Investing in our direct-care workers could help put an end to the worker shortages | Opinion
As the U.S. population continues to age, the demand for direct-care workers who provide care, services and support to the elderly and the disabled is expected to rise dramatically.
A recent survey by the National Center for Assisted Living found 99% of nursing homes and 96% of assisted living facilities are experiencing staffing shortages. An additional 1.3 million direct-care workers will be needed over the next decade to meet the needs of the aging U.S. population— creating a total of 7.4 million direct-care job openings.
The COVID-19 pandemic has highlighted the detrimental impacts of the direct-care worker shortage; however, this problem is not new, and it will continue to worsen without significant investments into the workforce.
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Addressing the direct-care worker shortage
Addressing the worker shortage in the direct-care area through Medicaid expansion and increasing worker compensation is central to President Biden’s agenda. These interventions are essential to addressing work force shortages and preparing for future increases in demand for direct-care workers.
Additional reforms to address the shortage are needed and include further interventions to improve worker compensation, increasing funding for health professions grant programs and funding paid family leave programs. Addressing the direct-care workforce shortage begins with fair compensation. The median hourly wage for a direct-care worker is approximately $13— with an annual income of $20,200.
One intervention to improve worker compensation is to require the Centers for Medicare and Medicaid Services (CMS) to mandate state Medicaid agencies to explicitly state how the proportion of proposed changes to Medicaid rates is allocated to direct-care worker compensation.
Another proposal is to require the Medicare Payment Advisory Commission (MedPAC)— which advises Congress on Medicare payments— to provide specific guidance about the proportion of payments made to Medicare-certified nursing homes and home health agencies that should go toward direct-care worker compensation. These interventions would establish a formal process for the evaluation of worker compensation.
Investing in direct-care workers
Interventions addressing direct-care workforce shortages must include training for new direct-care workers and an investment in the retainment and development of the skills of the existing workforce. This can be accomplished by increasing funding for health professions grant programs, such as the Health Profession Opportunity Grant Program and Nursing Home Worker Training Grants.
These programs have proven effective in recruiting and retaining direct-care workers by addressing factors that contribute to turnover, as well factors that deter prospective workers from pursing these jobs. This supports provides people with financial and logistical support that's critical to their ability to pursue direct-care jobs and to continue working in the field.
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Expanding funding for paid family leave programs is critical to addressing the direct-care work force shortages. Funding paid family leave benefits both family caregivers as well as the direct-care industry and its workers. By supporting family caregivers, more people who may have required long-term care are able to receive care in their homes.
Paid family leave prevents family caregivers from losing essential income, allows the elderly to age in place in their communities and relieves overburdened care facilities by decreasing the number of people in need of direct-care services. These interventions can reduce strain on care facilities and direct-care providers and help address the workforce shortage by reducing the number of direct-health workers needed.
As the debate about long-term care, homecare, and workforce shortages continues, I urge you to reach out to your lawmakers and tell them to invest in our long-term care workers.
Kevin Gibas is an infectious diseases doctor at Vanderbilt University Medical Center as well as a research fellow with a focus in health policy at the Vanderbilt University School of Medicine.
This article originally appeared on Nashville Tennessean: Direct-care work: Invest in workforce to help end the worker shortage
