This disturbing report exposes the state’s failure to adequately fund a sustainable direct care workforce that many Idahoans (children, adults, the disabled) are dependent upon for assistance with essential, daily tasks. This includes personal care (eating, bathing, etc.), nursing (wound care, health monitoring), home maintenance, counseling, transportation, physical therapy, dietary support, and many other services. Notable facts Conclusion: Idaho has a shortage of direct care workers that is worse than the national average because pay is capped by how the state manages Medicaid rates.
- 33,000 Idahoans rely on a direct care workforce.
- There is a shortage of 3,000 direct care workers needed to meet today’s needs. This shortage is projected to grow to over 9,500 workers by 2032. The shortage is most acute in North Idaho.
- A typical nursing assistant in Idaho is paid an average of $14.16/hour. Other direct care workers are only paid an average of $11.49/hour. Over 75% of these workers say that higher pay would keep them from leaving their job. I emphasized this concern during discussion in committee (click here).
- 80% of direct care workers reported that they did not receive paid sick leave. This can put people at risk if a sick worker shows up to avoid missing a day’s pay. 60% did not receive benefits such as paid personal or vacation days. Most receive no health insurance or retirement benefits.
- Direct care workers have the knowledge, skills and ability to get a 36-39% raise by seeking employment elsewhere.
Report recommendations
- The Division of Medicaid in the Department of Health & Welfare (DHW) should set competitive wage targets via comparison with similar occupations, and factor inflation into budget requests.
- Rates should be adjusted more frequently (the last wage survey was conducted in 2018). Region-specific rates could better account for different market drivers across the state.
- DHW should make training more accessible and develop a career ladder for direct care workers.
- Management capacity in the Division of Medicaid should be increased.
Personal observations This report is subject to the same observations for the previous report: hesitancy to request the necessary funding, failure to consider the consequential costs of not adequately funding vital services, and political resistance to spend tax dollars that benefit a small group of people relative to the larger population. Inmates were the “small group” impacted in the first report; here it is those who need direct, personal care and services. I reflected on this during committee discussion (click here). Note: Two new OPE reports were released to the public since the two reports above were reviewed at the September 22 JLOC meeting:
I will discuss these reports in a subsequent newsletter after they are formally reviewed at the next JLOC meeting.
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