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Investing in Missouri’s Workers and Citizens

A proposal to protect Missouri’s vital services and grow our economy

For more information contact: AFSCME COUNCIL 72 573.635.9145

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AFSCME Council 72 represents over 6,000 Direct Care and Craft & Maintenance state employees in ten agencies as well as thousands of community home care workers who are on the frontlines every day providing services to many of the most vulnerable Missourians.

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Missourian’s take great pride in helping our neighbors and participating in our community.  Nowhere is that commitment more demonstrated than in the investments we have made in our vital public services and systems. Missourian’s commitment to invest in strong health, mental health, and home care services has made our state a good place to live and work.

 

The proposed redirection of the American Recovery and Reinvestment Act funds announced last week by the Missouri House of Representatives will undermine the vital public services and structures thousands of Missourians rely on every day.

 

The proposed reallocation of the American Recovery and Reinvestment Act funds will have little effect on Missouri’s economy and will squander a historic opportunity to reinvigorate Missouri’s public services. Senator Charlie Shields (President Pro Tem) provides a succinct analysis of the Missouri House’s plan,

“A tax cut to Missourians would not likely stimulate Missouri's economy effectively because most of the state's population lives along borders and often spends money in other states…A lot of the money leaks out across the state borders,"  [Springfield News Leader. Chad Livengood April 24, 2009]

The new plan presented to the Missouri House of Representatives has provided an opportunity to reexamine Missouri’s investment priorities and created a new public debate about the use of American Recovery and Reinvestment Act funds. The current proposal before the Missouri House of Representatives would have a minimal one-time effect on Missouri families as the St. Louis Post Dispatch noted in a recent editorial,

 

“…if you’re married with three kids and make $45,000 a year, you’d see about $2.71 extra in your paycheck each week. You could have something from the value menu at McDonald’s.” [St. Louis Post-Dispatch. April 24, 2009]

 

Missouri policy-makers should choose a wiser plan of action and invest in public services that invigorate our economy.  Mark Zandi, the conservative economist and advisor to Sen. John McCain’s (R-AZ) Presidential campaign, notes that a one-dollar ($1) investment in public services nets one-dollar and thirty-six cents ($1.36) in economic activity.  [Moody’s Economy.com , January 2008]

 

 Missourian’s are good neighbors - a quality reflected in the desire to provide strong public services – it is in recognition of that commitment - the American Federation of State County and Municipal Employees  Council 72 offers the following recommendations for investment in Missouri’s public services and systems.

 

 

AFSCME workers provide quality services for Missouri’s Veterans, psychiatric patients, elderly, and intellectually and developmentally disabled.  But the latest budget cuts to state programs and agencies are putting workers’ jobs, safety, and economic stability at risk, with inevitable negative impacts on quality of consumer care. AFSCME support the following allocation of federal stimulus dollars that will serve as a strong investments in Missouri’s workforce and stimulate the state’s economy while maintaining valuable state jobs and quality of services

 

Ø  $2.6 million to the Department of Mental health maintaining critical services for 160  residents of the Marshal Habilitation Center and the St. Louis Developmental Disabilities Treatment Center and protecting 126 Missouri jobs.

 

Ø  $15.8 million to the Department of Mental Health to maintain state operation of 25 acute psychiatric beds and to maintain employment for 83 state employees at Western Missouri Mental Health Center

 

Ø  $35 million to transit funding for St. Louis Metro to restore normal service for thousands of St. Louis citizens and workers

 

Ø  $300,000 to achieve full funding of the voter established Missouri Quality Home Care Council

 

Ø  $1.7 million direct investment for Direct Care and Craft & Maintenance salaries  - aligning their salaries to the “market rate”  in accordance with Personnel Advisory Board recommendations from FY 2004- FY 2009

 

 

 

Over fiscal years 2009-2011, the state of Missouri is set to receive over four billion dollars in federal stimulus funds through the American Recovery and Reinvestment Act. Congress passed the ARRA with the expressed purposes of:

 

1)      Stabilizing state budget shortfalls allowing states to continue to provide much-needed services,

and

2)      Stimulating the economy by protecting existing jobs and creating new opportunities for employment.

 

Recently, the Missouri House Budget Committee proposed the redirection of $1 billion of the state’s stimulus share toward an income tax cut in addition to the existing tax cuts already provided for in the ARRA. This likely illegal manipulation of federal funds ignores the urgent budget deficits facing many state agencies and state services and puts at risk the growing number of vulnerable citizens who rely on the services they provide.

More than 4,600 Direct Care workers provide 100% of care for thousands of residents in facilities including Veterans Homes and Habilitation and Mental Health Centers operated by the Department of Mental Health. Depending on the severity of need, Direct Care staff provide clients with 24 hour personal care including bathing, feeding, maintaining personal hygiene,  as well as performing household tasks like laundry, cooking, and cleaning, passing out medications, and escorting clients to activities and day programs.  Over 2,400 Craft & Maintenance employees maintain infrastructure, make repairs, maintain safety and sanitation, and provide food and laundry services in direct care, correctional, and other state operated facilities and parks. Missouri’s 16,000 home care attendants provide up to 24-hours of personal care, companionship, and medical assistance to thousands of seniors and individuals with physical disabilities in their own homes.

The economic crisis, in the form of massive budgets cuts to the state services and programs, has had a devastating effect on these workers’ ability to continue to provide quality care for their clients and to make ends meet for their families. Redirecting recovery dollars toward a meager $2.71 per week tax cut is unlikely to make much of an impact. Senate President Pro Tem Charlie Shields has concluded that these costly tax cuts would have no significant impact for Missouri citizens because a majority of Missourians live along the periphery of the state and, “A lot of the money leaks out across the state borders.” Rather, the state should invest in its own workers and citizens - a strategy with a guaranteed return for all Missourians.

 

Budget Recommendations Ø  $1.7 million direct investment for Direct Care and Craft & Maintenance salaries  - aligning their salaries to the “market rate”  in accordance with Personnel Advisory Board recommendations from FY 2004- FY 2009   Ø  $2.6 million to the Department of Mental health maintaining critical services for 160 residents of the Marshal Habilitation Center and the St. Louis Developmental Disabilities Treatment Center and protecting 126 Missouri jobs.   Ø  $15.8 million to the Department of Mental Health to maintain state operation of 25 acute psychiatric beds and to maintain employment for 83 state employees at Western Missouri Mental Health Center   Ø  $300,000 to achieve full funding of the voter established Missouri Quality Home Care Council     Ø  $35 million to transit funding for St. Louis Metro to restore normal service for thousands of St. Louis citizens and workers

 

 

 

 

A History of Neglect
The impact of this economic crisis for AFSCME Direct Care and Craft & Maintenance workers, is amplified by a history of budgetary neglect over the last four years. Missouri consistently ranks as one of the lowest states in the nation for average salary for state employees, only edging out Arkansas and Oklahoma for the bottom spots in 2008. And this low rank was acquired long before whispers of an economic crisis began; in 2003 Missouri again was ranked 48th in the nation in state employee pay, when the average AFSCME wage was only $17,880 - a mere 114% of the Federal Poverty Line for a family of 3 and astonishingly only 94% of the Federal Poverty Line for a family of 4. Today the average AFSCME wage is $24,055, only 109% above the Federal Poverty Line for a family of 4, and 131% above the Federal Poverty Line for a family of three.

 

From fiscal year 2004-2008, the state’s own Personnel Advisory Board (PAB), a governor appointed, seven-member board that issues annual recommendations for state employee pay increases, recommended a total of a 16.9% market rate increase in wages, along with grade increases and class repositioning for certain critical job classes. However, in that time the legislature only approved a total increase of 10% general adjustments with virtually no grade increases or class repositioning. Grade increases and class repositioning actually increase the real wages, and ensure upward mobility for workers. Had the PAB recommendations for general adjustments been implemented beginning in 2004, state workers on average would be earning at least $2,400.00/year more than they are now. The PAB notes in their annual report that because the grade increases and class repositioning have not been implemented, Missouri continues to experience a “low-end compression” problem where in 2008 37.6% of employees were on the first three steps (out of 21) of their respective pay ranges.[1]  The Department of Mental Health outlined this very problem in a 2008 gubernatorial briefing document,

 

Facility direct care staff view their positions as dead-end jobs with no career advancement opportunities.[2]

 

For Missouri’s Direct Care and Craft & Maintenance workers this means that poverty wages are still the reality for most, with average salaries, well below the national averages for comparable positions in other states. For example, the highest possible wage for a Developmental Assistant I, the job classification of the majority of AFSCME direct care workers, was 28,000.00 in 2008. But because of rampant low end-compression, the majority of the DA I workers made well below that ceiling. The national average for DA I’s in 2008 was $30,000- $2,000 above the highest possible salary for Direct Care workers in Missouri.[3] 

 

The negative impact that the consistent neglect in Direct Care and Craft & Maintenance salary increases has had on workers’ ability to provide quality care cannot be overstated. Poverty wages have contributed to excessively high turnover rates within the Mental Health Department and Veterans Homes especially, as well as extreme staffing shortages in most facilities. Again the 2008 gubernatorial candidate brief prepared by the Missouri Mental Health Commission confirms the dangerous staffing situation in the Department of Mental Health facilities,

 

Missouri’s mental health workforce is critically low. There are not enough mental health professionals or direct care staff to fill positions in state-run facilities or contracted community agencies. High turnover rates at all levels, from physicians to food service workers, threaten the safety of consumers and staff alike.[4]

 

Impact of a Crisis- 2009-2010

The economic crisis has already impacted AFSCME’s Direct Care and Craft & Maintenance workers, as it has all working Missourians,  in the form of increase cost of housing, energy, and other basic goods. Although the legislature did approve a 3% market rate increase for state workers in fiscal year 2009, neither the House nor the Senate budgets included a market rate increase for state employees for fiscal year 2010, rendering an effective loss in real wages for workers who already struggle to make ends meet. In the words of one Craft & Maintenance worker, a Custodian who has worked at the Veterans Home in St. James for over 30 years,

In order to catch up to where we should be now- in order to be able to pay the rent or the mortgage, the utilities, and to just get by- we need at least a $1,200 across the board increase. At least 1/3 of the people here at the facility hold down second jobs if they can just to make it from day to day. And I know many co-workers that have had to go on public assistance and get food stamps just to feed their kids.

Staffing Shortages

Severe staffing shortages continue to be a problem, and show no sign of improving without significant changes to employee pay and general conditions within facilities. Direct Care and Craft & Maintenance workers have turnover rates of above 25% and never operate at full staffing capacity in any of the Mental Health facilities, and several of the Veterans Homes. 

 

Workers in both Direct Care and Craft & Maintenance positions are often subjected to mandatory overtime in order to compensate for the shortages. One Direct Care worker, a Psychiatric Aide I who works with adolescent children at the Hawthorne Children’s Psychiatric Hospital described his experiences,

 

We are severely short staffed at Hawthorne and I’m mandated for overtime at least twice a week and often three times a week. That’s a 16 hour day, and then you’ve got to get up and go to work the next day same as if you worked an 8 hour day. And at work, we don’t have enough staff to cover people for our 15 minute breaks or even for lunch. We’re dealing with kids who need constant care- some who need one-on-one surveillance, some who need to be at arms length from you at all times- so we can’t afford to leave them for even a second. That means that sometimes, we just don’t eat. 

 

Chronic understaffing severely impacts the quality of care provided by Direct Care and Craft & Maintenance employees, by allowing workers to be over tired and over-stressed. But many DMH facility operators have also resorted to down grading clients’ staffing ratio requirements from one-on-one status, in order to avoid violations.  A Direct Care Worker, a Developmental Aide I, reports witnessing downgrading this month at his facility, Marshall Habilitation Center,

I’ll be assigned to a home with a client who is a one-on-one for about a week. We rarely have enough staff to cover all the one-on-ones, and so one day I’ll come in and the client is no longer a one-on-one. Nothing’s changed in the client’s behavior or medication or doctor’s notes- it’s just that we don’t have enough staff to provide the care he needs so they change his status.

 

 

A total of 126 Craft & Maintenance employees who provide laundry, housekeeping, and cooking services for over 160 clients at the Department of Mental Health’s Marshall Habilitation Center and three facilities known as the St. Louis Developmental Disabilities Treatment Centers are also scheduled to be laid off because the House Budget has called for the early transition of these state operated facilities to a Medicaid waiver program. At Marshall Habilitation Center, the waiver program will transition 130 clients from state operated group homes to Independent Supported Living (ISL) homes throughout the community, and in doing so will eliminate a majority of the positions responsible for  all laundry services and as well as food services for clients. The facility closure will not only result in layoffs for 76 employees, but will require Direct Care staff to take on housekeeping and laundry responsibilities in addition to their existing roles as personal care givers. In St. Louis, 50 Craft & Maintenance positions will also be eliminated when housekeeping and laundry services are reduced. Federal stimulus dollars should be used to prevent this transition from occurring ahead of the Department of Mental Health’s recommended timeline, and avoid the real risks associated with an unprepared, untrained staff, as well as the shortage of community doctors needed to treat the new ISL clients.

 

 

 

 

Western Missouri Mental Health Center is scheduled to lay off over 83 employees, including over 40 direct care workers, when they privatize a 25-bed acute psychiatric wing and a 15-bed ER by leasing the beds to Truman Medical Center, a private hospital that already leases a 25-bed wing of the state owned facility. 

 

Families of the acute psychiatric patients, along with advocacy groups for the mentally ill are concerned that patients at Western Missouri will be forced into the care of Truman Medical Center, a private operator that is not required to accept Medicaid patients. DMH reports a “shortage of funds” as the impetus for the privatization and layoffs. But at a time when over half the private hospitals in the US are running losses, it is dangerous for the state to privatize the care of these vulnerable patients. John Bluford, CEO of Truman Medical Center, described the hospital’s fragile budget situation in a statement in 2006,

 

“You take $5 million away, and we're in the red. That does not afford us the ability to replenish ourselves by funding our depreciation. So our buildings get older. Our technology gets older. Look down the road five or six years, and we're back to the old General Hospital in terms of our facilities and capabilities."[5] 

 

 

 

 

In 2008, Missouri voters showed their overwhelming support for Proposition B, a ballot initiative of the people that created the Missouri Quality Home Care Council.  Missouri’s 16,000 home care workers ensure that elderly and developmentally disabled citizens who require assistance, are able to receive quality care in their own homes. However, until the initiative was passed, Missouri’s home care consumers and workers had no systematic or unified way to address statewide workforce problems. With the geriatric population expected to increase by 72% by 2030, and the home care workforce expected to decrease by 3%, Missouri’s elderly and individuals with disabilities Missourians were facing daunting challenges. By creating the Home Care Council, voters ensured that Missouri Home Care Council would match consumers with workers, offer referrals, build a backup network, oversee employment issues for the workforce, and coordinate recruitment or training for the direct care workforce. The initiative called for $510,560 of annual funding to establish the Council, however, the legislature did not approve full funding. Without adequate funding, the Council cannot begin to address critical workforce problems like high turnover rate, nor its negative implications for quality of consumer care.

 

 

Since March 30, 2009, the St. Louis Metro has been operating under severe service reductions, preventing thousands in the St. Louis region from normal access to transportation to and from jobs, schools, and businesses. AFSCME members, including state employees and home care workers who rely on Metro every day cannot afford this considerable disruption in work and family routines. Parents who rely on metro to pick up their children from school, to relieve child care providers, or even to make it on time to a second job will suffer even greater negative economic impacts by the service reductions, endangering not only their personal welfare but the welfare of the St. Louis economy in general. For these reasons it is imperative that the stimulus dollars go to maintaining full functionality of St. Louis Metro services. 

 

The Best Choice for Missouri

The Missouri legislature should consider their options closely while deciding how to spend the $1 billion dollars of federal stimulus funds. AFSCME’s 5,000 Direct Care and Craft & Maintenance employees as well as 16,000 home care providers support the allocation of stimulus funds to avoid 159 layoffs, maintain transportation for thousands in the St. Louis region, fully fund the voter approved Quality Home Care Council, and improve state workers’ poverty wages-all funding that would help maintain quality of care for vulnerable Missourians, and would have an immediate, positive effect on our state’s economy. We do not support an enormously costly yet meager 0.5% tax cut that will do little to improve both the state’s and individual Missourian’s personal economic situations. Allowing Missouri’s front line of service providers to continue to receive low pay, to work under egregious staffing shortfalls and without proper access to transportation, will only make worse the decline in quality of care provided to Missouri’s Veterans, elderly, intellectually and developmentally disabled, and psychiatric patients.

 

 

In a report issued today to Missouri legislators the American Federation of State, County and Municipal Employees called Republican moves to divert federal stimulus money to tax cuts as "an affront" to the American Recovery and Reinvestment Act, and "likely illegal."

"The proposed redirection," the AFSCME report charges, "will undermine the vital public services and structures thousands of Missourians rely on every day."

Furthermore, the report finds that "The proposed reallocation of the American Recovery and Reinvestment Act funds will have little effect on the Missouri's economy and will squander a historic opportunity to reinvigorate Missouri's public services."  The supposed economic benefit and wisdom of such tax cuts has been challenged even by Republican leaders.

The ARRA was intended to ease state budget shortfalls and stimulate the economy by maintaining jobs and opening up new employment. However, the AFSCME report finds that the recent Missouri House Budget Committee proposal to divert the state's $1 billion share of recovery funds into further tax cuts "ignores urgent budget deficits...and puts at risk the growing number of vulnerable citizens who rely on the services."