49 States Report Shortage of HCBS Workers

In a brief published by KFF on October 24, "Payment Rates for Medicaid Home- and Community-Based Services: States' Responses to Workforce Challenges," authors Alice Burns, Maiss Mohamed, and Molly O'Malley Watts analyze findings from a recent survey of states. All states and Washington, D.C. received the survey; all responded except Florida.

With all responding states reporting workforce shortages in home and community-based services (HCBS), 48 of 50 reported increasing provider payments to support access to HCBS. More than 80% of responding states reported expanding training programs and offering recruitment or retention incentives for staff.

In addition to analyzing the workforce, the authors also looked at pandemic effects on providers within states. Forty-three states reported experiencing permanent provider closures, with permanent adult day health closures reported in 32 states-the most prevalent among states. Nearly three in four states reported permanent provider closures in two or more service types.

Read the brief and review the data tables here.