Workforce Shortage

The workforce crisis stems primarily from caregivers’ poor wages, benefits, and working conditions. Average starting wages for long term care workers are about a dollar above minimum wage; average wages are about $9 an hour. Home care workers rarely receive health care benefits and almost never receive pension benefits. These are important jobs, but they cannot sustain families.

Home care workers also face a series of job-specific challenges. Poor training, a lack of natural supports from co-workers and mentoring, and a high risk of injury all add to the difficulty of providing care to seniors in their homes. For home care workers, as for other poorly paid workers, off-the-clock expenses including transportation, child care, or health crises often force them to leave the field. Unsurprisingly, vacancy and turnover rates are very high.

An unstable workforce has tremendous negative implications for consumers. For seniors and people with disabilities who are receiving services, turnover means the loss of a relationship painstakingly built over months or even years. Losing a caregiver can also mean not receiving enough care in the first place or not receiving care at the right time.

In the traditional home care system, seniors are limited to workers employed by Medicaid-authorized agencies, limiting their choice of and the availability of caregivers. If consumers use a professional agency, their caregivers may be sent at specified times – usually during regular workday/workweek business hours – resulting in consumers receiving assistance when it’s available instead of when they may actually need or want it.