PHI has published an in-depth analysis of the home care and personal assistance aides workforce who provide long-term services and supports to elders and people living with disabilities in home and community-based settings.
The report, Caring in America, A Comprehensive Analysis of the Nation's Fastest-Growing Jobs: Home Health and Personal Care Aides, shows that the between 2008 and 2018, the home care workforce is expected to grow at rates four to five times faster than jobs in the overall economy.
"Carework in America is at a crossroads," said PHI Director of Policy Research Dorie Seavey, Ph.D. who authored the report with PHI Policy Associate Abby Marquand, M.P.H. "We can continue the status quo of poorly supported and poorly compensated jobs, consigning home care workers to near-poverty earnings and home care to a revolving door of caregivers. Or, we can leverage this workforce's enormous potential as both an underutilized asset in our health care system and as one of the strongest job growth engines that our economy has to offer" Seavey said.
Obviously PHI is on the pro-workforce side of the issue and also supports the Labor Department's proposal to narrow the companionship exemption and require overtime pay. And there is no doubt that the industry is growing and wages are low. But just to be clear you need to know who is one which side of the issues.
The numbers of home care and personal assistance aides have reached historic proportions as a result of several trends: the preference of the rapidly-rising aging population to continue to live in their homes and communities despite complex medical conditions; medical innovations that allow people with disabilities to live longer and, with assistance, independently in their communities; and state and federal policies that increasingly support home and community-based services as alternatives to traditional, more costly institutional care.
The 121-page report covers:
- The Workforce
Basic facts on the size of the home care and personal assistance workforce and its demographic characteristics along with a description of job titles and tasks performed. - The Industry Sector
An analysis of the employers in the in-home care industry sector. - Service Delivery Systems
An examination of the complex of service delivery systems that provide daily services and supports to millions of elders and people with disabilities. - Training
The state of training for home care and personal assistance workers. - Job Hazards
The hazards accompanying this work and the high incidence of injuries and illnesses. - Workforce Compensation
A review of wages and benefits that leave home care workers struggling with basic conditions of employment and heavily reliant on public assistance programs. - Hours Worked
The part-time employment patterns of aides and low rates of over time worked. - Workforce Instability & Labor Shortages
A review of turnover and vacancy data. - Status of Wage & Hour Protection
The current status of federal and state wage and hour protections for this workforce.
Not surprisingly, the report concludes that the workforce is characterized by:
- Poor wages
- Inconsistent training requirements poorly aligned with wages
- Inadequate health care coverage
- High injury rates
- Unpredictable hours
- Heavy reliance on public benefits
Home care providers need to weigh in with their side of the story because frankly PHI does a good job from their side. I do not profess to know the finances of the industry and the margins that providers are operating. But it would be nice to understand both sides and then meet in the middle with all of this.
Learn more ~ or join the conversation!
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