States may have the solutions to the caregiver shortage, according to a new report by PHI. The nonprofit outlined several initiatives roughly a dozen states have adopted to attract and keep direct care workers.
The initiatives include strengthening Medicaid, reforming long-term care financing, improving data collection and monitoring, strengthening training standards and rectifying race and gender barriers.
“By implementing a tailored combination of these strategies, state leaders will make critical progress toward resolving the direct care workforce crisis in their own states — now and for the future,” the report said.
PHI singled out North Carolina as a state that has bolstered home- and community-based services by strengthening its Medicaid program through American Rescue Act Funding. The state is raising caregiver wages and creating additional slots to its Medicaid waiver program to reduce the wait time for caregivers.
There are other states taking effective approaches. Washington was the first state in the nation to create a social insurance program to help finance long-term care for residents. Starting in 2025, the WA Cares Fund will provide a daily $100 benefit to eligible beneficiaries.
New York has established a Medicaid Managed Long Term Care Workforce Investment program to help provide training to workers in long-term care. Tennessee has adopted a similar program, which awards badges to workers who finish various levels of training. 213
Finally, Texas has created a system that requires long-term care providers to submit data on the size, stability and compensation of direct care workers through mandatory cost reports.
PHI estimates there are approximately 4.5 million direct care workers in the U.S., with more than half working in the home care industry. The nonprofit also estimates that the direct care industry will need an additional 7.4 million workers by the end of the decade.
Although the pandemic has exacerbated the caregiver crisis, PHI said the crisis has “deep roots and a long history” in the U.S.
