Texas has the third largest number of people aged 65 and older among the states, totaling 3.7 million in 2019. The number of older adults is projected to increase to 5.6 million by 2030, which will be an increase of 114% since 2010. Many of these Texans will need attendant support and services as they enter their later years and experience disabilities. Attendants help with the activities of daily living, such as bathing, grooming, dressing, and meal preparation.
Texas is already facing a crisis-level shortage of community attendants to meet the existing (and rapidly growing) demand. Though attendant services are vital to maintaining the health, independence, and dignity of the elderly and disabled individuals, Texas consistently ranks near or at the bottom across all states for attendant wages.
Community attendants hold some of the worst-compensated jobs in the state with a base wage of just $8.11 per hour. Meanwhile, major retail and fast-food employers have raised hourly wages to $15-$18 and more in response to growing competition and the high costs of turnover. Very few attendants have benefits; most receive no sick leave, no health insurance, no vacation, and no retirement benefits. Many of these full-time workers live below the federal poverty line (FPL) and rely on public assistance to feed their families.
By 2028, Texas will need another 94,835 community attendants, the second highest number of new jobs forecast in the state, to meet the growing demand for these services. The work attendants do is critical for older adults and people with disabilities to remain and thrive in the community, and attendants must be better compensated to avoid a harmful and tremendously expensive system collapse.
To address the growing shortage of community attendants, the report recommends the following actions to reduce turnover:
- Raise the $8.11 base hourly wage for community attendants in home and community-based services programs to $15.00 in fiscal year 2024 and $17.00 in fiscal year 2025.
- Develop a mechanism to automatically adjust wages in response to market and demographic forces to avoid future wage stagnation and remain competitive in recruitment and retention.
The report estimates the impact of implementation from these recommendations would include:
- Cost: $3.7 billion (general revenue) for $15 per hour base wage in 2024, $17 per hour base wage in 2025
- Benefits over the 2024-25 biennium:
- $350.8 million potential SNAP savings due to less reliance on public assistance
- $319.8 million potential funds redirected to care by 25% reduction in attendant turnover
- $6 billion additional federal funds drawn down as a result of state investment
- Other fiscal savings on acute care, emergency room visits, hospitalization, and unnecessary institutionalization
Learn more by reading and downloading the full report “Crushing the Workforce 2.0” here.
About the Coalition of Texans with Disabilities
CTD works to ensure that all Texans with disabilities of any age may work, live, learn, play, and participate fully in the community of their choice. CTD is a social and economic impact organization benefitting and controlled by people with disabilities.
A report commissioned by the Coalition of Texans with Disabilities (CTD), in partnership with Episcopal Health Foundation, St. David’s Foundation, and UnitedHealthcare, calls for an improvement in the “poverty wages” paid to community attendants, which undermine the availability of critical in-home and community-based services for older adults and people with disabilities in Texas. CTD is a social and economic impact organization benefitting and controlled by people with disabilities that works to ensure that all Texans with disabilities of any age may work, live, learn, play, and participate fully in the community of their choice.