Wages for personal and home care aides have never been high – and they’re getting lower nationwide. Between 1999 and 2006, real wages for these workers fell by 4 percent nationwide.

State Chart Book on Wages for Personal and Home Care Aides, 1999-2006, (pdf) a new PHI publication by Director of Policy Research Dorie Seavey, looks at the buying power of the wages earned by personal and home care aides between 1999 and 2006. It finds that their median wages nationwide increased by an average of just 2 percent a year while the rate of inflation grew faster, causing the 4 percent decline in real wages.

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Are rising gas prices making it harder for you to deliver or receive care? Add your comments at the end of this post. 

We all feel the pinch from high gas prices, but for home care workers it’s more of a punch. As PHI President Steven Dawson puts it: “The doubling of gas prices over the past few years has been like a pay cut for many home care workers — particularly those serving clients in rural areas.

“Policy makers like to believe that home care is cheaper than nursing homes, but that’s only true because home care workers are paid less than nursing home workers, often without health benefits,” adds Dawson. “There’s not much good to say about higher gas prices, except perhaps that they will now force policy makers to look more closely at the real costs of shifting toward home-based care, and in response create realistic reimbursement policies that will offer home care workers a true livable wage and benefits.”

When PHI’s Michigan State Director Hollis Turnham wrote about the home care gas crisis in our blog in June, talking about the problems she was already hearing about, anticipating others, and asking what other people were experiencing, the response was swift and impassioned. An employer called rising gas prices “the 500 lb gorilla in the room for home care agencies.” A home care worker talked about seeing turnover increase and “looking for something closer to home myself.” The head of a home care and hospice aide recruitment agency said he planned to do “something very tangible to address this issue,” though he wasn’t ready yet to say just what. 

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Judging by a couple of recent articles in Canadian papers, the issues affecting direct-care workers don’t change much when you cross the border.

A July 25 article in the Prince George Citizen describes a British Columbia public relations campaign that aims to generate interest in direct-care work as a career, which was spurred by “a critical need for care aides and home support workers to care for B.C.’s elderly.”

The article says more than 1,500 qualified graduates are needed immediately to fill current positions in nursing homes, assisted living, and home care. To meet fast-growing demand, the government plants to complete 5,000 new long-term care beds and assisted living units by the end of the year, creating the need for more workers.

The $160,000 B.C. Cares Campaign includes a student loan forgiveness program.

And a July 4 article in The Canadian Press called on Ontario to “turn its understaffed, institutional long-term care homes, where residents are more likely to be restrained and medicated, into small community homes where staff have the time to drink coffee with their elderly charges.”

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“Just yesterday my son’s caregiver quit…she couldn’t provide care for my son because she didn’t have care for her own children. It’s a vicious cycle,” says one of the long-term care stakeholders interviewed for a report from the Texas Direct Service Workforce (DSW) Initiative.

Stakeholder Recommendations to Improve Recruitment, Retention, and the Perceived Status of Paraprofessional Direct Service Workers in Texas (pdf) distills input from key stakeholders into 14 recommendations on how to improve turnover and the perceived status of the state’s direct service workers.

With the help of PHI, whose technical assistance was supplied to the project by the Centers for Medicare and Medicaid Services’ National DSW Resource Center, the initiative divided the recommendations into compensation, opportunity, and support – the same three categories used in PHI’s Nine Elements of a Quality Job.

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A newly awarded federal grant will fund continuing research and analysis on how to strengthen and support the personal assistance services workforce.

The University of California San Francisco’s five-year-old Center for Personal Assistance Services (PAS Center) learned last week that is has been funded for another five years by the National Institute on Disability and Rehabilitation Research. In a news release about the grant, Charlene Harrington (pictured), the Center’s director and principal investigator, describes the center’s goal as “providing support so that people with disabilities can live and work independently in their community, as opposed to being institutionalized in a nursing home.”

Starting this October, the center will focus on three areas under the $4.25 million grant: improving access to PAS by individuals with disabilities; improving the workforce to support individuals with disabilities, and understanding the complexities of the economics of PAS. The center has done research documenting low wages, a scarcity of health care benefits, and high turnover rates among PAS workers.

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“If I had only one sentence, this would be it: Direct support work is a highly skilled job,” says Amy Hewitt.

“It’s not viewed that way by society – or, frankly, by many employers – but not everybody can do this job. You have to be smart; you have to be able to problem solve; you have to be flexible and a quick thinker. You also need patience and empathy and creativity. We’re not going to get anywhere in terms of policy advocacy or getting the supports we need in place without clearly articulating that this is a highly skilled job.”

Hewitt is a senior research associate at the University of Minnesota’s Research and Training Center on Community Living. The center’s mission is to support community living for people with intellectual and developmental disabilities – and that has led to a focus on strengthening and supporting the direct support workforce.

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