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New Report: ‘It’s Time to Care’ about Direct Care Workers

January 21, 2020

NEW YORK — According to a new report released today by PHI, direct care workers are critical to the lives of millions of Americans, yet the persistent job-related barriers they face threaten the future of this sector.

In fact, new data on future demand for these workers shows that from 2018 to 2028, the direct care workforce will add 1.3 million jobs, and an additional 6.9 million jobs will become vacant as existing workers leave the field or exit the labor force. PHI’s new report argues that “it’s time to care” about these workers and their jobs.

It’s Time to Care: A Detailed Profile of America’s Direct Care Workforce provides a detailed overview of the direct care workforce (including key concepts and definitions), an analysis of how this role has evolved, and a statistical profile of the workforce with key demographics, socio-economic characteristics, and employment projections.

Direct care workers—formally classified as personal care aides, home health aides, and nursing assistants, but known in the field by a much broader array of job titles—provide assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs) across care settings.

“Direct care workers are a lifeline to millions of older people, people with disabilities, and their families, and this report emphasizes why we must focus our attention on these workers and make a large-scale investment that improves their jobs and elevates their value in the healthcare system,” said Jodi M. Sturgeon, president of PHI, a national research and consulting organization widely considered the leading expert on the direct care workforce.

Highlights from ‘It’s Time to Care’

  • Every day, nearly 4.5 million direct care workers support older adults and people with disabilities across the United States.
  • The direct care workforce is predominantly female (86 percent), and the majority of direct care workers (59 percent) are people of color.
  • According to the most recent data from the Bureau of Labor Statistics, the median wage for all direct care workers is $12.27 per hour and—due to high rates of part-time employment as well as low wages—median annual earnings are just $20,200.
  • Fifteen percent of direct care workers live in poverty (defined as living below 100 percent of the federal poverty level), while 44 percent live in low-income households (meaning below 200 percent of the poverty line).
  • Although there is no reliable national figure on turnover in the direct care workforce, turnover has generally been reported at 40 to 60 percent or higher.

It’s Time to Care offers two immediate opportunities to recruit and retain a strong direct care workforce: improve hourly wages and annual earnings for direct care workers, and build the workforce pipeline, notably by targeting new populations of potential workers and by addressing the harmful effects of recent immigration policies.

“These investments are an important step towards improving the quality of direct care jobs—but a comprehensive solution, which we’ll explore in future reports this year, will require remedying the inadequacy of the LTSS financing system, improving training and career development for direct care workers, and ensuring that direct care workers are well-supported on the job, among many other strategies,” said Kezia Scales, PhD, director of policy research at PHI and author of It’s Time to Care.

It’s Time to Care is the first installment in a yearlong series of reports that will examine the importance and impact of the direct care workforce. The final, comprehensive report—Caring for the Future: The Power and Potential of America’s Direct Care Workforce—will be released in January 2021. Each report in the series will provide original data, in-depth analyses, and immediate opportunities for action, as well as feature the stories of individual direct care workers from around the country.

To complement the series of reports, PHI has launched a year-long, online dialogue about the state of direct care workers, which audiences can follow on Twitter at #CaringForTheFuture.

“Our primary goal with this campaign is to spark and sustain a year-long conversation across our field—from policymakers to industry leaders to the full array of advocates—about why the direct care workforce matters, the variety of structural barriers facing these workers, and what we must do to transform these jobs and improve care for all of us,” said Robert Espinoza, vice president of policy at PHI.

This report was made possible through generous support from the W. K. Kellogg Foundation and the Woodcock Foundation.

Read It’s Time to Care >>

Learn more about PHI’s “Caring for the Future” campaign >>

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