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Stone Belt Divisions :  Milestones Clinical & Health Resources 

September, 2014 Letter to Governor Pence from CEO Leslie Green

Dear Governor Pence:

I was in the audience at the Bedford Town Hall meeting last week. I appreciated hearing about your priorities and accomplishments for Indiana. You highlighted your focus on workforce development and job creation, and indeed, the news seems more promising in these areas than it has in the last 5 years.

Unfortunately, all is not well for some Indiana employers and their employees. I'm the CEO of Stone Belt Arc, a non-profit disability services provider operating in Monroe, Lawrence, Bartholomew and surrounding counties. Our direct service workers, their managers and other staff serve hundreds of people with intellectual and developmental disabilities in residential, employment, and educational programs. I believe our accomplishments are impressive. We've helped dozens pf individuals move out of costly institutions and into the community and have supported hundreds of local families, like those in Bedford, meet the needs of their loved ones with significant disabilities. 

But we're in the midst of a significant care gap crisis. In my 35 years of working in this field, I have never been as concerned as I am right now. We need your help Governor Pence.

What's causing this care gap crisis? In a nutshell we have insufficient numbers of staff tp meet our obligations to our clients. here is some background.

In 2010, in response to the downturn in State revenues during the Great Recession, FSSA cut Medicaid reimbursement rates for the majority of our services. As I'm sure you're aware, almost all of our clients receive Medicaid due to their disability levels. In addition to their basic health care services, this funding reimburses providers like Stone Belt for long-term services and supports. This allows out clients to receive habilitative services aimed at increasing their self-sufficiency and supports them to live in the community. Direct support staff provides instruction and assistance to our clients in areas ranging from persona hygiene; to household management; to helping them find and keep a job in the community. These jobs require skills and a good deal of training in order for us to achieve good outcomes.

The total loss of revenue to Stone Belt following the cuts was about 5%. We were able to reserve all programs to clients, though many now get fewer hours of service, but we could not preserve the salaries and benefits to our hard-working and dedicated staff. In addition to salary reductions, Stone Belt's ability to contribute to employees' 401(k) plans was eliminated. 

In the four years since the cuts, employees have had no appreciable raise, yet their personal expenses have increased. Recently, we drastically curtailed our expenditures on health care for our employees, saddling them with plans that have high deductibles - a cost none of them can afford on the wages we are able to provide. Regrettably, we had no other choice.

National studies show that 40% of those providing direct supports to people with disabilities are receiving public benefits themselves, just to make ends meet.

The stagnant wage scale was more tolerable during the height of the recession, but as the economy has improved, we are not recruiting and retaining enough staff to meet client needs. Currently we are competing for employees with the fast-food industry. Workforce shortages have put untenable pressures on the system. Currently Stone Belt has opening for the equivalent of 54 full time positions, about 12% of our workforce, most of whom we need to provide direct supports to our clients. Of those working, we can expect 31% to leave in the next year. The impact of this high vacancy rate and employee turnover means:

  • we are operating with skeleton crews to care for clients' intensive health and safety needs.
  • some clients go without any services or get far fewer hours than they need.
  • clients face disruption and must continually see staff come and go
  • dedicated staff leave jobs they love because they can't make it on the wages their employer can afford.
  • many managers are filling in, providing direct supports to clients, which prevents managers from accomplishing their supervision and monitoring responsibilities.

In short, the clients we support are at risk and the staff is very weary. Furthermore, there are dozens of people who have asked us to serve them, but we have little or no capacity to bring them on. Indiana has made progress in providing funding to decrease the waiting list for services, but it will serve no purpose if providers, such as Stone Belt, have insufficient staff to provide the services.

So I am calling on you, Governor Pence, to fully restore the Medicaid reimbursement rates that were cur from the Medicaid Waiver and Intermediate Care Facilities funding in 2010 and to create a system that accounts for inflation for the years to come. As Indiana's population ages, and more direct services workers are needed, we will see increased pressures on maintaining a sufficient workforce to provide these critical services for some of Indiana's most vulnerable citizens. Hard working Hoosiers who provide these critical services deserve to be paid more than someone flipping a burger. 

My colleagues in other disability service organizations around Indiana would concur that this is a state-wide problem. I know some have spoken to you directly about this critical issue. As you prepare your budget proposal for the next biennium, I hope you will include a system to put organizations lie Stone Belt on a sustainable path.

I would be happy to meet with you and your staff, as well as to host you for a visit to our organization, so you can see firsthand the challenges we face and our commitment to support a high quality of life for people with disabilities. Thank you for your time, your consideration and for your service to all Hoosiers.

Respectfully yours,

Leslie Green


Cc: Rep. Eric Koch, Sen. Brent Steele, Rep. Peggy Mayfield, Rep. Matt Pierce, Sen. Mark Stoops, Rep. Matt Ubelhor, Rep. Bob Heaton, Rep. Dr. Tim Brown, Sen. Luke Kenley, Congressman Todd Young, John Dickerson - The Arc of Indiana, Kim Opsahl - INARF