As our population ages, it’s important to prepare for the increased demand for long-term care services. Currently, challenges faced by nursing home facilities and our caregivers ignite questions about where we are, where we are headed, and where we need to be.

Since 2016, 30 skilled nursing homes have closed in Wisconsin, with many providers citing low reimbursement rates as a barrier. A 2016 national study actually ranked Wisconsin as the nation’s worst state in terms of Medicaid nursing home payments.

It’s also becoming harder to find people to work as caregivers, especially in border regions. According to a 2018 report, Wisconsin’s median wage for direct care workers is $10.75 an hour, which is $22,360 a year assuming full-time employment. That wage is lower than pay in other industries and lower than pay in Minnesota, which helps explain why, increasingly, caregivers in northwestern Wisconsin are leaving the profession or working across the river. The report also estimates 16,500 current vacancies across the state’s long-term care facilities and notes a significant decline in newcomers to the direct care workforce.

Wisconsin’s demographic shifts are also important to consider in the context of health care and workforce capacity. The state estimates that by 2040, Wisconsin’s 65 and older population will increase by 72 percent. However, the state’s working-age population will also decline by 0.2 percent. In 18 counties, at least 33 percent of the counties’ total population will be comprised of individuals age 65 and older.

Without change, the challenges facing our long-term care system will grow. We need real solutions and partnerships to prepare for the future. 

Governor Evers’ budget offers some paths forward to address this issue. For one, it proposes to accept federal dollars for Medicaid expansion, just like 36 states have already done. States like North Dakota, Iowa, and Kentucky have expanded Medicaid to increase access to health care and free up state dollars. Here in Wisconsin, the nonpartisan Legislative Fiscal Bureau found that Wisconsin’s refusal to expand Medicaid has resulted in $1.1 billion in forgone federal dollars since 2014. That’s money that could have gone toward schools, roads, or tax relief for working families.

The budget also invests an additional $26 million through nursing home rate increases and $16 million in direct care funding for personal care services. It also expands the dementia care specialist program to all Aging and Disability Resource Centers statewide.