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Sarah lifting Karen

Personal care worker Sarah Rosenthal lifts Karen Foxgrover, who has spinal muscular atrophy, out of her chair to use the bathroom at Foxgrover's apartment in Downtown Madison in February, as trainee Morgan Miller observes.

Wisconsin, which has 39,000 home care workers, will need nearly 20,000 more by 2024 because of the state’s aging population, according to a new national report.

But finding the workers will be a challenge because low wages and difficult work conditions already make it hard to fill open positions, said the report, issued last week by PHI, a national research firm in New York.

“Without improvements to the quality of home care jobs, the state faces serious gaps in the workforce and risks leaving older adults without the supports they need,” the report said.

The findings echo the State Journal’s series this month, “Workers Wanted: Wisconsin’s Looming Crisis,” as well as concerns that personal-care and assisted-living groups have expressed about workforce problems.

The challenge to find home care workers — who assist older adults and people with disabilities with bathing, dressing, eating, toileting and other daily tasks — is becoming especially acute in rural communities, the PHI report said.

The population of women ages 20 to 64, who comprise most of the home care workforce, will drop by 9 percent in rural parts of the state by 2040. The starting hourly wage for home care workers is $8.60 in rural areas, compared to $9.61 in urban areas.

The median wage for the job statewide is $10.47 an hour. With three-fourths of the workers working part-time, the median annual income is $12,600, and nearly a quarter of the workers are living below the federal poverty level.

With inadequate training, poor supervision and few advancement opportunities, the annual turnover rate is more than 50 percent, the PHI report said.

Wisconsin is also experiencing a workforce “crisis” at assisted- living facilities and nursing homes, according to a report last year from the state’s four associations that represent providers of both kinds of care.

One in seven caregiver positions is unfilled, often because there are no qualified applicants for the jobs, the report said. Workers can get similar or better pay at retail or fast-food outlets.

The Wisconsin Personal Services Association, which includes home care, asked for a 15 percent increase in Medicaid reimbursement for personal care workers in the 2017-19 state budget, saying the last increase was in 2008 and costs have continued to increase.

Gov. Scott Walker and the Legislature approved a 4 percent increase, from $16.08 an hour to $16.72 an hour.

After billing, scheduling, health insurance, worker’s compensation insurance and other expenses are factored in, personal-care workers make about $10.75 an hour, the personal services association says.

Darci Knapp, president of the association, renewed her plea for higher reimbursement last month, after the state ended a $16 million contract meant to curb Medicaid personal care fraud two months after the oversight began. The state, which had spent nearly $4 million, said the risk of fraud had been reduced.

Knapp said the state should use the remaining $12 million to boost worker wages. Walker and the Legislature maintained the 4 percent raise.

“Wisconsin must take action now to address the direct care workforce crisis so that it can continue to keep its community promise,” Knapp said.

“Wisconsin has long been a national leader in supporting people with disabilities and older adults in the community instead of institutions, but the workforce crisis threatens to undo this progress.”


David Wahlberg is the health and medicine reporter for the Wisconsin State Journal.