The Common Council unanimously voted last week to authorize the development of a comprehensive response to the crisis in home health care in Madison.
The Common Council directed the Disability Rights Commission to develop a plan to submit to the council by Oct. 1 detailing steps the city should take to improve access to home healthcare for older residents and people with disabilities.
This legislation was championed by District 12 Ald. Barbara Vedder, who stepped into the Common Council as interim alder in January 2023 to fill the vacancy left by former Ald. Syed Abbas after his resignation in November 2022.
The issue personally impacts Vedder, who herself has quadriplegia. She said she struggled with trying to find long-term home-based health care, even after working with various agencies for several months.
“There’s a void. A total lack of people who are working in home health care when people try to find folks to help them,” Vedder said. “There’s no new staff available to send out.”
A survey by the Caregiver Crisis Coalition (CCC) of Wisconsin found over 18,000 people in Wisconsin sought services from a long-term care provider in 2022, but were denied or delayed service due to staff shortages. With a growing aging population, Madison’s need for direct care workers will only continue to grow.
The Wisconsin Department of Health Services (DHS) reported one in four direct caregiver positions were vacant as of 2020, and the state of Wisconsin is expected to need 20,000 more home care workers by 2024.
Part of the reason for this caregiver shortage is the low wages they receive, according to the Disability Rights Commission. Direct care workers make an average of $13.53 per hour, lower than the City of Madison’s living wage rate of $14.68.
As a result, many direct care workers have not been making the necessary rate to support themselves and their families. The lack of funding puts a strain on the current limited workforce, as well as provider agencies who cannot meet the increased demand for their services.
When unable to find adequate home care providers, loved ones end up having to fill this role. Patti Becker, chair of the Wisconsin Long-Term Care Workforce Alliance and co-chair of the Survival Coalition of Wisconsin Disability Organizations, said she has long been concerned about the caregiver crisis and its impact on families, citing a Survival Coalition survey that found 80% of paid and unpaid care is provided by a family member.
“The system capacity to support people as they age, as well as those living with disabilities throughout their life is not adequate to meet the needs of the people of Wisconsin,” Becker explained.
However, half of the families surveyed by the CCC reported their current situation is unsustainable. Many families reported feeling overworked, and some said the lack of outside help forced them to give up their full-time jobs in order to stay at home and care for loved ones.
“There’s layers to the loss of Wisconsin’s workforce at a time when we have shortages, which is a drain on communities and businesses trying to function in those communities,” said Becker.
The other option for older adults and people with disabilities is to live in institutional care — hospitals, nursing homes or assisted living facilities. However, Vedder and Becker argued this is a last resort option for many who would prefer to stay at home.
“People are being forced to move into nursing homes, into living facilities, into hospitals to live — because they can’t find help,” said Vedder. “That is a problem for people with disabilities and people who are older, not being able to find the help to get us up for the day and go to bed at night, and be productive members of the community.”
“This workforce crisis is infringing upon the rights of Madisonians to live like their neighbors,” added Becker.
The Common Council will continue working on developing this response, which Vedder said she hopes includes working with various members of the community and spreading awareness of the widespread nature of this issue.
“We need to connect with people all over in the community, to let them know about this big, huge, serious issue and how it affects so many people,” Vedder said. “There needs to be a huge recruiting effort all around the community.”
Becker said the work done to address the caregiver crisis will also have a universal impact on other issues and communities, especially in their efforts to alleviate the problems current caregivers are facing and look for more people to join the direct caregiver industry.
“I’m hopeful that the city will respond by looking at, ‘What are the best services that the city offers to everyone that can help the workforce?’” said Becker. “What are we doing about public transportation? What are we doing about affordable housing?”