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Size of Workforce: Totaling approximately 6,000 workers, Alaska’s direct-care workforce provides daily services and supports to elders and individuals with disabilities who need assistance with personal care and other daily activities. Direct-care workers fall into three main categories tracked by the U.S. Bureau of Labor Statistics: nursing aides, home health aides, and personal care aides. Personal care aides include workers with many other titles—for example, personal attendants, direct support professionals, and home care aides. The estimates shown below for each occupation may heavily undercount independent providers hired directly by households.

Occupational Growth: Direct-care workers constitute one of the nation’s largest occupational groupings. Moreover, across the country, direct-care jobs are among the fastest growing occupations and those expected to produce the largest numbers of new jobs over the coming decade. In Alaska, demand for direct-care worker positions is expected to increase by 35 percent from 2008 to 2018. In contrast, jobs overall are expected to increase by only 10 percent. Direct-care workers employed in home and community-based settings are a growing segment of Alaska’s workforce in both size and significance.

Median Wages: Direct-care workers in Alaska earn significantly less than the average wage across all occupations in the state.

Wages Adjusted for Inflation: Over the past decade, inflation-adjusted median hourly wages for Nursing Aides, Orderlies, and Attendants in Alaska increased by only 3 percent, from $11.81 to $12.16. Real wages for Home Health Aides increased by 5 percent and those for Personal Care Aides increased by nearly 10 percent.

Health Insurance: Compared to the national civilian workforce, more of Alaska’s direct-care workers are uninsured. Because of low wages, direct-care workers often have difficulty affording private health insurance coverage; however, many earn too much to qualify for Medicaid.

Employer-Sponsored Insurance: Compared to the national civilian workforce, significantly fewer of Alaska’s direct-care workers have access to and use employer-sponsored insurance. Some work for employers that do not offer health insurance. Others work for employers that limit eligibility for health insurance to full-time employees. This creates a barrier for many direct-care workers, especially those in home and community-based settings, who often work only part-time due to the episodic nature of direct-care work. Even workers who do have access to insurance from their employer may find the co-pays and premiums unaffordable.

Public Assistance: Forty-eight percent of direct-care worker households in Alaska rely on some form of means-tested public assistance, particularly Medicaid or food and nutrition assistance. This reliance reflects the generally poor quality of direct-care jobs in terms of wages and benefits, and the part-time nature of many direct-care jobs.

Notable Initiatives

Alaska Native Tribal Health Consortium: Behavioral Health Aide Project: The Alaska Native Tribal Health Consortium is pioneering a multi-tiered career ladder for behavioral health aides built on the “grow your own” philosophy. This approach involves training community members within their regions, thereby ultimately enhancing the availability of services in that community.

Resources

Core Competencies for Direct-Care Workers: The Alaska Mental Health Trust Authority, in collaboration with the University of Alaska and the State of Alaska Department of Health & Social Services, sponsored the development of the Alaskan Core Competencies for Direct Care Workers in Health & Human Services. Developed by the Annapolis Coalition on the Behavioral Health Workforce, the identified competencies are designed to cut across most health and human service areas.

Survey of Direct Service Workers in Alaska (PDF): This 2009 survey of Alaskan direct service workers was conducted to develop a profile of job satisfaction and to assess the influence of employment benefits on job recruitment and retention for this workforce.

ABOUT THE CENTER: The PHI State Data Center provides state-by-state data and resources relating to nursing aides, home health aides, and personal care aides (including direct support professionals). These occupations are known collectively as the direct-care workforce (learn more).
DATA SOURCES: See our page on data sources and definitions.
CONTACT: For more information or to suggest a resource for addition to this page, contact Abby Marquand, PHI policy research associate, at amarquand@phinational.org
CREDITS: The PHI State Data Center was developed with support from The SCAN Foundation and Centers for Medicare and Medicaid Services/National Direct Service Workforce Center.

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