MN is bracing for significant changes in services for individuals with Developmental Disabilities.   

According to ANCOR (ANCOR Issues Findings from 2021 State of America’s Direct Support Workforce Crisis Survey) 

“The COVID-19 pandemic drastically changed the landscape of service provision and accelerated the shortage of direct support professionals, or DSPs, the frontline workers who support people with intellectual and developmental disabilities (I/DD) to be included in the community.

For decades, the United States has witnessed a significant shortage of DSPs due to stagnant reimbursement rates and the inability of providers to offer competitive wages with entry-level industries, such as fast food, retail and convenience. In February 2020, ANCOR conducted a survey of providers of community-based I/DD services to glean a deeper understanding of how they experience the human and financial impacts of the DSP workforce crisis. The results of that survey revealed what at the time felt like staggering findings: at alarming rates, providers were discontinuing services, turning away new referrals, delaying the launch of new programs, struggling to adhere to quality standards and more.

And then came the pandemic.

With the onset of COVID-19 and throughout the entire duration of the pandemic to date, we have been fielding desperate calls from our network of more than 1,600 private providers of community-based I/DD services. These calls have made clear the new pressures and hazards of providing essential, close-contact services during the pandemic and how those pressures and hazards have exacerbated the existing workforce crisis. While many in the private sector pivoted by offering increased wages and hazard pay, community providers—who rely almost exclusively on Medicaid funding and are thus beholden to paying wages that Medicaid reimbursement rates will permit—lacked the resources to fund these kinds of unanticipated programmatic costs.”

Key findings from ANCOR’s 2021 State of America’s Direct Support Workforce Crisis survey include that:

  • 77% of providers are turning away new referrals, a 16.7% increase since the beginning of the pandemic.
  • 58% of providers are discontinuing programs and services, a 70.6% increase since the beginning of the pandemic.
  • 81% of providers are struggling to achieve quality standards, a 17.4% increase since the beginning of the pandemic.
  • Nearly 3 in 10 providers report spending at least $500,000 annually on costs associated with high turnover and vacancy rates.
  • 92% of providers report that the COVID-19 pandemic continues to complicate their ability to recruit and retain qualified direct support professionals.

The workforce shortage continues to be the number one concern for HCO.  Without an adequate workforce, we can’t continue to provide our current services.  During the past three years, HCO has taken the issue of workforce shortages head on.  In 2019, the HCO Board of Directors, employees, and stakeholders developed a Strategic Plan to combat the issue of  workforce shortage.  A number of tactics are being used, such as new marketing campaigns, increasing base wages ($15 in 2021) and implementing aggressive retention models. As a result of these strategies, HCO is providing more hours of service and employing the highest number of employees ever.  Despite this, there is simply not enough people to provide the care that is needed. COVID-19 is causing many employees to be unable to work due to exposures, testing, and isolation, and individuals not receiving services in their day programs has drastically increased the demand for support.

ARRM CEO, Sue Schettle, and ARRM Board member, Alan Berner, testified in front of the Minnesota Senate Human Services Committee regarding the dire workforce shortage facing residential providers. You can watch the hearing below. (Sue Schettle starts speaking at 1:28:00)

So where does this leave those served by agencies like HCO and the workforce that has put their heart and soul into providing care?

Making the tough decisions:

HCO is trying to find a balance between providing good care for as many individuals as possible, without depleting our already exhausted workforce.  Like other agencies, HCO understands that we will likely have to close programs and stop additional services for those who count on us.  This is a heartbreaking decision, yet it can be the only way to enable providers to keep their doors open.

What would it mean if an organization like HCO had to close? It would leave the people we serve, who have no family and no other support system, without anyone to care for them. It could leave those living in our residential programs without a place to call home. Families of those we serve would need to take on the full support of their loved ones, which may be unsustainable for those in need of 24-hour care. It is devastating to consider not being able to serve all those who need it, however, we know that ensuring that we are able to serve some is better than being able to serve none.

How can you help?

HCO continues to be involved with identifying innovative solutions and working with DHS and local legislators to make needed changes. We need people who are willing to share their stories, speak with legislators, or contact local media outlets to help us bring visibility to critical service issues. What sort of impact have you seen HCO services have on those around you? What would happen if you, your family, or your friends in the community didn’t have this support any more? We need your voice today. If you would like to get involved, join our Grassroots Taskforce by contacting me today via email at

Do you have questions or thoughts?  Please call and share your ideas with me (507.452.1021).

Suzanne Horstman, Executive Director