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Idaho's Direct Care Workforce Crisis

What Is The Crisis?

Direct care workers are the lifeblood of independence for tens of thousands of Idahoans with disabilities across the lifespan. Direct care workers help people, young and old, stay independent in their own homes, and in their own communities, rather than having to live in an institution, like a nursing home. Direct care workers who provide in-home care also save Idaho taxpayers millions of dollars, all while living up to our State's values of independence and freedom.

Many Idahoans who qualify receive in-home care through the Idaho Medicaid Home and Community Based Services program. Over the past two years, wages in Idaho have significantly increased, but reimbursement rates for direct care workers has stayed stagnant. Some direct care workers are making minimum wage ($7.25/hour) or a few dollars more, for incredibly difficult work. The lack of competitive wages has meant direct care workers cannot pay their own bills or make ends meet.

What has this crisis meant for Idahoans?

  • Critical in-home care programs and agencies are closing their doors because of a lack of direct care workers.

  • Idahoans living in the community, even at a young age, are at risk of being institutionalized resulting in loss of opportunity to attend church, be employed, live in our own homes, or go to school.

  • Idahoans living in institutions are unable to return home, essentially taking away their freedom and committing them to what amounts to a prison sentence against their will almost always at a far HIGHER COST to Idaho taxpayers.

Who Are Direct Care Workers?

Direct care workers are also called an in-home care worker, personal assistant, personal attendant, or homecare aide. They work for Idahoans with disabilities and older adults to ensure that they have the personal care required to live, work, volunteer, attend school and church, and live the values of Idaho in their own homes and communities – FREEDOM and INDEPENDENCE.


Direct care workers assist Idahoans with daily living tasks and personal care duties, such as hygiene, toileting, dressing, eating, mobility, transferring, cooking, shopping, money management, and medication assistance. For children with disabilities, they may also provide critical care to support their growth and development. Direct care workers are largely women who are lower-income, and often have disabilities themselves.

What Can We Do?

It is important that we share the barriers we are experiencing accessing in-home and in-community supports, such as direct care workers, with the Idaho Department of Health and Welfare and Idaho Legislators. We can do this in several ways:

Advocate for Direct Care Workers!

Join LINC  for Operation Advocacy, February 20 and 21, 2023. We will come together for some training and relationship building on Monday, February 20, and the following day we will meet with legislators at the Idaho State Capitol to advocate for a stronger and more sustainable direct care workforce in Idaho. You can RSVP for Operation Advocacy today!

Barriers to Services Questionnaire

Please complete the Barriers to Services Questionnaire. The purpose of this questionnaire is to understand the challenges people with disabilities and older adults in Idaho are experiencing trying to live in the community in their own home. The information collected in this questionnaire is critical to improving services for people with disabilities and older adults. It will help us educate elected officials so that they can improve access to home and community-based services, such as promoting competitive wages for direct care workers by increasing reimbursement rates.

File an Olmstead Complaint

Federal laws give people with disabilities civil rights to equal access, or changes that allow us equal access. Under ADA Title II, “reasonable accommodations” apply to make services available in institutions available OUTSIDE institutions. In the landmark Olmstead v. L.C. decision (1999), the U.S. Supreme Court held that states have an affirmative obligation to ensure that individuals with disabilities live in the least restrictive, most integrated settings possible.

What this means is that Idahoans with disabilities have the right to live in their own homes and communities, and that the State of Idaho has an obligation to make sure the services are available to make this possible. In low reimbursement rates for in-home care is resulting in a lack of direct care workers, then the State of Idaho is not living up to it's legal obligations.

If you think your right to equal access is being violated, you can file a formal complaint with the US Department of Justice. To learn more about Olmstead, review this Olmstead training video and the accompanying presentation.

More Info? 

If you have a question, need more information, or would like support completing the Barriers to Services Questionnaire or filing an Olmstead complaint, email Dianna Willis at

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