Group home closings put pressure on families
Concerns about staffing shortages have been raised for years, but impact is growing.
ROCHESTER — Kate Sawinski doesn’t know where her 56-year-old daughter with special needs will be living after March 5.
“If she had no other option, I would be the option,” she said, asking that her daughter’s name not be used.
In December, the family was informed the group home where Sawinski’s daughter has lived for 14 years would be closing, along with nine other homes in Olmsted and Winona counties.
Sawinski, a retired nurse, said her daughter, who has cerebral palsy with physical and intellectual disabilities that require 24-hour care, could move in with her on a temporary basis, but the lack of support raises questions.
“Because there aren’t any workers available, the whole scenario is scary for me,” she said.
Her other daughter, Kelly Rae Kirkpatrick, said the option hasn’t been ruled out with less than three weeks remaining until the deadline.
“It’s looking like my sister is going to go live with my mother, who is elderly, and I am going to have to fill in with care,” she said, adding that her position as a Rochester City Council member limits her ability to be available as a helping hand.
The family isn’t alone.
When Cardinal of Minnesota announced it would close 10 of its 55 homes, approximately 30 families were faced with similar uncertainty.
Judy and Joel Young were among them when they discovered their son, Andrew, would need to find new housing.
“As soon as we heard this, we took a few days to get over the emotional shock and then started reaching out to other providers,” Joel Young said.
Nearly two months later, the couple said they are in the final stages of securing a new provider for their son, who is in his 30s and was born with fragile X syndrome, which results in struggles with anxiety, communication and how his brain responds to sensory information.
For several years, the Youngs had provided a house for their son, with Cardinal contracted to oversee support for Andrew and one housemate, but staffing concerns led the agency to pulling back its support.
“After we felt like we had done everything we could as an organization to improve the situation, it wasn’t enough,” Cardinal CEO Michelle Priggen said, adding that it was a difficult decision to close the group homes. “We had come to a standstill.”
Agencies providing direct support for people with developmental disabilities have been sounding the alarm for years, citing a lack of financial support from the state, which has kept salaries low and hampered efforts to retain staff.
Until recently, most agencies paid less than $15 an hour as a starting wage for the direct support professionals who staff group homes throughout the day and night.
Last year, to attract more staff, several agencies increased their typical hourly starting pay to $15 or slightly higher, which outpaced the 5% increase in state support provided at the start of the year. The pay is on top of standard benefits for full-time staff, according to several local agencies.
Kirkpatrick said the wage increases still don’t go far enough.
“Every month, these people are living, or attempting to live, with wages that don’t even pay the standard of living that’s necessary in Olmsted County, which the wage calculator says is $18.95 an hour minimum,” she said of the support staff.
Priggen said Cardinal’s staffing challenges were exacerbated by COVID-19 and related temporary closures of day programs.
To combat COVID-19 impacts, the agency also announced in December that it would require staff to be vaccinated by March 5. With 500 employees statewide, Priggen said she expects 50 to leave rather than be vaccinated.
Amy Thompson, Olmsted County’s director of Adult and Family Services, said it’s a projection that has changed since December, when Cardinal expected one-third of its staff might opt to find work elsewhere.
She said Cardinal took steps to educate its staff and make vaccines available, which helped reduce the workforce loss.
Priggen said sign-on bonuses, the unfunded pay increases and other bonuses since December also helped, but the vaccine mandate puts the agency in a unique position.
“We don’t know of other providers that are making that choice,” Olmsted County Adult and Family Services program manager Jennifer Bagne-Walsh said.
Another challenge was a record loss of key leadership staff last year.
“That is really crippling to an organization,” Priggen said, noting many long-term employees opted for jobs in other fields with steady hours and reduced likelihood of being called to fill open shifts.
“We were paying, myself included, our highest-paid senior leaders to cover these hours, because we did not have enough people,” she said of the situation faced when the December decision was made.
While some staffing challenges are unique to Cardinal, other agencies face similar struggles and have had to close homes on a smaller scale in recent years.
Last year, Hiawatha Homes closed a group home, but it was able to find beds for clients in its other homes.
Cindy Ostrowski, the agency’s CEO, said the closure was directly related to staffing.
In 2014, Hiawatha Homes had 400 employees; today, that number is 250.
“We are turning a lot of people (clients) away, just because we don’t have the team members to support everyone,” Ostrowski said.
The agency is licensed to support 82 people in its 20 local homes, but only has 76 due to staffing shortages.
Bear Creek Services has also closed a home in the recent past, but Executive Director Linda Driessen said the change was made when the affected clients could be moved to other Bear Creek homes.
Like others, she said staffing was the primary concern.
“Our staff are killing themselves,” she said. “They are working all the time. It’s difficult as an employer to watch the most valuable asset you have dwindle away, both physically and mentally, because they are working all the time.”
She and others said they are hoping to avoid the tough decision Cardinal faced, but they also said the change is felt throughout the system.
“When I heard about the number of houses that are closing, it kept me awake,” Driessen said. “They are not even my houses. … All I could think about is what will happen to those people.”
Bagne-Walsh said 150 group homes are operated in the county, with approximately 450 beds, but more and more agencies are scaling back available space in order to ensure they can meet clients’ needs with limited staff.
“Right now, we have a bunch of Olmsted County, and I think across the state, beds sitting empty because of these closures over the last couple of years – downsizing or closures. Nobody is in a position with staffing to open more homes,” she said.
Thompson said Olmsted County officials were recently informed that Wabasha County is facing potential group home closures. It's a situation in other Minnesota counties too.
Locally, it’s left staff scrambling to find housing options.
“Every day, social workers are pining for places to stay for these people,” Olmsted County program manager Jennifer Mann said.
Some of the displaced clients have moved in with family members and others have found beds in other Cardinal homes or with other agencies, but it’s not always as simple as moving into another home, since facilities frequently cater to specific needs.
Sawinski said she’s only been able to find one potential home that might have space to accommodate her daughter’s needs and it will only open when an existing resident moves out. It’s with another agency, which adds uncertainties to the stress of finding a new home, because, while she finds some faults with Cardinal, she considers it the best provider in the county.
Wade Welper, regional director for REM River Bluffs, said matching the home, its residents and services is key to success for any client.
“We’re always trying to match up people that will be a success,” he said. “It’s a home; you have to live with people.”
The Youngs cited similar concerns. While they found two potential providers for their son's home, they said his first stay at a typical group home didn’t go well, so they know transition can be difficult.
Agency directors acknowledged the challenges, pointing out that each case is unique.
“It can be difficult for an individual to acclimate to a new home setting,” said Matt Heitzman, program director and designated coordinator for Fourth Avenue Homes, which is looking at perhaps taking over some of the homes closed by Cardinal.
With six existing group homes in Rochester, Fourth Avenue opened its newest location a year ago, and Human Resources Director Nate Schueller said the organization needs to weigh a variety of factors to make sure new homes don’t reduce services elsewhere.
“Some of the locations make sense with their current staffing patterns and current residents,” he said.
More work to do
Bagne-Walsh said it appears that at least two of the seven Cardinal homes in Olmsted County will be serviced by a new provider next month, which could reduce the need to relocate people.
She said it still leaves Olmsted County staff working to finalize housing for some residents, while neighboring counties help their clients, who are living in Olmsted County.
The immediate concern remains providing beds for people by March 5, but county staff and agency leaders said long-term concerns need to be addressed at the state level.
They’ve been lobbying for increased reimbursement for years and forecasting eventual home closures, but directors and CEOs said policy changes could also help.
The industry’s advocacy group, Association of Residential Resources in Minnesota, has a list of potential policies it’s hoping the Minnesota Legislature will consider this year.
They include proposals for scholarships to help recruit young staff, child care grants for existing staff and adjusting how reimbursement rates are determined.
Amid the discussion of changes, Kirkpatrick said one of the challenges is informing lawmakers that group homes are not the same as nursing homes and other long-term care facilities, and that changes to help facilities caring for the state’s older residents don’t necessarily help others needing similar services.
Julie Young said more effort is also needed to engage families and support workers to find out what will address current needs.
“They don’t ask the people in the trenches,” she said. “They just make decisions.”
And, she said those decisions have some people wondering what the future will hold for their family members.