'Feel like they're forgotten': Push for higher pay for caregivers of people with disabilities

In spite of the demand, advocates feel the program has been historically underfunded.

AUSTIN (KXAN) – Glen Bradley’s son, Todd, had cancerous tumor and a stroke as a baby, leaving him with brain damage, loss of vision and some issues with fine motor skills. Todd was just three months old when the father learned his son would need around-the-clock supervision for the rest of his life.

"You have to start preparing and making plans for what that's going to look like when they're older,” Bradley said.

That planning paid off when Todd was accepted into a state program offering long-term care services in the Dallas area. Now, as an adult, Todd receives these "Home and Community-Based Services," or HCS, while living in a group home with a few other men.

Bradley said it allows Todd a level of freedom he might not have otherwise, while still getting all the care he needs.

“We had started talking to Todd early on about that,” Bradley remembers. “We had said, you know, 'His sisters are going to graduate from school, go to college, and then they're going to go out on their own. And Todd, you're going to get out of school, and you're going to go out on your own, as well.'”

He described the caregivers in his son’s group home as “amazing,” helping with daily tasks such as bathing and feeding. However, in the last few years, the Bradley family has noticed more staff turnover and — at times — a shortage of caregivers in his home. 

"He develops relationships with his caretakers, and then they're gone,” he said.

It’s why Bradley made the three-hour drive to Austin to testify before state lawmakers about the need for better retention methods for these kinds of caregivers.

“I don't think he could ever imagine that he would lose his home,” Bradley said. “But now I realize how fragile and how tenuous the situation is that he's in — and other people in those homes — because without those frontline workers there to take care of them, I mean, you can't provide a home.”

‘Fighting’ over staff

The state offers different types of care options for people with intellectual and developmental disabilities.

According to the Texas Health and Human Services Commission, or HHSC, they can receive services while living in their own home, a group home with around four other people, a slightly larger intermediate care facility (ICF/IID) in their community, or one of the 13 State Supported Living Centers (SSLC).

• Read more about the options here

People living in their own home or a group home can apply for several different Medicaid "waiver” programs, including HCS, which are funded through a combination of federal and state dollars.

Demand for these programs remains high, with a notoriously long wait list. According to HHSC, as of February 28, 2023, more than 157,000 people were waiting on an “interest list” for these kinds of community-based services.

In spite of the demand, advocates feel the program has been historically underfunded.

“There’s so much fear, and we are seeing an extreme number of group homes having to close,” said Sandy Frizzell Batton, Executive Director of the Providers Alliance For Community Services of Texas, or PACSTX.

PACSTX has been advocating for the legislature to fund an average wage of $15 an hour for these caregivers.

In April, the House passed a version of its budget bill, including funding for that $15 an hour average wage. Meanwhile, the Senate budget bill being considered by lawmakers in that chamber instead calls for what Batton refers to as a “floor” — a $11 an hour base wage.

According to state records, it would be an increase from the current base wage of $8.11 an hour. The base wage has increased only 11 cents from the $8 an hour base wage passed by the Legislature in 2015. Prior to that, an HHSC report states it was $7.84 an hour.  

Batton said if either version of the budget passes this session, it will be the “most significant investment” they’ve seen from lawmakers for wages for several years. Still, her group is hoping the legislature will provide for an average — as opposed to a base wage — in order to avoid wage compression, where current and more experienced workers are devalued compared to newly-hired employees.  

Batton said, right now, the legislature has funded an average of around $9 an hour.

According to a survey of community and personal care attendants published by HHSC in February 2023, survey respondents’ median wage was approximately $10 per hour, “indicating that half of the respondents make less than $10.00 per hour and half make more.”

Batton pointed out that HHSC recently announced higher salaries and starting wages for staff at SSLCs, another type of care option for people with intellectual and developmental disabilities. In a release in January, HHSC said pay for direct support professionals would start between $17.50 and $21.

“We're all fighting over the same workers,” said Denise Gasmire, CEO and owner of Champion Services. “Everybody knows that the fast-food restaurant has $15 dollars an hour in their window. So, I think everybody knows that it is essential.”

Champion Services operates several support, services and group homes in the Dallas-Fort Worth area, including the one where Todd Bradley lives. It’s personal for Gasmire, who started Champion because her son needed these kinds of services, too.

“These folks are our brothers; they're our sisters; they're our children; they may be our aunts, and uncles — whatever, they're our friends. We want them in the community, with us, and not placed away in an institution. So, that's why it's so important, so that they can maintain their connections with their families and their friends, and be a part of the community. They are a part of humanity,” she said.

Unlike some other types of long-term care that accept private pay, Gasmire explained all her revenue comes through the state’s HCS program. She said Champion recently increased pay for caregiving staff to $12 an hour, but that money has to come out of other operating expenses and services. She believes, without an increase from the legislature, it'll be tough to keep her group homes in business.

Gasmire said 33% of all the necessary shifts at Champion Services are open, even after offering higher wages.

“I don't have staff to fill them,” she said.

Batton called it a trend across the state: “That means at any given time, one out of three homes doesn't have regular staff on site — meaning staff that are there that have already worked 12 hours, 18 hours, and there is no one there to relieve them."

She acknowledgedgener staffing shortages and extended shifts also increase the likelihood of mistakes on behalf of the caregivers, and subsequently, the care for patients.

Last year, an investigation from the Austin American-Statesman found the state has investigated nearly 80,000 allegations of abuse, neglect and exploitation in the programs that provide services to the IDD community. The Statesman investigation also uncovered attacks on these caregivers in the system.

‘A fair wage’

Gasmire and Bradley testified about the need for a rate increase at a hearing in late February. They both told KXAN they were hopeful that this session lawmakers were listening.  

“Our direct care workforce sometimes feel like they're forgotten. It just would mean a lot, just not only financially to them, but for the legislature and for the state, to let them know that they're important enough to pay a fair wage for the work that they do,” Gasmire said.

KXAN will continue to follow the legislative effort and will update this story when more details become available.