Size of Workforce: Totaling approximately 57,000 workers, Georgia’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 Georgia, demand for direct-care worker positions is expected to increase by 32 percent from 2006 to 2016. In contrast, jobs overall are expected to increase by only 14 percent. Direct-care workers employed in home and community-based settings are a growing segment of Georgia’s workforce in both size and significance.

Median Wages: Direct-care workers in Georgia earn significantly less than the average wage across all occupations in the state. Furthermore, wages for Personal Care Aides and Home Health Aides 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 Georgia increased by 7 percent, from $7.25 to $7.74. Real wages for Personal Care Aides increased by 4 percent while those for Home Health Aides actually decreased.

Health Insurance: Compared to the national civilian workforce, more of Georgia’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 Georgia’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: Thirty-eight percent of direct-care worker households in Georgia 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

Direct Service Workforce Resource Center – Intensive Technical Assistance: In 2007, the DSW Resource Center provided CMS-funded technical assistance to the Georgia Initiative for Direct Support Workforce Development (GIDSWD) to work towards the goal of developing career paths for workers rooted in the National Alliance for Direct Support Professionals (NADSP) Credentialing Program.

Resources

Culture Change Network of Georgia: The Culture Change Network of Georgia includes service providers, advocates, community health advisors and others in long-term care who are working to promote and foster culture change to improve the quality of life for older Georgians in all settings.

The Critical Link Between Workforce and Organizational Excellence (pdf): This May 2007 article describes the work of the Georgia Quality Initiative, which found that nursing facilities with higher employee satisfaction did better on clinical outcomes, workforce performance, and occupancy.

“I Get Along with Most of Them”: Direct Care Workers’ Relationships with Residents’ Families in Assisted Living
: This 2009 study by Kemp and colleagues, published in the Gerontologist, explores staff-family relationships in assisted living facilities in Georgia. Results show that most of the direct-care workers considered their relationships with families to be good or pretty good and that these experiences affected direct-care workers’ caregiving experiences.

Factors Contributing to Job Retention of Direct Care Staff in Urban Assisted Living Facilities: This 2007 article presents results from a secondary analysis of data from 11 assisted living facilities in Atlanta and data from in-depth interviews with 13 participants from sample facilities. The findings show that retention of direct-care workers is influenced by personal and workplace factors.

Care Workers’ Motivations for Employment in Long-Term Care, Assisted Living and Particular Facilities: Reconciling Inconsistent Values: This 2008 report looks at the reasons why direct-care workers chose to work in one type of facility over others. Using qualitative and quantitative data from a study of 45 assisted living facilities in Atlanta, the study finds that direct care workers chose their jobs both to earn money as well as to help others.