Community Support Advocates President and CEO Christina Smith hopes a recent investment in a new 87,000-square-foot building in West Des Moines will allow her to pay her staff higher wages down the road.

Medicaid and Medicare reimbursement rates allow Smith to only pay CSA workers $15 to $17 an hour, she said, limiting her ability to navigate a workforce challenge that is affecting many in the industry.

After the start of the COVID-19 pandemic, Smith noticed a spike in the need for services coinciding with higher staff turnover rates at Community Support Advocates, a nonprofit organization that serves people who have disabilities, including intellectual disabilities and other developmental disabilities, brain injury, mental illness and substance use.

“Services have dwindled greatly because of a lack of staff,” Smith said. “So if I’m a CEO and my job is to put services out and staffing some of my peers at certain times, I’ve had over 50% open. So what happens? You close services. You can’t have 24-hour care with 50% open. People aren’t safe. So you close beds, you close homes, you close things that provide 24-hour care to people.”

As a result, emergency rooms, jails and coordination programs fill up, Smith said. “And everybody’s doing direct care who isn’t supposed to.”

Smith took the money she was using for rent at CSA’s previous location near Merle Hay Mall and invested it in the new location at 1516 Valley West Drive in West Des Moines.

“If I can get a nicer place for them to work and pay off the building, then all of my money can go toward staff, then I could pay them more,” she said. “That’s my thinking.”

The new facility is home to CSA’s Integrated Behavioral Health Clinic that specializes in creative arts play therapy, an At-Tain Out of the Box Initiative representational library and an accessibility tech center supported by Google Fiber.

It also includes a permanent gallery for CSA’s Momentum Arts program and a public art installation called “Hands of Hope,” made from individual tiles painted by 500 different community members.

“My goal here was to create a space where people wanted to come, not just staff, but people wanted to come and get services,” Smith said. “I wanted a place where the community wanted to come, so they wanted to come and see art, they wanted to come for mental wellness. I wanted to create a space where people wanted to engage in conversation, or in care.

“Have a meeting here, come visit an art show. We have openings right now for therapy, or [medical] management with our nurse practitioner. … Everything helps, little and big.”