Bruder said Utah is a national leader in one aspect — promotion of "self-administered families," which are allowed to hire and supervise staff that they choose. "We are leagues ahead of other states in that regard."

The roughly 5,000 people who provide support to about 8,000 long-term disabled Utahns does have a bit of an identity crisis relative to other professions. On the health job ladder it's on the same rung of pharmacy aides, cooks and orderlies.

"Calling it a crisis doesn't overstate the situation at all," said Phil Shumway, executive director of Turn Community Services. "It's at least a crisis waiting to happen. We simply don't have enough people to do this work."

The evolution of the disabled from being institutionalized and into communities is a process that's "a bit stuck," Shumway said, noting that wit "We shouldn't be trying to recruit at minimum wage; it puts out a message that our state doesn't care about direct service, and we can't do that to truly our most vulnerable citizens."

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E-mail: jthalman@desnews.com