By Michael Pochowski, CEO Wisconsin Assisted Living Association

Wisconsin’s population is projected to decline over the next 25 years, but the number of people aged 65 and over will increase.

So demand for services for older adults, such as assisted living, will increase. These serves also will be harder to provide because of fewer working-age people.

A recent report from Forward Analytics, “On the Brink: Probing the Coming Senior Care Challenges,” asks the question: “Is Wisconsin on the verge of a crisis?” According to the report, “Should these trends continue, Wisconsin would need to increase aging-care infrastructure by about 33,000 total beds by 2030 to accommodate the increased number of seniors. During the following decade, another 26,500 would need to be added. Combined, the 59,500 beds that might be needed constitute a 76% increase over 2023.”

Adding to our state’s challenges is that a growing number of older adults are having to rely on Family Care to obtain their long-term care services.  Family Care is a Medicaid program for older adults and adults with disabilities.

Wisconsin assisted-living providers have already for years been facing staffing shortages, a situation that in the past has been exacerbated by the inadequate funding of the Family Care program.

The Legislature in 2017 and in subsequent state budgets responded by creating the Direct Care Workforce Funding Initiative. This allows for a payment mechanism to help address caregiver workforce challenges in the state.  

Still, the Family Care program needs major overhauls in its design, including the ability to recognize and react in a timely manner to changes in the economy, such as labor market trends and inflation on goods and services.

As an example, in the last two-year state budget adopted in 2023, the budgetary assumptions specified that the average caregiver wage in Family Care was $13.02 per hour -- even though the consensus among providers was that starting wages were actually closer to $17.75 per hour.

Ultimately, the state Department of Health Services established a minimum fee schedule. Effective Oct. 1, 2024, that increased the average wage assumption from $13.02 per hour to $15.75.

We’re fortunate that our state leaders have been responsive in the past to investing in programs that help with the challenges affecting Wisconsin’s long-term health care system.

Still, the long-term care system faces stiff competition in its ability to recruit and retain a workforce that may opt to pursue the same or higher pay in other less-stressful employment. This includes areas such as light manufacturing, warehousing, restaurants, retail and convenience stores.

Maintaining current funding levels for the minimum fee schedule and Direct Care Workforce Funding Initiative in the upcoming state budget is imperative. These two initiatives are helping to keep the Family Care program afloat. This program will touch thousands of families in the years to come. It requires the attention of the governor and our state lawmakers as the next state budget is finalized and signed into law.

Without these investments, providers such as assisted living will continue to struggle to make ends meet. The result could be assisted-living facilities shutting down or likely exiting the Medicaid Family Care program.

https://madison.com/opinion/column/article_67316a16-ff64-11ef-952b-cb29fb6ddcc4.html