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Workforce Notice from Mark Mills

April 14, 2022

To All PathWays Stakeholders

Throughout my 22 years at PathWays, I have been amazed at our ability to continually evolve to meet the needs of the people we serve. We are currently facing one of our biggest challenges ever: recruiting and retaining employees in the wake of a worldwide pandemic.

Workforce continues to be a significant challenge across the country. A lack of qualified direct support workers has reached a crisis point in the developmental services system in New Hampshire. This has resulted in a lack of capacity at our provider agencies and is impacting our ability to meet the local demand for services here at PathWays.

This workforce crisis has resulted in a decision to close our Riverdale residence in Lebanon this week. We have reached a point where we simply do not have enough staff to keep that program open. We have moved the three individuals living there into temporary placements while their teams work on planning for the future.

There are a number of initiatives underway to address the current direct support workforce crisis:

The Center for Medicaid and Medicare Services (CMS) has allocated some of the Federal American Recovery and Protection Act (ARPA) funds to states for the implementation of immediate strategies to address this crisis. New Hampshire has received its share of those funds and has distributed them to the 10 area agencies based on spending plans that were developed and approved. PathWays is also responsible for allocating funds out to our contracted provider agencies.

These funds must be used for “Direct Support Workers” (DSW) as defined by the New Hampshire Department of Health and Human Services. The roles that meet that definition here at PathWays include DSPs, RSPs, ESPs, Personal Mentors, and their direct supervisors. Our strategies include retention bonuses, hiring bonuses, training initiatives, and creating a credentialing career ladder with incentive bonuses.

There is also a workgroup consisting of advocates, family members, area agencies and provider agencies meeting to develop a longer-term plan to build and sustain the direct support workforce in New Hampshire. This group has been charged by DHHS to write a plan with recommendations by early June. These recommendations will be incorporated into state initiatives to create a new rate structure and redesign the community care waivers that are currently underway.

The solutions to this current crisis are complex and will need to include increased wages and benefits for direct support workers. We also need to raise the societal value of direct support work as a profession. This will only be possible if New Hampshire creates a rate structure that adequately funds the important work we do. It is encouraging that this issue is being recognized and addressed at the state and federal level. We will need to be vigilant to assure that the current planning translates into concrete action.

I am confident that we will make it through this challenging period if we continue to work together and remain focused on our mission. Thank you for all you do each day in support of the individuals and families we serve.


Mark Mills
Chief Executive Officer