Labor Shortage and Relational Transportation

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On Hendersonville Road, a Walgreens sign blinks a familiar message: NOW HIRING PHARMACY TECH.

“I guess they still can’t find anyone,” says Ellen, a resident of Givens Gerber Park. “That sign has been there since I moved in two years ago.”

The shortage first appears in hiring signs like this one. Now it is straining home care, transit, and emergency response.

Essential Services Suspended

Asheville’s essential services are losing staff. The result is route cuts, service denials, and outright terminations.

Asheville Rides Transit

Mountain Mobility

In-Home Aide

The same pattern appears in home care. The county’s own funding and spending records for In-Home Aide show a program that steadily lost the ability to deliver service over time.

The county has the funding. The workforce is gone.

Exodus of Workers

A city that prices out its working people loses the human infrastructure that keeps old age humane.

The Silver Tsunami

What begins as isolation often ends in emergency response.

Emergencies: The De Facto Safety Net

When daily systems fail, emergencies take their place. In Asheville, the housing-driven labor crisis has forced the Asheville Fire Department (AFD) to become the city’s de facto elderly care and medical dispatch service.

To absorb this growing burden, AFD has swelled into the city’s largest municipal department, with a size and call volume that far outpaces peer cities across North Carolina.

  • By the Numbers: AFD operates with 304 budgeted positions.
  • The Comparison: Despite Asheville’s population of roughly 94,000, its fire department is significantly larger than Concord’s (population 112,000). Furthermore, AFD is more than double the size of fire departments in similarly sized municipalities like Apex and Gastonia.

Asheville is not facing more fires. The issue is what firefighters are being sent to do.

Fire stations are spread across the city in a geographic grid, so a fire engine can reach a patient faster than an ambulance can. Firefighters are often dispatched for lift assists and basic care after falls or missed medications. The fire department is filling in for a missing everyday workforce.

A functioning city operates on preventative maintenance (example, a senior takes an ART bus to a routine doctor’s appointment). A degrading city operates entirely on reactive crisis management (example, the senior misses the appointment, falls ill, and requires an expensive emergency EMS and Fire Department response). Costs rise as outcomes decline.

Relational Transportation

Without aides in the home, more seniors will have to seek care in group settings, where one worker can support many people at once.

But group care only works if seniors can reach it. A senior can get a ride to the doctor more easily than a ride to a meal, a program, or another place where daily support happens.

“Because a number of COABC’s clients have transportation barriers, the Resource Coordinators are often the means by which clients receive tangible support.”
– Council on Aging of Buncombe County.

“Progress has been slower than anticipated due to ongoing challenges with Mountain Mobility (MM) route availability.”
– Mountain Aging Partners.

The county’s own report repeatedly identifies transportation as a barrier to basic support for seniors.

The BTT Solution

Without transportation, many of those connections are lost.