To ensure the Maryland Regional Direct Services Collaborative has a comprehensive understanding of both the demographics and the issues affecting the older adults and persons with disabilities communities, the Board of Directors took the leadership to conduct a regional Environmental Scan.
The 2018 study conducted by PHI National of New York highlighted the following:
The population in the Maryland and D.C is rapidly growing older, which is driving up demand for long-term services and supports.
From 2014 to 2024, Maryland will need nearly 40% more direct services workers and D.C. will need 35% more workers to meet growing LTSS needs.
The majority of direct services workers in the region are women (88%) and people of color (88%) and 32% were born outside the U.S. The demographic profile of the workforce varies significantly across the region, particularly between rural and urban areas.
Direct services workers in Maryland earn a median hourly wage of $13.03 and median annual income of $22,700, while those in D.C. earn $14.15 per hour and $23,700 per year.
Earnings vary from $14,600 for some workers on the Eastern Shore to nearly $28,000 in D.C.
Nearly 1 in 5 direct services workers in D.C. and more than 1 in 10 in Maryland live in poverty. Sixty-three percent of workers in D.C. and 43% in Maryland rely on some form of public assistance.
Nearly 50% of the direct services workforce have not completed formal education beyond high school, though educational attainment rates range from about 40% to nearly 60% across the region.
At least 1 in 10 direct services workers in Maryland (16%) and D.C. (10%) lack health insurance. In some parts of the region, more than a third of the workforce with health insurance relies on Medicaid, Medicare, or another form of public coverage.
Transportation needs vary across the region: most workers in Maryland rely on private cars to get to work (72%), while nearly half of workers in D.C. (46%) use public transportation.
As the Collaborative assumed a regional role in addressing the issues confronting the direct services workforce, the Board of Directors drew upon the considerable reservoir of volunteers who had expressed interest in working together to bring about positive change. From this body of support, three working groups of “taskforces” were established with the charge to lay out an action plan framework for change.
Issue briefs were prepared covering each of three core issues. Initial attention focused on the matter of wages and benefits calling for improvements that would….”attract workers and adequately address workforce vacancies and shortages, reduce turnover, and allow direct service workers to earn living wages”. An outcome of this priority resulted in the introduction of a legislative proposal in January 2020 co-sponsored by Dr. Terri Hill of the Maryland House of Delegates. The proposal called for the Maryland Department of Health to institute changes to positively affect personal care aides employed by residential services agencies.
The following year at a meeting that invited legislators and other key leaders throughout the region, Senator Guy Guzzone, Maryland Senate Majority Leader and Chair of the Senate Budget Committee, introduced the “Direct Care Workforce Innovation Program”. The bill provides annual grant support to enable community based organizations to build and expand on innovative recruitment and retention strategies. While action was completed during the shortened session of the General Assembly, the bill was reintroduced in the 2021 session.
One of the fundamental issues rests with the absence of a clear understanding of the frontline workforce and the roles it plays in both institutional and non-institutional settings. Many are unclear as to the composition of the workforce. Estimates show that positions related to direct care constitute one third of the health care workforce – outnumbering physicians, nurses, and medical assistants. These jobs are the backbone of the long term care workforce.
COVID-19 has dramatized importance of the direct services workforce in meeting the medical and health care needs of older adults and persons with disabilities.
“CCBC/BCPSC Model Apprenticeship Program – This initiative will provide health care pathways for direct services workers. The model involves partnerships with BACH as sponsor and public sector partners with the Maryland State Department of Education and the Department of Labor. Implementation of the program is set for 2021.
“School of Aging Services Demonstration” – Enabled by the Maryland Association of Community Colleges , six community colleges have expressed interest in taking the steps toward piloting a “School of Aging Services”. The Collaborative has developed the “Blueprint” encompassing a proposed curriculum and planned attributes. Outside foundation support will be sought for implementing the first stages of the program.
“Escalate Regional Resolve to Strengthen Wages and Benefits” – The Collaborative will take the next steps that further partnerships with key stakeholders and working with legislators to draft and advance legislation in coordination with state agencies. Legislation has been developed designed to provide guidance to positively affect person care aides employed by residential services agencies.
“Enable the Construct and Understanding of the “Direct Care Workforce Innovation Program” – Proposed legislation will establish the Direct Care Workforce Innovation Program” with an appropriation of$250,000 providing matching grants to “eligible entities” for the purpose of expanding and/or creating recruitment and retention strategies tat increase the number of direct care workers across the state.
The Collaborative upon enactment will work to facilitate the promotion of the program to be administered by the Division of Workforce Development and Adult Learning under the Maryland Department of Labor.
Maryland Regional Direct Services Collaboration
2490 Market Street NE #443
Washington, D.C. 20018