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Size of Workforce: Totaling approximately 17,000 workers, Utah’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 Utah, demand for direct-care worker positions is expected to increase by 55 percent from 2008 to 2018. In contrast, jobs overall are expected to increase by only 21 percent. Direct-care workers employed in home and community-based settings are a growing segment of Utah’s workforce in both size and significance.

Median Wages: Direct-care workers in Utah 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 nine years, inflation-adjusted median hourly wages for Nursing Aides, Orderlies, and Attendants in Utah increased by 7 percent, from $8.18 to $8.76 Real wages for Home Health Aides and Personal Care Aides declined.

Health Insurance: Compared to the national civilian workforce, significantly more of Utah’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 Utah’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 Utah 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 Utah with CMS-funded technical assistance regarding building a web-based training module for direct support providers, and gaining a better understanding of the adequacy of direct support professional wages in Utah.

Resources

Recommendations on the Development of a Comprehensive, Competency-Based Training Program to Integrate into a Web-Interfaced Learner Management System in Utah (pdf): This 2008 report provides training recommendations for Utah’s Disability Services Division to use with its constituents in the Home and Community Based Services Waiver Program. The report focuses on the competencies needed by direct service workers and frontline supervisors to perform effectively in community human support programs and aging services.

Report on Utah’s Home- and Community-Based Direct Service Workforce: This This 2009 report was prepared by the Direct Service Workforce Resource Center as part of the Center’s CMS-funded technical assistance to Utah. The report assesses the status of Utah’s HCBS workforce and recommends interventions to improve workforce outcomes.

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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