Posted: September 19th, 2015

Turnover Remediation Plan.

Everyday Lives (EL) is an organization that provides services to individuals with intellectual disabilities. The services primarily include residential and vocational programs. The residential programs are of two types. One provides four-bed group homes, while in other cases EL provides services to those living in their own homes (Supported Living). With respect to vocational opportunities, EL provides support to individuals who work in community businesses.

EL’s mission reads as follows:

Everyday Lives is committed to supporting individuals with intellectual disabilities as they make choices with respect to living the lives they desire.

Among the values it has adopted are:

To interact with all stakeholders in a respectful manner.
To allow individuals with disabilities to be involved in all decisions affecting their lives.
To be creative in finding ways to support individuals as they pursue the lives they desire.

Among the visions it has adopted are:

To successfully compete with other service providers in acquiring new clients.
To become the employer of choice in the local labor market for direct support professionals (DSPs).

The programs–residential and supported employment–are structurally quite different. Residential consists of approximately 24 group homes. There are 8 home managers, each responsible for three homes. Although most of the clusters of three for each of the managers is within 3 miles of the other 2, there are two house managers with homes that are more than 12 miles apart. At each of the homes there are an average of 12 staff to cover all shifts 24 hours per day, 7 days per week. In addition, for some homes with very active individuals–in a couple of cases, even violent individuals–there are additional part-time staff to supplement full-time staff, particularly during meal times and in the early morning.

Another set of residential staff supports individuals living in their own homes. For example, a DSP might travel to the person’s home to help the person plan for meals, shop, or clean the home. In some cases the person is living at a family residence with parents and/or siblings. On other occasions the person might be living in a supported apartment either alone or with one or more roommates. Unlike a group home, there would not routinely be staff 24/7 in these locations. Those DSPs working in supported living report to the Supported Living Director.

The supported employment program provides support during the workday, generally between 9:00 a.m. and 4:00 p.m. There are 45 individuals who have been placed in part-time community employment (e.g., baggers in grocery stores; clerical staff in offices), and 12 staff responsible for developing contacts with local employers, placing individuals in positions at those employments and mentoring individuals on their jobs.

Income Sources

EL receives the vast majority of its income from federal and state funding streams, the largest of which are from Medicaid. Given the economic situation at both the federal and state levels, there has been no increase in actual dollars from these sources for the past two years. The frozen financial payments have resulted in a net loss of approximately three percent each year given inflation.

Regulatory Issues

The human service industry is highly regulated. At least once a year, a group of federal or state surveyors will appear unannounced to monitor activities in the various programs that EL manages using published standards of performance. Among the issues that create substantial concern are the minimum staff relationships that exist. The ratios vary depending on the level of care required for the individuals served. For example, in many of the group homes the majority of individuals are physically fragile. Many cannot move against gravity, therefore are constantly bedridden. In a number of those situations individuals require skilled nursing care. In two of the group homes there are dually diagnosed individuals (i.e., both a mental retardation diagnosis + a mental illness diagnosis). In these cases additional employees are scheduled to work in order to help respond to emotional outbursts that can occur, outbursts that can endanger both staff and the individuals EL serves.

On average, regulations require at least 1 DSP per every two residents, except on the night shift (midnight to 8:00 a.m.).

This particular requirement necessitates that if someone calls in sick and there is no one else available to cover a shift, someone on the preceding shift might be required to work overtime. To refuse to work overtime in this situation is a serious disciplinary infraction.

The Marketplace and EL’s competitors

Within the city in which EL exists there are three other organizations providing similar services on a somewhat similar scale. Primary funding for all of these organizations comes from federal and state sources. Although EL is a not-for-profit entity, two of the other three organizations are for-profit. The state agency that administers the funding streams has a contract with each organization to provide residential and vocational services. The agencies receive stipends for each person that enrolls in any of the programs. The stipend varies with respect to the amount of service required. Agencies are not, however, guaranteed clients. They must compete in the local market place to identify and enroll individuals, most of whom are represented for such purposes by a parent or guardian.

Employee Issues

Perhaps the most critical problem related to employment at EL are the high levels of turnover, particularly in the group home settings. Those environments require 24/7 coverage. Turnover of evening shift employees (4:00 p.m. to midnight) is particularly high, approximately 65 per cent a year on average.

EL conducts exit interviews with all departing employees. Recent statistics indicate the following:

83 per cent of those leaving were unhappy with pay, which has hovered about $2.00 per hour over minimum wage for the past five years.
77 per cent did not like their working hours.
63 per cent were unhappy with the involuntary overtime, particularly since most had other jobs which would be compromised if they didn’t show up for work.

This latter issue is particularly important. EL has known for years that pay rates were not high enough to provide a stable family income. In many cases even individual staff with no dependents have been eligible for food stamps. Seventy-four percent of DSPs had second jobs, very often in similar organizations providing similar services, some of which are EL competitors. Also, 43 per cent of DSPs are single parents. On the other hand, a large percentage of full-time employees work second jobs in other service industries, primarily food service (e.g., fast food chains).

The high turnover rates have resulted in an increased need (and therefore cost) of HR staff to constantly recruit new staff.

Assignment – Application Paper 1: DSP Turnover Remediation Plan

The executive staff conducted a quarterly review. One of the group’s concerns was the high turnover rate of DSPs. They have asked you, as their HR Director, to address the issue.

Using concepts and evidence reported in the text, readings, assignments and commentaries, develop a plan that you believe will help to reduce DSP turnover.

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