District Seniors and People with Disabilities Face Reduced Access to Care Due to Shortages of Direct Care Staff
A new survey of providers who serve DC seniors and people with developmental disabilities in home and community-based settings highlights unprecedented staffing shortages that are already reducing access to care and driving up health care costs.
The DC Coalition on Long Term Care sent the survey to all DC licensed home health agencies, all DC licensed home support agencies, all DC licensed assisted living facilities, all DC Medicaid certified adult day health providers, and all members of the DC Coalition of Disability Service Providers. Twenty-nine providers responded for a response rate of 41%. Fifty-five percent of respondents are Home Care or Home Support Agencies; 38% are Developmental Disability (DD) providers.
Key findings include:
- Across all respondents, the workforce shortage has gotten worse or much worse.
- Staff shortages are increasing costs and are already reducing access to care.
- 100% of home care agency respondents and half of DD providers have limited admissions.
- If workforce challenges persist, 90% of respondents report that they will have to stop accepting new clients; over 80% report they will have to establish a waiting list.
- Respondents are paying more for staffing including bonus payments, increased overtime, and increased reliance on staffing agencies. They are also implementing other strategies such as paying for training and education, offering gift cards, promoting staff, and addressing workplace culture. Yet for the majority of respondents, these strategies have not worked to increase recruitment or reduce turnover.
- Lack of funding to pay competitive wages and lack of qualified candidates are the two biggest obstacles to recruitment and retention of staff.
- Lack of funding is disproportionately impacting Home Care, Adult Day Health, and DD Providers, who have the greatest reliance on Medicaid as a payor source.
- Regulatory barriers were cited as obstacles by nearly two-thirds of respondents.
According to the District’s WIOA State Plan, DC will need over 3,000 new home health aides and nursing assistants every year from 2022 to 2028, making these entry-level health sector positions the highest demand and highest need among all health sector jobs.[1]
“We are encouraged that Mayor Bowser has appointed a Health Care Workforce Task Force to address workforce issues broadly across the health sector. But as our survey shows, the current crisis, coupled with the projected future need for workers, underscores the importance of giving priority attention to this sector and these essential jobs,” notes Claudia Schlosberg, Chair of the Coalitions Subcommittee on Workforce Development.
The Long Term Care Coalition has developed a set of recommendations (see below) to provide immediate, short-term relief and to address underlying structural issues that contribute to regulatory barriers and a lack of workers interested in these jobs. Judith Levy, Convenor of the Coalition on Long Term Care, shares, “We are looking forward to presenting our findings to the Task Force and to working with the Council to make needed changes to elevate the quality of direct care worker jobs to ensure that seniors and people with disabilities continue to have access to essential care and support.”
For more information:
Contact:
Judith Levy
DC Long Term Care Coalition
202-895-9435
Claudia Schlosberg, Chair
Workforce Development Subcommittee
DC Coalition for Long Term Care
202-486-0822
[1] https://dcworks.dc.gov/sites/default/files/dc/sites/dcworks/publication/attachments/District_of_Columbia_WIOA%20State%20Plan%20Final%202-28-2022.pdf (Table 7).
###