Crisis in Care

The nonprofit agency, which provides services for residents with developmental disabilities, wrestles with the same problem that most other human services agencies do.

A lack of funding from the state keeps salaries for caregivers perpetually low and can make it hard to keep qualified workers, said Rick Callahan, The Arc's deputy executive director. The agency, with offices in Annapolis, Glen Burnie, and Easton, has a staff of about 200 workers.

"We are completely dependent on our direct care staff, but retaining them is always challenging," said Mr. Callahan, who has been with the agency since the early 1990s. "The biggest thing is the difference between their average rate and what we're funded to pay our staff (from the state)."

The average direct-care worker in the developmental disabilities field earns $11.30 per hour. The state reimburses agencies at a rate of $9.12 per hour, and the agencies have to scramble for the funds to pay employees' benefits.

"The question is, how do we address that difference?" Mr. Callahan said.

It's a question the seven developmental disabilities agencies in the county are asking.

Providers said they don't have the funds to chip away at the waiting list for state-funded developmental disabilities services, which hovers at about 17,000 residents statewide and 1,100 residents in Anne Arundel County. In Maryland, more than 22,000 developmentally disabled people receive services.

Agencies also said they don't have the money to pay direct-care workers better, which means good employees regularly leave for more lucrative work.

"If we were able to pay people better, more people could make this a real career," said Vicki Callahan, Mr. Callahan's wife and executive director of Hanover-based Opportunity Builders Inc. OBI provides job

training and life skills for developmentally disabled residents.

"Right now, in some cases, we're paying people less than $10 per hour to take care of vulnerable individuals," she said.

Agencies received some relief two years ago when the General Assembly passed legislation asking the governor to include in his yearly budget a cost-of-living increase for providers. This year, they received a 1.5 percent increase - or $8.1 million in additional funds - instead of the 4 percent recommended by the state Community Services Reimbursement Rate Commission.

Providers could also receive an additional 1.5 percent cost-of-living increase if the Maryland Lottery rakes in $13 million more than expected, but that's not guaranteed.

The right hires

Attracting passionate direct-care workers is tough, especially in an area where the cost-of-living is high, said Michele Stutzer, co-chairman of The Arc of Maryland's governmental affairs committee.

In 2006, the median household income in Anne Arundel County was $79,160, according to Census Bureau figures. The average annual income of a direct-care worker in the developmental disabilities field is just under $23,000 annually.

While a high school education is all that's required for most support staff positions, those positions also mean hours of training with the state Developmental Disabilities Administration and a lot of responsibility, Ms. Stutzer said.

Sharona Sykes is a personal development assistant technician at the Providence Center in Millersville, an agency that provides job training for the developmentally disabled. The Baltimore woman described the demands of the $10.70 per hour job.

"Sometimes you come to work, you might get attacked, you might get bitten," said Ms. Sykes, who is married with a 6-year-old daughter. To make ends meet, she works a second job as a caretaker for an elderly person. "It hurts direct-care workers ... we don't get paid what I feel we deserve."

Ms. Sykes feels especially pinched now, with gas at $4 a gallon. She lives in northeast Baltimore and has a 50-mile round trip commute, and has considered looking for a similar job closer to home.

"But I like being here," she said.

Stories like Ms. Sykes' are all too common, said Ms. Stutzer, a Harford County nurse who serves as a parent surrogate for a 20-year-old disabled man.

"The funding has not kept up in any way," Ms. Stutzer said. "It is a big concern for me. If we don't see more money, how is that going to impact the individuals who are being served? This is everybody's problem."

The Callahans said it's not uncommon to see caregivers taking on second jobs to make ends meet, just like Ms. Sykes does.

They once did it themselves.

After they graduated from Penn State and got married, Mr. Callahan worked as a paid intern with Bello Machre, an agency in Glen Burnie, and was eventually hired as a live-in house manager at one of Bello's group homes. Mrs. Callahan was hired at OBI.

It was the late 1980s, and both earned under $15,000 each.

For a while, they slept on an air mattress and used upside-down cardboard boxes as end tables, they said with a laugh. Both logged extra hours at both OBI and Bello Machre for more money, and were often on call on the weekends.

But they loved their jobs, they said.

"I think if you are passionate about your job, you can live in a smaller house or drive a smaller car," Mrs. Callahan said.

Mrs. Callahan acknowledges both she and her husband were lucky; because they both have college degrees, they were able to work their way up the ladder to better hours and salaries. However, working long hours for low pay can lead to burnout, which leads to turnover.

"It's very rare to see people with high tenure," Mr. Callahan said. "We might have less than 5 percent of our staff who have been here for 10 years or more."

Dedication to work

Those who do plan on staying long-term say they love their jobs, which allow them to help people that society often seems to overlook.

"This is the best job I've ever had," said Rebecca Spann of Glen Burnie, a one-on-one program instructor and driver for the Providence Center.

The 23-year-old looked into pursuing careers in human resources and social work, but chose the Providence Center because "I just fit in." She also grew up with an uncle with spina bifida, so she said she's used to people with disabilities. Her job takes a lot of patience, she acknowledged.

"I've seen people (new employees) come in for a day and then leave," said Ms. Spann, who said she has dreams of opening her own agency someday.

It would be nice to make more money, she said, but she makes enough to live and that's enough for her.

"I'm a lifer," she said of the field.

No one ever becomes a direct-care worker for the cash anyway, said Chris Stritch and Mike Lewis, two Arc employees who work at a group home in Arnold.

Mr. Stritch is the house manager, attending to the every need of Christine, a 56-year-old woman with cerebral palsy; Earl, a 60-year-old with Down syndrome and Alzheimer's Disease; and Chad, 30, who has cerebral palsy and severe mental retardation.

Mr. Stritch brushes their teeth. He grooms them. He prepares their meals and gets them ready for bed and takes them on vacations in the summer. He also lives with them full-time, sleeping in a one-bedroom apartment in the basement of the modest home near Anne Arundel Community College.

Mr. Lewis covers an afternoon shift at Mr. Stritch's house, helping run the home and care for its residents along with a few other shift workers.

"I love this field," the Annapolis man said.

Now 35, he began his career 15 years ago at the Providence Center, where he first met Earl.

"You never know what's going to happen in life," he said. "My dad said to me that when he gets older, he hopes he has someone to take care of him the way I take care of Earl. That's why I'm in this field."

Mr. Stritch said he bounced back and forth for 20 years between the restaurant industry and working with the developmentally disabled. But it was an unexpected tragedy that led to his current stint with the Arc.

He was living in his family home in Dundalk and working at a restaurant in Fells Point when Tropical Storm Isabel's storm surge leveled the house in fall 2003.

Mr. Stritch had no flood insurance on the property.

So when this job, with its free room and board, opened up, it seemed like perfect timing.

He's technically off on weekends, when a weekend support worker relieves him. But Monday through Friday, "it's 24/7," he said.

The Callahans agreed working with developmentally disabled residents is a challenge no matter what agency you work for and what your job is. But it's a good kind of challenge, and neither has any regrets.

Their two children, Tyler, 17, and Brianna, 15, grew up around people with disabilities and have learned how to be tolerant of those who are different from them. Both have volunteered at OBI, and Tyler plans to follow in his parents' footsteps.

"They don't see the disabilities. They see the person," Mr. Callahan said.

What's kept them here, they agree, is the clients. Every day is something new, Mr. Callahan said.

"You can really go home and say that you've made a difference," he said.