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Size of Workforce: Totaling approximately 30,000 workers, New Mexico’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 New Mexico, demand for direct-care worker positions is expected to increase by 40 percent from 2008 to 2018. In contrast, jobs overall are expected to increase by only 13 percent. Direct-care workers employed in home and community-based settings are a growing segment of New Mexico’s workforce in both size and significance.

Median Wages: Direct-care workers in New Mexico 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 New Mexico increased by 14 percent, from $7.42 to $8.44. Real wages for Personal Care Aides increased by 5 percent while those for Home Health Aides declined.

Health Insurance: Compared to the national civilian workforce, significantly more of New Mexico’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 New Mexico’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-five percent of direct-care worker households in New Mexico 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.

Legislation/Regulation

HM 56: This bill requested the Department of Health to convene a task force to examine the possibility of coordinating governmental training programs in the state for direct caregivers across all disability programs and their respective state agencies. (Adopted March 19, 2010)

Notable Initiatives

Demonstration to Improve the Direct Service Community Workforce to Support the Needs of People with Disabilities in the Community: This 2006 report summarizes the results of New Mexico’s efforts to make health care coverage more accessible to Direct Support Professionals. Those efforts were supported by a CMS Direct Service Community Workforce Demonstration grant awarded in 2003 to the New Mexico Department of Health, Long Term Care Services Division.

New Mexico Direct Caregivers Coalition: Established in 2009, the New Mexico Direct Caregivers Coalition brings together organizations that represent professional direct-care workers as well as family caregivers to speak out on workforce issues.

Resources

Web Data Entry and Reporting System: DDSD Statewide Training Database at the University of New Mexico’s Center for Development & Disability: This presentation explains the web-based system through which New Mexico collects information about training and workforce outcomes from developmental disability providers around the state.

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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