"Why is there concern about the direct service workforce?"
Two demographic trends could combine to create a severe shortage of direct service workers in the coming years: the increasing number of people who need long-term services and supports and the decreasing number of workers available to provide these services.
Driven by the aging of the “Baby Boom” generation, the demand for long term services and supports in the aging population will grow much faster than the supply of caregivers, either paid or unpaid. While not everyone age 65 years and older needs long term care services, the number of older people who do need assistance will nearly double between 2000 and 2040. At the same time, divorce rates, smaller family size, and the way families are spread out across the country will result in a larger number of older people with no access to family support.
In addition to older Americans, millions of individuals below the age of 65 have some type of permanent or long lasting disability. The fact that most individuals with disabilities prefer to live in the community, rather than in nursing facilities and institutions, and the Supreme Court’s Olmstead decision, which requires states to offer the option of community-based services make it likely that the demand for long-term services and supports will increase in the disability community as well as in the aging community.
These two trends will drive an increasing demand for direct service workers. The Bureau of Labor Statistics projects demand for health care support to grow 33.3 percent between 2004 and 2014, faster than any other sector of labor force demand. To meet this demand, the direct service industry will be competing for available workers with other industries that offer better wages, better benefits and better working conditions. At the same time, the the overall labor supply is growing much more slowly than demand.It will require the commitment of government agencies and private employers to improve the recruitment and retention of direct service workers.