Katie McCall: Supported living model of care needs investment from state

If you are someone with intellectual and developmental disabilities looking for your own home in the community, our state is currently telling you to wait in an ever-growing line.

I am proud to work in supported living, a care model where this vulnerable population lives in their own home – often with one or two housemates. Direct support professionals provide round-the-clock care and assist with everything from helping clients bathe to medications and behavioral support.

This critical service, more than 99 percent reliant on Medicaid for funding, requires a level of public investment for consistent care that is today glaringly absent. That’s why I was proud to join a recent rally in Olympia alongside clients, direct support professionals and providers to call on the Legislature to dedicate funding for more housing and adopt a sustainable Medicaid funding framework for supported living.

The lack of Medicaid funding has led to a waitlist of more than 450 people ready for placement in supported living but who do not yet have access to this critical service. And it has led to a more than 50 percent annual turnover among direct support professionals whose wages rely on Medicaid and so are currently earning less than a fast food or grocery store worker. As reported by The Spokesman-Review, “Fifteen years ago, professional caregivers in Washington were paid 10% more than what was considered a self-sufficient wage at the time. Today, those same professionals are paid 21% below a self-sufficient wage” (“Worker turnover, housing shortage plague supported living communities,” Jan. 21). As a percentage of minimum wage, the average wage of direct support professionals in Washington is in the bottom 10% of states. How can we say that we are prioritizing care for vulnerable populations when we cannot even fund a living wage for those providing that care?

The lack of support is not new and the need to increase funding is founded in expert analysis. Earlier this month, a study commissioned by the Legislature two years ago confirmed that a 10% increase in Medicaid funding is immediately necessary to make up the difference between actual costs and the rates paid.

We are grateful for champions on both sides of the aisle – this is not a partisan issue. It is also not a complex issue – we can either invest in this critical service or we can see more and more people in crisis in our hospitals and in aging state institutions. When Gov. Jay Inslee announced his proposed budget in late 2023, we were disheartened that he made no additional investment at all in supported living. I hope that legislative leaders recognize this failure and follow the recommendations of their own report.

I have been proud to work in supported living for 24 years. But as we all watch the cost of housing increase, the same crisis affects how many homes are available for those with intellectual and developmental disabilities. The most common type of home is a single-family house for one to three people, depending on an individual client’s needs. Despite a historic investment in the 2023 Housing Trust Fund of $25 million to develop more housing for those in supported living, the amount of grant applications was more than double the amount of funding. The unmet need in supported living is great and can be measured by a growing waitlist just as it can be measured by an inconsistent funding model for this type of housing. House and Senate committees held public hearings in January on a proposal that would establish a new real estate transfer tax of 1% on the value of the selling price of properties over $3.025 million, forming a dedicated funding source for affordable housing, including supported living. As we all work to confront the affordability crisis, we must ensure that those least able to manage the crisis have our support.

For most who work in supported living, the job is a calling. If it were about reasonable hours or a big paycheck, we would find work in an easier field.

An investment this year in housing and Medicaid support won’t make the hours easier or the paychecks fat, but it will make this fundamental service more sustainable for those who rely on it the most.

Katie McCall is the Spokane-area director of Alpha Supported Living Services, a nonprofit supported living provider serving over 200 clients in Spokane, King and Snohomish counties.