Direct Care Crisis

“54.4% of respondents state there is high turnover and their in-home providers change often.”

Source: Ohio Statewide Disability Needs Survey 2022

Ohio is in the midst of a Direct Care Crisis. Roughly 4,000 aging Ohioans and Ohioans with disabilities are currently going without needed personal care services. Direct Care workers are essential to ensuring that Ohioans with disabilities are able to live and work independently. We must take action to prevent unnecessary institutionalization.

More information about how to reform the direct care system is below in the Advocacy section. Also, in the Timeline for Budget Consideration section you will discover the legislative process for making change happen and understand just how urgent it is for you to act now. Lastly, if you have your own personal experience relating to the Direct Care Crisis, you can share your story with the form near the end of this page. The buttons below will also take you directly to those sections.

Legislative Day of Action

On May 26, 2022, twenty-six disability advocates had in-person meetings with 31 legislators and/or their aides about the in-home direct care workforce crisis that thousands of people with disabilities are facing in Ohio.

This group discussed their concerns, issues with the direct care system, and potential solutions. An informational packet was distributed to all members of the Ohio legislature detailing information related to low pay, complicated systems, and lack of recruitment and retention efforts within this workforce.

Advocates expressed the urgent need for Ohio to develop long-term solutions as the emergency-level workforce shortage is putting people who need these services at serious risk of institutionalization or injury.


The tabs below contain a collection of useful information and examples to help you understand how to be a part of change and what can be achieved.

In 2022, Ohio created the Direct Care Workforce Expansion Group. After three days of testimony and accepting public comments, the working group drafted a report with recommendations for Ohio agencies.

“Everyone has the right to live, work, and play in the communities of their choice. Many people with disabilities need the support of Direct Care Workers (DCW) to eat, bathe, dress, tend to medical needs, or complete other activities of daily living. These workers are essential to empowering people with disabilities to live independently. Low pay, complicated systems, and lack of recruitment and retention efforts within this workforce have led to an emergency-level workforce shortage, putting people who need these services at serious risk.”

Click on the link below for talking points.

In 2019, the State of Colorado amended its Medicaid code to set a minimum wage for direct care workers:

January 1, 2022 Amendment that set Colorado’s Direct Care Workforce Minimum Wage to $15.00/ hour:

Ability Center Direct Care Workforce issue brief with model legislation:

Letter from Ohio Olmstead Taskforce asking for a joint action plan to solve the direct care crisis (August 2021):

Letters from Ohio Olmstead Task Force asking to use ARPA funds to set an hourly rate of pay for Direct Care Workers (November 2022):

Letter from The Ability Center asking the Ohio General Assembly to ensure parity in funding for nursing homes and direct care (December 2022): 

Letter from Ohio Olmstead Task Force asking state agencies to raise wages for direct care workers as part of their budgets (October 2022):

Timeline on Budget Considerations

End of January

Governor proposes 2-year state budget (the “Executive Budget”) to the House of Representatives

Early February – Early April

House Finance Committee hears testimony from state agencies about the governor’s proposed budget. Finance Committee refers budget to subcommittees.

Public Testimony — Subcommittees hear testimony from Ohioans about the critical needs across the state, then report back with budget recommendations to Finance Committee, which hears more public testimony.

Committee members propose, accept, and/or reject amendments, creating a substitute bull (”Sub Bill”). Finance Committee passes Sub Bill and takes it to the full House for a vote. House votes on final amendments and passes the House budget, sending it to the Senate.

Late April – Mid-June

Public Testimony — Senate Finance Committee hears testimony from state agencies, organizations and Ohioans.

Members make amendments, creating another Sub Bill, which goes to the full Senate for a vote. Senate vote on final amendments and passes the Senate budget, sending it to Conference Committee.


Conference Committee (3 from the House, 3 from the Senate) create a compromise (”reconciled”) bill that combines elements of the House and Senate versions. Reconciled budget bill goes to Senate and House for votes. By law, both must pass the bill and send it to the Governor by the end of the state fiscal year, June 28.

June 30

Governor signs the budget into law (and may veto individual line items).
2 Logos - Breaking Silences and Ohio Olmstead Task Force

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Are you satisfied with the service?
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