Impossibly Low Wages Hurt Community-Based Caregivers and Clients

Our state Legislature has failed to fund attendant caregiver wages for people who provide care for individuals with intellectual and developmental disabilities (IDD). 

Despite Texas having a $33 billion budget surplus, despite Governor Greg Abbott saying that addressing low attendant wages was among the most important legislative goals of the session, despite provider agencies only receiving less than 1 percent of an adjustment to their fundamental rates over the last 12 years or six sessions, our legislators allocated only $10.60 per hour for provider agencies to hire staff who then provide comprehensive, necessary, and life-sustaining support to those with intellectual and developmental disabilities. This rate of pay is $5 per hour less than the starting pay of a new Dairy Queen employee in Austin.

Due to inadequate wage rates, several provider agencies at a recent hearing in Austin told Texas Health and Human Services Commission (HHSC) officials that they are experiencing 30 percent of their group home shifts being unstaffed while administrators are working in the direct attendant gaps to ensure clients’ needs are met. One provider agency testified that, while covering an unstaffed shift in a group home, their administrator had a finger bitten off. While surprising to the average Texan, it is par for the course for those who work in the industry.

Our legislators, presumably, believe that people who are supposed to ensure intellectually disabled individuals receive their medications, that special needs training and behavioral intervention plans are understood and implemented, as well as shop for and prepare meals to the appropriate texture (while taking into consideration dietary restrictions), facilitate transportation needs, that wash urine-soaked bedding, and meet the hygienic requirements (including wiping feces off an individual) should be paid less than a teenager who works at a fast-food restaurant.

Realize also that our legislators have decided, over the last 13 years, to increase payment rates for similar workers in our State Supported Living Centers (SSLC’s) over 100 percent, where care now costs taxpayers over $28,000 a month per individual served. Meanwhile, community-based providers received rate increases of less than 9 percent, over the same period. (With most of that going into effect September 1, 2023, after the most-recent legislative session.)

The resultant disparity in funding over almost a decade and a half has blighted the community-based provider employee base with wages now pegged at $10.60 per hour, while direct care workers at state facilities receive between 17.50 to $22 per hour. Keep in mind that both the SSLC and community-based providers serve a decidedly similar consumer. At the extreme ends of the spectrum, community-based providers take care of those with the highest levels of need at a rate five times higher than that of our SSLC’s by percentage of individuals served. 

Attendants at state-run facilities have extra hands to obtain and prepare food, give medications, help with behavioral needs, transport individuals, and maintain the properties. They have administrators as well as doctors, psychologists, psychiatrists, nursing, and therapeutic staff onsite. I argue that attendant workers in community-based programming often do a more difficult job, serve more needy clients with less support, and help more than those paid twice as much per hour. 

How is this possible? Well, the individuals who run HHSC and the legislative staffers who work in our government seem to be ignoring the issue.

My wife, Shelly Clark, runs a small company that provides services to disabled individuals under state programs. She started our company and then brought me on full-time in 2013. We have grown from serving 20 consumers to approximately 130 individuals since that time.

Prior to that, I was in law enforcement for almost two decades as a detention officer, a police officer, and a reserve officer, until obtaining my Master Peace Officer’s License. I have been around special needs individuals throughout my life, beginning with my uncle but also during my law enforcement career. I have really enjoyed my transition to Avid Quality Care and enjoy the problem-solving that comes along with the management of an agency that provides critical, necessary, and life-sustaining support for those with IDD.

But paying fair wages to our employees is a struggle. I’m not a lobbyist, but felt forced to speak out after seeing that HHSC executive officials do not appear to provide our legislators with the appropriate contextual information about market rates of pay, inflationary costs, services rendered, how community-based care compares to institutional levels of service, or the imminent implosion of community programming that currently serves tens of thousands of Texans. 

As a result, Texas has remained the second-to-last in funding in the country for our most needy citizens since that metric has been tracked, according to an analysis by the ANCOR Foundation. Our officials are failing the least of us through what appears to be carelessness, and they are the only ones allowed to have substantive conversations with members of our Legislature.

It doesn’t help matters when one of the legislators presiding over the Health and Human Services Committee, Senator Lois Kolkhorst, gets named among the worst legislators in the state by Texas Monthly. I am struggling to understand how that happened, but after three years of reaching out to Kolkhorst about programming for those with IDD, I was never even able to obtain a meeting with her. 

Is there a legislator in this state who believes that when they create a program, meant to take care of the least of us, it should be funded enough to reasonably function? 

Community-based providers have been holding up their end of the deal. I challenge any legislator with a spine to start holding up their end. This poor attendant wage issue needs to be placed on Abbott’s call for a special session so that it can be immediately addressed as he directed. We cannot allow functional incompetence to be the goal of HHSC and our Legislature any further; especially when it comes to those who cannot care for themselves. Just one man’s opinion.