"It is becoming increasingly difficult to hire physical and occupational therapists to Southeast Missouri due to the nation-wide shortage," said Michelle Fayette, executive director of the Sikeston center, which provides physical, occupational and speech and language therapy to hundreds of children in the rural areas of Southeast Missouri.
One of the things that makes it difficult for the Center to hire Southeast Missouri natives is that the closest places offering degrees in PT or OT are St. Louis and Columbia.
"Students getting ready to attend college from this area may be interested in these fields but not be able to go that far away for a number of reasons. Therefore, we don't have kids from this area graduating with those degrees and returning home so that we can replenish our supply," Fayette said.
Tuitions range anywhere from $12,000 to $60,000 per year, and all of KRCC's therapists have graduated with anywhere from $20,000 to $60,000 in loan debt.
"With us being a non-profit center, we can't pay enough to compete with for-
profit centers," Fayette said.
This makes repayment of student loans more difficult for the therapists who've chosen to work at KRCC, Fayette explained.
"Therapists who work here have often moved a long way from home, have single income households and must meet day-to-day living expenses," Fayette said.
Physical therapist Brandy Dallas, who is the clinical coordinator at KRCC, worked for 10 years in Columbia. During that time, she worked for facilities and for a period of that time, she ran a private practice that included the state program for preschoolers called First Steps.
Recently, Dallas relocated to Southeast Missouri because her fiance lives here. She found out about the Center, and applied for a job because she loved working in pediatrics, she said.
"The pay cut was difficult to swallow and had I not been moving in with someone who could help pay the bills made, it would've been impossible to do it (because of the loan payment)," Dallas said.
In Columbia, Dallas had a bit of a therapist shortage at her practice with a waiting list of five or 10 children, she recalled.
"Here, at the Center, I have over 75 children on our waiting list at this time," Dallas said.
Sometimes children can be on the list for over a year, Dallas said. "We just don't have the therapists," Dallas said. "Every single one of our therapists' schedules are maxed out with only two or three hours a week allotted for paperwork."
Unfortunately, children in the area are sitting on a waiting list because the Center can't find anybody to provide them the service, Dallas said.
KRCC can attract therapists from all over the United States, but they don't stay long-term, Fayette said.
Metropolitan areas will not hire PTs or OTs for a pediatric setting without any experience, Fayette said. And what happens is, for example, a new graduate living in St. Louis will come KRCC for about two years and then go back to the city.
"If they know they want to be in a pediatric environment, then that is a big draw for them," Fayette said.
Fayette said one of the other draws to the Center she tries to push with prospective therapists are the center's hours. Therapists work 8 a.m. to 4:30 p.m. Monday through Friday and have weekends and holidays off.
Both Dallas and Fayette pointed out KRCC is the only center in Southeast Missouri dedicated strictly to pediatrics. It also has state-of-the-art equipment, they said.
"When people know they want to work in pediatrics, they will work for less money," Dallas said. "But there does come a point in time when they have to pay bills and be responsible to their livelihood."
Fayette wants to ensure the Center continues serving the region's children and said she took a proactive approach by recruiting U.S. Rep. Jo Ann Emerson to address the therapist shortage in the area.
On Friday, Emerson toured the Center for the first time and met with children attending the Center. Fayette asked Emerson for help to create a program that would forgive a certain amount of KRCC therapists' student loans for each year of service provided. Similar programs already exist for professions facing shortages such as nurses, doctors and pharmacists.
"This would get therapists to stay longer than the typical two years before returning home to their homes and families," Fayette said. Dallas said a tuition or loan forgiveness program would be a major incentive for prospective therapists.
"If you have a $20,000-plus student loan and know that part of debt will be forgiven, it certainly makes it more attractive," Dallas said.
If tuition reimbursement/forgiveness isn't possible, then Fayette said she will have to look to other options. She is already looking into grants, and of course the annual telethon is always a huge help.
"One option would be to charge a family for services they received -- and we haven't done that in 31 years," Fayette said. "And if they had to pay, we probably wouldn't get them to come."
Another option -- one Fayette hopes never happens -- would be to not provide therapy because without therapists, no service can be provided, she said.
Emerson said she will look into finding some way to help the Center. She plans to check for ideas at Washington University in St. Louis and a cerebral palsy center currently being built in Texas.
"You can't ever say never," Emerson said about the possibility of a loan forgiveness program. "The need (for the center) is huge. It really is a jewel."