Nearly All Community-Based Providers Faced Moderate To Severe Staffing Shortages In 2023

At the beginning of 2024, staffing woes remain acute for home- and community-based care providers.

ANCOR, an advocacy organization for over 2,000 community-based providers, recently released “The State of America’s Direct Support Workforce Crisis 2023,” which detailed how home- and community-based providers are faring in the staffing department.

The report surveyed nearly 600 providers, and particularly those who support those with intellectual and developmental disabilities.


About 95% of providers indicated that they had moderate or severe staffing shortages over the past year, while 77% turned away new referrals due to those staffing shortages.

Worse yet, 72% of respondents reported difficulty adhering to quality standards due to those staffing woes.

As reflected above, staffing shortages affect nearly all home-based care providers across the country. But those shortages are especially troubling when they affect providers delivering care in areas not saturated by other care providers.


For instance, 54% of respondents indicated they deliver services in a market where there were “few or no other” providers delivering similar services.

If providers cannot accept new referrals, that leads to patients not receiving vital care, leading to adverse outcomes for those individuals.

Of the care management organizations that participated in the study, 75% said they had difficulty connecting patients with care services due to “a lack of available providers.”

As a result of the report’s findings, ANCOR made multiple policy recommendations.

“Given the precarious situation continuing to confront providers, ANCOR concludes its 2023 report by recommending policy actions that can help significantly strengthen the direct support workforce,” the report read. “Specifically, we recommend increasing funding for workforce initiatives, establishing a Standard Occupational Classification for DSPs, and investing in career pipeline programs to enhance training and professionalization within the field.”

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