Several recent stories about workforce shortages across Minnesota (“Worker shortage worst in decades,” Jan. 14, and “North Shore takes search for workers to Puerto Rico,” Jan. 21) call out two particularly concerning issues.

One, despite being among the first to ring the alarm bell on this issue, health and human services providers who deliver critical supportive care to people with disabilities received no mention in these stories. Yet tens of thousands of Minnesotans rely daily on direct care professionals, personal care attendants, home health aides and other direct care staff, whose average wage hovers around $11 to $13 per hour.

Not to underestimate the tumult that would ensue if bar owners across the state closed up shop because they could not fill their sub-$15-per-hour positions, but in fact health and human services providers are the Minnesota employers “on the brink” requiring a feature.

Second, the workforce shortage that is a very real concern for all employers in Minnesota is only going to get worse, as both articles point out. This spells real trouble for health and human services providers of all types, as even now this sector is already feeling the pain more significantly than others, particularly those employers who provide community-based supports to people with disabilities, also known as Home and Community-Based Services (HCBS).

While the Jan. 14 article showcased a 4 percent overall job vacancy rate across Minnesota, HCBS providers are at more than double that for direct care positions. Among sub-$15-per-hour vacancies, while the statewide average is around 6.4 percent (specifically highlighted as troubling in the article), direct care staff vacancies are at approximately 9 percent.

With about 9,000 open positions, direct care professional vacancies by themselves make up 7 percent of all job vacancies in the state.

Unlike the businesses discussed in both articles, health and human services providers are largely handcuffed in responding to market pressures. In the case of HCBS providers, 95 percent of the revenue for these organizations comes from Medicaid, the financial support source for most people with disabilities unable to work. This means rates for services are set by state law and business practices are heavily regulated, removing many market levers businesses in other sectors can pull to help right the ship.

Case in point: While Minnesota’s overall economy responded to tightening labor markets with a 4 percent wage increase from 2016-2017, HCBS providers needed to spend months convincing legislators to approve rate adjustments reflecting a Bureau of Labor Statistics update, which happens only every five years.

This needs to be a wake-up call for policymakers, regulators, community leaders, and health and human services providers alike. There is no one simple solution to reversing this trend, and if we do not invest the time and resources to turn the tide, many of the most vulnerable in our state will be in serious trouble.


Sue Schettle is CEO of the Association of Residential Resources in Minnesota (ARRM).