Atrio of West Michigan nonprofits are requesting millions of dollars in federal stimulus funding to help combat a longstanding and worsening workforce shortage among service providers for people with intellectual and developmental disabilities.
Grand Rapids-based Thresholds Inc., Muskegon-based MOKA Corp. and Spectrum Community Services — three of the four largest providers of Medicaid services for people with intellectual and developmental disabilities (IDD) in Kent County — have requested up to $14 million in American Rescue Plan Act funding from Kent County.
County officials are currently considering the three separate proposals for funding. If approved, the organizations would use the funds to provide their employees with premium pay and overtime as well as offset costs for technology upgrades that would help reduce existing staffers’ load.
Nonprofit leaders say the funding requests are intended to stem the worsening rates of worker burnout and staff vacancies and build capacity at their residential facilities that are currently at capacity or understaffed. Low Medicaid reimbursement rates that fail to provide a competitive work environment to attract talent are at the heart of the problem.
“This has been a longstanding problem in our field. It’s just very difficult to find good staff,” said Thresholds President and CEO Jacquelyn Johnson. “We’re not able to pay a very competitive wage because people we serve have Medicaid.”
The organizations’ primary community health funder, Network180 LLC, also is limited in boosting funding to the groups, Johnson added.
COVID-19 “brought all of this to a crisis” with the “Great Resignation” and physical risk factors that came early in the pandemic, Johnson said.
“That really hit us as far as staffing shortages, then it just compounded,” she said. “We struggle to find staff, but also, other for-profit companies are able to do things like limit their hours. We can’t — we provide care 24 hours a day. We can’t close early. It has really become a crisis.”
The $1.9 trillion American Rescue Plan Act (ARPA) offers some hope for the nonprofit leaders, who are angling among hundreds of other proposals for a share of Kent County’s $127 million allocation. After issuing a public call for funding proposals, county officials last month began sifting through more than 300 requests, including three from the nonprofits.
Thresholds, with 15 residential homes, has about 200 full- and part-time employees and serves about 175 people a year. MOKA, which has served people with intellectual disabilities for more than 40 years, employs about 360 and serves about 800 people a year across Muskegon, Ottawa, Kent and Allegan counties.
Johnson said applying to Kent County was a creative solution since the three organizations are, in effect, competitors.
“The idea we’ve talked about is that: We may not be able to greatly expand our staff base, but how about we shore up the ones we have and support the staff we have so they can really focus on the work we pay them to do?” Johnson said.
Technology and equipment upgrades could help “minimize any of the unnecessary physical burdens they have” by making residential facilities more accessible.
Ballooning overtime pay remains another growing challenge for the organizations. Johnson said overtime pay, historically, accounted for an extra 4 percent to 5 percent of disability service providers’ payroll. Today, it is in the 20 percent to 25 percent range.
“And it’s not reimbursed,” Johnson noted, adding that a smaller staff is leading to more overtime. “That’s a real need in our field. I have staff working 100 hours a week, not because they want to, but no one else will do it.”
MOKA Executive Director Tracey Hamlet said convening the three organizations was driven largely by the need for the community to recognize the problem, which involves 20- to 30-percent staffing vacancy rates among the three nonprofits.
“It’s been a huge problem for decades, COVID escalated it,” Hamlet said. “We came together thinking: Maybe it’ll be a more powerful proposal if we do it together.”
So far, the proposals have met with a lukewarm response from the Kent County Board of Commissioners. In late October, commissioners voted to rank the 300-plus proposals based on priority, and the nonprofits’ three proposals as a whole generated a low priority.
Hamlet said she was “discouraged” by the results of the ranking and hopes to receive more clarity about how the county will ultimately approve funding requests.
However, the pursuit of funding continues elsewhere, including for a share of Ottawa County’s ARPA funding that MOKA requested as part of a partnership with Grand Rapids Community College, Hamlet said.
MOKA also is taking measures and “testing different things” to reduce staff burdens by investing in technology, such as smart home technology that allows staff to leave at night. Upgraded lifts that are used to move people also require fewer staffers to operate.
“Sometimes, if you just implement one device, it can lower the impact on staff,” Hamlet said. “Anything like that can be helpful.”