How to avert the direct care workforce shortage

It is impossible to overstate the importance of direct care workers for people and families across the country. From cooking meals to assisting with dressing and bathing, direct care workers provide critical services that make it possible for millions of older Americans and Americans with disabilities to live healthy and independent lives. But these essential services are increasingly harder to find.

States across the country are reporting unprecedented shortages of direct care workers, which include home health aides, personal care aides, and nursing assistants. As Baby Boomers continue to age, the current number of unfilled direct care jobs foretells the shortages we will likely experience in the not-too-distant future.

Direct care occupations are projected to add more than 1.3 million new jobs between 2018 and 2028, far outpacing any other sector. Despite this expected increase, public health officials and patient advocates are increasingly concerned that the sharp rise in demand for direct care workers is threatening to deprive many families of the support they desperately need. The looming shortage is alarming, but it is also preventable. The key is understanding its cause.

Direct care workers provide our loved ones with invaluable practical and emotional support. But, in exchange for delivering compassionate care, workers are frequently subjected to low wages and difficult working conditions. Rates of workplace injury for direct care workers are three times higher than other professions, and the current median wage for direct care workers is just over $11 an hour. As a result, nearly a quarter of home care workers live below the federal poverty line and more than half are forced to rely on public assistance to cover their basic needs.

Too often, workers are not financially or emotionally capable of staying in these jobs for long periods of time. Consequently, the turnover rate in the direct care workforce is anywhere from 45 to 60 percent.

There is no mystery behind the struggle to recruit and retain direct care workers. If we want to fill these critical jobs and ensure older Americans access to quality care, we must provide direct care workers the respect and compensation they deserve. Last September, I joined Rep. Susie Lee (D-Nev.), Sens. Tim Kaine (D-Va.), and Maggie Hassan (D-N.H.) to introduce a bold and necessary proposal that would transform the experience of direct care workers across the country.

The Direct CARE Opportunity Act, H.R. 4397, makes significant investments in direct care workers. It establishes grants that will help increase their earning potential and opportunity by supporting training programs, mentorship opportunities, and other proven strategies to make direct care a more sustainable career. In most other professions, workers can increase their pay as they increase their skills and experience. Direct care workers should have that same opportunity.

This proposal would also incentivize talented people to stay in their jobs by providing financial assistance for transportation, child care, and housing, which will help direct care workers balance their family and financial commitments.

The investments in the Direct CARE Opportunity Act can also be used to fund regional innovation by states and local organizations because the best solution to the workforce shortage in Newport News, Va., may be different than the best solution in Newport Beach, Calif.

The Direct CARE Opportunity Act has earned the support of several patient groups as well as advocates for direct care workers who have the clearest view of the challenges facing communities across the country.

If we put off these smart investments today, we will be paying greater human and financial costs in the future.  In addition to the continued hardship felt by direct care workers across the country, failure to avert a widespread workforce shortage will eventually make long-term direct care either unaffordable or inaccessible for a vast majority of Americans. Without access to essential care, older Americans and people with disabilities—who would otherwise be able to live at home—will be forced into more expensive and less personalized institutional care.

Congress has a proposed solution to this foreseeable problem. The Direct CARE Opportunity Act will significantly improve the lives of direct care workers, while ensuring that future generations of older Americans and people with disabilities have access to the care they need to live independently and with dignity.

Scott is chairman of the Education and Labor Committee.