After struggling to find staff to care for a disabled married couple in their Douglas County home, Lutheran Social Service of Minnesota made the difficult decision to end services to them in 2018, and the couple ended up in a nursing home.

"It became harder and harder to find staff for the money we're able to pay them," said Nancy Rosemore, associate vice president for the agency. "They can go to any of the nursing homes and they're paying $14 or $15."

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Rosemore's agency is one of many asking the Minnesota Legislature to provide more funding so they can pay their workers more. They held a rally at the state capitol on Tuesday. Low pay for those who care for Minnesota's most vulnerable residents is affecting staffing levels, the agencies say.

"It's an industry-wide issue," said Drew Henry, communications director for the Association of Residential Resources in Minnesota, one of the groups lobbying for more funding.

Last year, nearly all of 77 personal care assistance agencies surveyed said they were having difficulty filling vacant assistant positions, according to a Minnesota Department of Human Services report. Many of them reported that in the absence of being able to fill those jobs, people with disabilities either had already moved into nursing homes or assisted living centers, or were facing that prospect.

Disability service providers help people with intellectual or physical disabilities do everything from remain at home to go to work. They do whatever the client needs, whether that's bathing, administering medications and enemas, getting up and dressed, or housekeeping.

They earn an average of $12.32 an hour, which advocates say is about 17 percent less than occupations that require similar education and training, such as bus driving or office clerks.

To try to recruit and keep workers, Lutheran Social Service raised wages to $13 an hour in Douglas County, but that didn't help the couple who lived at home, especially as their needs intensified, Rosemore said.

"Ethically, you have to look at, are they safe? Their health was getting more complicated and it came down to what's best for them was to go into a nursing home," she said.

Her agency still owns two group homes in Douglas County and provides services to one privately-owned home, she said. Those facilities look likely to continue for the foreseeable future, she said.

But statewide, staff shortages are forcing agencies to rely more on their existing work staff, which creates burnout. Last year, Lutheran Social Service paid $1.6 million in overtime, Rosemore said. Meanwhile, it lost about $500,000 in providing disability services.

To attract more workers, her agency is offering more full-time positions, a change from its previous emphasis on part-time roles. It also is offering benefits such as health insurance.

The industry hopes the state will agree to adjust payments to disability services providers every two years instead of every five, based on inflation. And it hopes to restore a 7 percent cut in funding it sustained last year.

While disability advocates are hopeful that state lawmakers will provide extra funding, they're far from betting on it, Rosemore said. Last year, the Legislature provided additional funding in an omnibus spending bill, only to see the entire spending package vetoed by then-Gov. Mark Dayton.

"We're all sitting here watching and hoping," she said.