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Tacked to a cork board among photos, drawings and newspaper clippings, a monthly staff schedule stands out at a group home for people with disabilities.

Amid the calculated clutter, the schedule is most prominent, most colorful. Each open shift is highlighted in neon pink or green. Some days there’s more neon than black ink.

The emptiness of the schedule is a manifestation of the staffing issues that Reach, a community disability services provider, has been dealing with throughout the pandemic. But the shutdowns and uncertainties that proliferated the early days of the pandemic last year did not scare many employees away.

Skyrocketing prices in the Bozeman housing market — prices for a single family home in Bozeman in September increased by 26% from September 2020 — along with the inability to raise staff wages due to a reliance on Medicaid reimbursements helping to pay employees’ wages, have led to a gaping hole in staffing.

Reach now has 36 job openings throughout the organization. Those who stayed now work 70- to 80-hour weeks and accumulate near endless hours of overtime.

The issue of staff leaving did not begin until this year.

Reach Supportive Living

A calendar in the Reach office in one of their supportive living homes reveals the number of shifts that still need to be filled on Nov. 23, 2021. The unfilled shifts are highlighted in pink.

Reach Supportive Living

Group Home Supervisor Julia Stewart and Shift Coordinator Olivia Kesterson make food for the clients in the Reach supportive living home on Nov. 23, 2021.

In March 2020, the nonprofit had to shut down and shutter some services. Executive Director Dee Metrick said that when Reach closed, she feared there would be a “mass exodus” of staff because of ever-changing protocols and the limited knowledge that was available about how COVID-19 was transmitted from person to person.

But the staff stayed. The people they served needed them. However, the scope of the organization’s services shrank when supported living services, or care in homes where Reach does not operate, and the work center, where people with disabilities train and learn skills to enter the workforce, shuttered much of last year.

The residential properties that Reach operates, which now house 46 people with disabilities, stayed open. But by the time vaccines rolled out in January this year, staff began to leave. None of the staff who handed in their notices wanted to leave, Metrick said. They just couldn’t afford to stay.

“The interesting thing was, I think once things started to feel more normal … I think when staff felt like, ‘OK, the clients are going to be OK,’ that’s when our staffing issues really took off,” Metrick said.

———

The pandemic may have worsened a staffing problem years in the making.

Patrick Maddison, the president of the Montana Association of Community Disability Services and CEO of Flathead Industries, said that hiring and retaining staff has grown more difficult for organizations like Reach over the past decade.

“There’s so many problems we’re facing, it’s going to take a lot of us to come up together to create long term sustainable solutions,” Maddison said.

One of the biggest lingering issues is the inability for businesses in that sector to stay competitive with what they pay their employees. A portion of staff’s hourly pay is based on a Medicaid rate, Maddison said. And that roughly $8-an-hour rate has not changed for over 10 years.

The Medicaid rate is like a baseline for staff wages, with the businesses contributing to the rest of the wage. What Flathead Industries and Reach can pay their staff varies depending on their financial success, the amount of grants and fundraising. Metrick said that hourly pay for the slew of job openings at Reach varies between $16 to $19.11 per hour.

Montana had one of the highest quit rates in the country in September, bringing the total people who quit their jobs this year to 7,000, according to data from the U.S. Bureau of Labor Statistics released in September.

The number of people who have quit from health care and social assistance jobs — like the jobs available at Reach — has increased since September 2020. About 163,000 people across the country quit from that field over the past year, according to data from the U.S. Bureau of Labor Statistics.

Staying competitive with incoming businesses that offer entry-level wages for less intensive work, like Target or Starbucks, has been a difficult challenge, Maddison said.

Maddison said that as of August this year, agencies across the state had 25% staffing vacancy.

The Medicaid rate could change, which would help boost wages for employees at Reach, and community disability service providers like it across the state. Maddison said that the Montana Department of Human Health and Services would be reviewing the rate within the next few weeks.

Jon Ebelt, a spokesperson for the Montana DPHHS, said in an email that the state’s health department would be moving toward more “data-driven decision making” when it came to the Medicaid rate, and that the department is in the process of “kicking off a comprehensive review” of rates for disability services.

Housing is an issue, too. Metrick said that some staff had to leave because they could not afford their rent. Others needed to find better-paying jobs to stay in their homes.

Only three members of the management team at the nonprofit are homeowners in Bozeman, the rest either rent or commute, Metrick said. At the end of July this year, Reach had 17 job openings. But the housing market’s dramatic and quick change had an effect, doubling that number in just a few months.

Reach Supportive Living

Alex helps dish out dinner with Shift Coordinator Olivia Kesterson at a Reach supportive living facility on Nov. 23, 2021. Eight people live in the home, four on each side of the building. Each side of the building has its own kitchen and bathroom.

Reach Supportive Living

Mitch points out a message he wrote on a whiteboard at the Reach supportive living facility where he lives on Nov. 23, 2021. Eight people live in the home, four on each side of the building. Each side of the building has its own kitchen and bathroom.

Then there is the factor that businesses like Reach cannot reduce hours, or close the doors on a given day due to lack of staff, because many of the services that these businesses provide are 24/7 care for people with disabilities in group homes.

“If we have multiple locations (you) can’t just close one and send all your employees to support, you know, the Starbucks down the road,” Maddison said. “It’s kind of like your back’s against the wall, and you don’t have any moves to make to adapt and be able to thrive through some certainly different times.”

Reach has six different residences, and the majority of the people it serves live in these homes. Staffing these group homes has proven difficult, but not impossible.

The nonprofit has been able to reopen its work center since the start of the pandemic, but at a lower capacity because of a lack of staff to do one-on-one work with people with disabilities. Metrick said that the organization doesn’t have enough staff to maintain its supported living care for people with disabilities at previous levels. Much of the focus remains on staffing the organization's residential properties.

The parents and families of people with disabilities now have to take care of their children, and fill the spot that a staff from Reach once occupied.

“We said to the families, ‘As soon as we have someone, we will get your your kid back into our services,’ but we don’t have applications for those positions,” Metrick said. “And we have to prioritize the people in our housing right now.

Without the supported living services, Reach now has 90 people with disabilities who staff works with.

The weekends at the group homes, however, are a different story.

Metrick said that because of staffing gaps, Reach’s Human Resources director travels from Butte and works in one of the homes for the weekend. Metrick said that she even fills in where she is needed. Metrick, like other Reach staff members in Bozeman, works six to seven days a week to ensure that the people in those homes get the care they need.

“If it was just a paycheck, people would be going to the retail place where they can get, you know, $2 more an hour,” Metrick said. “But I know when I wake up in the morning that I’m showing up to a place where I’m going to make a positive difference in the community and for the clients and for my team.”

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Julia Stewart, a house supervisor at one of Reach’s group homes, worked 18 days straight last month.

She, like others at Reach, has worked nearly nonstop so people living in the group homes wouldn’t notice the severity of the staffing problems. The group home she works in — which houses eight people with disabilities — has been mostly spared the brunt of the organization’s staffing issues.

But for a while, Reach had staff openings at the house, like the overnight shift, that needed to be filled. People would be pulled from across the organization to fill in, creating a patchwork of staff. Stewart said maintaining a routine for the residents was crucial.

According to Alex and Mitch, residents of the home that Stewart supervises, that routine wasn’t really broken by staffing issues.

For about a year, neither could interact much with the world outside of their home. Alex said that he was bored and ended up watching hours on end of the long-running soap opera, “Days of Our Lives.” Mitch was unable to see his girlfriend in person, but managed to stay in touch through Zoom and the occasional drive-by hello.

Reach Supportive Living

Mitch points out his garden at the Reach supportive living facility where he lives on Nov. 23, 2021. Eight people live in the home, four on each side of the building. Each side of the building has its own kitchen and bathroom.

Reach Supportive Living

Friends and roommates Mitch and Alex joke around while they help make dinner at the Reach supportive living facility where they live on Nov. 23, 2021. Eight people live in the home, four on each side of the building. Each side of the building has its own kitchen and bathroom.

“We didn’t see much (change) in the group homes because everyone worked so hard,” Stewart said.

But with that hard work came the lingering possibility of burnout.

Stewart said that she’s been able to avoid burning out, mostly because her day typically doesn’t start until noon. She gets the time to recharge, and if she needs time off, like the week she took off after working 18 days straight, she gets it.

Staff have to bounce from position to position to fill in where they are needed. Abigail Vandervoort, a supportive living instructor at Reach, said that the near-constant shifting from job to job helped her to manage burnout. She typically works about six days a week.

She sometimes does cover shifts in group homes and said that she can see the strain of overworked supervisors and staff.

“A lot of the stuff that we do when you’re working in the group homes isn’t optional, you know, the clients really need that support in their lives,” Vandervoort said.

———

Reach is not alone in its staffing issues. Counterpoint, a community disability services business in Livingston, has struggled, too.

Twila Marchetti, vocational rehabilitation director at Counterpoint, said the people with disabilities they serve are having their needs met, but that the staff is exhausted.

Similar to Reach, management at Counterpoint steps in to help where they are needed. Marchetti said that if anyone needs a day off, they get one with no questions asked. But getting applicants has been difficult.

“I don’t know how people are figuring out how to live without jobs, but I can’t get applicants,” Marchetti said. “It’s a tough field for staff anyway, but the pandemic didn’t do any favors. It’s absolutely brutal.”

Coronavirus relief money is in the pipeline, and would go toward paying staff, but would be difficult to use for recruiting, Maddison said.

Community disability service providers in Montana are funded by federal and state programs. Maddison said that 70% comes from the federal level, which got an injection of American Rescue Plan money this year. That boost means that the state has revenue to spare to bolster money given to these organizations, which could be used to increase pay for staff.

Getting the money would be simple, at first.

Over the course of the next two years the state plans to dole out additional money based on a percent of what businesses are billing. The first round is a 15% additional payment followed by a 12% additional payment.

Reach is set to receive $200,000 from that program’s first round. Metrick said that all of the money is going to cover staff overtime.

From there the percentage goes down every six months and reporting requirements kick in, Maddison said. Those reporting requirements indicate that providers like Reach and Counterpoint have to show that their expenses exceed their revenues in order to receive additional payment.

Maddison said that long term that will not work.

“But, again, it’s like, and then what?” Maddison said. “So, in order to get this additional revenue that I need to pay my staff, I have to increase my expenses, they have to be 12% above my revenue? Well, nobody can do that. In two years, you know, I can’t have my revenues over my expenses, or I’ll go out of business in three years.”

This story has been updated to reflect Reach's staffing issues, how the issues shrank the scope of the organization's services in supported living and in the work center and how the organization plans to use its coronavirus relief funds.

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Alex Miller is the county and state government reporter and can be reached at amiller@dailychronicle.com or by phone at 406-582-2648.

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