People with Intellectual and Developmental Disabilities Face a Crisis of Care

For several years, staffing shortages have been at CRISIS levels for people with developmental disabilities in Nevada. The crisis is going to get worse if we do not act immediately.

Without caregivers, many people with developmental disabilities cannot safely live in the community. People with developmental disabilities rely on fixed, state-set rates for their caregivers’ wages. These rates haven’t increased fast enough to keep up with record-high inflation. As a result, employers of caregivers (known as “Providers”) are losing more caregivers than they can hire.

The State of Nevada used federal COVID crisis funding (from ARPA) to temporarily increase rates to Providers in 2022. Providers used this temporary funding to increase wages and pay hiring bonuses, retention bonuses, shift bonuses, etc. Even so, this temporary funding has not been enough to fully compete with other industries that are rapidly raising their prices to increase wages and benefits to compete for a limited pool of workers.

The temporary funding Providers have relied on in 2022 to prop up staff wages and bonuses has now EXPIRED!  This has created a fiscal “cliff” that is set to make the already dire staffing crisis catastrophically worse! This presents a true CRISIS OF CARE for people with disabilities in Nevada.

This Crisis of Care is increasing the number of people with developmental disabilities who have no place to go because Providers cannot find enough staff. Some people with developmental disabilities with the highest needs are bouncing in and out of short-term placements and hospitals. In some cases, these individuals may be released from hospitals or other short-term placements and have nowhere to go.  As staffing levels decrease, more people are at risk of finding themselves in this predicament.

Because of staff shortages, providers have consolidated homes, cut back on services, and stopped adding new services.  After doing everything they could, Providers have had to stop serving individuals with complex needs because there are not enough staff to safely support them. Providers have successfully served these individuals for many years prior to the staffing shortage. Other individuals are at risk of losing services if additional employees quit. The industry is in a very fragile position.

Many workers get paid higher wages to do less stressful jobs outside of disability services. Often, caregivers report that the pay is too little compared to the detailed responsibilities, personal risk, and stress of being responsible for people's lives without adequate help. Starting wages at many other jobs are now well over $16/hour, while the state-set disability rates only result in a starting wage of around $12.50/hour for direct support staff.

Unless rates and wages are changed to attract and retain more workers (and the temporary funding from 2022 is made permanent, avoiding the catastrophic “cliff” scenario), individuals with developmental disabilities face an escalating and unsafe crisis of care.