Nursing home and other direct care workers are in trouble. This could help them out | Opinion
Direct care workers are the unsung heroes of our healthcare system. These are the compassionate individuals who provide care for the elderly and people with disabilities. They are the ones who go into the homes of others and assist with everything from transportation to chores to basic care.
But this essential work is in crisis because of the inadequate reimbursement that directly affects their rates.
Direct care workers don’t set their own rates. Agencies like Milestone Decisions, where I’ve worked for 22 years, operate under the constraints of Medicaid funding — as do any long-term care facilities or services. And Medicaid-dependent agencies work off rates set by our state legislators.
We’ve embraced the challenge of getting creative, running a sustainable business while offering reasonable compensation to invaluable employees with limited, state-dictated budgets. But our dedication to providing quality care comes at a cost — the cost of housing, utilities, and numerous other expenses that remain unreimbursed. We’ve chosen not to compromise on the well-being of our clients, even when it means going without compensation. But that model is not sustainable.
Direct care workers undertake responsibilities far beyond conventional healthcare roles — they are mentors, life coaches, and community builders, striving to empower those they serve to become active participants in society. Their job goes beyond administering medications and basic health and safety; these workers are enriching lives, fostering independence, and helping people with disabilities stay involved in our communities.
Yet, the reality for these caregivers is depressing. The average hourly wage for direct care workers in our organization hovers around $15.50 to $16.50 — an amount that fails to take into consideration just how much these people do. When you consider that the statewide average for this work sits between $13 to $14 per hour, they may as well go work at McDonald’s. At least there they get a free meal out of the bargain.
The challenges faced by direct care workers get worse when you consider the high demand for their services. In our facilities alone, we require around 100 staff members to provide care services for 37 clients. If one of those clients needs service around-the-clock care, that one client requires the work of three eight-hour shifts each day, seven days a week, 365 days a year.
Burnout is constant when these caregivers provide continuous, high-quality care without the luxury of a day off, sick leave, or personal time.
When the pandemic came to Idaho, determined care workers stepped up, doubling shifts, staying overnight with patients to ensure that no one was left alone during this time of need. This situation showed the unsustainable nature of the current system. Crisis staffing models became a necessity, showcasing the fragility of a system on the brink.
Direct care workers bridge the gap between vulnerability and independence, creating opportunities for individuals with disabilities to thrive. However, the lack of sustainable funding that changes as the world does — with inflation and time — jeopardizes not only the well-being of these caregivers but the very essence of the care they provide.
Something has to change. Idaho’s legislators must recognize the urgency of the situation. It’s not just about higher rates; it’s about acknowledging the fundamental value of direct care workers and the vital role they play in our communities. Legislators have the power to change the narrative, to set rates that reflect the true worth of these caregivers, and to ensure that agencies like Milestone can continue to provide exceptional care without compromising the dignity and livelihoods of those who dedicate their lives to this noble profession.
As we navigate this crisis, I extend an open invitation to legislators, decision-makers and community members to witness firsthand the incredible work being done by direct care workers. Step into our agencies or the homes of the seniors and people with disabilities who we serve. Meet our staff. See for yourself the profound influence they have on the lives of those they serve. Let this be a call to action, a plea for change, and a collective commitment to fostering a healthcare system that truly values the heart and soul of caregiving.
Our direct care workers deserve more than our gratitude — they deserve fair compensation, respect, and the assurance that their contributions to society are not only recognized but adequately rewarded. Let us come together to safeguard the well-being of those who selflessly serve people with disabilities and seniors in their homes to keep them working and participating in their community.