Worker Shortage Puts Florida Group Homes in ‘Survival Mode’

But for some of the state’s most vulnerable citizens who receive around-the-clock care in residential facilities, the competition for workers is having more-dire consequences.

More than 100 group homes for people with intellectual and developmental disabilities have shuttered since March, and more closures might be on the horizon, providers warn, unless the Legislature boosts funding for the facilities.

Craig Cook, executive director of Attain, Inc., told The News Service of Florida his nonprofit organization has closed four group homes in Orange, Lake and Seminole counties over the past year and has stopped taking referrals because he can’t staff the facilities.

“Basically we’re in survival mode. Right now, our turnover is higher than our recruitment level. So we’re losing staff faster than we’re hiring them,” Cook, whose organization is down to 20 group homes in Central Florida, said in a phone interview.

Attain and other facilities provide residential care and day services to people with intellectual disabilities who often have other complex behavioral issues and can require one-on-one attention. The majority of the group homes, which are overseen by the state Agency for Persons with Disabilities, have four or six beds.

The facilities, which rely largely on Medicaid funding, are paid by the state through a complicated reimbursement schedule based on the types of services residents need.

Clint Bower, president and CEO of MACTown, Inc., said the state’s reimbursement rates for services equate to an average of about $10 an hour for direct-support professionals.

“We’re really getting under $10 an hour, and we’re making up the difference because we have to. We have no choice,” Bower, who operates group homes in Miami-Dade and Palm Beach counties and in the Treasure Coast region, told the News Service.

Based on a survey of providers, the Florida Association of Rehabilitation Facilities estimates group homes are paying an average wage of about $11 an hour to direct-support professionals, up from an average $9.50 an hour last year, association CEO Tyler Sununu told the News Service. While wages have increased, reimbursements from the state have not.

“Most of our members are telling me they’re bleeding dry right now by paying their staff more than they can afford, hoping that something will change before they go out of business,” Sununu said.

The association is asking lawmakers, who will begin their annual legislative session in January, to increase reimbursement rates for services to the equivalent of $14 an hour for direct-support employees.

“To be competitive right now we need to be paying $14 or $15 an hour, and that’s what these people are worth. These people work hard. They shouldn’t be making $10 an hour,” Bower said.

Like other employers throughout Florida, Bower and other providers also face increases in the minimum wage. The first installment of a voter-approved increase in the state’s minimum wage went into effect last week, bumping the rate from $8.65 an hour to $10. The minimum wage will increase $1 a year until reaching $15 on Sept. 30, 2026.

In part to address the minimum-wage hike, lawmakers this year increased wages for the state’s lowest-paid employees to $13 an hour.

Senate President Wilton Simpson, a Trilby Republican who pushed the wage increase for state workers, said in a prepared statement he wants to boost pay for direct-support professionals before the 2026 deadline. Simpson also pointed to a requirement in the budget for state agencies to identify, among other things, the impact of the minimum-wage increase on contracts with vendors, including direct-service providers.

“In my view, people who spend their career caring for those with unique abilities and other vulnerable Floridians deserve our admiration and respect, and my goal would be to make sure we also bring them up towards $15 an hour in advance of the required timeline,” Simpson said. “The issue is that it’s been difficult to assess how much money that will actually take and where it needs to go, which is why we asked for the agencies to identify those positions and report back to us in advance of next session.”

Meanwhile, the state has fewer than 2,200 group homes for people with intellectual disabilities, and 105 have closed since March. In trying to hire direct-support professionals, group homes must compete with nursing homes, which have higher reimbursement rates, and hospitals.

“And right now, hospitals are paying a whole lot more than we can pay, but so are fast-food restaurants,” Bower said. “MACTown is paying $12 an hour to start. I can’t even get people to walk in the door.”

Bower’s organization, which he said was fully staffed before the onset of the COVID-19 pandemic last year, has a 15 percent job-vacancy rate and is averaging about 1,000 overtime hours per pay period. The situation is unsustainable, he said.

In western Volusia County, Duvall Homes CEO Steve DeVane has temporarily shut down two of his 15 group homes. Duvall, which runs residential sites for adults with developmental disabilities as well as a day-training program, employs about 85 workers and has 25 open positions, he said in an interview. The nonprofit organization’s overtime expenses are totaling between $45,000 to $55,000 per month — up to 17 percent of its labor costs.

“If we close down, these folks are going to be out of a place to live,” DeVane said.

Cook, of Attain, Inc., said he was forced to discharge some “of our most challenging individuals,” who can become dangerous to themselves and others, due to staffing shortages.

“The outcomes for those individuals have not been great,” he said, adding that some of them ended up in psychiatric hospitals or jails.

Group home executives are dipping into savings or using other strategies such as sign-on bonuses and referral bonuses to attract and retain workers.

Cook has even hired a marketing group to try to lure employees and has launched radio ads, he said.

“We’re doing every incentive you can think of to try to invite people to be part of the mission,” he said.

–Dara Kam, News Service of Florida