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Improving Labor Standards for the Publicly Funded Direct Care Workforce
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PHI ~ Quality Care through Quality Jobs
• PHI works to improve jobs for direct-care workers in order to improve quality of supports and services
• PHI works with all LTSS stakeholders – consumers, workers, employers/providers, organized labor, policymakers, researchers
• Workplace practices and policy solutions
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DCW at a Glance (2011)
• Female ~ 89%• Average age in home health care is 45• 47% are white; 30% are African-
American; 16% are Latino • Foreign born ~ 21%• Some college or a degree ~ 46%• One in 12 low-wage workers is a DCW
Source: US Census Current Population Survey analysis done by PHI
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United States: Median Hourly Wages for Direct-Care Workers, 2012
Source: PHI analysis of BLS/OES
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LTSS Financing
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Medicaid Funds for LTSS
State & Federal Tax Dollars (~$134 billion in 2012)
States
Managed Care Plans
Employers (average rate $21/hour)
Workers (average wage $9.50/hour)
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Comparing Cost of Home Care Services and Caregiver Pay, 2008
Type of Service National Average Cost of
Services(per hour)
National Average Starting
Pay for Caregivers(per hour)
Companionship $18.75 $8.92
Homemaker Services $18.90 $9.10
Personal Care $19.82 $9.69
Home Health Services $22.37 $11.78
Source: National Private Duty Association (2009) State of Caregiving Industry Survey, Executive Summary. Available at: NPDA State of Caregiving Industry – via PHI, Caring in America
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New York City: Medicaid Redesign Spurs Action on Worker Wages
– Employment relationships: LHCSAs (indirect payments from state), home attendant agencies (payment by city)
– NYC living wage law; unionization
– Managed care companies/Integration
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Home Care Aide Worker Parity Law
• Proposed by the Governor as an amendment to the state budget
• Downstate metropolitan counties – NYC, Nassau, Suffolk, & Westchester
• Increased in three increments to $10/hour on 3/1/14. Requires $4.09 additional in benefits.
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Maryland
• Maryland Minimum Wage Act of 2014 (HB 295)
• Requires a 3.5% increase in reimbursement rates to agencies, and requires that it be spent on wages
• Public funding an opportunity & a challenge
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Public Authorities for Home Care Workers
• Public agency that provides an organizing framework for independent home care workers (OR, CA)– Acts as the employer of record– Collective bargaining agreement– Provides training and a registry– Fragmented workforce without a worksite
and high turnover hard to organize.
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For more information, contact:
Gail MacInnes, National Policy [email protected]
Visit PHI PolicyWorks at: www.phinational.org/policy