Steve Laska used a tablet to have a video call with his mother. The coronavirus outbreak poses unique challenges for people with developmental disabilities and the organizations that care for them.
Photo from HCO.

Outbreak stresses care for disabled




In a normal spring, volunteer sewists make costumes for Home and Community Options’ (HCO) annual musical. This spring, the musical is canceled, and the costumers have been charged with a more urgent task: making face masks.

As the COVID-19 pandemic affects almost every aspect of life in the Winona area, its impacts are not falling on all people evenly. Those who were challenged before the outbreak are often under even greater pressure now.

People with developmental disabilities are at greater risk of serious illness from COVID-19, according to the U.S. Centers for Disease Control (CDC). Some of the individuals HCO serves have complex health histories with underlying conditions that may put them at risk, HCO Executive Director Suzanne Horstman said. Some may have a limited understanding of how to protect themselves — why hand washing is so important or why social distancing is necessary, she explained. “But beyond that, some of individuals do not have the capacity to tell us when they’re sick,” Horstman continued. “So they’re non-verbal or they have a very high pain threshold or they just are not able to tell us when they’re sick, and our staff are very attuned to watching for signs for that individual and how they usually communicate maybe they’re not feeling well.”

At the same time people with developmental disabilities are at higher risk, the organizations that care for them are facing challenges, too.

Providers like HCO and Cardinal of Minnesota offer homes with specialized care for individuals with intellectual and developmental disabilities as well as support for individuals living in their own apartments or homes. Due to limited state funding for wages and the general workforce shortage, these providers faced challenges hiring and retaining staff before COVID-19, said Buff Hennessey, southeast region director for the Arc of Minnesota, a nonprofit that advocates for people with intellectual and developmental disabilities.

“We already had a workforce shortage long before this happened, and in January and February we were looking at being about 300 hours a week short of employees to cover our basic needs,” Horstman said.

“No matter what you do there’s just not enough workers available, and then when the jobs you offer don’t pay very much, it becomes very challenging,” Hennessey explained. “We keep trying to work on that in the legislature, and some years are more successful than others, but we are not anywhere near where we need to be,” she added.

The coronavirus pandemic magnified that existing challenge. Many of HCO’s staff members are Winona college students. When local universities called off in-person classes and encouraged students to go home, many student-workers decided to do just that, and HCO lost staff in the process, Horstman explained.

Then, local organizations such as the Winona ORC, Winona DAC, and Benedictine Adult Day Center — where many disabled individuals work or take part in activities during the day — had to close their doors to those individuals in order to protect their safety. That lessened the risk of exposure to the coronavirus, but placed new demands on other caregivers.

“We have many programs that don’t have any staff during the day,” Horstman said describing HCO houses. “So we went from not having anybody physically at the site to needing to have three, four staff depending on the need of the individuals.”

All together, it was a double whammy. “We got a decreased workforce and an increased load of work,” Horstman stated. Despite that, she added, “Our employees are coming to work with just wonderful levels of energy, positive attitudes, and good ideas. They’re creative and most importantly, they’re compassionate.”

“That has its own set of challenges, too,” Cardinal of Minnesota Director of Program Services Sky Royston said of the closure of work sites and day programs. “Because then you’re changing the routines for a population that is really dependent on their routines.”

“We have individuals, especially your individuals who have autism, that have such a hard time struggling with the changes and that are needing a lot of care right now,” Horstman said.

“Some providers in the area have potentially tried to hire people at day programs so at least people would see familiar faces, but that has not been as easy to do as people thought it might be,” Hennessey said.

However, there is some good news. “People are settling into new routines,” Horstman reported. “Routine is so incredibly important and finding that new routine is really healthy for our individuals.”

HCO and Cardinal have been shifting staff from other duties to fill in the gaps. Both organizations are hiring, and Horstman said HCO is seeking volunteers to video chat with people HCO serves.

Normally, the people HCO serves build a lot of friendships during the spring musical rehearsals, she noted. “Those relationships still need to grow,” Horstman said. “If someone can video chat with someone who is in our programs and feeling a little bit down, or is living in their own apartment and is feeling alone and scared, those are wonderful opportunities.”

Following state and federal guidance, HCO and Cardinal staff said they are putting a huge emphasis on sanitation, hygiene, and the use of personal protective equipment (PPE) — the gloves, respirators, face masks, gowns, and face shields that provide a crucial degree of protection from the new coronavirus — to try to prevent infections.

Still, Royston said, “It’s not a matter of if, it’s more of a matter of when a staff or client would become ill.” He explained, “Right now we’re finding ourselves in this calm before the storm. We’re preparing ourselves for what could happen, and we’re researching what has happened in other places. We foresee the biggest potential challenge we’re going to have is what happens if we don’t have enough staff to cover the home, and our clients are — before this all happened — some of the most vulnerable people, and we know that.”

Across the country, hospitals, nursing homes, and first responders all have limited supplies of PPE. “Supplies are tight everywhere, and we are just like every other health care provider in needing those supplies,” Horstman said. She said state health officials have encouraged HCO to try to buy PPE on the open market. “That’s a great plan, but we’re not getting anything,” she stated. “There’s nothing there.”

For now, HCO and Cardinal are making do. They have some supplies of PPE, staff are using swimming goggles in place of face shields, and people are sending them homemade masks and gowns. How long those supplies will last is another question.

“We have an inventory of much of the pieces we need. It’s when you’re looking at the entire agency becoming overwhelmed and the sheer quantity as you’re looking down the road that that starts to become a problem,” HCO Communications Coordinator Ashly Wiczek Bissen explained.

People can help these organizations. “We need employees and volunteers,” Horstman said. “Apply, apply, apply,” Royston encouraged potential hires. HCO is a nonprofit that accepts donations. “Even a few dollars make a huge difference right now,” Horstman said. Both organizations are accepting homemade masks. For more information, visit and


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