# NCI State of the Workforce - Aging and Disabilities: Results and Implications for Policy & Practice

## TL;DR

The US faces a critical shortage of direct service workers for aging and disabilities due to low wages, poor benefits, and high turnover.

## Contribution

This study provides new empirical data on workforce challenges in aging and disabilities services across six US states.

## Key findings

- The average turnover ratio among agencies is 48%, with many unable to accept referrals due to staffing shortages.
- Median hourly wages are significantly below the living wage in most states, contributing to high turnover.
- Fewer than half of agencies offer paid time off, health insurance, or retirement plans to direct service workers.

## Abstract

There are approximately 5 million direct service workers (DSWs) providing supports to older adults and people with disabilities in the US. While this number seems high, the demand for DSWs often outstrips the supply; combined with high levels of turnover at direct care provider agencies, the workforce crisis is intensifying and has a substantial impact on the quality of supports. This presentation will showcase key findings from the National Core Indicators (NCI) State of the Workforce Aging and Disabilities 2023 survey of more than 1,200 provider agencies in 6 states. Altogether, these provider agencies employ more than 1.4 million DSWs. Among the states that participated, the average turnover ratio was 48%, with 1 out of ever 3 agencies reporting that they turned away or stopped accepting referrals due to staffing issues. The median hourly wage across states was $16.00 per hour, and 99% of agencies pay a median hourly wage that is more than $0.50 below living wage in their state. Finally, just 55% of agencies offered paid time off to DSWs, 41% offered health insurance, and 38% offered an employer-sponsored retirement plan. The low wages and limited benefits offered to DSWs are likely contributors to the high rates of turnover. These data highlight the unsustainable working conditions for many DSWs, and point to tangible quality improvement opportunities for state and service providers.

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Source: https://tomesphere.com/paper/PMC12763337