2007 dsp turnover-costs & operational-cost-increases study ... · 2007 dsp turnover-costs &...

2007 DSP Turnover-Costs

& Operational-Cost-Increases Study

Final Report

Barbara Fraley, Ph.D.ARRM Research Director

March 31, 2008

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Contents

List of Tables / 3

Introduction / 4

Methods / 4 Participants / 4 Materials / 4 Procedure / 5

Results / 5 Testing for Differences / 10 Urban vs. Rural Differences / 11

Discussion / 13 Some Areas for Improvement / 14

Footnotes / 15

Appendices / 16 Appendix A: Aggregated Profile for 2007 Turnover Participants / 16 Appendix B: DSP and Wage Definitions Used for Data Collection / 17 Appendix C: ARRM's 2007 DSP Turnover-Costs & Operational-Cost Increases Questionnaire / 18

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Tables

1. 2006 DSP Wages / 52. 2006 Turnover, 6-Months-Or-Less Tenure, Vacancy, and Average Number of Months

Employed / 63. 2006 Termination Status, Number of DSPs Hired, and Number of On-Call DSPs / 74. 2006 Number of Weeks to Fill DSP Positions / 75. 2006 Direct Costs of Hiring: Recruitment, Selection and Orientation-and-Training,

and Payroll Costs / 86. 2006 Overtime and Grand Total of Hiring Costs / 87. 2006 Total Actual Expenses and All Hiring Costs as a Percent of Total Actual

Expenses / 88. 2006 Number of Agencies Providing the Following Benefits to DSPs / 89. 2006 Operating-Cost Averages: Previous-to-Current 12-Month Period Percent

Change within Total Actual Expenses / 910. Number of Agencies that Changed Their Health Insurance Policy in the Following

Ways / 911. Number of Agencies that Made the Following Overall-Budgeting Decisions to

Maintain Programs During the Current 12-Month / 1012. 2006 Rural DSP Wages / 1213. 2006 Urban DSP Wages / 1214. 2006 Rural Turnover, 6-Months-Or-Less Tenure, Vacancy, and Average Number of

Months Employed / 1215. 2006 Urban Turnover, 6-Months-Or-Less Tenure, Vacancy, and Average Number of

Months Employed / 12

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INTRODUCTION

In August 2007, ARRM conducted a random-sample study examining DSP wages, turnover,turnover costs, and operating-cost increases in August 2007. Twenty-five ARRM OrganizationalMembers participated in the study and, although they remain anonymous, ARRM thanks eachone for their effort, time, and cooperation with this project. We truly appreciate all your work!

The study's purpose was to show current DSP compensation (wages and benefits); measureturnover, vacancy, and the time it takes to fill DSP positions; demonstrate specific and overallcosts associated with turnover; measure various operating-cost increases; and examine provideractions to help maintain their programs. This study replicated many of ARRM’s 2005 DSP wagestudy metrics, along with additional measures of turnover costs and benefit and operating-costincreases. Several ARRM Members volunteered their time, providing considerable input into thedesign of the survey to help ensure reliable and meaningful results across the sample. Thanks toLori Kingston, Denny Theede, Lori Jasper, Eric Pederson, and Georgette Peterson for all theirhard work in developing this survey.

METHODS

ParticipantsThe study involved 30 randomly selected ARRM Organizational Members (out of 147Organizational Members at the time). Twenty-five participants (83%) completed the survey. SeeAppendix A for an aggregate profile of the sample participants based on ARRM's AnnualMember Survey data (N=21). In broad terms, the size of the participating agencies, based on thetotal number of people they serve, consisted of 11 agencies who serve fewer than 100 people and10 agencies who serve more than 100 people.

MaterialsThe survey questionnaire asked agencies to select a recent 12-month period to use for their data(i.e., calendar year, fiscal year, or other), based on January 2006 or later. Wage-related questionsconsisted of base-entry-level, average-starting, and overall average DSP wage. See Appendix Bfor definitions used for Direct Support Professional and each of the wage types examined. Belowis a brief description of other variables measured in the survey (see Appendix C for a completecopy of the survey).

Several questions provided the basis for calculating a turnover rate, the percent of DSPs with a 6-months-or-less tenure, vacancy rate, and, for those who left in year, the average number ofmonths they were employed. The survey asked for the number of DSPs who terminatedvoluntarily vs. involuntarily, the total number of DSPs hired in the year, the number of on-callDSPs at the agency, as well as the time it took to fill the last three full-time and part-time DSPpositions.

A section of the survey examined both direct and indirect costs of turnover. Direct costs werebroken out into the following sections: Recruitment, Selection and Orientation/Training, andPayroll Costs (Supervisor and Employee Hours and Rates involved in various steps of hiringprocess). See Appendix C, survey question #5, for complete worksheet descriptions used to

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collect this data. The indirect cost of turnover involved DSP overtime paid in the year (the totalhalf-time wages paid out of the total one-and-a-half-time wages paid). It was based on theassumption that overtime is primarily due to understaffing issues. Also in this section, agenciesprovided their 12-month total actual expenses to allow the calculation of hiring costs as a percentof their total actual expenses for the year.

A short section on health insurance benefits for DSPs asked the percent eligible for healthinsurance; the percent of those eligible who elect health insurance; and whether or not agenciesprovide health insurance, PTO, and employer-contributed retirement to their full-time, part-time,or both types of DSPs.

The survey then focused on operational-cost increases. ARRM asked participants to providecurrent year and previous year percentages of their total actual expenses for transportation andfuel; utilities (heating, electricity, water, and sewer); and the following insurances: workers-compensation, property, and liability. A brief section on health insurance asked the premium ratechange for the current period relative the previous 12-month period and whether or not theagency increased co-pays, increased the premium percent paid by employee, reduced the generalbenefit set of the policy, or added plan options/choices.

Finally, participants reported whether or not their organization made any of the following overallbudgeting decisions in their current 12-month period to help maintain their programs: reducedpay, staff hours, or staff-to-client ratios; promoted part-time over full-time; or restructured or leftadministrative positions unfilled.

ProcedureAll participants received the option to opt out of the study a couple weeks before it launched. Noparticipants chose to opt out of this study. Data collection ran from July 31st to August 31st.Participants received an email announcing the survey launch that contained a link to the onlinesurvey tool. The email included a PDF version of the survey to allow participants to gather theirinformation in advance of completing the online survey. ARRM secures and keeps all participantdata confidential and presents results only in aggregate. All analysis was conducted in SPSS.

RESULTS

Most participants (19, 76%) chose the 2006 Calendar Year to define their current/recent 12-month period for their data. The remaining participants (6, 24%) chose the 2006-2007 FiscalYear to draw their current data. In survey questions asking for a previous 12-month period,participants used a comparable 12-month period to their current period. For simplicity, allcurrent-period results in this study are referred to as 2006 results.

Table 1. 2006 DSP Wages (N=25)Base-Entry-Level Average Starting Average Overall

Average $9.56 $10.33 $10.99(Standard Deviation) ($1.54) ($1.41) ($1.48)Range $7.00 - $13.22 $8.50 - $14.14 $9.00 - $15.14Median1 $9.21 $10.00 $10.35

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Turnover Rate. A DSP turnover rate was calculated for each agency with the following:

• The total number of DSPs that left during the year. (Including any DSP officiallyhired that received at least 1 hour of pay.) DIVIDED BY…

• The total number of DSPs on the final day of the final month of the year. (Includingonly positions that are filled.)

Percent of DSPs Who Left with a 6-Months-Or-Less Tenure. This percent was calculated foreach agency with the following:

• The total number of DSPs who worked within the year and left (resigned, promoted,or terminated) within the first six months of employment. DIVIDED BY…

• The total number of DSPs that left during the year. (Including any DSP officiallyhired that received at least 1 hour of pay.)

Vacancy Rate. A DSP vacancy rate was calculated for each agency with the following:

• The total number of open (funded-but-unfilled) DSP positions at your agency on thefinal day of the final month of your 12-month period. DIVIDED BY…

• [The total number of DSPs on the final day of the final month of the year. (Includingonly positions that are filled.) ADDED TO… The total number of open (funded-but-unfilled) DSP positions at your agency on the final day of the final month of your 12-month period.] MULTIPLIED BY 100.

Average Number of Months Employed for Leavers. This is the average number of monthsemployed by the DSPs who left during the year.

Table 2. 2006 Turnover, 6-Months-Or-Less Tenure, Vacancy, and Average Number ofMonths Employed (N=24)

Turnover 6-Months-Or-Less Vacancy Leaver Ave. Mnths EmplydAverage 41% 46% 6% 11 Months(Standard Deviation) (21%) (21%) (6%) (10 Months)Range 0-81% 21-100% 0-20% 0-36 MonthsMedian 36% 39% 4% 7 Months

A test of significant differences between those agencies whose overall DSP wage was belowaverage compared with those whose overall DSP wage was above average showed an impact on6-Months-Or-Less Tenure, but not on Turnover or Vacancy Rates.

Specifically, those agencies whose overall-average DSP wage was less than $11.00 lost 59% oftheir newly hired DSPs in the first 6 months and those agencies whose overall-average DSP

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wage was more than $10.99 only lost 37% of their newly hired DSPs in the first 6 months. Thedifference in the percent of DSPs who left in the first 6 months (59% vs. 37%) was foundstatistically significant (p < 05).

Table 3. 2006 Termination Status, Number of DSPs Hired, and Number of On-Call DSPs(N=24)

Of the DSPs Who Left in Year…% TerminatedVoluntarily

% TerminatedInvoluntarily

Ave. # & % ofDSPs Hired inYear at Agency

Ave. # & % On-Call DSP atAgency

Average 76% 20% 87, 50% 16, 16%(Standard Deviation) (24%) (19%) (131, 28%) (31, 21%)Range 14-101% 0-80% 1-607, 9-126% 0-138, 0-100%Median 83% 16% 38, 45% 5, 12%

Note that the average percentage of DSPs hired in 2006 by agencies (50%) is greater than theturnover rate (41%) reported in Table 2. Although ARRM did not collect the data to qualify thenumber hired, we speculate a common reason this number exceeds turnover is related toincreased services due to business expansion or higher-intensity requirements. The turnovercalculation is the accepted methodology for this industry, replicating the research methodologyused by Minnesota's Institute on Community Integration.

Table 4. 2006 Number of Weeks to Fill DSP Positions (N=23)Average Number of Weeks to Fill DSP PositionsFull-Time Part-Time Full & Part-Time

Average 3.4 Weeks 3.6 Weeks 3.5 Weeks(Standard Deviation) (3.2 Weeks) (4.2 Weeks) (3.4 Weeks)Range 0-10 Weeks 0-17 Weeks 0-13 WeeksMedian 1.8 Weeks 2.0 Weeks 3.0 Weeks

An examination of hiring costs for the current 12-month period included the following: (1)recruitment costs; (2) selection and orientation-and-training costs; (3) payroll costs for thesupervisor and new employee spent on pre-hire work, hiring paperwork, training and orientation,and other direct payroll costs; and (4) DSP overtime (only the half-time wages paid out of totalone-and-a-half-time wages paid). Recruitment costs involved advertising costs, brochure andmarketing-material costs, and hiring/referral/retention bonuses given. Selection and orientation-and-training costs included drug screening, background checks, tests/procedures for new hiressuch as a mantoux or physical, and various training and orientation procedures. For specificworksheets used to gather payroll costs and expenses for all categories of the hiring process, seeAppendix C, survey question #5.

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Table 5. 2006 Direct Costs of Hiring: Recruitment (N=22), Selection and Orientation-and-Training (N=23), and Payroll Costs (N=22)

Recruitment Costs Selection & Orientation& Training Costs

Payroll Costs Total: Direct Costsof Hiring (N=20)

Per Year PerEmployee




Ave. $6,897 $210 $115,379 $1,296 $69,366 $860 $132,686 $2,307(SD) ($7,475) ($300) ($218,747) ($1,942) ($121,860) ($728) ($169,644) ($2,317)Range 0-$27,521 0-$1,250 $600-

$970,593$75-$9,330

$212-$558,440

$19-$3,524

$1,360-$600,870

$410-$10,875

Median $4,050 $112 $22,440 $700 $23,934 $767 $53,200 $1,408

Table 6. 2006 Overtime (N=22) and Grand Total of Hiring Costs (N=19)Grand Total: Direct Costs of Hiring + OvertimeOvertime (half-

time wages only) Per Year Per EmployeeAverage $53,105 $193,936 $2,865(Standard Deviation) ($108,079) ($254,804) ($2,689)Range 0-$443,275 $1,360-$884,842 $597-$11,663Median $11,256 $61,497 $1,762

Table 7. 2006 Total Actual Expenses (N=21) and All Hiring Costs as a Percent of TotalActual Expenses (N=18)

Total Actual Expenses for Year All Hiring Costs as a Percent ofTotal Actual Expenses

Average $6,828,802 3%(Standard Deviation) ($9,039,031) (2.05%)Range $213,519-$30,779,615 .10-8.50%Median $3,955,768 2.80%

Average Percent of DSPs Eligible for Health Insurance (N=23): 39% (Median = 40%)

Average Percent of Eligible DSPs Who Elect Health Insurance Coverage (N= ): 52%(Median = 52%)

Table 8. 2006 Number of Agencies Providing the Following Benefits to DSPs (N=25):FT Only FT & PT

Health Insurance 15 (60%) 4 (16%)Paid Time Off - Paid Vacation, SickLeave, Holiday

7 (28%) 13 (52%)

Employer-Contributed Retirement 2 (8%) 15 (60%)

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Table 9. 2006 Operating-Cost Averages: Previous-to-Current 12-Month Period PercentChange within Total Actual Expenses:

Transportation & Fuel Costs: .25% (N=19)Utilities (Heating + Electricity + Water + Sewer): .11% (N=18)Workers' Compensation Insurance: .38% (N=19)Property Insurance (Including Umbrella Policy): .03% (N=17)Liability Insurance: -.02% (N=17)Total Percent Change from Previous to Current: .75% (N=19)

Average Health Insurance Rate Change from Previous to Current 12-Month Period (not apercent of total actual expenses), N=19: 11.76% (Median = 12%)

Using results from this study and ARRM's 2007 Health Care Access Commission Survey, thecost of the employer-paid portion of health insurance averages 4.26% of an agency's total actualexpenses.2 Further calculation with this number showed the recent health insurance rate increaseas a percent of total actual expenses to be .5%. Adding this increase to the total in Table 9,ARRM roughly estimates that providers experienced, from the previous to current 12-monthperiod, an average of a 1.25% increase in their total actual expenses for these operating costsalone.

Table 10. Number of Agencies that Changed Their Health Insurance Policy in theFollowing Ways (Agencies Checked All Applicable Items), N=25:

Increased patient co-payments for office visits,prescription drugs, etc.

12 (48%)

Increased percentage of premium paid byemployee

4 (16%)

Reduced the general benefit set of theinsurance policy

3 (12%)

Added plan options/choices 7 (28%)

A total of 14 (56%) Agencies made at least one of the above changes to their Health InsurancePolicy.

In response to whether or not Agencies made any major business-related change (e.g., new orclosed programs) that significantly affected any of their numbers provided for transportation,utility, and insurance costs, 4 (17%) said Yes and 19 (83%) said No, N=23.

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Table 11. Number of Agencies that Made the Following Overall-Budgeting Decisions toMaintain Programs During the Current 12-Month Period (Agencies Checked AllApplicable Items), N=25:

Reduced pay 2 (8%)Reduced staff hours 10 (40%)Reduced staff-to-client ratios 6 (24%)Promoted Part-Time over Full-Time 6 (24%)Restructured administration or leftadministration positions unfilled

10 (40%)

A total of 17 (68%) Agencies made at least one of the above budgeting decisions to helpmaintain programs.

Testing for DifferencesARRM conducted several additional tests looking for statistically significant differences betweengroups. This section presents those tests and their findings.

ARRM tested whether or not having more than average health-insurance-eligible DSPs electinginsurance (i.e., more than 52% of eligible DSPs) related to higher DSP wages. Specifically, theinvestigator tested whether base-entry-level, average starting, and overall average DSP wagediffered significantly for those agencies with more vs. fewer than average eligible DSPs electinginsurance - i.e., does higher wages increase insurance enrollment? All results were statisticallynon-significant.

ARRM investigated whether or not having a greater than average percent of DSPs eligible forhealth insurance (i.e., more than 39%) related to higher DSP wages (base-entry-level, averagestarting, and overall average), lower turnover, lower 6-months-or-less turnover, or lower vacancyrates. All tests were non-significant.

The investigator examined whether agencies that offered Full-Time and Part-Time DSPs morebenefits (i.e., the benefits of health insurance, PTO, or employer-contributed retirement) had lessturnover, fewer 6-month-or-less leavers, or smaller vacancy rates. Specifically, a test wasconducted between agencies that offered only one of these benefits vs. two or all three of thesebenefits to see if more offerings reduced turnover and vacancy rates. The findings showedturnover and vacancy rates were not affected by more or fewer benefit offerings. However, whilenot statistically significant, the difference found in the percent of DSPs who left with 6-months-or-less tenure was close to significant (p = .08). This is to say, agencies who only offered one ofthese benefits had more 6-month-or-less tenure leavers (49%) than agencies that offered two orall three of these benefits (37%), and this difference was nearly statistically significant.

ARRM tested for a relationship between an agency's making at least one change to its healthinsurance policy and the size of their health insurance premium rate change from the previous tothe current 12-month period. Findings showed agencies that did not make any changes had asignificantly smaller premium rate increase (Mean = 4.86%) than those that made at least onechange (Mean = 15.78%), at p < .05. The changes include increasing co-pays or employee-

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portions of the premium, reducing the benefit set, or adding options/choices. Because the changeoptions in the survey contained one option that could be perceived as positive, i.e., addingoptions/choices, in the midst of three other options that were arguably negative, ARRM did notconduct further analysis of this variable to examine its relationship to wages, turnover, etc. Anysignificant findings of such analysis would have been inconclusive due to the mixed nature of thepolicy-change options.

ARRM examined whether agencies that answered Yes to having made business-related changes(e.g., new or closed programs) had significantly different actual-expense increases fortransportation, utility, or insurances (i.e., health, workers compensation, property, or liability).The investigator found no significant differences.

Finally, a test was conducted to compare whether one vs. multiple budgeting decisions (i.e.,reduced pay, staff hours, or staff-to-client ratios; promoted part-time over full-time; orrestructured administration or left administration positions unfilled) impacted turnover, thepercent of DSP leavers with 6-month-or-less tenure, or vacancy rate. No significant differenceswere found.

Urban vs. Rural DifferencesSeveral members requested a comparison of urban and rural wages. While this study was notspecifically designed to collect reliably for each of these groups, a post-hoc analysis wasconducted to examine some descriptive differences. Below is background on how this wasconducted.

In ARRM's 2005 DSP Wage Study, membership was stratified for urban and rural providers anda proportionate sample was randomly drawn to generalize the findings to our membership. Our2005 membership consisted of 40% rural and 60% urban providers, according to thedetermination outlined below.

The methodology used to define urban and rural providers involved reviewing each agency'soffice and site locations. If any of an agency's offices and/or sites were located in the seven-county metro area (Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, or Washington), inOlmsted County, or within the cities of St. Cloud, Duluth, or Mankato, then the agency wascategorized as urban. Providers located outside of these urban counties and cities werecategorized as rural. Data collection methods consisted of participants sending in their agency'soverall numbers, i.e., they were not asked to provide separate data for urban or rural locations.Although this is not a perfect method of measuring differences between urban and ruralproviders, ARRM preferred this process to keep data collection methods simple and results asclean as possible (i.e., preventing interpretation issues). Essentially, those providers in the ruralcategory purely represent services in rural areas, whereas those providers in the urban categoryare not necessarily pure, they may also serve in rural areas. In other words, the "urban" findingsare such that urban areas have influenced an agency's statistics.

Using the same methodology of the 2005 study, ARRM made a post-study assignment of the2007 Turnover Study participants as either urban or rural and conducted an analysis of wages,turnover, and vacancy rates between these groups. Because this was a post-hoc analysis on

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groups that were not considered during the sampling methodology, ARRM did not analyzedifferences further than descriptive statistics - we would only want to conduct further testingwhen assumptions for those tests have been properly met. ARRM was able to categorize 24 ofthe 25 participants (one participant couldn't be identified). Of those, 7 (29%) fell into the ruralcategory and 17 (71%) fell into the urban category. The following tables show results for thesetwo groupings.

Table 12. 2006 Rural DSP Wages (N=7)Base-Entry-Level Average Starting Average Overall

Average $9.32 $10.11 $10.50(Standard Deviation) ($1.49) ($1.44) ($1.34)Range $7.96 - $12.00 $8.61 - $12.24 $9.13 - $12.73Median $8.86 $9.42 $10.05

Table 13. 2006 Urban DSP Wages (N=17)Base-Entry-Level Average Starting Average Overall

Average $9.63 $10.44 $11.24(Standard Deviation) ($1.64) ($1.47) ($1.55)Range $7.00 - $13.22 $8.50 - $14.14 $9.00 - $15.14Median $9.25 $10.00 $11.10

Table 14. 2006 Rural Turnover, 6-Months-Or-Less Tenure, Vacancy, and Average Numberof Months Employed (N=6)


Table 15. 2006 Urban Turnover, 6-Months-Or-Less Tenure, Vacancy, and AverageNumber of Months Employed (N=17)


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DISCUSSION

The present random-sample study illustrates the current, 2006 wage and benefit statistics ofMinnesota DSPs. While technically the results can only generalize to ARRM Membership, onemight argue they represent a fair indication of DSPs in our disability industry as a whole due tothe widespread nature of ARRM's Membership - its range of provider sizes and the variation ofgeographic locations and service offerings.

A quick comparison between the current study's results and ARRM's 2005 DSP Wage Study(based on 2005 data) show the overall average DSP wage increased by 22 cents (2%), now at$10.99 in 2006. The 2006 DSP turnover rate (41%), the DSP 6-months-or-less tenure rate (46%),and vacancy rate (6%) are the same as we found in 2005, indicating, at least, reliability betweenthe two studies. A compelling finding in the present study was the statistically significant impactof higher wages on reduced turnover in the first six months employment. We found agencieswith an average DSP wage exceeding $10.99 (the overall average) had fewer newly-hired DSPsleave in the first six months of employment (37%) relative to this turnover in agencies with alower than average DSP wage (59%).

Also, the percent of on-call DSPs has made a large increase such that it is now at 16%, up from9% in 2005. Another important trend showed the average number of weeks to fill full-time DSPpositions more than doubled in 2006 (3.4 weeks) relative to 2005 (1.5 weeks).

A primary focus of the current study was on turnover costs. To support ARRM's quest to findways to reduce turnover, we examined a breakout of the costs inherent to new hires, fromrecruiting to training, payroll, and overtime. In summary, it is very costly for providers who haveto continually restart the hiring and training process due to such rapid turnover. With the annualper-agency average cost of hiring at $193,936 or $2,865 per employee, ARRM hopes toconvince legislators of our need to properly address this real problem for people and services inMinnesota.

The operating-cost results showed an aggregated total for transportation and fuel; utilities; andworkers' compensation, property, and liability insurances to be a .75% increase of providers totalactual expenses for the year. While only data that could be determined reliable was included inthe results, these survey questions caused confusion for some participants. The questions askedfor the percent of these expenses as a portion of total actual expenses, and the responses were notalways comparable. Future replications of these measures should involve clearer instructions andthe consideration of all the necessary categories to most completely define operating costs andtheir relative increases from year to year.

The current study's results included a post-hoc analysis of rural vs. urban wages, turnover, etc.Although the results provide some insight into the differences between these groups, please notethat a more reliable comparison between urban and rural can be found in ARRM's 2005 DSPWage Study results. Because the 2005 study was designed to gather reliable samples for thesetwo groups, we recommend those urban-rural results for any public purposes.

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Some Areas for ImprovementWhile 25 out of 30 randomly-selected participants represents a fairly good response rate, the factthat all participants had the option to opt-out in advance of the survey suggests the need forgreater attention surrounding the effort to gain 100% participation in these small-sample studies.Future small-sample studies might involve gaining advanced consent through phoneconversation rather than email to help maximize the participation rate.

As mentioned above, the baseline used for several percentages requested in the survey, i.e.,percent of total actual expenses, confused several participants. Some participants interpreted thisrequest to be only the actual expenses that pertain to the particular category a percent was beingsought, for example, hiring costs or operating costs. Although ARRM was able to go back andgather the appropriate number on some of these cases, it still remained a point of confusion for afew, and those cases were excluded from the analysis. Future research will need to better clarifyintent to prevent misinterpretation during the data collection process.

Regarding health insurance rate increases, this survey should have included the percent of totalactual expenses so this cost could have been added to other operating cost increases. Althoughnot ideal, a rough calculation was made using the results of ARRM’s participation in the HealthCare Access Survey and it showed health care costs to the employer approximates 4.26% of totalactual expenses. Future research should provide for a more accurate calculation of thispercentage.

Finally, future research might expand the focus on DSP turnover rates to examine retention ingreater detail, including the length of tenure and the average pay for long-term employees. Suchmetrics could support an argument for the cost of retaining good DSPs and how the C.O.L.A.falls short of meeting this reality. Also, in the current study, we found 76% of the DSPs who leftdid so voluntarily. A future study should extend this finding by examining the number who leftthe position due to an internal promotion.

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FOOTNOTES

1 The median is the score that comes in the middle of the list when we have ordered it fromlowest to highest. Unlike the mean, or average, the median does not take account of the values ofall the scores, only the value of the score at the middle position. The mean (sum of scoresdivided by the number of scores) is sensitive to all the scores about it, especially extreme values.

2 ARRM calculated an average percent of expenditure for health insurance using the averageagency total actual expenses from this study divided by the average agency employer healthinsurance share from the 2007 Health Access Commission Survey results.

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APPENDIX AAGGREGATED PROFILE FOR 2007 TURNOVER PARTICIPANTS

2007 ARRM TURNOVER STUDY MEMBER SURVEY RESULTS - 3/18/08 Latest Data ('04 - '07)

Number of Organizational Members in Dataset: 21Number of Organizational Members Missing from Dataset: 4TOTAL # SERVED: 4,533 (Range = 6-1,546; Average = 216; Median = 85)TOTAL # EMPLOYED: 7,342 (Range = 3-2,517; Average = 350; Median = 168)Number Served w/in Each of Eight Service CategoriesICF/MR 196SILS 176DT&H 771DD Waiver 2,840CADI Waiver 360CAC Waiver 10TBI Waiver 42EW Waiver 160

Number of Organizations Offering these Waiver Svcs Residential In-Home CDCS Direct CDCS SupportDD Waiver 18 16 4 5CADI Waiver 13 10 1 3CAC Waiver 1 2 0 2TBI Waiver 8 4 0 0

Number of Organizations Offering these Other SvcsMental Health 4Personal Care Attendants 7Crisis/Respite 14

ICF/MR Member Organization Statistics - Based on Latest Year Provided ICF/MR Class A ICF/MR Class B ICF/MR Class A&BTotal Licensed Beds 34 163 197Total Open Beds 2 7 9Total # Days Above Beds Open(average # days open * # of openbeds per Org.)

365 1,915 2,280

Bed Closures 0 0 0Site Closures 0 0 0

SLS Member Organization StatisticsTotal Licensed Beds 1,332 TOTAL (ICF + SLS) Lic. Beds = 1,529Total Open Beds 76 TOTAL (ICF + SLS) Open Beds = 85Total # Days Above Beds Open(average # days open * # of openbeds per Org.)

18,416 % of Lic. Beds (ICF + SLS) Open = 6%

Bed Closures 4Site Closures 3

TOTAL (ICF + SLS) # Days Beds Open= 20,696

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APPENDIX BDSP AND WAGE DEFINITIONS USED FOR DATA COLLECTION

Direct Support Professionals (DSP): Employees whose primary job responsibilities includeproviding direct support and personal assistance to people with disabilities. DSPs may performsome supervisory tasks, but their primary job responsibility and at least 80% of their hours arespent doing direct support work. Unless noted, do not include DSPs whose position is on-call/occasional/casual (those who do not have any regularly scheduled hours).

Base-Entry-Level DSP Wage This is the lowest pay your agency gave in 12-month period toanyone entering the field for this position. This is not an average; it's the wage your agency givesto someone without any experience in the industry or any education above High School. Again,these DSPs spend 80% of their time in direct support - do not include sleep rate.

Average Starting DSP Wage Add all the starting wages together and divide by the total numberof starting wages at your organization during the 12-month period. These wages include base-entry-level as well as wages given to DSPs who came with experience and/or education. If allDSPs start at the same wage, please report that entry wage. Again, these DSPs spend 80% oftheir time in direct support - do not include sleep rate.

Average DSP Wage Add together all the hourly wages in the final day of the final month ofyour 12-month period for your DSPs who spend 80% of their time in direct support (do notinclude sleep rate) and divide by the total number of these DSPs at your agency.

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APPENDIX CARRM's 2007 DSP TURNOVER-COSTS & OPERATIONAL-COST INCREASES

QUESTIONNAIRE

INSTRUCTIONS:

Please do not complete this hardcopy version of the survey. The actual survey is online via alink sent to you by email on the launch date, July 31, 2007, which can be forwarded to theappropriate person to complete, if necessary. The online survey will have a different question-numbering system than the hardcopy (an aspect of designing it through the Survey Monkey tool),but the order of the questions online should be the same as those in this hardcopy. All yourresponses are confidential and will be kept secure in a password-protected database. Results willbe presented only in aggregate.

Definitions

Direct Support Professionals (DSP): Employees whose primary job responsibilities includeproviding direct support and personal assistance to people with disabilities. DSPs may performsome supervisory tasks, but their primary job responsibility and at least 80% of their hours arespent doing direct support work. Unless noted, do not include DSPs whose position is on-call/occasional/casual (those who do not have any regularly scheduled hours).

Full-Time: Full-time is defined as what your agency considers full-time.

Participant-Defined 12-Month PeriodSelect which 12-month period you will use for your agency’s data:

___ 2006 Calendar Year

___ 2006-2007 fiscal year

___ A 12-month period beginning after January 2006: Please fill in dates.

From _____/_____ To _____/_____ mth/yr mth/yr

The 12-month period you've selected will sometimes be referred to as "your 12-monthperiod" or "current/recent 12-month period" in this survey. Please use this same periodconsistently throughout the survey.

You will also be asked to calculate some numbers for a previous 12-month period. Please use acomparable 12-month period to the one you defined for your current/recent 12-month period.

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1. Wages for Direct Support Professionals (DSPs) in 12-Month Period:

Base-Entry-Level DSP Wage $_____.____ Per HourThis is the lowest pay your agency gave in 12-month period to anyone entering the field for thisposition. This is not an average; it's the wage your agency gives to someone without anyexperience in the industry or any education above High School. Again, these DSPs spend 80% oftheir time in direct support - do not include sleep rate.

Average Starting DSP Wage $_____.____ Per HourAdd all the starting wages together and divide by the total number of starting wages at yourorganization during the 12-month period. These wages include base-entry-level as well as wagesgiven to DSPs who came with experience and/or education. If all DSPs start at the same wage,please report that entry wage. Again, these DSPs spend 80% of their time in direct support - donot include sleep rate.

Average DSP Wage $_____.____ Per HourAdd together all the hourly wages in the final day of the final month of your 12-month period foryour DSPs who spend 80% of their time in direct support (do not include sleep rate) and divideby the total number of these DSPs at your agency.

2. DSP Turnover, Tenure, and Vacancy Rates: Include workers who are on-call/occasional/casual.

A. Provide the total number of DSPs at your agency on the final day of the final month of your12-month period. Include only those positions that are filled. __________

B. Provide the total number of DSPs at your agency who left during your 12-month period.Include any DSP who was officially hired and received at least 1 hour of pay. __________

C. Provide the total number of DSPs who worked between your 12-month period and left(resigned, promoted, or terminated) within the first six months of employment. __________

D. Provide the total number of open (funded-but-unfilled) DSP positions at your agency on thefinal day of the final month of your 12-month period. __________

E. For those DSPs who left during your 12-month period, provide the average number-of-monthsemployed. __________

F. For DSPs who left during your 12-month period, provide totals for these two categories:

(1) Total number terminated voluntarily. __________

(2) Total number terminated involuntarily. __________

G. Provide the total number of new DSPs hired during your 12-month period. __________

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3. Provide the total number of On-Call/Occasional/Casual DSPs at your agency on the finalday of the final month of your 12-month period: __________

4. For the last 3 DSPs hired into each permanent full-time and part-time position, howmany weeks was the position vacant? Write 0 only if the new employee started immediatelyafter the former employee left. Last DSPs Hired in Permanent Positions Full-Time Part-Time

Person 1 # weeks # weeksPerson 2 # weeks # weeksPerson 3 # weeks # weeks

5. DSP Hiring Costs:A. For the following DSP-recruitment costs, estimate a total for your 12-month period:

• Help-wanted ads (newspaper, radio, TV, Internet, etc.) • Brochures and marketing materials • Hiring/referral/retention bonuses given

$____________

B. For the following DSP selection and orientation-and-training costs, estimate the total cost forone employee: Use the mini worksheet below to help generate the cost.

Expenses:______ Drug screening______ Background and credit checks______ Regular test or procedure made on a new hire, e.g., mantoux, physical, etc.______ Average time doing a reference check applied to the average wage/salary of checker______ Initial training with HR & orientation training (VA/MOM, Rule 40, Consumer Rights, etc.)______ Certification training, including cost of any in-house capabilities (CPR, 1st Aid, & other skills)______ On-Site training with House Manager______ Misc.______ Total Selection & Training Expenses for One Employee (1)

Payroll Costs - Hours, Rates, & Totals:Supervisor EmployeeHours Hours______ ______ Pre-hire work: applicant contact, interviewing, reference checking______ ______ Hire paperwork______ ______ Training and orientation______ ______ Other direct payroll costs______ ______ Total Hours for Supervisor and Employee Involved in Selection & Training

Supervisor EmployeeHourly Rate Hourly Rate______ ____________ ______ Total Payroll Cost in Hiring One Employee (2)

Multiply each rate by the corresponding hours to get totals for payroll costs.

$____________ Grand Total of Selection & Orientation/Training Cost for One Employee Add (1) and (2) above together.

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C. DSP overtime paid in 12-month period: Provide only the total half-time wages paid out of thetotal one-and-a-half-time wages paid. Take this question literally; it's based on the assumptionthat overtime is primarily due to understaffing issues.

$____________

D. What was your agency’s 12-month total actual expenses? $ ____________________

This number will allow us to calculate the percent of your total actual expenses that went towardreplacement costs (recruitment, selection, training, & overtime) during your 12-month period.

6. Benefits: Include On-Call/Occasional/Casual DSPs in your responses to A - C below:

A. Of your DSPs, what percentage is eligible for health insurance? ______%

B. Of those in A, what percentage of eligible DSPs elect health coverage? ______%

C. Does your agency provide the following benefits to its Full-Time and Part-Time DSPs? EnterFT, PT, or FT & PT into the blanks indicating which type of DSP receives this coverage.

__________ Health Insurance__________ Paid Time Off (Paid Vacation, Sick Leave, Holiday)__________ Employer-Contributed Retirement

7. Operational-Cost Increases:

A. Transportation & Fuel Costs Provide the percent of your actual expenses for…

(1) The current 12-month-period: ____________

(2) The previous, comparable 12-month-period: ____________

Was this an estimate or actual? ______________ Please write in your response.

B. Utilities: Heating + Electricity + Water + Sewer Provide the percent of your actual expenses for…



Was this an estimate or actual? ______________ Please write in your response.

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8. Insurance-Cost Increases:For the following questions on insurances, keep in mind we understand some comparisons reflect anagency's ability to seek out a better deal. The fact that better deals are possible is an important factor toshow through the results. Although we will not qualify every aspect of a decrease, our findings willinclude the assumption that a decrease may have resulted from changing carriers.

A. Health InsuranceProvide the premium rate change (percentage increase or decrease) for the current 12-month-period relative to the previous, comparable 12-month-period:

____________ Include negative sign if appropriate.

B. For the current 12-month period, has your organization changed its health insurance policy inany of the following ways? Check all that apply.

___ Increased patient co-payments for office visits, prescription drugs, etc.

___ Increased percentage of premium paid by employee.

___ Reduced the general benefit set of the insurance policy.

___ Added plan options/choices.

C. Workers-Compensation Insurance Provide the percent of your actual expenses for…



D. Property Insurance, Including Umbrella Policy Provide the percent of your actual expenses for…



E. Liability Insurance Provide the percent of your actual expenses for…



9. Was there any major business-related change (e.g., new or closed programs) thatsignificantly affected any of the numbers you provided in Questions 7 or 8 ontransportation, utilities, and insurances?

____________ Yes or No

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10. Overall-Budgeting Decision for the Current 12-Month Period:

In order to maintain programs during our current 12-month period, our agency…Check all that apply.

___ Reduced pay

___ Reduced staff hours

___ Reduced staff-to-client ratios

___ Promoted Part-Time over Full-Time

___ Restructured administration or left administration positions unfilled

2007 dsp turnover-costs & operational-cost-increases study ... · 2007 dsp turnover-costs &...

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