Long-Term Services and Supports: 2025 Annual Report

This study is the first in a series of annual reports directed by House Bill 1694 assessing the workforce available to supply Long-Term Services and Supports (LTSS) and the projected demand for LTSS in Washington State. Data from the U.S. Census Bureau and Bureau of Labor Statistics, combined with Medicaid LTSS claims data, are used to describe current LTSS workforce and utilization patterns, and to generate forecasts to 2050 of Medicaid-paid LTSS utilization and the number of individuals providing paid direct care in LTSS settings. We found that demand for LTSS is projected to far outpace supply, based on current utilization and employment patterns. Analyses found that wages were low for the direct care workers supplying the majority of LTSS services compared to Washington’s median wage and wages of similar occupations. Potential strategies to address this gap include increasing wages and benefits for these workers from their historical lows and incentivizing new workers into the LTSS field with tax benefits, expanding training and career opportunities, enhancing public perceptions of the LTSS jobs.