Low wages and high poverty rates for direct care workers sound the alarm for policy efforts to improve conditions in nearly every state, according to a new report from PHI.
In addition to improving wages, the authors of the worker and eldercare advocacy organization’s “2024 Direct Care Workforce State Index” suggest that states strengthen training standards, fund matching service registries, expand Medicaid, establish paid leave policies and earned income tax credits, repeal anti-union laws in right-to-work states, and increase employment protections for LGBTQ+ workers.
“There is no state in the country where the average direct care worker is thriving financially, or even earning the same amount per hour as their counterparts in other entry-level occupations,” the report authors wrote.
Approximately 4.8 million people in the United States deliver direct care via positions such as personal care aides, home health aides and nursing assistants, according to the report; 85% of them are women, 64% are people of color and 28% are immigrants. Workers’ median hourly wage is $15.43 an hour, or approximately $25,000 a year, the report stated, adding that 37% of US direct care workers live near or below the federal poverty level.
“Due to low wages combined with the prevalence of part-time and unstable work hours, direct care worker median annual earnings ranged from $17,398 in New Mexico to $34,203 in Washington, DC,” the report noted.
The index combines several measures of compensation and economic stability. Rhode Island received the top score, followed by Alaska, New Hampshire, Maine and Hawaii. Mississippi, Louisiana ranked the lowest, below New Mexico, Missouri, Texas and Louisiana.
The federal minimum wage is $7.25 an hour, although many states have set the bar higher, according to the report. Hourly minimum wage rates that exceed the federal threshold, for instance, range from $8.75 in West Virginia to $17 in Washington, DC.
It is worth noting, according to PHI, that some states are taking an extra step to boost the wages of direct care workers. In California, for example, the minimum wage for healthcare workers — including some direct care workers — will be increased to $25 per hour incrementally over the next few years.
“[S]tates have made notable progress toward supporting and strengthening the direct care workforce, but there is still a long way to go,” according to the researchers. “Even the highest-ranking states in the state Index — those which have implemented a robust range of supportive workforce policies — have room for improvement.”
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