PHI PolicyWorks | Arkansas

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Size of Workforce: Totaling over 30,000 workers, Arkansas’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 Arkansas, demand for direct-care worker positions is expected to increase by 23 percent from 2008 to 2018. In contrast, jobs overall are expected to increase by only 7 percent. Direct-care workers employed in home and community-based settings are a growing segment of Arkansas’s workforce in both size and significance.

Median Wages: Direct-care workers in Arkansas earn significantly less than the average wage across all occupations in the state. Furthermore, wages for all direct-care workers fall below 200 percent of the 2009 federal poverty line for a single individual working full time ($10.42). The 200 percent poverty level is low enough to qualify households for many state and federal assistance programs.

Wages Adjusted for Inflation: Over the past decade, inflation-adjusted median hourly wages for Nursing Aides, Orderlies, and Attendants in Arkansas increased by 15 percent, from $6.67 to $7.70. Real wages for Home Health Aides increased only slightly while those for Personal Care Aides stagnated.

Health Insurance: Compared to the national civilian workforce, significantly more of Arkansas’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 Arkansas’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: Fifty-three percent of direct-care worker households in Arkansas 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

Arkansas Direct Service Worker Registry: The Arkansas Department of Human Services operates a web-based matching service registry to help individuals directing their own care to find a personal care attendant and to help personal care attendants secure employment. The registry was developed as part of Arkansas’s 2004 CMS Direct Service Community Workforce Demonstration Grant.

Schmieding Home Caregiver Training Program: As part of the Arkansas Aging Initiative, the goal of this training project is to increase the numbers of individuals in Arkansas trained to care for older adults, especially in home and community-based settings. The program provides 3 successive levels of certified caregiver training as well as training for non-paid caregivers. With support from The Donald W. Reynolds Foundation, the program is being replicated in four Arkansas locations: Jonesboro, Pine Bluff, Texarkana and West Memphis.

Resources

Recommendations to Balance Arkansas’s Long-Term Care System (PDF): This 2009 report, prepared for the Division of Adult and Aging Services at the Arkansas Department of Human Services, includes recommendations for steps that the state can take to strengthen and stabilize its long-term care workforce. These include: improved wages for direct service workers across sectors; increased access to training, lifelong learning and career paths for direct service workers across sectors; and greater parity in wages, benefits and training for workers across facility and community-based settings.

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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