• The end of the DSP wage increases after 1/1/24 means agencies are not well positioned to continue to address the DSP/supervisor workforce crisis.
• Fierce competition for staff continues with escalating overtime costs stressing agency budgets.

• Agencies continue to compete for workers with the private sector where, according to the Bureau of Labor Statistics (BLS), compensation costs for civilian workers increased 4.3 percent for the 12-month period ending in September 2023.

• A quality workforce is critical to quality services and cannot be achieved without adequate wages.

• Agencies have had to absorb the costs of unprecedented inflation.
• Yearly inflation for 2022 alone was 8.2%, with the top categories experiencing increases impacting agencies, including, transportation, housing, food, and energy.

•  Agencies care for people, there are no shortcuts that will lower costs as in other industries.

•  Agencies face additional unreimbursed costs with upcoming regulatory changes at the federal level, including an increase to the overtime threshold, the HCBS rule and the Access rule.

•  According to the most recent released report of its kind, The State of America’s Direct Support Workforce Crisis 2022,
• The number of organizations closing programs across the country and services has grown by 85%
• 83% said they are turning away new referrals.
• 63% indicated that they have discontinued programs and services, and more than half said they’re considering further closures.
• Nearly all respondents said they’ve had trouble achieving quality standards.

• With over 2,000 people on the priority waiting list current services and future expansion are in jeopardy.

The reality is absent a strong service system, we turn back the clock 30 years when individuals had few opportunities to live in the community. Without a rate increase the system is simply not sustainable at the capacity families want and deserve.

Transportation rates for intellectual and developmental disability services and supports have not kept pace with inflationary costs, thereby, causing hardship not only for providers, but families and individuals as well.

• Even though the rate for transportation is included in the overall day services rate, providers are unable to cover the costs of staff, travel, gas and vehicles for the programs.

• Without transportation, some individuals are unable to attend programs.

• Individuals may have to depend on their families, who may work as well, for transportation to attend day program.

• As unreimbursed transportation costs become a larger portion of agency’s budgets, programs are experiencing reduced capacity with a corresponding loss of revenue.

• The issue is not new. Transportation costs have not been adequately met since the implementation of fee for service in 2014 and when developed were not based on cost but based on available revenue at the time.

• It is critical this issue is addressed.

Agencies across the system are facing difficulties in this area, the resolution must include additional funding for transportation, with the best way to accomplish this a separate additional rate.

The consequences of doing nothing are varied and severe for people with disabilities and their families, with those currently on the waiting list likely to languish longer and individuals who theoretically have access to Medicaid-funded supports struggling to find providers or experiencing service disruptions.

● A508/S2668: Establishes annual cost of living adjustment based on Consumer Price Index for programs providing mental health, substance use treatment, or services to persons with developmental disabilities.

● This bill would not require the state to automatically raise rates, just to start the budget process with a cost-of-living adjustment in the budget proposal. The Legislature/Governor would still have the final say on spending.

● Since New Jersey transitioned to a fee for service model, many rates have not kept up with inflation.

● Investing in community disability/mental health programming saves New Jersey substantial money by keeping people out of inpatient and carceral settings.

● Nationally, 83% of intellectual and developmental disability service providers are turning away new referrals according to the American Network of Community Options and Resources (ANCOR)

● This lack of investment means thousands of people are being turned away for services they are qualified for.

● In New Jersey, community mental health providers have seen health care costs for employees rise 11.5% in 2022 according to New Jersey Association of Mental Health and Addiction Agencies (NJAMHAA).

● The coming carve in of managed care in mental health/substance use treatment services in Medicaid will result in even less money available to provide services.

● Passing this bill would provide greater certainty to the state and providers on what investment in community disability/mental health services should be.

● The estimated cost to the state of $90.5 million (Aug. 2022) after revenues is very reasonable for a high inflation year.

● Without sustained investment over time, a system already under duress will collapse. We can only squeeze water from a stone for so long.

• Direct Support Professionals (DSP’s) are the backbone of the system serving people with IDD but their wages have been low due to low reimbursement rates that do not reflect the responsibilities and demands of the career.
• NJACP is appreciative of the increases to DSP wages over the last five years so that wages stay ahead of the mandated minimum wage in New Jersey.
• There is consensus and more needs to be done as programs are still not operating at capacity and are unable to expand because of staffing shortages.
• With Target willing to pay $24/hour it is more difficult than ever to retain and recruit staff that are responsible for people’s lives.

For statistics about the crisis:

ANCOR State of America DSP Workforce Crisis