Direct Support Workers: An Essential Workforce Surviving on Poverty Wages

they want to keep the worker…. people keep, have kept, workers that they really didn’t want to keep because they couldn’t find anybody else. That’s still a problem today.” Consumers too often find themselves in a position where they have to make a difficult decision between accepting a lower quality of care or having no care, often compromising safety in order to remain at home.

Investment in the Direct Support Workforce for Home and Community Based Services is Desperately Needed NOW.

Low wages for the direct care workforce makes it difficult to complete for skilled, high-quality workers, results in unmet care needs that increase the risk of adverse health outcomes and institutionalization and increase worker dependency on public aid. Increased wages and improved benefits are a necessity for addressing this workforce shortage and to attract the high-quality workers needed to keep older adults and individuals with disabilities in their homes, during the pandemic and beyond. The Biden Administration proposed $400 Billion toward addressing these unmet needs in their 2022 budget. As Congress completes budget negotiations, this level of investment towards the wages and benefits is an imperative.

Advocates recognize that the system itself is in desperate need of innovation, beyond the critical investment of more money. The Better Care Better Jobs Act, H.R. 4131/S.2210 would move this issue beyond trying to catch up to the immediate demands of the system, and support states’ development of programs, approaches, and innovations to meet the critical care need, better support workers, and keep aging and disabled people safe and in their own homes.


Funding acknowledgement: This study was funded under grant #1R01HS028172-01 from the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services (HHS). The authors are solely responsible for this document’s contents, findings, and conclusions, which do not necessarily represent the views of AHRQ. Readers should not interpret any statement in this report as an official position of AHRQ or of HHS.

H.R. 4131/S.2210 )

Scales, Kezia. 2020. It’s Time to Care: A Detailed Profile of America’s Direct Care

Workforce. New York: PHI.

Recommended citation: Wendel-Hummell, C & A. Hyten. (2021). Direct Support Workers: An Essential

Workforce Surviving on Poverty Wages. Kansas: KU Center for Research on Aging and Disability Option &

Topeka Independent Living Resource Center.

For more information on this study, contact Dr. Carrie Wendel-Hummell at 785-864-3797 or

For information about the Better Care, Better Jobs Act (H.R. 4131/S. 2210) and the proposed Biden Administration investment in Home and Community Based Services, contact Ami Hyten at 785-233-4572 or