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New Hampshire’s Workforce Crisis

Posted: December 28, 2017

Over the past several years, there have been many efforts to study the problem of a workforce shortage in our state, particularly in the healthcare and community support industries.  Numerous commissions, advocacy groups, and government officials have weighed in on this challenge and made recommendations for how we might begin to solve this crisis.

I use the word crisis for a reason:  there are too few workers to meet the current needs of individuals with disabilities and those who are aging and need assistance, and all predictions point to a growing gap between the demand for workers and the supply of qualified individuals to provide the work.  In the absence of an adequate workforce, family members are bearing the brunt of the load by staying home to care for their loved ones.

New Hampshire has been a national leader in supporting individuals with developmental disabilities and acquired brain disorders in home and community-based settings, rather than in institutions which rob people of their individuality and sense of belonging.  It is a basic human right to be able to live independently, and for those who need long term supports and services to do so, it is our moral and legal obligation to provide that support.   Unfortunately, however, we are falling short of our obligation by not ensuring that there is a robust and qualified workforce to meet this need.

Direct Support Professionals (DSPs) have responsibility for the safety and well-being of our most vulnerable citizens. They provide assistance with bathing, feeding, dressing, hygiene, medication administration, housekeeping, transportation, access to the community, employment support, attending medical appointments, and other important activities of daily living.  For all of this responsibility, the current Medicaid reimbursement rates only allow for an average wage of about $12 per hour.  Potential workers are opting to take jobs in retail and fast food businesses, where the starting pay is higher and the job does not entail being responsible for another person’s life.

Medicaid is the primary funding source for long term supports and services, and is a program that is comprised of state and federal dollars.  The amount that the state contributes is determined by our legislature every two years through the state budget process.  Those funds are then matched by the federal government through the Medicaid billing process.  The NH Legislature has the power to fund increases in the Medicaid reimbursement rates to adjust for cost of living increases, yet no rate increase has been provided to New Hampshire’s Developmental Services system in nearly a decade.  A 2017 House Bill, HB387, would have provided a modest increase to help with this situation.  The bill was defeated in the House, by one vote.  With turnover rates among DSPs exceeding 25%, and fewer people entering this vital field due to the low compensation and benefits available, it is well past time to right the ship.

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