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Iowa’s direct-care workforce is among the lowest-paid employment groups in the state, according to a survey published by the Iowa CareGivers Association.

The average direct-care worker in Iowa makes just $11.50 an hour, according to the 1,276 survey respondents, a group that included certified nursing assistants, home health aides, and personal care assistants.

By contrast, Iowa’s median hourly wage for all workers is $14.40.

Nearly half (49.9 percent) of Iowa’s direct-care workers live in households earning under 200 percent of the federal poverty level.

Iowa’s direct-care workers also struggle to obtain health insurance, the survey found: nearly one-forth (23 percent) of respondents said they were not insured. Overall, 12.4 percent of Iowa’s adults lack health coverage.

Additionally, only 43 percent of direct-care workers in Iowa are offered paid sick leave.

Low Pay Discouraging to Workers

According to the survey, this lack of adequate wages and benefits is driving many Iowans away from direct care. More than 20 percent of direct-care workers surveyed said that they are actively seeking to leave the field entirely in order to find better-paying jobs.

“Workers are leaving direct care at exactly the wrong time,” said John Hale, a public policy consultant for the Iowa CareGivers Association. He notes that, of the ten jobs expected to be most in demand over the next decade, three are in the field of direct care.

“We cannot meet the future demand for workers who will enter and stay in the profession unless we make these jobs better by improving their pay and benefits,” Hale continued.

Recommendations for Future

The report offers several ways that Iowa can address the issue of low pay and benefits for direct-care workers.

For example, the report says that Iowa could insure more workers by expanding Medicaid eligibility to 133 percent of the federal poverty level. The Affordable Care Act will require all states to do that beginning in 2014, but states have the option of expanding Medicaid eligibility (pdf) at any point before then.

The report further recommends that Iowa expand eligibility levels for its subsidized child care program, as well as increase the size of its Earned Income Tax Credits.

– by Matthew Ozga

Iowa’s direct-care workers still lack adequate wages and benefits, according to an Iowa CareGivers Association survey that is set to be released in the coming days.

The survey, conducted by the Child & Family Policy Center, is the third — and so far, most comprehensive — overview of Iowa’s direct-care workforce published over the past decade. The last survey was released in 2004.

Like the rest of the country, Iowa is facing a shortage of direct-care workers just when the demand for their services is peaking. The aging of the baby-boomer generation will create a need for an additional 10,000 new direct-care workers in Iowa alone over the next 10 years.

In that context, the need for high-quality direct-care jobs is more urgent than ever.

“The needs of persons with disabilities and aging Iowans will go unmet if we continue to ignore and undervalue this incredibly important workforce,” said Di Findley, the executive director of the Iowa CareGivers Association.

“We can no longer, as a society, get by thinking that we can compensate people poorly simply because they are nice, caring people,” she continued.

Specific Survey Findings

Among the findings in the 2010 Iowa survey:

• Iowa’s direct-care workers are among the lowest-paid in the state, earning an average of $11.50 an hour, compared with the median hourly wage of $14.40 for all Iowa workers.
• A majority of direct-care workers in Iowa work full-time hours — but nearly half (49.9%) report household incomes that fall below 200% of the federal poverty level. Nearly one out of five direct-care workers in Iowa (18.2%) are below the federal poverty line entirely. Many rely on public benefit programs such as food stamps and child care assistance to make ends meet.
• Across the board, direct-care workers are less likely to be covered by health insurance than non-elderly workers throughout Iowa.
• More than one-fifth of all direct-care workers in Iowa say they are actively trying to leave the field, mostly due to low pay and poor benefits.

The survey suggests that some of the financial difficulties faced by Iowa’s hard-working direct-care workers could be offset by expanding public services, such as Medicaid eligibility and earned income tax credits, to more Iowans.

It also recommends that the Iowa government use its position of as a primary purchaser of direct-care services (under Medicaid) to raise wages and provide more benefits.

– by Matthew Ozga

John Hale, Iowa Caregivers Association

A guest column in the Des Moines Register by John Hale, a public policy consultant for the Iowa Caregivers Association (ICA), debunks the myth that home health care aides and other direct-care workers are low-skilled workers.

In “Care Workers with Low Skills? Hardly,” Hale refutes an Associated Press article published over Labor Day weekend that refers to a direct-care worker job as being a “lower skill and lower-paying job.”

He writes that the authors got this “half right” and explains the difference between having skills and having a formal education that results in academic degrees.

Hale describes the plethora of skills required to be a direct-care worker and emphatically makes the point that having an advanced degree does not mean that you have the skills to provide services and supports to older adults or people with disabilities.

Appreciated But Not Compensated

He laments that artists and athletes are valued for the gifts they have been “blessed with” and are paid “handsomely,” but society has yet to compensate (pdf) direct-care workers for the gifts that they possess. Many people may value the work of these paid caregivers, he writes, “yet [they] remain comfortable with them living in near poverty status.”

Hale tells readers that they should ask candidates who are “asking for your vote this fall” what they plan to do for direct-care workers and then “vote accordingly.”

‘Come Care With Me’ in Iowa

Hale has informed PHI that “the Iowa Caregivers Association has received expressions of interest from the two leading candidates for Iowa Governor to participate in Come Care With Me events,” and “dates and locations for the events are now being discussed with the campaigns.”

Come Care With Me events are designed to better inform elected officials about the work performed by direct care workers in a variety of care settings.

“ICA is also working with several key leaders in the Iowa legislature to schedule Come Care With Me events with them,” Hale added.

– by Deane Beebe

Local sector employment programs are effective in helping economically disadvantaged Americans find quality jobs, according to a new study.

The study was published in August by Public/Private Ventures (PPV), a nonprofit organization that supports low-income communities, and was funded by the Charles Stewart Mott Foundation.

It found that low-income, low-skilled people who used the programs generally fared better at finding and keeping good jobs, compared with those who did not participate in the programs.

Sector employment programs go beyond mere job-training programs, in that they concentrate their skills training within specific occupational sectors, such as construction, computer repair, or health care.

Findings of Study

The PPV study, entitled Tuning into Local Labor Markets, evaluated three sector employment programs — one each in Milwaukee, Boston, and New York City.

PPV charted the progress of nearly 1,300 study participants for two years. Half of them used one of the three sector employment programs, while the other half — the control group — did not.

Compared with the control group, participants in the sector employment programs:

• earned significantly more money;
• worked significantly more hours;
• found work more consistently; and
• were more likely to work at a job that included benefits, such as health insurance and paid time off.

Implications for Direct-Care Workforce

Sector employment programs that include health care components can be a boon to aspiring direct-care workers, the study shows.

For example, one of the three sector employment programs included in PPV’s study — the Milwaukee-based Wisconsin Regional Training Partnership — includes a health care track. Program participants trained within this track were “significantly more likely” to earn their certified nursing assistant (CNA) certification than members of the control group, the PPV study found.

PHI has long been considered a national example of sectoral employment strategies targeted to the direct-care workforce. PHI’s affiliates, Cooperative Home Care Associates of the South Bronx and Home Care Associates of Philadelphia, have modeled this type of sectoral training for more than 20 years, and together annually enroll more than 500 training participants.

“This PPV study used the ‘gold standard’ of social research — randomized control — to prove that sectoral employment strategies create measurable financial benefits for low-wage workers,” noted Steven Dawson, president of PHI.

“The timing of its release is exceptionally important, given the country’s desperate need to help low-income workers find solid employment. It is a strong rebuttal to those in Washington, D.C. policy circles who have long claimed that ‘training doesn’t work.’

“Yet, training focused on a particular occupation is only one half of an effective sectoral strategy,” added Dawson. “The other half is strengthening the employment practices of that sector’s employers — from improved supervision and peer mentoring, to better compensation and career ladder development.”

– by Matthew Ozga

NY Capitol Building in Albany

The New York State Senate passed a Domestic Worker Bill of Rights that would guarantee certain workforce protections to thousands of workers who are employed as nannies, housekeepers, or companions to the elderly. Read the full story

PHI has launched a social media campaign calling on Department of Labor (DOL) Secretary Hilda Solis to end the exclusion of home care workers from minimum wage and overtime protections. Read the full story