MADISON, Wis. — A study by a coalition of Wisconsin health care organizations says the state's shortage of long-term care providers is continuing to grow.

The "Long-term Care Workforce Crisis" report found that about 1-in-5 direct caregiver positions in Wisconsin are unfilled, up from 1-in-7 positions in 2016, Wisconsin Public Radio reported . The report was assembled by the Wisconsin Health Care Association, the Wisconsin Center for Assisted Living, the Wisconsin Assisted Living Association, LeadingAge Wisconsin and the Disability Service Provider Network.

Beginning wages are deterring potential workers from applying for positions, with the median hour starting wage at $10.75, the report said. Other starting positions outside of the health care industry have hourly starting wages at $12 an hour.

Facilities are cutting back services because they don't have enough staff, despite growing demand for long-term care, said Sarah Bass, the operations and communications director of the Wisconsin Assisted Living Association.

The state's low rate of Medicaid reimbursement plays a large role in keeping provider wages down, the report said.

Lawmakers added about $60 million for Medicaid reimbursement for skilled nursing care in the latest state budget. The state should continue such efforts to address the issue, the coalition said.

Other initiatives are also trying to address the long-term issue.

The WisCaregiver Career Program aims to recruit, test, train and retain 3,000 newly certified nursing assistants, said John Vander Meer, executive director of the Wisconsin Health Care Association and Wisconsin Center for Assisted Living.

About two-thirds of the state's nursing home residents receive Medicaid.