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Long-Term Care Division learns of workforce shortage

Minnesota will need more caregivers in order to support its aging population, but it’s difficult to recruit and retain direct support professionals – including personal care assistants – to serve people who are elderly or have a disability.

The problem isn’t limited to any one region, but has impacted communities across the state, Alex Bartolic, director of the Disability Services Division at the Department of Human Services, told the House Long-Term Care Division Monday.

In Minnesota, the number of empty direct support professional jobs started to increase dramatically around 2010, reaching a 20-year high in 2017 that is expected to continue or worsen, with thousands of more direct support professionals needed in the coming years, said Kari Benson, DHS director of the Aging and Adult Services Division.

“Some of it is just plain demographics” as Baby Boomers age and fewer people enter the workforce, Bartolic said.

But direct support professionals also earn less than people in jobs that have similar requirements when it comes to both education and work experience.

House Long-Term Care Division 1/14/19

According to Bureau of Labor Statistics, the hourly mean wage for personal care aides in Minnesota is about $11.83, and $12.69 for home health aides. In contrast, the hourly mean wage for bus drivers is $15.97, $17 for office clerks, and $18.51 for customer service representatives.

[WATCH: Full video of Monday's House Long-Term Care Division meeting]

Nationally, about 45 percent of direct support professionals live in households below 200 percent of the federal poverty level and in 2015, more than half relied on some sort of public assistance, according to the presentation.

Low pay remains a factor in high turnover rates for direct support professionals: 38.8 percent over a 12-month period, according to an interim DHS survey.

In 2018, the Cross-Agency Direct Care and Support Workforce Shortage Working Group recommended increased wages and/or benefits as the top way to improve recruitment, job satisfaction, and retention, Bartolic said.

Direct support professionals are key in providing long-term services and supports as the focus of care continues to shift from institutions – like nursing homes – to programs that help people who are elderly have a disability remain in their homes and involved in their communities. This “home and community-based” approach is more cost-efficient than, and preferred to, institutional alternatives, Benson said.

There is no single, easy solution to workforce shortages and addressing the issue will require collaboration between many groups, but the Legislature can make a difference through both policy and fiscal measures, Bartolic said.

DHS contracted with the University of Minnesota to conduct a one-time voluntary workforce survey in 2018 that should be released this winter, but would like the authority and resources to gather additional data to better track the issue and the effectiveness of solutions, Bartolic and Benson said.

These solutions could include the establishment of a rate-setting methodology for Personal Care Attendant services, fully implementing other rate-setting methods for Elderly Wavier services, and initiatives to raise wages for people providing Home and Community-Based Services, they said.

Division Chair Rep. Jennifer Schultz (DFL-Duluth) expressed her hope that the subcommittee will be able to find bipartisan solutions to the issues coming before them over the course of this session.

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