NCI report shows aging and disability direct care workforce strain eases slightly

By AI, Created 10:15 AM UTC, May 20, 2026, /AGP/ – A new national report from Human Services Research Institute and ADvancing States finds persistent low wages, high turnover and limited benefits for direct service workers supporting older adults and people with disabilities. The 2024 data also show fewer agencies turning away referrals because of staffing shortages, suggesting targeted workforce strategies are starting to help.

Why it matters: - State aging and disability systems depend on direct service workers to keep home- and community-based services available. - The report shows the workforce remains underpaid and unstable, which can limit access to care for older adults and people with disabilities. - The findings give states evidence they can use in Medicaid funding decisions and workforce policy changes.

What happened: - Human Services Research Institute and ADvancing States released the National Core Indicators® State of the Workforce for Aging and Disability 2024 report. - The study is the only state-comparative report focused on provider agencies and the Direct Service Worker workforce in state aging and disability service systems. - Researchers collected data from 966 provider agencies representing 100,631 Direct Service Workers. - The seven participating states were Illinois, Indiana, Missouri, Nebraska, New Hampshire, North Dakota and Oklahoma. - The report was released April 28, 2026.

The details: - The median hourly wage for Direct Service Workers was $16.00, unchanged from 2023. - No participating state reported median wages above a living wage for a single adult. - The weighted average turnover rate was 45%. - Among workers who left in 2024, 70% had been employed for less than one year. - Fewer than half of agencies offered paid time off, at 49%. - Just 37% of agencies provided health insurance. - Those benefit rates trail 2024 IDD provider agency results, where 70% offered paid time off and 57% offered health insurance to Direct Support Professionals. - The report also tracks workforce strategies now in use, including apprenticeships, training and credentialing, realistic job previews and financial incentives. - The report and a 2024 data-at-a-glance summary are available through NCI Aging and Disabilities materials.

Between the lines: - The data suggest the field is still relying on low-wage jobs that do not provide financial security. - The drop in agencies turning away or stopping new referrals points to some improvement when states invest in recruitment and retention. - In 2024, 18% of agencies reported turning away or stopping new service referrals because of staffing shortages, down from 29% in 2023. - Every state that participated in both 2023 and 2024 showed improvement in service access. - That pattern suggests workforce investments can improve availability even if core compensation problems remain unresolved.

What’s next: - States, providers and advocates are likely to use the findings to press for higher Medicaid funding and broader workforce reforms. - The report frames ongoing recruitment and retention strategies as tools to expand access to services for older adults and people with disabilities. - HSRI and ADvancing States say credible, comparable data can help states make the case for those investments.

The bottom line: - The direct service workforce remains stressed, but the latest data show that targeted state action can improve access even before pay and benefits catch up.