Staff shortages at Texas group homes are putting residents with intellectual and developmental disabilities (IDD) at risk, advocacy groups say, and they're asking Texas lawmakers to fix the problem by giving workers a raise.
Group homes are funded through Medicaid, and the state Legislature sets the base wage for workers. Last legislative session, they bumped the hourly rate from $8.11 to $10.60.
That raise was woefully inadequate, according to group home operators, who say it's a struggle to recruit and retain staff. They are left running their group homes with many staff vacancies, driving burnout among workers and worsening care for residents.
State representatives on the House Committee on Human Services invited advocates to talk about the workforce crisis at a hearing on Tuesday. One of them was Carole Smith, executive director of the Private Providers Association of Texas.
“I have never, ever seen the IDD service system this unstable,” said Smith, who has worked in the field for almost 50 years.
Group homes give people with disabilities the option to live in small settings in their home communities. Someone might live in a group home if they want to live independently but still need some help, or if they need intense levels of care their family cannot provide.
Group home workers cook, clean, dispense medication, monitor residents’ health and handle behavioral issues, among other tasks.
The Private Providers Association of Texas, along with two other advocacy groups, surveyed Texas group home providers and found their employees work an average of 60 hours a week. Some weeks, they work 100-plus hours.
The staffing problem leaves providers struggling to meet regulatory standards. Some reported in the survey they have seen an increase in medication errors, behavioral issues and hospitalizations.
Staff turnover has a profound impact on residents, too, Smith told lawmakers.
"The instability is grave. Their quality of life is diminished. Continuity in their services and supports is disrupted, and trusted relationships they once had with staff are lost,” she said.
Workers at state supported living centers — the state-run institutions for people with disabilities — got a much bigger raise last year than group home workers. Their starting wage is now more than $17.
Group homes need to be able to offer competitive wages, Jeff Miller with Disability Rights Texas said. If he was running a group home, he said he’d need to fight for workers with state supported living centers.
"They’re paying close to $20 an hour with benefits,” he said. “My workers are going to go work for the state supported living center if they can."
Raising the wage is a matter of survival, said Cathy Cranston, an organizer with the disability rights group ADAPT of Texas. The majority of the direct care workforce are women and people of color, like herself, she said.
"It is unjust to expect workers to come in at $10.60 an hour to do the services. But we do, because we believe in what we're doing," she said.
Cranston called for a $20 an hour base wage.
Many group homes have shut their doors due to the workforce crisis. From January 2023 to February 2024, 229 homes closed, with more closures anticipated, according to the provider survey.
Time to Care, a coalition pushing for a wage increase, held a press conference Monday in anticipation of the legislative hearing.
When group homes close, residents either move to other facilities or end up with family, said Charles Njuguna, president and CEO of The Center for Pursuit in Houston.
“In many cases, you're turning them over to siblings who themselves are stretched, who themselves are struggling to live their lives," he said.
A person at the press conference asked if state lawmakers have given any indication they plan to raise the base wage in 2025. Last session, they said they were going to help, and only gave a small increase, Njuguna said.
"They say the right things, but their actions speak louder than words, which is why we're here today, asking them and imploring them to action," he said.
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