Autism centers say they are in a staffing crisis

An indoor playground
St. David's Center children's gym in Minnetonka, Minn. The center says a staff shortage has led to changes in scheduling.
Linton Ritchie Jr. | MPR News

Vanessa Slivken tries to get the children in her autism services center the time they need, but persistently short staffing has forced them to ask every family to deal with a rotating schedule.

Slivken says it’s the fairest way to go.

“When we don't have staff that can provide the service for you we are gonna have to ask that your child does not come to day treatment that day,” Slivken, the senior director of autism and day treatment services at St. David’s Center for Child and Family Development said.

In a trend that is more acute in the last two years, centers for autistic people in Minnesota have been struggling to find enough staff members — and the money to pay them.

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People who work in the field say the longer those staffing problems continue, the greater the consequences for children and families.

The state Department of Human Services notes that the Minnesota Autism Developmental Disabilities Monitoring Network found that in Hennepin and Ramsey counties around one in 44, or 2.3 percent of 4-year-olds were identified with autism spectrum disorder in 2018.

“We are now hitting a crisis. We do not have enough people who are willing to work in these professions,” said Julie Sjordal, CEO of St. David’s Center.

“You can go work at Uber Eats and drive for the same price you could work as a practitioner providing services,” Sjordal said. “This is really hard, intense emotional work that we're in. So, we need to pay at a level that really shows our community values the people who are stepping into these roles and into these fields.”

The entrance to a building
The main entrance welcoming families, visitors and children to St. David's Center for child and family development in Minnetonka, Minn.
Linton Ritchie Jr. | MPR News

There’s a shortage of behavioral therapists, paraprofessionals and mental health practitioners — all vital to providing the best care for people with sensory sensitivities and other issues that can affect learning and navigating society, autism treatment center executives say.

One root of the staffing problem is the financial hit that treatment centers took during the pandemic.

Dr. Eric Larsson, president of the Association for Science in Autism Treatment said during the pandemic the financial problems temporarily were eased by federal aid, but now those programs have ended.

“We're owing several hundred thousand dollars to the bank and not able to make up that deficit,” Larsson said.

In a May 2022 letter pleading for help from state budget negotiators, Larsson’s organization, which represents a number of autism treatment centers including St. David’s, noted they are only able to charge a fee for service. When Medical Assistance reimbursements decline, the centers have a hard time paying staff, leading to lower levels of services for children.

The long term answer, Larsson and others said, is more funding from the state of Minnesota and the federal government. For its part the state seems to agree. The Department of Human Services said on its website that providers of services for these children and others “are also challenged to recruit and train a sufficient number of staff to serve the number of people who need treatment. Staff retention is also affected by reimbursement rates, lack of training to meet the demands of the position.”

A classroom with wooden tables
Children's behavior therapy classroom at St. David's Center in Minnetonka, Minn.
Linton Ritchie Jr. | MPR News

Not having enough workers can create tough work environments. Jeff Nichols, CEO at the Minnesota Autism Center said “it just invariably shifts some of that intangible burden in a day to other staff.”

Without regular care Larsson said, “the overall testing data shows that children with autism are losing a year to two years of education.”

Nichols said his center remains open as much as possible.

“We're still trying to serve as many or more kids at least give them something, but it is not always full time, every day, five days a week.”