Saturday, June 15, 2019

A Fair Deal for Direct Support Professionals



(The supporter above asked that I not show her face in the photo)

The D.C. council’s committee on human services and committee on health co-chaired a joint hearing on June 13 to consider Bill 23-214, “Direct Support Professional Payment Rate Act of 2019.”  This bill arose from the conclusions of a working group that has been looking at DSP pay and retention issues over the past year.  At this time DSPs must be paid the D.C. living wage, which any organizations receiving $100,000 or more in contracts or assistance from the D.C. government must pay their employees.  However, by July 2020, D.C.’s minimum wage will reach $15.00 and catch up with the living wage.  With little (now) or no (by next year) differential between the two wage rates, there will be little incentive for people to assume the arduous work of being a DSP rather than taking a far less demanding minimum-wage job.  In order to address this, the bill - co-sponsored by councilmembers Nadeau (human services committee chair), Gray (health committee chair), Silverman and Grosso - recommends adoption of a tiered wage system for DSPs ranging from 110% to 125% of the D.C. living wage.  Here is a summary of the bill - https://tinyurl.com/y33t88yl.  (I have not yet located a copy of the actual bill.)

The D.C. Coalition of Disability Service Providers (http://dc-coalition.org/), as well as many individual service provider agencies, DSPs, people receiving support, family members and others turned out in support of the bill, with more than 40 people testifying in favor.  Supporters pointed to the fact that neighboring jurisdictions in Maryland have established DSP wage floors above the Maryland minimum wage.  (The Maryland state minimum wage is currently lower than D.C.’s, but Montgomery County already is supporting a DSP pay rate of $15.00, above the current D.C. minimum wage which will go to $14.00 on July 1.)  They also discussed the difficulty facing DSPs who want to live in D.C. as opposed to the far suburbs – according to a 2018 report by the budget director of the D.C. council (https://tinyurl.com/y5hvbkot), the actual cost of living for a single adult living in D.C. would require an hourly wage of $17.78 per hour, and many DSPs must hold at least one other job in order to make ends meet.  A key argument made was that vacancy and turnover rates in D.C. are higher for DSPs than in neighboring jurisdictions.

Speaking for the D.C. government, deputy mayor and director of the Department of Health Care Finance Wayne Turnage and DDS director Andy Reese argued that  the National Core Indicators (https://www.nationalcoreindicators.org/) do not show the same numbers for DSP vacancy and turnover rates as those cited by the Coalition and other supporters.  They went on to say that singling out DSPs as worthy of a higher pay rate than similar care providers such as home health aides and personal care assistants would not be defensible and that the pay raise, if enacted, would need to be extended to others, meaning higher costs.  They said providers are able to pay DSPs at a higher rate now if they want to and can justify the costs.  They further said that self-direction, which DDS plans to introduce next year, will provide more flexibility in this regard.

Government representatives are always going to argue for budget restraint.  It’s what they have to do.  For me, though, what’s true without a doubt is that DSPs can’t support themselves, much less a family, living within the boundaries of D.C.  Do we want D.C. providers to keep having to reach further and further out into the suburbs for DSPs who have to drive 10 or 15 miles to get to the people they support?  In the end, what the deputy mayor testified may also be true – these same benefits may need to be extended to other groups of care providers.  But doesn’t that just show that we don’t yet have a living wage in D.C.?

This was an amazing event at a great many levels, including the fact that this is the first time in the past decade that I recall sitting in a hearing on legislation about which local advocates and DDS were on opposite sides of the issue.  This is a sign of maturity in the D.C. disability community, and it was exciting to see how many folks turned out to testify.  I hope that people will stay just as motivated as we move ahead to create a system of disability supports in the District that is equitable and rights-based for everyone.

And there’s still time on this bill – written testimony can be provided through June 26 at humanservices@dccouncil.us.  Let your voice be heard!

Thursday, June 13, 2019

And So Many Aren't Even Eligible for Disability Supports in D.C.


As I wrote in my last blog post, all signs are pointing toward cutbacks in waiver services through the Department on Disability Services. This is happening while many folks still aren’t even eligible for any waiver supports at all because they can’t qualify for the restrictive IQ cutoff that determines eligibility.  Foremost among these in terms of numbers are D.C.’s autistic citizens.  I’ve written about this before, but I’m glad to see that the D.C. council is beginning to pay more attention to this issue, as shown in the FY 2020 budget report issued by Brianne Nadeau’s committee on human services:  https://tinyurl.com/y47p8qu5.  The discussion of the DDS budget starts on page 44 of this report, and on page 49 is a section entitled “Identifying Autism Spectrum Disorder [sic] needs and providing supports.”    In this section and in the committee’s “Policy Recommendations” on page 52 of the report, the committee commits itself to work with the Office of the State Superintendent of Education (OSSE) “and any other relevant parties” to identify needs of those on the spectrum.  The committee also states that it will “urge DDS to make changes in their referral system…[and] continue meeting with stakeholders to determine whether legislative action might be appropriate moving forward.”

This is an immense breakthrough, which we should all hail wholeheartedly.  Having the ear of the council on this matter is essential, and the wording as it stands has only one crucial drawback:  there are people with other developmental disabilities who also are being excluded by the IQ requirement, and the council needs to ensure its further discussions and planning remain inclusive of these other less numerous groups of people who also may need targeted supports.

It may seem counterintuitive to be discussing budget constraints and eligibility expansion in the same blog post, but the important thing to note here is that this is a time of ferment in the city’s thinking about disability supports.  With the closing two years ago of the Evans case that for so long defined the city’s disability services, now is the time to shape a new future.  At this moment the mayor may be seeing this only through the optic of budget strictures, but that can change if she hears from folks who care about disability rights in the District.  And as the committee report I quoted above demonstrates, human services chair Brianne Nadeau (Ward 1) is just waiting to hear more from us on this subject.

D.C. has made remarkable strides over the past dozen years in the planning and delivery of supports for people with disabilities.  It’s gotten loads of credit for the progress that’s been made.  Now is the time to set the stage for D.C.’s next big breakthrough and keep us at the cutting edge of disability rights. 

Wednesday, June 12, 2019

DDS: Let's Talk About Where You're Headed


During consideration of the mayor’s proposed FY 2020 budget there were significant disagreements between the Bowser administration and the D.C. council with respect to public housing, and according to WAMU these continue to create hurdles for the District’s budget next year:  https://tinyurl.com/y68xxhse.  It becomes more obvious each and every day that housing also is undermining prospects for the future of D.C. disability services and supports.  This is true even though DDS fundamentally got the budget for FY 2020 that it requested.  (See page 3 of the report of the D.C. council’s committee on human services at https://tinyurl.com/y47p8qu5.)

Advocates and provider agencies spent much of this past spring reviewing policies and regulations that will change how people receiving residential supports from DDS will be able to obtain and pay for housing and other costs.  Now, having gotten the funding it requested for FY 2020, DDS has quietly begun rolling out a far more significant and fundamental change: a proposed regulation that would restrict intakes for residential supports to those in an emergency situation who have limited informal supports.  Many are seeing a direct line from the housing policies discussions earlier this spring to this new development – with DDS now proposing to cut not only the costs of residential services for individuals (a separate regulation would limit day services for people receiving residential supports to 30 hours per week), but also seeking to throttle back on the number of people for whom it provides housing supports – with foreseeable results for those left out in the cold.

These new draft regulations were distributed in a routine way week before last and input was sought from whoever was able to attend the standing Monday afternoon I/DD waiver meeting on June 3. This was a remarkably low-key rollout for regulations that will have such a momentous effect on anyone hoping to live on their own with support rather than continuing to live with their parents until they die or abandon their son or daughter.  It’s nothing short of amazing that DDS never breathed a word of it in the budget hearings and briefings that were just completed two months ago.  Obviously this already was in the works, but DDS waited to drop the other shoe until its budget was safely through the council.  How the process will play out from here on these regulations is unclear.

Budget season would have been the logical time to present such a fundamental shift - one so clearly driven by cost-cutting considerations.  With the DDS director and deputies in the room, there would have been the opportunity for a dialogue with senior managers about this electrifying new departure, why it was being proposed and whether there were alternatives.  There might have been room to pursue in greater depth the ways in which DDS is collaborating with other parts of the D.C. government to open more housing to people with disabilities across the board within District boundaries and perhaps to find more creative approaches to future housing needs of those receiving residential supports.

Instead of such an open discussion, DDS is continuing the drip-drip of new policies and regulations, holding low-key “y’all come” listening sessions, with no sense for the broader context of strategic directions and choices. People also are facing new roadblocks as they seek services for themselves or family members, not just with respect to housing and residential supports. This leaves everyone – families, providers, self-advocates and other advocates – feeling insecure about the direction things are taking. 

I believe the time is overdue for a real dialogue between the senior management of DDS and the entire stakeholder community, to understand the vision DDS is pursuing for its future and the trajectory it plans in order to get there.   This is even truer in light of the discussion of broader unmet needs in the community which were raised in the DDS performance review and budget hearings (see discussion of the DDS budget in the committee report above beginning on page 44).  (I’ll talk more about this in a future blog post.)  For now, though, I urge you to reach out to Andy Reese and his senior team at DDS:

Andrew Reese, DDS director
andrew.reese@dc.gov

Jared Morris, DDS chief of staff

Winslow Woodland, DDS/DDA deputy winslow.woodland@dc.gov

Erin Leveton, DDS deputy, quality and performance        erin.leveton@dc.gov

Darryl Evans, DDS/RSA deputy
darryl.evans@dc.gov

Ask for a series of public dialogue sessions (with a variety of participation modes to take account of accessibility and availability issues) specifically on the agency’s vision and strategic direction for FY 2020 and beyond.  There has to be more driving the future than clamping down on residential costs. and while looking back on FY 2018 is fine and important (https://dds.dc.gov/page/respect-dignity-inclusion-report-community), people need to understand clearly where things are headed as well.   DO THIS TODAY!