Florida’s intellectual and developmental disabilities (I/DD) nonprofit service providers, such as the Key Training Center, are in a Direct Support Professional (DSP) provider hiring crisis. The simple fact is that the iBudget Medicaid waiver has never been funded adequately. Florida’s average expenditures for an individual’s cost plan are low compared to national averages. In 2019, the state of Florida’s economy was ranked fourth largest and second in fiscal stability, but Florida is ranked 50th in funding individuals with I/DD in the United States.

Melissa Walker

Melissa Walker is the Key Training Center Executive Director.

The DSP national hiring crisis continues to be reinforced by reports through the President’s Committee on People with Intellectual Disabilities (PCPID), American Network of Community Options and Resources (ANCOR), the National Core Indicators (NCI) / Human Services Research Institute (HSRI), and most recently the PHI titled “It’s Time to Care: A Detailed Profile of America’s Direct Care Workforce.“ All reports declare recommendations of increasing wages of direct care staff and the creation of a workforce pipeline. DSP workers are a lifeline to millions of people with disabilities and their families and are among the nation’s most vulnerable workers due to low rates resulting in a DSP workforce plagued by turnover rates 40% to 50%, and for us, it’s over 40%. The Key Training Center cannot pay competitive wages when staff can go work at fast-food restaurants or retail stores for higher wages.

The good news is the Florida Senate has offered almost $20 million in iBudget rate increases. This is a good start, but we need an additional $14 million in state General Revenue funds to make sure that direct care staff who provide these services earn at least $11 per hour on average.

The concerning news is that the Florida House has not included rate increases in its budget. The House’s Health Care Appropriations Subcommittee members need to follow the Senate’s Appropriations Subcommittee on Health and Human Services lead but understand that when to going to conference we are not there yet to achieve the $11 per hour and more funds need to be added especially in adult day training (ADT) and residential services.

The Key Training Center has provided services to Citrus County for over 53 years and is currently serving over

300 adults with I/DD. We currently operate two ADT campuses, 18 group homes and four apartment complexes serving 145 residents. We employ

285 staff members consisting of 40% residential, 30% ADT and the remaining 30% for retail stores, foundation, and business office.

Please join us in advocating for a Florida iBudget rate increase to raise ADT, residential habilitation, personal supports/companion, and respite average direct care wages to $11 per hour to reduce staff turnover and attract qualified employees. This investment in the I/DD service system will require

$37 million in general revenue funds that would draw down $54.4 million in federal Medicaid funding. The Key Training Center and other nonprofit providers across our state continue to be committed to working with Florida lawmakers to ensure tracking methodologies that validate the requested funding is utilized for direct care staff increases.

Key legislative committees and local representatives:

1. Senate’s Appropriations Subcommittee on Health and Human Services www.flsenate.gov/Committees/Show/AHS.

2. House’s Health Care


3. Sen. Wilton Simpson:simpson.wilton.web@flsenate.gov.

4. Rep. Ralph Massullo: Ralph.Massullo@myfloridahouse.gov.

Melissa Walker is executive director of the Key Training Center.