Due to rising demand and stagnant wages, there is a pronounced shortage of direct support professionals. Acute shortages of home health aides, direct support professionals and other personal care staff are appearing across the country. The lack of workers is threatening the quality of care for individuals with disabilities as well as vulnerable senior citizens. Across the United States, some assisted living facilities have been forced to deny admission to patients due to a lack of direct support staff. This shortage of DSPs is especially challenging for individuals with disabilities and senior citizens who live in rural areas.
For example, in the state of Ohio, 10% to 20% of DSP staffing positions are vacant. Out of the direct support workers who are employed, the turnover rate hovers around 50%. In the neighboring state of Michigan, it is predicted that by 2020, an estimated 196,000 personal care aides will be needed, with the shortage ranging between 20,000 and 30,000 direct care workers.
Agencies and organizations in Illinois have experienced staffing shortages of up to 30 percent, according to a court monitor overseeing a federal consent decree. In neighboring Wisconsin, data shows that roughly 14% of caregiving positions in Wisconsin nursing homes and group homes remained unfilled. Some surveys show that 70% of administrators reported a lack of qualified job applicants. As a result, 18 percent of long-term facilities in Wisconsin have had to limit admissions, declining care for more than 5,300 vulnerable residents.
Why is there a shortage?
Much of the DSP staffing shortage is due to the fact the industry suffers from low wages. Wages vary across the United States, but the range from $10 to $11 an hour is mainly funded by state Medicaid Programs. After the recession of 2008-09, positions in Medicaid-funded home health agencies, nursing homes and community service agencies were relatively easy to fill for several years. But the improving economy has led workers to pursue other higher-paying and less stressful alternatives like retail services.
Competition from other industries has pulled workers away from the direct support profession. The fact remains that being a DSP is very physically and emotionally demanding work. Unless wages are increased, it is unlikely that the industry will be able to remedy the current labor shortage. According to reports from the National Alliance for Direct Support Professionals (NADSP) :
- Average DSP wages of $10.72 per hour.
- Half of DSPs relying on government-funded and means-tested benefits.
- Most DSPs working two or three jobs.
- Average annual DSP turnover rates of 45 percent (range 18–76 percent).
- Average vacancy rates of more than 9 percent.
This staffing shortage is even more challenging due to the fact that for many direct support professionals, the job is seen as a temporary position. In the industry, there is an unspoken expectation that DSPs will leave at some point.
These trendlines will likely only become worse as the nation’s senior citizen population expands from 48 million to 88 million people by 2050. This population has always required more direct care and medical assistance due to the higher rate of chronic health conditions and disabilities in this population. For many years, industry experts have predicted that the demand for services from a rapidly aging population would outstrip the capacity of the direct care and direct support professional (DSP) workforce. This includes job titles like personal care aides, home health aides and nursing assistants.
As of July 2018, the employment of home health aides and personal care aides is projected to grow 41 percent from 2016 to 2026, much faster than the average for all occupations. As the baby-boom population ages and the elderly population grows, the demand for the services of home health aides and personal care aides will continue to increase. As a point of reference, as of May 2017, the median annual wage for home health aides was $23,210, the median annual wage for personal care aides was $23,100. However, for the same time period, the median pay for retail workers was $23,370 per year which was roughly $11.24 per hour.
Organizations have tried to raise awareness for DSPs and their importance through initiatives such as promoting Direct Support Professional Recognition Week. But this is only a small step in the series of steps that need to be taken. This is only one of the challenges that the direct care industry is facing.
Solutions to the DSP labor shortage problem:
- Provide a realistic living wage and benefits.
- Offer better job training and oversight for DSPs.
- Create a career advancement opportunities for DSPs.
- Improve the professional identity and recognition status of the DSP position.
EWebSchedule delivers workforce management tools and services are uniquely designed for human service agencies with direct support professionals. Our custom-built software application was created specifically for the unique billing and scheduling needs of HCBS Medicaid Waiver providers. Whether your agency offers adult-day array, non-medical transport, ICF/DD (group homes), supported living or institutional respite – we can help. Contact us today.
Follow us on Twitter: @eWebSchedule
Direct Support Professionals, Staffing Shortage,