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Long Term Services and Supports

Session 5 focused on rural health in North Carolina; the state of our health care workforce for an aging population; and the settings, services, and supports that make up long-term care. At least fifty North Carolina counties are considered rural, and 21% of the state’s population lives in those counties. These populations are older, sicker, poorer, and more isolated than those in other parts of North Carolina. They have higher mortality on many indicators and fewer resources. Challenges exacerbated by COVID-19 include hospital closures and the digital divide. North Carolina’s direct care workforce includes personal care aides, home health aides, and nursing assistants who support older adults and those with disabilities. Women make up 92% of this workforce, and 61% are people of color. The median wage is $17,100 annually and 53% live at or below the federal poverty level. Policy solutions are needed to address an impending shortage in this workforce. When it comes to long-term services and supports, fewer than 1 in 5 members of the “Boomer” generation have taken action to prepare for this kind of care. Meanwhile, the number in need of LTSS is growing while the workforce is experiencing shortages.