to enter into the disability service industry that may not be necessary in other fields, Russell said there remains an often-untapped audience for these positions, particularly among young people.
“Someone who might be going to school as a nurse, having this type of job would be really great to have on a resume once you’re finished with school,” Russell said. “Some people coming out of high school who aren’t sure what they want to do or aren’t ready for college, this is a great career opportunity as long as money isn’t the primary factor in your decision making.”
Gov. John Kasich added a 6 percent increase to disability service care in the last state budget, and many support providers are already using this extra support to directly reach out to their employees in hopes it will ultimately help those with disabilities, Davis said.
He also said running these practices more efficiently can help provide more money for staff wages, which then helps improve the quality of services they provide.
Aside from ongoing efforts within several disability organizations, some are also examining similar industries, and seeing hope in others’ successes.
“When I think about these types of policy issues, I always try to compare them to other systems. If you look at the Medicaid system, if you look at the aging system, they don’t have the same issues that the DD system has,” Russell said. “And so that tells me that there is a solution.”