By Ruth Brown, Idaho Reports  

After a late start this session, the Joint Legislative Oversight Committee met Thursday, allowing the publication of a long-awaited report regarding the state’s direct care services workforce. 

The Office of Performance Evaluations drafted the report at the committee’s request last year. Direct care workers are responsible for helping people who need care in the home, such as elderly disabled people or people with developmental disabilities.  

OPE found there are roughly 33,000 people in Idaho who rely on the direct care workforce, and only 23,000 workers to help with personal care, nursing, transportation and other daily tasks.  

The report found the state needs an estimated 3,000 more direct care workers. The shortage is worse in North Idaho in counties that border Washington and Oregon, where wages are higher for the same jobs. Disabled people who are reliant on Medicaid are also facing disproportionate shortages.  

The number of employees working in direct care fell sharply in mid-2021. Because that wasn’t the start of the COVID-19 pandemic, OPE evaluator Sasha O’Connell told the committee that shortage aligns with the hypothesis that that’s when other employers started increasing their wages. 

The data showed in the second half of 2021, there were 2,642 fewer direct care employees. 

Because of the workforce shortage, the surveyed businesses said they kept low-performing employees longer, hired employees with fewer qualifications, declined to accept new clients and had waitlists for services.  

The report focused on Idaho’s Medicaid rates, which do not support competitive wages for most direct care services. The Division Medicaid sets the rate every five years, according to administrative rule. 

OPE recommended the Legislature consider requiring the Division of Medicaid to include more information on inflation costs in its budget request. The Legislature could also consider allowing the division to set region-specific reimbursement rates, OPE suggested. 

Other recommendations included expanding existing efforts to make training available for direct care workers or creating a career ladder. Of the direct care workers polled, seven in 10 workers said their employer did not offer a retirement plan, and six in 10 reported they did not qualify for health insurance, even if it was offered. About 18% of direct care workers had health coverage through Medicaid expansion. Workers surveyed reported an average wage of $14 an hour. Most workers reported they would stay in their job if that wage increased to $19 an hour. 

Because OPE reports are intended to be educational, JLOC did not take further action regarding the report Thursday. 

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