Recruitment and Retention (post pandemic transition): (A) Providers are competing with ALL area businesses to recruit and retain employees. All businesses in my local area have raised their starting wages to 12.00, 13.00 all the way up to 17.00 per hour. It is very difficult to compete with the current wage culture. Providers need an increase in the reimbursement rate for waiver services. Small providers are not able to compete with other businesses--we cannot afford to provide insurance, retirement, and only able to provide very small amounts of leave (sick and vacation leave) for employees. How can providers compete with other community businesses that match or exceed starting rates of pay AND offer a benefits package? (A1) Currently, providers are not allowed to hire individuals that have non-violent felonies. This needs to be revisited. Rural providers have a disadvantage with being able to recruit qualified, dependable, and efficient workers. Non-violent felons should be able to apply for DSP positions if they have not incurred additional criminal charges for a certain period of time (5-7 years). As Human Service providers and agencies it is unfortunate that we continue to bar these individuals from employment opportunities. If they have served the time and displayed behavior showing that they have been reformed and are making better life choices, why can't they be viable candidates at some point? (A2) Funding to assist with recruitment measures (working with employment agencies for direct hire), building partnerships with other agencies to provide a possible pipeline of qualified applicants (DSS, VA Employment Commission, DARS), and creating a committee to see how the state can assist providers in their recruitment and retention strategies. (A3) Providers need to be able to pay higher starting wages (1) it takes a special person to care for individuals with special needs and behaviors, (2) higher wages will increase the ability for providers to provide raises, incentives, and other possible benefits, (3) DSP's are required to take a lot of training to remain in compliance with the department/state requirements each year and at the time of hire. Providers need to be more attractive to potential candidates and compete against other businesses that are "punch in and out" and do not have the additional training, documentation, and care requirements. Honestly, folks that want to be care providers, in any capacity, should be some of the highest compensated individuals because they are provided care to other human beings.
Creating Efficiencies: Providers big and small are all treated in the exact same manner. This creates an imbalance in the system because small providers do not have the same revenue available, the ability to provide the same rates of pay, the same level of trainings, and/or able to provide specialized personnel to oversee specific departmental requirements. Many times, small providers are providing direct care, managing employees, recruiting and hiring, orientation, risk management committee, quality improvement committee, trainers, auditors, etc. (A) We have been audited over five different times since 2020. Understandably, providers should be audited but this is excessive, takes time, and interferes with small providers care routines. (B) Create an electronic reporting, data, and documentation system that providers can utilize to make information more streamline, accessible, and to increase efficiencies across the state. (C) Creating a training library to assist providers in ensuring that they are conducting the required yearly trainings in a manner that meets department expectations as well as gives access to complete trainings for providers to utilize for their staff. This should also include trainings that will meet the required trainings needed for the additional DSP Competency Checklist (Health, Behavior, and Autism).
Consolidation and Paperwork Reduction: A review of all the required documentation needs to be studied and reviewed. For small providers, paperwork has become an increasing overbearing task. Yes, documentation for services provided are needed and should be a part of care and provider requirements. However, as stated prior, small providers are providing direct care and managing the paperwork requirements. For example, employees may have to have all four the DSP Competency Checklist completed (dependent upon the individuals being serviced). This requires a substantial amount of time--observation, documentation, individual meetings, review, and upkeep as well as specialized training (additional cost based on the training requirements outlined for each of the supplemental checklist).
CHRIS System Replacement: Please please please look at replacing or upgrading the CHRIS reporting system. This system is not user friendly, it is not obvious to navigate, the trainings and the training manual are inadequate, and the way the system is setup does not make logical sense which in turn leads to citations. Those citations lead to more paperwork and time. The 10-day reporting time period should also be extended and/or the process to request an extension be made clear and added into the system so that it can be completed electronically.
