[Congressional Record Volume 149, Number 158 (Tuesday, November 4, 2003)]
[House]
[Pages H10301-H10304]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




SENSE OF CONGRESS ON CRISIS IN RECRUITING AND RETAINING DIRECT SUPPORT 
                             PROFESSIONALS

  Mr. McKEON. Mr. Speaker, I move to suspend the rules and agree to the 
concurrent resolution (H. Con. Res. 94) expressing the sense of the 
Congress that community inclusion and enhanced lives for individuals 
with mental retardation or other development disabilities is at serious 
risk because of the crisis in recruiting and retaining direct support 
professionals, which impedes the availability of a stable, quality 
direct support workforce, as amended.
  The Clerk read as follows:

                            H. Con. Res. 94

       Whereas there are more than 8,000,000 Americans who have 
     mental retardation or other developmental disabilities, 
     including mental retardation, autism, cerebral palsy, Down 
     syndrome, epilepsy, and other related conditions;
       Whereas individuals with mental retardation or other 
     developmental disabilities have substantial limitations on 
     their functional capacities, including limitations in two or 
     more of the areas of self-care, receptive and expressive 
     language, learning, mobility, self-direction, independent 
     living, and economic self-sufficiency, as well as the 
     continuous need for individually planned and coordinated 
     services;
       Whereas for the past two decades individuals with mental 
     retardation or other developmental disabilities and their 
     families have increasingly expressed their desire to live and 
     work in their communities, joining the mainstream of American 
     life;
       Whereas the Supreme Court, in its Olmstead decision, 
     affirmed the right of individuals with mental retardation or 
     other developmental disabilities to receive community-based 
     services as an alternative to institutional care;
       Whereas the demand for community supports and services is 
     rapidly growing, as States comply with the Olmstead decision 
     and continue to move more individuals from institutions into 
     the community;
       Whereas the demand will also continue to grow as family 
     caregivers age, individuals with mental retardation or other 
     developmental disabilities live longer, waiting lists grow, 
     and services expand;
       Whereas outside of families, private providers that employ 
     direct support professionals deliver the majority of supports 
     and services for individuals with mental retardation or other 
     developmental disabilities in the community;
       Whereas direct support professionals provide a wide range 
     of supportive services to individuals with mental retardation 
     or other developmental disabilities on a day-to-day basis, 
     including habilitation, health needs, personal care and 
     hygiene, employment, transportation, recreation, and 
     housekeeping and other home management-related supports and 
     services so that these individuals can live and work in their 
     communities;
       Whereas direct support professionals generally assist 
     individuals with mental retardation or other developmental 
     disabilities to lead a self-directed family, community, and 
     social life;
       Whereas private providers and the individuals for whom they 
     provide supports and services are in jeopardy as a result of 
     the growing crisis in recruiting and retaining a direct 
     support workforce;
       Whereas providers of supports and services to individuals 
     with mental retardation or other developmental disabilities 
     typically draw from a labor market that competes with other 
     entry-level jobs that provide less physically and emotionally 
     demanding work, and higher pay and other benefits, and 
     therefore these direct support jobs are not currently 
     competitive in today's labor market;
       Whereas annual turnover rates of direct support workers 
     range from 40 to 75 percent;
       Whereas high rates of employee vacancies and turnover 
     threaten the ability of providers to achieve their core 
     mission, which is the provision of safe and high-quality 
     supports to individuals with mental retardation or other 
     developmental disabilities;
       Whereas direct support staff turnover is emotionally 
     difficult for the individuals being served;
       Whereas many parents are becoming increasingly afraid that 
     there will be no one available to take care of their sons and 
     daughters with mental retardation or other developmental 
     disabilities who are living in the community; and
       Whereas this workforce shortage is the most significant 
     barrier to implementing the Olmstead decision and undermines 
     the expansion of community integration as called for by 
     President Bush's New Freedom Initiative, placing the 
     community support infrastructure at risk: Now, therefore, be 
     it
       Resolved by the House of Representatives (the Senate 
     concurring),

     SECTION 1. SHORT TITLE.

       This resolution may be cited as the ``Direct Support 
     Professional Recognition Resolution''.

     SEC. 2. SENSE OF CONGRESS REGARDING SERVICES OF DIRECT 
                   SUPPORT PROFESSIONALS TO INDIVIDUALS WITH 
                   DEVELOPMENTAL DISABILITIES.

       It is the sense of the Congress that the Federal Government 
     and the States should make it a priority to promote a stable, 
     quality direct support workforce for individuals with mental 
     retardation or other developmental disabilities that advances 
     our Nation's commitment to community integration for such 
     individuals and to personal security for them and their 
     families.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
California (Mr. McKeon) and the gentleman from Michigan (Mr. Kildee) 
each will control 20 minutes.
  The Chair recognizes the gentleman from California (Mr. McKeon).


                             General Leave

  Mr. McKEON. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days within which to revise and extend their remarks 
on H. Con. Res. 94.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from California?
  There was no objection.
  Mr. McKEON. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise in strong support of House Concurrent Resolution 
94, which expresses the sense of the Congress that community inclusion 
and enhanced lives for individuals with mental retardation or other 
developmental disabilities is at serious risk because of the crisis of 
recruiting and retaining direct support professionals.
  I want to congratulate and thank my friend, the gentleman from Texas 
(Mr. Sessions), for introducing this resolution to highlight a very 
serious problem facing this country and the disability community.
  As the resolution states, it is vitally important that our Nation 
increase its attention on recruiting and retaining these support 
personnel who work directly with individuals with disabilities and help 
them to become a contributing member of society.
  From developing the skills of existing personnel to preparing new 
leaders and researchers to replace those who are leaving or retiring 
from the field, we must expand our capacity to recruit new and retain 
existing personnel.
  Last month, the Department of Health and Human Services announced 
five new demonstration grants aimed at helping recruit, train, and 
retain direct service workers to aid those who need help with eating, 
bathing, dressing, and other activities of daily living. These grants 
will also test offering health insurance benefits to workers to 
determine if that helps keep workers on the job.
  These grants were offered through the President's New Freedom 
Initiative which promotes the goal of removing barriers to community 
living for people with disabilities. Under this initiative, 10 Federal 
agencies have collaborated to remove barriers to community living for 
people with disabilities. Secretary Thompson and others who have 
championed the New Freedom Initiative should be commended for their 
hard work to improving the lives of individuals with special needs.
  But we all know that much more needs to be done. As a Nation, we have 
a commitment to improve the opportunities available for all of our 
citizens, especially individuals with disabilities.
  Over the past 30 years, we have made important strides in enhancing 
the lives of individuals with disabilities. The Workforce Investment 
Act, the Vocational Rehabilitation Act, and the Assistive Technology 
Act are a short list of the important laws that the

[[Page H10302]]

Congress has passed since 1998 to better the lives of our fellow 
citizens with disabilities.
  We know that those individuals with mental retardation or other 
developmental disabilities face significant challenges and obstacles in 
participating in their community and in the workforce. But every day, 
every week, and every year we continue to make more progress.
  I am particularly pleased with the improvements we have made to 
support individuals with disabilities through the Workforce 
Reinvestment and Adult Education Act of 2003 which passed the House in 
May. In this legislation, State workforce investment boards and local 
workforce investment areas must develop strategies to address the 
employment needs of individuals with disabilities consistent with the 
goal of community integration. In addition, by increasing the 
coordination among employment and training programs in the one-stop 
centers created under the Workforce Investment Act, this 
reauthorization legislation seeks to ensure appropriate services are 
available to all job seekers, including those with disabilities. 
Through this legislation, we will give individuals with disabilities 
the opportunity to participate more fully in the workforce by enhancing 
their ability to receive training, and we have increased the emphasis 
on serving individuals with disabilities.
  Next year, I hope to work with my colleagues to improve the Assistive 
Technology Act so that we can provide greater access to technology that 
improves the quality of life for individuals with disabilities. We will 
work to ensure that the program is focused on the needs of individuals 
to secure technology for them so that they can participate in their 
community and at work.
  I am pleased to support this important resolution to improve the 
opportunity for individuals with mental retardation and developmental 
disabilities to participate more fully in society, and I ask my 
colleagues to support this resolution.
  Mr. Speaker, I reserve the balance of my time.
  Mr. KILDEE. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise in support of H. Con. Res. 94. This resolution 
expresses our concern that there should be an adequate supply of direct 
care providers to provide services to individuals with disabilities in 
community-based settings.
  Individuals with disabilities, including those with mental 
retardation or other developmental disabilities, have long sought to 
work and live in their communities. This allows them to join with the 
rest of society in being productive and contributing citizens.
  Access to services in the community, rather than institutional-based 
services, is critical to many individuals with disabilities. The U.S. 
Supreme Court, as part of the Olmstead decision, affirmed the right of 
individuals with mental retardation or other developmental disabilities 
to receive community-based services as an alternative to institutional 
care. Unfortunately, there is a shortage of direct care providers.
  Low pay and other factors are leading to a high turnover and a 
struggle by service providers to maintain a full complement of support 
staff and quality supports. High turnover rates can result in major 
negative implications, including heightened stress levels, injury, and 
the inability to live in the community.
  With the advancements we have seen to date as a result of the 
Olmstead decision, many individuals with mental retardation and related 
developmental disabilities live in community-based residences. 
Nevertheless, many more are listed on waiting lists for community-based 
services.
  I believe this resolution is the first step in Congress recognizing 
the significance of the problem in this area.
  Our colleagues, the gentleman from Texas (Mr. Sessions) and the 
gentlewoman from California (Mrs. Capps) should be recognized for 
bringing this issue to our attention.
  Mr. Speaker, in closing, I urge all Members to support this 
resolution.
  Mr. Speaker, I reserve the balance of my time.
  Mr. McKEON. Mr. Speaker, I yield such time as he may consume to my 
good friend, the gentleman from Texas (Mr. Sessions), the author of 
this bill and one who speaks about this subject from the heart.
  Mr. SESSIONS. Mr. Speaker, I also would like to thank the gentleman 
from California, who has had personal relationships in his life where 
he dealt with people who might well be impacted very directly by this 
bill, and his kindness and his insight is not only appreciated, but 
also respected.
  Mr. Speaker, I am pleased that the majority leader, the gentleman 
from Texas (Mr. DeLay), has given us time to recognize H. Con. Res. 94, 
the Direct Support Professional Recognition Resolution which highlights 
a growing national crisis affecting community integration for 
individuals with mental retardation and other developmental 
disabilities.

                              {time}  1645

  Mr. Speaker, I will include for the Record one piece of supportive 
data.
  Mr. Speaker, in one of his first acts as President of the United 
States on February 1, 2001, our great President, George W. Bush, 
announced his groundbreaking New Freedom Initiative, a nationwide 
effort to remove barriers to community living for people with 
disabilities.
  This New Freedom Initiative represents an important step in working 
to ensure that all Americans have the opportunity to learn and develop 
skills, engage in productive work, and choose to work and live in a 
participatory and a productive community life.
  The goals of this initiative include increasing access to newly 
developed assistive technologies, expanding educational opportunities, 
promoting home ownership, integrating Americans with disabilities into 
the workforce, expanding transportation options, and promoting full 
access to community living.
  If the President's New Freedom Initiative is to be successful over 
the long term, it is critical for there to be an adequate qualified, 
skilled workforce in place to help people with mental retardation and 
other developmental disabilities to help them live a self-directed life 
within their community. Indeed, in September of 2002, in a speech to 
private providers of community supporters and supports of services, the 
United States Labor Secretary, Elaine Chao, observed the following: 
``The paraprofessional long-term care workforce is the cornerstone of 
America's long-term care system. Direct support workers are critical to 
the success of the New Freedom Initiative.''
  In recognition of this reality, H. Con. Res. 94 calls on the Federal 
Government and States to make it a priority to promote a stable quality 
direct support workforce for individuals with mental retardation and 
other developmental disabilities that advances this Nation's commitment 
to community integration for such individuals and to personal security 
for them and their families. Direct support professionals are critical 
to fulfilling the national promises of community living made to people 
with mental retardation as articulated in the President's 
administration policy as outlined in the New Freedom Initiative.
  These valuable front line workers provide a wide range of supportive 
services on a day-to-day basis to people with disabilities, including 
habitation, health needs, personal care, hygiene, employment, 
transportation, recreation, housekeeping, and other home management-
related assistance. Without them, these people with mental retardation 
would not be able to live their lives in communities where they could 
enjoy the mainstream of the American life.
  Unfortunately, today there is a national crisis in securing an 
adequate supply of qualified direct support professionals. Severe 
staffing shortages and turnover rates in the direct support workforce 
is now threatening the quality and continuity of community-based 
supports and services for these people who they serve, all this at a 
time when demand for community support and services is growing rapidly 
as States move more and more individuals from institutions into a 
community-based setting and aging parents find it necessary to seek 
outside support for the care of the children whom they love.
  Tough work, increased demand for services, and aging population, all 
of this is threatening the quality and continuation of community 
support for

[[Page H10303]]

services for people with mental retardation and leaving parents 
extremely fearful that there will be no one there for their children.
  It is my hope that each of our colleagues will join me in expressing 
sincere appreciation for the very important work performed by our 
Nation's direct support workers, and let us vow to put our heads 
together to develop a national strategy to address the recruitment and 
retention of this crisis that is affecting community support for people 
with developmental disabilities.
  Mr. Speaker, I hope that each of my colleagues will join in not only 
the vote that they make here today, but by going back home and giving a 
pat on the back to those health care professionals and others who are 
engaged in the services for each of these people who are important to 
each and every one of us.

  Tonya Simmons' Remarks to the American Association of the Mentally 
Retarded (AAMR) Region 9 Service Award for Contributions for Improving 
    Services for People with Developmental Disabilities Living in a 
                           Community Setting

       I am very grateful and thankful for this award. It is an 
     honor. I was new to the human services field 2 years after 
     graduating from the Baltimore County Community College and 
     the AmeriCorps Program. I began working at Spectrum Support 
     without the knowledge of what it was and without the required 
     training: but it was okay because of the training I received 
     and the knowledge that would come from hands-on experience. I 
     was ready and excited about a new challenge. I was successful 
     because I was committed, passionate, strong, and caring. I 
     have a heart. I have feelings, I am concerned, but most of 
     all, this job made me realize that I am a leader. My only 
     brother died this year and what I found from the individuals 
     that I support was that they were now supporting me. Many 
     people do not believe or understand that when you love people 
     they will love back. I received phone calls, they had the 
     staff bring them to visit and they were at the services. I 
     will always remember an individual saying to me, ``If you 
     need anything, Tonya, I'll be here for you. It's going to be 
     all right.'' At that moment I realized that my job was 
     appreciated, that I was appreciated, respected and loved. 
     This is all because this is what they receive from me.
       I am working in an underpaid position, working 140 hours 
     bi-weekly between jobs that support adults with disabilities, 
     attending Coppin State College all to support my family. It's 
     okay. I enjoy what I do and look forward to going to work 
     each and every day. Why? Disabilities do not mean inability 
     and I believe in what we do where I work. The individuals 
     that I support and the program are not just my friends but 
     family as well. It's because of them that recently I have 
     learned so much more about myself. I am afraid of public 
     speaking but because of being able to work in the wage 
     campaign, I am overcoming that fear. Thank you for giving me 
     an opportunity to advocate for Direct Support Staff in the 
     Campaign for Increased Wages. At Spectrum Support I am in 
     training everyday where I am encouraged and allowed to grow. 
     I am learning from the best because we are the best. We 
     believe that people can achieve their life goals. We 
     recognize, respect and celebrate each person's contribution 
     to his or her community and believe that each person has 
     unexplored talents that when discovered lead to amazing 
     outcomes. Co-workers we are growing, changing all while 
     moving forward. We will continue to do our best.

  Mr. LANGEVIN. Mr. Speaker, I rise today in support of H. Con. Res. 
94, which expresses the sense of the Congress that community inclusion 
and enhanced lives for the 8 million Americans who have mental 
retardation or other developmental disabilities is at serious risk due 
to a professional shortage of direct support professionals.
  I was proud to join Mr. Sessions and Ms. Capps in introducing the 
Direct Support Professional Recognition Resolution earlier this year, 
because I know the impact that the work of direct support professionals 
has on the families of people with developmental disabilities. America 
has come a long way from the days when warehousing of people with 
mental retardation and other disabilities was painfully routine. Today, 
seasoned professionals and families alike are deeply grateful for the 
advances of self-determination that many Americans with developmental 
disabilities enjoy through living and working within their communities.
  Unfortunately, this progress is jeopardized by a real and immediate 
workforce shortage. As the demand for community supports and services 
has grown, so has the demand for Direct Support Professionals, people 
who devote their lives and careers to providing the day-to-day supports 
necessary for individuals with mental retardation or developmental 
disabilities to live and work in their communities. This support is 
crucial for people with disabilities to enjoy the daily freedoms and 
rights the rest of us take for granted. The current workforce shortage, 
reflected in high turnover and vacancies, will only worsen with an 
increased demand for long-term supports as family caregivers age, 
individuals with mental retardation or other developmental disabilities 
live longer, waiting lists grow, and services expand.
  Mr. Speaker, we must make it a national priority to ensure a quality, 
stable direct support workforce that advances this Nation's commitment 
to community integration and personal security for people with mental 
retardation and other developmental disabilities, and their families. 
The recruitment and retention of quality, trained direct support 
workers is essential to providing quality supports and services to 
people with disabilities. I hear far too often from parents in Rhode 
Island who fear there will be no one available to take care of their 
sons and daughters with mental retardation or other developmental 
disabilities as they grow older--and I know their situations represent 
so many more across the country. While this resolution takes a small 
step in recognizing a professional shortage in the field, it is my 
sincere hope that it represents a commitment on the part of every 
Member of the House of Representatives to take bigger steps toward 
realizing the goal of community inclusion. We must do all we can to 
support the quiet heroes that choose this noble line of work.
  Mrs. CAPPS. Mr. Speaker, I rise in support of H. Con. Res. 94, the 
Direct Support Professional Recognition Resolution. I was pleased to 
join Representative Sessions and Representative Langevin in introducing 
this resolution. They have been tireless in their efforts to pass it 
and deserve credit for their leadership on this issue.
  Right now more than 8 million Americans have mental retardation or 
other developmental disabilities. Though they need some degree of 
assistance, they deserve to live the fullest, most complete lives 
possible. And they can, with the help of America's direct support 
professionals.
  But it is harder and harder for community-based homes and other 
institutions to find and keep men and women who want to do this kind of 
work. There are not enough new people taking up this calling and too 
many are leaving the field. Though this line of work can be very 
rewarding, it is also very challenging. Those in the field now are 
overworked and often underappreciated by our society. Those who commit 
themselves to it should be recognized and honored for their dedication.
  But we need to do more to ensure that our support network for the 
developmentally disabled does not collapse in the face of this problem. 
That is what this resolution is about.
  Demand for these services, and for direct support professionals will 
also continue to grow in the coming years. But right now our Nation's 
long-term care system relies on a variety of public and private funding 
sources that may not be reliable in the long run.
  Medicaid supports many of these programs, but the amount of their 
support varies from State to State. And now some critics of Medicaid 
are trying to make sweeping reforms that may jeopardize the support 
this system has now.
  Congress needs to take a serious look at this problem and begin 
developing solutions. We cannot afford to have a shortage of direct 
support personnel. I urge my colleagues to give these men and women the 
support they deserve. I urge my colleagues to dedicate themselves to 
helping avoid a shortage. And I urge my colleagues to support this 
resolution.
  Mr. BOEHNER. Mr. Speaker, over the past few decades, our Nation has 
made tremendous progress in improving the opportunities of individuals 
with disabilities I am proud to say that Congress has significantly 
improved the ability of individuals with disabilities to become more 
involved in their communities.
  We have passed historic legislation securing the rights of 
individuals with disabilities, including the Individuals with 
Disabilities Education Act and the Americans with Disabilities Act. We 
have clearly demonstrated our support for individuals with 
disabilities, and continue to be committed to improving opportunities 
for all individuals with disabilities.
  However, we know that there are millions of individuals with 
disabilities that face significant challenges in their daily lives. 
Those individuals with mental retardation and developmental 
disabilities who want to maximize their ability to live independently, 
find meaningful employment, and join the mainstream of American life 
continue to need our support and commitment.
  As a Congress, as a Nation, we must strive to help these individuals 
explore new and challenging opportunities. We must encourage people to 
pursue careers working with individuals with disabilities. We must 
provide opportunities to individuals with disabilities to make 
meaningful decisions about the jobs they pursue, the places they live, 
and the education they receive.
  We have made important reforms to key pieces of legislation this past 
year. In the Improving Results for Children with Disabilities Act, we 
have provided greater coordination of services for students as they 
transition away

[[Page H10304]]

from school to postsecondary education, the workforce, or community 
living. We have made it easier for States to provide quality services, 
and enhanced the ability of individuals with disabilities, and their 
families, to choose what services they receive.
  In the Workforce Reinvestment and Adult Education Act, we have given 
individuals with disabilities the opportunity to participate more 
meaningfully in the workforce by enhancing their ability to receive 
training, and we have increased the emphasis on serving individuals 
with disabilities.
  I strongly support this important resolution, and I encourage my 
colleagues to support it as well. Mr. KILDEE. Mr. Speaker, I have no 
further requests for time, and I yield back the balance of my time.

  Mr. McKEON. Mr. Speaker, I have no further requests for time, and I 
yield back the balance of my time.
  The SPEAKER pro tempore (Mr. Boozman). The question is on the motion 
offered by the gentleman from California (Mr. McKeon) that the House 
suspend the rules and agree to the concurrent resolution, H. Con. Res. 
94, as amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds of 
those present have voted in the affirmative.
  Mr. McKEON. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the 
Chair's prior announcement, further proceedings on this motion will be 
postponed.

                          ____________________