Good Trouble

Congressman John Lewis encouraged Americans to get into “good trouble.”  These are the words he lived by, pushing the envelope and standing up to injustice.  His ongoing fight against social and economic injustice for people of color led him from his march on Selma to his years of dedicated service to the US Congress.  Throughout his lengthy career, Lewis worked tirelessly to right many societal wrongs.

At Venture, our idea of “good trouble” is calling attention to the significant human services workforce problem.  We recognize this problem as a wide-ranging social crisis and we recognize that it’s about way more than just jobs.  If McDonald’s doesn’t have enough staff to make your Big Mac, then you can go down the street to Burger King for a Whopper.  That is not the case in human services.  The systemic lack of staff available to fill positions in our field has led to 7000 adults with disabilities unable to access day programs.  For some families, this is devastating. They rely on that time to work outside of the home or to have respite from care taking.

The social crisis impacts the thousands of workers in the human services industry, too. Because the industry doesn’t pay a living wage, our workers are often forced to work multiple jobs in order to make ends meet.

These choices have a real and significant impact on the families of our employees, too.  Living in low-income households has long-term, far-reaching effects on the children of our employees. Studies have shown that children who grow up in poverty are more likely to develop chronic illnesses such as asthma and obesity. They are more likely to be sedentary and experience exposure to tobacco, increasing their risk of cardiac and pulmonary diseases.  Only 62% of children from low-income families graduate from high school, compared to 90% of middle and upper economic class families.  Of those, only 3% graduate from college as compared to 37% for middle and upper economic classes.  These children tend to have more behavioral problems in the home and in school.  Parental absence can also be tied to poorer cognitive ability in language, reading and mathematics.

Our employees do admirable work and are dedicated to the field. They collectively have a very positive impact on adults with disabilities throughout Massachusetts. We are all – vendors, staff, parents, guardians, concerned citizens – part of a system that should be supporting the welfare of our Direct Support Professionals and their families so that they can continue to support adults with disabilities.

Lewis said “When you see something that is not right, not fair, not just, you have to speak up. You have to say something; you have to do something.” I urge you all to continue connecting with your legislators. They need to know how important the work that the human services industry is and honor the commitment that the Commonwealth made decades ago to care for people with disabilities. Let’s make some good trouble and make our voices heard!

Up to the Senate Now

Budget season is well underway here in Massachusetts and the work continues in the legislature to create the financial framework and details for the new fiscal year that begins on July 1st.  The Governor submitted his proposal to the House of Representatives in January and the House sent their version to the Senate last month.  Now, it is up to the Senate to lead the way in recognizing the vital work done by skilled professionals in human services agencies by finally paying them a fair wage.  It is, in fact, long overdue.

Agencies in Massachusetts provide critical services to people with disabilities and mental illness through contracts with the Commonwealth.  These contracts contain dollars dedicated to staff salaries and those contracts have been woefully underfunded for more than a generation now.  This is at the heart of the workforce and social crisis that has existed for several years, well before Covid-19 entered our lives.  The industry has asked the legislature to add $351 million to the Governor’s budget proposal specifically to enhance pay for all of the people who spend their days and nights caring for others.  Yes, I understand that $351 million is a big number all by itself but it represents just 0.007% of the proposed state budget;  0.007% to reinforce the critical safety net that supports several hundred thousand Massachusetts residents each year.  This safety net is wholly dependent on a skilled workforce that must no longer be marginalized and taken for granted.  It is time for the Senate to take a bold step and reinvest in this workforce so that Massachusetts can remain a national leader in healthcare.

Unfortunately, the House chose not to add a single dime to the salary line proposal in the Governor’s budget.  This is why we need the Senate to step in and accept this challenge to give agencies the financial ability to stabilize and grow a tired workforce that has done so much for so many in this state.  Massachusetts already dedicates considerable resources to people with disabilities and other needs and it is something for which leaders in Boston should take a well-deserved bow.  However, we cannot stop short when it comes to paying skilled professionals a decent wage to help people who desperately need to be helped.  Massachusetts made a promise long ago to support individuals in the community rather than returning to the misery of state run institutions and that promise has been kept largely on the backs of a talented but depleted workforce.  These professionals need to be paid well enough that they can now afford to keep helping people.  Dedication to helping others should not have to come with a vow of poverty and the Senate can start the process to ensure it does not. Let’s see what they do with the chance. 

It’s Too Bad We Need To Keep Talking About This

Spring is finally here in Massachusetts and with it comes all the usual trappings: the days are getting longer, the temperature is starting to rise, trees are blooming, and people are spending lots of time outdoors.  Spring also means that budget season is in full swing now as the House of Representatives and the Senate in Boston take turns building a new annual budget for the Commonwealth.  Unfortunately, that process brings with it another annual rite: the need to ask yet again, why professionals who are dedicated to helping others are not paid as well as they should be.  And that conversation is getting old.

The Human Services sector in Massachusetts is a very large one with almost 200,000 jobs and close to ten percent of the population in the state receiving some type of help.  In spite of the many lives being touched and supported, the people who do this work, and do it tirelessly, remain vastly underpaid because state contracts do not provide for the type of pay they deserve.  As a result, the industry continues to experience a severe workforce crisis that is now leaving people who need help behind.  At this time, approximately 7,000 people with disabilities and mental health needs are unable to attend day programs they attended before the pandemic because there are not enough staff to help them.  Fixing this crisis begins with finally paying professionals a truly competitive wage and this starts with the legislature.  People on Beacon Hill need to step up and recognize the incredible contributions and skills of these professionals and the positive impact their work has across this state.  The time to discuss the issue is over and the time to fix it is now.

Individuals who work in the human services sector already live a life of sacrifice.  They put in grueling hours, miss holidays with their families, miss birthday parties, risk physical harm, and face the constant emotional strain of the work they do.  For all of this sacrifice, the average annual pay for direct care staff is still well over ten thousand dollars below the state average.  How can this still be the case?  Every year we talk about the vital work being done by people in this field and the uncommon skills they have.  And yet, we are still left to justify why they should be paid a livable wage in Massachusetts, a state with a very high cost of living.  Without the amazing men and women in this challenged workforce, hundreds of thousands of people would be at even greater risk than they are now.  In short, human services professionals solve a great many problems for Massachusetts and they are absolutely entitled to significantly higher wages for the heavy burden they carry. 

The social safety net in Massachusetts is one that leaders in the state should be proud of and one they have invested in over many decades.  However, that system is approaching a breaking point because of a workforce crisis that existed long before the pandemic came along.  There is a tremendous array of programs and services available in the Commonwealth but the people who directly provide those services remain terribly underpaid.  Countless people have left the industry because they simply cannot afford to do the work they love.  It is time to fix this by funding contracts that pay professionals appropriately for their commitment and unique abilities.  Without them, there is no safety net at all.

Washington Needs To Work Harder

by Mike Hyland, Venture President & CEO – The Covid-19 pandemic really has made 2020 a year unlike any other.  At every turn, we can see how things have changed in our daily lives.  We wear masks (well, most of us), we shop differently, our children go to school differently, and too many local businesses have had to close their doors for good.  Human services agencies have not been immune to the financial strife caused by the pandemic and now, more than ever, we need the people tasked with leading this nation to do what it takes to support us.  Sadly, they aren’t even trying to do that right now.

The people in the Senate, the House of Representatives, and the White House simply need to work harder.  It seems they spend all day every day bickering and posturing rather than moving forward.  Pandering has replaced leadership and complete abandonment of professionals who work with disabled people has replaced accountability.  It is unfathomable that no one in our federal government has taken the time to publicly acknowledge the amazing work these professionals do to keep others safe and that the work is both vital and commendable.  Instead, this work has been privately ignored while these elected officials spend their time sticking their tongues out at one another.  Wow!

Massachusetts has always valued the work done by human services providers but the Commonwealth is now facing a significant fiscal crisis as the Baker administration tries to come up with a workable budget for this new fiscal year that began in July.  In order to properly fund agencies that are still realizing extraordinary expenses due to the pandemic, Massachusetts needs the federal government to do its job and create a relief package that supports the work that Venture and others do every day.  Instead, the Senate (with the approval of the White House) has passed a package that raises a collective middle finger to human services agencies by completely ignoring us and the House of Representatives has turned their attention to political posturing.  Once again, WOW!

I know that the political climate in D.C. is both toxic and dysfunctional, probably more than at any other time.  If there is one thing those elected officials should be able to agree upon, it is the work being done by millions of people to help others every day is important.  This work also requires specific and immediate support, either directly or through money funded through the states, in order to continue at the high level people deserve.  Waiting another however many months for elected officials to get to it is entirely unacceptable and even dangerous.  These people know what they need to do and they need to work harder now to do it.

Let’s Make Sure We Keep the Promise

By Mike Hyland, President and CEO

The end of the year tends to be a busy time.  The holidays are upon us, there are seemingly endless tasks and errands, high school seniors are planning the next steps in their lives, and Old Man Winter makes his annual return.  This is also the time of year when Congress tries to wrap up business.  In 2017, that means tax reform, which we all know is an unfailingly complicated business.  In addition, this year Congress will also take up the chore of confirming (or not) a new Secretary of Health and Human Services.  With all due respect to the enormity of the work happening in Washington D.C., we should be careful to ensure we don’t leave people who need help, and those who provide that help, behind.  In other words, let’s make sure we keep the promise.

It is most important that we remember that massive change has the potential to inflict unintended consequences on various groups.  As such, our Congress has a responsibility to be sure that any legislation or action does not inadvertently harm people with disabilities or the professionals who work tirelessly to help them.  The cost of providing quality services to people is not cheap, and it’s not supposed to be.  An automobile with front and side airbags costs more than one with pillows stapled to the steering wheel because it’s safer for people, and that’s what provider agencies do: we keep people safe.  Providing supports that allow people to live vibrant lives with dignity and choice is the minimum of what we should require as a society.  And this is not just a responsibility at the national level either.  Individual states must also ensure that we don’t lose the gains we’ve made over the years.

Massachusetts is one of a number of states now moving under the auspices of managed care entities the fiscal oversight responsibilities for many of the services provided to people with disabilities   The goal of reducing redundancy through better coordination of care is appropriate and even admirable.  That goal, however, is dwarfed by the responsibility to make sure that no one who currently receives community supports is forced to make do with less. We must take great care to guard against the pitfalls experienced in states such as Texas, where many severely disabled children have seen a horrifying reduction in vital services, or Kansas, where some families have been asked to sign blank treatment plans that ultimately called for drastic cuts to supports that keep loved ones in the community.  Massachusetts has always been a compassionate leader in the provision of social services and that commitment must remain absolute in the face of any systemic changes that may take place

As politicians struggle with the need and pressure to reduce runaway costs in certain areas, they owe it to everyone who receives community based-supports to remember just what people with disabilities (and their families) were told to expect when such supports were moved out of institutions and into local communities.  They were promised that people would be safe.  That is a promise that needs to be kept.  It’s everyone’s responsibility to see that it is.

Is this the Final Assault on Medicaid?

By Mike Hyland, President and CEO

With the year half over already, the U.S. Senate is working furiously to pass a bill that overhauls the Affordable Care Act before Congress recesses for the July 4th holiday.  A bill written in complete secrecy by just 13 members of the 100-member Senate is finally making its way to all of the people who will ultimately vote on it next week and, like the bill passed by the House of Representatives last month, the details are alarming.

Of paramount concern is the Senate’s plan to mirror the bill passed by the House that significantly cut Medicaid over a ten-year period, while also converting it to a block grant.  It is not just an assault on Medicaid, but an unequivocal betrayal of people with developmental disabilities and the hard-working men and women who support them in the community.  With Governor Baker already asserting that this legislation will cost Massachusetts billions if enacted, the Commonwealth will find itself in a position where draconian cuts to basic supports will be inevitable.  The human service industry already struggles to hire people, and will now be gutted even further.  The funds available to increase wages will disappear.  There have been months of advocacy that have taken place to educate the White House and Congress about what these cuts will do to people with disabilities, as well as the professionals dedicated to helping them.  Both the proposed Senate and House bills represent that the people who wrote them and voted for them just don’t care.  They know that services for people with disabilities will be cut and that pay for direct care professionals will freeze. Their actions prove they truly don’t give a damn.  How did we allow our society to get here?  If there is one thing that elected officials should be able to agree upon, it is the duty to protect people with disabilities and the too-long-taken-for-granted workforce that helps them.  Instead, President Trump and leadership in the House and Senate have chosen to abandon them and dedicate dollars that currently support these groups to the most affluent in our country via a tax cut.  Perhaps worst of all, these actions come following a promise from candidates that, if elected, they would protect Medicaid and the disabled.  Obviously, it was a lie from the start.

There is still a process that these bills must go through before becoming law.  Essentially, the House and the Senate must find a way to reconcile the two bills into one and send it to the White House to be signed.  It is my hope that people will flood lawmakers like never before with phone calls and emails that decry this horrific dismissal of people in need.  We should inundate our lawmakers with the notion that people with disabilities have the right to live safely in local communities.  We must also remember the professionals who are dedicated to supporting them.  So many people have worked way too hard, for far too long, under grueling circumstances to be so blithely abandoned in favor of millionaires and stubborn ideology.  Gandhi once said, “The true measure of any society can be found in how it treats its most vulnerable members”.  If one believes this, it would seem that we are dangerously close to failing the test.

Forum with Congressman Joe Kennedy

On Monday, Venture representatives attended a Disability and Health Care Forum with Congressman Joe Kennedy hosted by the Association of Developmental Disability Providers at the Boston Marriott in Newton.  The event was attended by staff members and leadership from human service agencies, self-advocates, and family members of people with disabilities.  Kennedy shared his commitment to “recognizing the potential in every person”, regardless of their physical or intellectual disability.

Congressman Kennedy expressed his concern about the American Health Care Act and how it will affect the rights of people with intellectual disabilities, with $1.4 trillion in cuts to health care.  He shared his concerns regarding threats to social security, affordable housing, food stamps, and even Special Olympics.  He pledged his commitment to the disability community, saying that we cannot support “cuts to services that we will all likely use someday, or be used by someone we love”.  In addition to thanking attendees for their activism, he encouraged the group to continue advocating and raising their voices.  He asked advocates to contact friends and family in other states and encourage them to find one more Republican Senator to oppose the AHCA.

Recently, Congressman Kennedy addressed Congress, rebuking The American Health Care Act.  Watch the video here.

Congressman Joseph Kennedy III represents the 4th District of Massachusetts and is a member of the House Energy & Commerce Committee.  For more information, visit his web site.

Don’t Betray Innocent People

By Mike Hyland, President and CEO

Once again there is a bill in Washington that would replace the Affordable Care Act with another version of health care policies, regulations, and practices.  Obviously, this is a heated political issue and will likely remain so for many years – but the politics of it tend to obscure an important fact: the current bill, like the last failed bill, will unequivocally harm people with disabilities and the professionals who support them.  In other words, it betrays innocent people.

The proposed bill will punch holes in Medicaid funding that individual states will not be able to fill.  With cuts of almost $850 billion over the next ten years, people with disabilities and their advocates once again find themselves (for the second time in a year that is barely four months old) in danger of being left behind.  In fact, given that this is the second bill in 2017 that threatens them, it would appear that a good many people in Congress are also choosing to simply say that these people just don’t matter.  How in the world can that be okay in this country?

Medicaid is a $600 billion annual program that contains many provisions and it is probably time for the program to be evaluated in terms of efficiency and outcomes.  Nonetheless, converting it to a block grant or per capita program goes well beyond that.  It destroys safety nets and opportunities for people with disabilities and turns a blind eye to the work force that has battled for years to be recognized with appropriate pay and benefits for the valuable work they do and have always done.  Drastic reductions to Medicaid funding undeniably makes it even harder to support professionals who are already stretched too thin.  Clearly, these proposed Medicaid cuts are tantamount to Congress and the new administration telling this workforce that what they do isn’t important.  At best, the people proposing this latest bill just don’t understand what this industry does.  At worst, they just don’t care.

People with developmental disabilities rely on current levels of funding to stay safe, to remain in a community of choice, to get to work programs, and to access wellness and recreation.  It’s utterly baffling that this would be a group that politicians seem to have deemed as needing less than they get now.  We’ll ignore the reality that savings realized from service cuts to disabled people are intended to fund a tax cut for people making a million dollars a year and up.  That’s an issue to be taken up elsewhere.  What needs to be talked about is the reality that the current legislation, as written, will take away from people who essentially have the least.  People with developmental disabilities already struggle to work, to get adequate health care, to have reliable transportation, to develop social networks, and to be heard.  They also are victims of abuse and neglect at a higher rate than the general population.  So why does Washington believe that reducing programs that support them is a good idea?  No one seems willing to answer that question, particularly those who when campaigning pledged not to cut Medicaid.  The hypocrisy is staggering!

The ACA is obviously a hot button issue that will remain so for a long time to come.  It’s expensive and it is the duty of elected officials to examine it and anything else that divides so many people.  But don’t do something that harms people who are ignored far too often.  Don’t turn back the clock and wipe out years of progress on so many fronts for people with developmental disabilities.  Hey Washington – don’t betray innocent people.

Let’s Remember Those Who Need Help

by Mike Hyland, Venture President & CEO

It’s far too easy to get caught up in and distracted by rhetoric, particularly in a time when people are conditioned to get their information from agenda driven headlines and 140 characters of social media.  Those dynamics make it all the more important that we all make a commitment to doing something that used to be simple: let’s remember those who need help.

The pending changes to Medicaid are intended to redirect federal funds (not reduce them) and the collateral damage of this initiative will ultimately be a reduction in services and accessibility for the people that Venture and other committed agencies have supported for so long.  For some people who are thriving as vibrant members of local communities, the new Medicaid system will leave them without the support they rely on now to be as successful as they are.  For others, a reduction in dollars dedicated to community programs will prevent them from achieving appropriate levels of independence.  While Medicaid is a tremendous expense on both the federal and state levels, trying to contain costs by putting at-risk populations at even more risk is simply irresponsible.  Furthermore, trying to save Medicaid dollars by weakening safety nets for people who are already routinely marginalized, and often can’t advocate for themselves, is abhorrent.

We must also remember that this is not actually a political issue; it’s a human issue.  We’re not talking about immigration or manipulation or Medicaid fraud.  We’re talking about people who rely upon community supports from under-paid professionals to remain out of more expensive settings.  If Medicaid becomes a block grant program rather than its current program of matching federal dollars, people who have never abused the benefits of the program will be forced to make do with less.  Even the Chief Medical officer at the Health and Human Services department in Washington, Dr. Andrey Ostrovsky, is opposed to the idea of converting Medicaid to a block grant funding model, as is now proposed in Congress.  Dr. Ostrovsky believes that the harm caused by the suggested shift in funding will be wide-spread and certainly include people with disabilities.

And what of the dedicated professionals who work so hard and so well in the industry?  They are already grossly underpaid and over-burdened as it is.  The battle to provide this critical (and economically significant) workforce with appropriate wages and health insurance is constant.  These people will undoubtedly be left behind again if there are Medicaid cuts that reduce the amount of money that currently funds community-based supports for individuals and families. At a time when recruitment of staff to work in human services is at a crisis point, the act of reallocating current funds away from the people who already make sacrifices to care for others is nothing short of disgraceful.

Cuts to Medicaid will have a long-term ripple effect too.  Progress that has been made over the years in helping people with disabilities will halt and eventually reverse, and the workforce will be further diminished because livable wages will be harder to provide than ever before.  In short, pending reductions to the dollars vital to so many people who need help amounts to one big broken promise.