According to Oregon Administrative Rules 411 320; "Comprehensive Services" means developmental disability services and supports that include 24-hour residential services and attendant care provided in a licensed home, foster home, or through a supported living program. Comprehensive services are regulated by the Department alone or in combination with an associated Department of Human Services-regulated program for employment. Comprehensive services are in-home services provided to an individual with an intellectual or developmental disability when the individual receives case management services from a Community Developmental Disabilities Program. Comprehensive services do not include support services for adults with intellectual or developmental disabilities enrolled in supports that occur in their own home.
The lynchpin issue in this crisis is the inability to find, hire and retain quality Direct Support Professionals (DSPs) who provide comprehensive care for individuals with the most significant disabilities in 24/hour residential supports.
There are multiple forces at work creating this perfect storm resulting in growing DSP and mid-manager vacancies in the comprehensive support system, a decrease in provider capacity to provide quality supports, and a reduction in Oregon’s ability to comply with multiple federal system change requirements. Oregon is primed for a quality and safety breakdown.
But the biggest tragedy of it all is the impact on the individuals with disabilities receiving services. They experience a revolving door of staff; who provide the most intimate of supports including but not limited to: bathing, toileting, feeding, medication administration, and the loss of trusted relationships so critical to what Oregon has always prided itself on providing - quality, person-centered supports.