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A Blog by Art Dykstra


From My Pad to Yours is about leadership and other topics, and is written by Art Dykstra, the CEO of Trinity Services, Inc.

And One More Thing

by Art Dykstra | May 04, 2017

The DSP workforce crisis is an exercise in playing with fire. We are at a point today that we have never been before in my 50-year career. Simply stated, human service organizations cannot recruit or hire sufficient direct support staff because the pay they can offer is so low. As a result, the quality of life for the people we serve in CILAs has been slowly decreasing while the risk for bad things happening is rapidly increasing.

The primary problem is that a home needs at least two people on duty to provide adequate care. That care includes:

  • Passing medications (What happens to the medication process should the DSP need to address a disruption?)
  • Showering (Who is available for other residents when a person may require individual attention during bathing?)
  • Toileting (What happens if a person must wait to use the bathroom while another is receiving the help he or she needs?)
  • Response when a person elopes or wanders off (Does the DSP leave the other residents alone to track down the person who has left?)
  • Care when an accident occurs (Can the DSP offer proper attention to someone who has fallen if other residents require help?)
  • Providing community outings (How do residents react over time when they are basically trapped in their home for long periods of time because one DSP cannot provide sufficient supervision for an outing?)
  • Supervision during mealtimes (Who handles a choking incident when others require help?)

Who would want to work or continue to work under these circumstances at poverty-level wages? Worse still, who wants to be charged with neglect when something goes wrong because he or she was the only person on duty? What would you do if you were in our place? It’s a question we have asked of everyone, including the governor’s staff.

Since human service organizations in our position are doing their best to reduce risk, we are all having to:

  • Halt the development of new residences
  • Consolidate homes
  • Close homes on weekends
  • Close homes entirely
  • Discharge individuals
  • Turn away persons with challenging behaviors (This will include those 200 persons proposed to be discharged from State-Operated Development Centers (SODCs) in the governor’s 2018 budget.)
  • Provide the extra staff support required for dealing with persons with challenging behaviors
  • Spend extra time and effort on recruitment that doesn’t pay off because the wages we can offer are too low.

Recruitment, however, is a necessity. Trinity, like most providers, has instituted very aggressive recruitment efforts—some 40 initiatives—to address the staffing crisis. Among them are;

  • Hiring a full-time recruiter
  • Asking Trinity’s parents and family members for their help in sharing job openings through their network of people in social media, church groups and other organizations
  • Running employment ads before the main feature at local movie theaters
  • Running a digital advertisement that was displayed at the corner of a busy intersection close to a local community college
  • Running a three-month ad with Pandora that included options for a person to click on the ad to reach Trinity’s online application
  • Distributing business-size “Now Hiring” recruitment cards to all Trinity employees with printed information on job openings and how to apply
  • Partnering with local restaurants by posting fliers with employment opportunities in windows and at tables.

Results have frankly been disappointing. There are too many jobs that offer higher wages. Will County is a particular disaster for us because of all the warehouses and distribution centers being developed that pay workers $13.00 an hour. In fact, the Wall Street Journal published an article on April 9, 2017, featuring the burgeoning growth of warehouses across the country and the sudden rise in wage offerings as companies compete for a shrinking pool of people seeking employment.

Furthermore, in 2012 legislation passed that raised the wages of personal care assistants to $13.00 an hour. It had a major negative impact on providers. Many staff left to earn $4,000 to $5,000 a year more—and who would blame them? Obviously, any wage increase under $13.00 will not help organizations that serve people with disabilities.

The resulting staff shortages place human service organizations in an extremely precarious position. The legal obligation called “duty of care” in tort law requires providers to ensure adherence to reasonable care standards while carrying out any actions that could foreseeably harm others. Essentially, the concept describes a situation in which an untoward event deemed to be unreasonable occurs or a care worker fails to act in a reasonable, responsible manner to prevent injury. These events happen when a worker or agency has done something that it should not have or failed to do something that it should have. This is the first element that must be established to proceed with an action addressing negligence.

It is a frightening concept. I have a frequent nightmare that in the very near future we will see television ads that read:

"Do you have a loved one living in a CILA? Has that person complained about their care? Has the Office of Inspector General made any determinations of neglect against that provider or a staff member?
"Call today! You may be entitled to compensation."

In talking with providers, it is clear that more CILA lawsuits are being filed today than ever before. The recent Chicago Tribune articles provide evidence of that. One thing is certainly happening. Providers have no choice but to turn away individuals who have greater medical risks or who may harm others. Something clearly needs to be done on many levels.

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