A growing crisis in the caregiving industry

Right before the COVID-19 pandemic, Sid Eder and his wife, Renee, put an advertisement on Craigslist and the university job boards looking for some additional help in caring for their adult daughter, Lara.

Lara, 53, is in a wheelchair and has spastic cerebral palsy, which requires advanced care in some cases.

The Eders, who live outside Moscow, waited weeks and received no responses to the call for help. They added an advertisement on Indeed, an online job board. Many of those who responded either weren’t qualified for the job or refused to get vaccinated for COVID-19. For the Eders, catching COVID-19 could be fatal, Sid said, as both Sid and his wife are in their 80s.

“And we hoped it would yield something over about a five-month period,” Sid said. “It yielded absolutely nothing, which puzzled us. In the past … we would post a job announcement and within a week we would get eight, nine, maybe even 15 responses — but this time, nothing.”

Last month, the Eders placed a full-page advertisement with Lara’s picture in Inland360 magazine, outlining Lara’s needs and the requirements expected of the caregiver.

Since then, a previous care provider returned to the job and the Eders no longer have to care for Lara alone, though they are still looking for additional support.

The lack of care providers in the region isn’t specific to the Eders. It is affecting many people looking for help caring for elderly or disabled relatives locally and across the U.S.

Fears of contracting COVID-19 at work in the pandemic have made the caregiver staffing problem tougher than ever, according to a Kaiser Health News report from September. Persistent low pay amid a tight U.S. labor market makes it that much harder to attract workers.

According to the report, worker shortages across the health care spectrum — from nurses to lower-level staffers — are an unprecedented challenge for hospitals and other medical organizations. The shortage is at an “epic level,” said Elizabeth Priaulx, a legal specialist with the National Disability Rights Network.

“We’re actually on the cusp, I think, of a really major crisis to be quite honest in terms of people living in their homes and getting the support they need,” said Mark Leeper, executive director of the Disability Action Center NW, a nonprofit based in Moscow. “It’s not just that, but actually in terms of direct care services, even in facilities.”

Leeper said Disability Action Center NW has a two-pronged approach to working in the community. It provides services for people with disabilities on a peer-to-peer basis and works with communities to better serve those with disabilities with things like affordable housing, transportation or assistance with compliance with the Americans with Disabilities Act.

Leeper said finding someone to provide care for a family member is difficult as families like the Eders often are competing with the rising wages at service industry jobs like McDonald’s or Amazon.

In the Kaiser report, Diane Wilush, CEO of the Atlanta-based United Cerebral Palsy of Georgia, said her organization has more than 100 vacancies among 358 jobs in 24/7 residential programs. Many day programs, including those run by her group, have been unable to offer full services because of staffing gaps.

“We can’t compete with every retail shop paying $15 to $18 an hour,” Wilush said.

Local agencies who provide in-home care providers have had to release clients from their care when they can’t find staff to help them.

“For those that do have a place, and have been receiving services in the community, the crisis really is in reimbursement rates,” Leeper said. “Idaho is far below what surrounding states are in terms of reimbursements.”

Leeper said Idaho pays agencies about $17 an hour in reimbursement, but an individual care provider may only see $10 to $11 of that. The rest goes toward the agency training, hiring and other costs they have before staffing. From what Leeper has seen, many staff reimbursement rates come in around $9 to $11 an hour.

“So it’s a real crisis. And part of it, I think, is certainly pandemic related,” Leeper said.

Disability Action Center NW will work with individuals who are looking for care providers as much as they can, but even they are having trouble finding staff.

“We used to keep a registry of people wanting work and that would be available,” Leeper said. “People could get that registry and choose somebody. … At this point, of course, there is no registry because there’s no waiting pool of workers.”

Despite the challenges, Disability Action Center NW has been working toward helping people with disabilities who are experiencing problems with getting a COVID-19 vaccine by having vaccine clinics. They are also providing bonuses and hazard pay through CARES Act funding.

“It’s definitely a challenge and I think it’s something that we as a state — we as a country — have to deal with because folks want to age in place,” Leeper said. “And if they don’t, then the option is a much more expensive institutional place. That’s not where we think everybody wants to go.”

Nelson can be reached at knelson@dnews.com.