Colorado is so short on workers for people with disabilities

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BY JENNIFER BROWN THE COLORADO SUN

When James Wester arrives at his day program, he typically heads straight for an iPad and looks for a vacation video. Two iPads are even better — then it’s travel guide Rick Steves talking about Europe on one screen and Laurel and Hardy laughing it up on the other.

Some days, 27-year-old Wester will shake a tambourine in the music room or dance while one of the other clients at the day program for people with intellectual and developmental disabilities exercises to a Richard Simmons video.

Wester looks forward to his time at Community Living Alternatives in Aurora, and so does his 70-year-old mother, Christine. It’s about the only time during the week that she gets a break to have lunch with friends or run errands.

But Wester gets to go less often now. e day program, where attendees play games or attend art and cooking classes, can take only 10 clients each day compared with 20 a couple of years ago. e center had to cut the hours for Wester and others because it doesn’t have enough sta to take care of everyone. Wester comes only three days each week, although his Medicaid insurance plan has enough funding for four.

It’s a longtime problem in Colorado: Even when people with developmental disabilities are approved for Medicaid services, there isn’t the work force to actually sign up for them.

And the workforce crisis of the past two and a half years has made it worse. While the number of day programs for people with developmental disabilities has rebounded after a pandemic dip, families across the state say they’re struggling to nd spots. e programs are open, but they are so short-sta ed that they’ve had to cut hours for clients, keep huge waitlists and, in some cases, inform people they can’t come at all. e reason is that day programs, which are reimbursed for services by the state Medicaid program, can’t a ord to pay their workers more than they would make at a fastfood restaurant, said Gregg Wilson, manager of the day program at Community Living Alternatives. And the job, though rewarding, is more demanding.

Community Living Alternatives has been trying to ll two positions for two and a half years. e center hired one worker in September, but she stayed just ve weeks.

“We are competing now with McDonald’s and Wendy’s,” he said. “It’s really hard to get people to show up for these interviews.”

Wilson’s program pays its employees about $17 per hour to care for up to ve people at a time. He’s down to two workers, so that means 10 cli- ents per day — in a spacious facility that once was KinderCare Learning Center — is max capacity.

Wilson, who has worked with people with disabilities for more than two decades, said it was easier to nd workers when he rst started out. ey often were people who had grown up with a sibling or friend or neighbor who had developmental disabilities. “I can’t even nd those people anymore, who have passion for this kind of work,” Wilson said.

“And you have to have a passion for it, because nobody’s really getting rich doing that.”

Medicaid o cials seek to raise base pay to $15.45 per hour e salaries day programs can provide are directly connected to the Medicaid rates set by the Colorado Department of Health Care Policy and Financing and the state budget. e base wage rose to $15 per hour two years ago, up from $12.41. is year, the department is asking lawmakers to raise it to $15.45. e number of day programs statewide dropped dramatically in 2020, when the pandemic kept people isolated at home. At rst, the state Medicaid program continued to reimburse day-program providers even though they weren’t open, trying to ensure they could pay their sta and the rent. When the federal government cut o those “retainer payments,” Colorado o cials shifted to allow day centers to get reimbursed for virtual programs, connecting with people via computer screens.

It’s taken two years to recover from the drop in services, but the number of day programs has rebounded to 2020 levels, said Bonnie Silva, director of the O ce of Community Living at the state Medicaid division. e number of people using day services has rebounded, too, she said. But many people stuck with the virtual option or switched to oneon-one services instead of group programs, Silva said. e department does not have data to determine how many people are using