Pittsburgh Post-Gazette. April 25, 2024

Across Pennsylvania, thousands of families are waiting in limbo, unsure whether their loved ones with intellectual disabilities and autism (ID/A) will ever get the care they need. This month, Gov. Josh Shapiro made an ambitious promise to help them, one they’ve been waiting to hear for a long time: The commonwealth is committing, finally, to work through and end the wait list.

This is a wonderful milestone, but there’s a catch: The promise’s timeline is vague, and current funding proposals aren’t enough to fulfill it.

The new budget increase of $480 million will boost state reimbursement rates for the direct support professionals (DSPs) who care for patients with ID/A by 12%. While that only shakes out to another roughly $1.75 an hour, it’s at least a start towards livable wages.

It’s essential that this boost kick in as soon as possible: It’s just another reason Mr. Shapiro and the divided General Assembly must strike a budget deal on time this year.

Currently, DSP wages rarely even reach $17 an hour — for vital work that requires skill, compassion and often strenuous physical labor. This has left hundreds of empty positions and a steadily growing wait list for care the state is legally obligated to provide. Meanwhile, aging parents and relatives continue, and increasingly struggle, to care for their loved ones with ID/A.

Mr. Shapiro says he is hopeful that the latest boost will, over several years, fully eliminate at least one part of the waitlist: individuals with “emergency” status. There are currently 6,000 of them, over 1,000 in Allegheny County, according to the PA Waiting List Campaign.

Helping people in these critical situations would be a welcome turnaround for the state, as monetary support for people with ID/A received a huge setback last year. That budget cycle, the care system lost a total of $370 million, as the previous year’s appropriation hadn’t been completely used. Of course, this was only because service organizations couldn’t hire enough staff at the current, abysmal compensation rates.

One way to advance more certainly toward the goal of ending the wait list would be to index DSP rates to inflation. That’s the purpose of HB 661, introduced last year by House Majority Whip Dan Miller, D-Mt. Lebanon. Right now, DSP rates go through an onerous review process every three years; the current review was accelerated by order of Mr. Shapiro. But responding to inflation shouldn’t require a bureaucratic process: It should be automatic.

Mr. Shapiro’s promise, along with this year’s 12% raise, has been among the most promising news for the commonwealth’s ID/A community, or their families, for many years. But there’s still much more work to do. Legislation like Mr. Miller’s HB661 could provide a framework for ensuring fairer DSP pay long-term. Paying living wages will be the only way to attract the professionals Pennsylvania families desperately need.

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