PHI PolicyWorks | West Virginia

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Size of Workforce: Totaling approximately 20,000 workers, West Virginia’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 West Virginia, demand for Personal Care Aides is expected to increase by 29 percent from 2008 to 2018. Demand for Nursing Aides, Orderlies, and Attendants is expected to increase by 14 percent. Direct-care workers employed in home and community-based settings are a growing segment of West Virginia’s workforce in both size and significance.

Median Wages: Direct-care workers in West Virginia 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 West Virginia increased by 14 percent, from $6.82 to $7.81. Real wages for Personal Care Aides and Home Health Aides stagnated over the same time period.

Health Insurance: Compared to the national civilian workforce, more of West Virginia’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, fewer of West Virginia’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 West Virginia 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

HB 2142: This bill provides for the adequate staffing of nursing homes and training of nursing home staff. Included in the bill are provisions for increasing training requirements for nursing aides from 120 hours to 160 hours, and providing a grant program for projects aimed at reducing employee turnover in nursing homes. (Introduced January 12, 2011)

HCR 65: This bill requests the Joint Committee on Government and Finance to study the state’s in-home direct care workforce. The aim is to improve the quality and quantity of in-home direct care workers so as to ensure that a trained and competent workforce exists to care for the state’s growing aged population. (Introduced February 11, 2011)

Resources

In-Home Direct-Care Worker Database Work Group-Final Report (pdf): In this 2010 report, the West Virginia Long-Term Care Partnership recommends the development of a database for tracking in-home direct care worker background and work history information, and the adoption of a single course of study leading to a uniform certification for these workers.

West Virginia Direct-Support Workforce Study (pdf): This 2009 report by the Center for Excellence in Disabilities at West Virginia University, describes the strengths and challenges of West Virginia’s direct support workforce for individuals with developmental disabilities. It includes input of direct support workers, provider agencies and the individuals who receive these services and recommendations. The report was funded by the WV Developmental Disabilities Council.

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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