You Get What You Pay For

My adult son with autism requires staff who are trained at least annually by the behavior specialist who authors his behavior plan.  They are part of his ISP team that decides his goals and programming each year.  They understand how to communicate with him despite his lack of verbal skills and are comfortable communicating with those in the community when he cannot, even if that communication is about extreme behavior.  Staff who are dedicated enough to take him to stores, libraries, waterparks, pools, museums, zoos, amusement parks, volunteer opportunities, etc. daily and even on an airplane for vacations periodically.  His staff are required to document on his goals and medication administration daily and file incident reports weekly.  They are trained annually in the administration of his medication, incident reporting and advocating for him.  They communicate daily with one another and his family, sending pictures several times a week.  His staff are educated, well-paid professionals with many years of experience with him.  Safe inclusion in the community is only possible for my son because of their expertise.  They rise to the expectations of a professional career and deserve to be treated and compensated in a professional way.  Without their dedication to my son’s life, he might stay alive, but he would not have a life.

Staffing your agency is much easier said than done.  Everyone agrees that quality, highly trained staff are essential for any entity that provides care.  However, how to recruit, pay and retain these staff remains a puzzle.  The barriers to securing quality staff include low Medicaid Reimbursement, high non-billable training costs and the poor history and reputation of the industry.  Low Medicaid reimbursement sets the expectation of paying just over minimum wage in order to have a viable business.  Minimum wage workers are typically not looking for a career, but for a job.  Young people on school breaks, people with a career looking for a “side hustle” or people looking to pick up a little extra cash often take this type of job.  While these individuals can make great employees, they are not looking for a long-term career or to develop expertise in the field.  While this type of employee might be able to keep your loved one alive, they are not able to “give your loved one a life”.  The program that we have outlined requires a much higher degree of professionalism and dedication.  For example, in the field of education, teachers are required to earn a college degree before they can begin teaching, continue their education through training or continued college education and have opportunities for upward mobility through education, training and experience.  Their compensation is based on their training and experience.  This creates an expectation of a professional teacher who should be paid a professional wage.  This is in direct contrast to other workers who care for children but are not required to be trained or paid at a professional rate.  Other childcare workers are tasked with keeping children alive, not changing their lives.  Where the expectation of a teacher is that they will change the life of a child by teaching them things they will carry with them throughout their life.  Unfortunately, care giving for individuals with disabilities has not risen to be looked upon as a professional career.  This has created a sad, segregated, oppressed industry that does not reward training and experience.  The program that we adhere to cannot be successful without a more professional caliber of staff which requires a higher rate of compensation.  Ability Matters has accomplished this by securing the services of a CEO with a Ph.D. in Applied Behavior Analysis (ABA) and special education in addition to 20+ years of experience.  This allows us to diversify our funding streams outside of lower Medicaid Reimbursements and elevate all of our programming and staff to a higher level.  While this might not be a solution available to all care agencies, the fact remains that industry-wide transformation will require a structured system that rewards and demands education and experience.  You cannot set high expectations for individuals with disabilities and their programming if you do not set high expectations for their staff.