Close up on a file tab with the word employees plus a note with the text sick leaves, blur effect at the background. Concept image for illustration of sick leave

A national compensation strategy is needed for direct care workers in light of pandemic disparity, according to a new report from PHI. 

The pandemic also highlighted the need for a universal sick leave policy across the healthcare industry, the authors said.

The report details findings on hazard pay and paid sick leave policies enacted across all 50 states and Washington, DC, from March 2020 to August 2021.

Left to the states, hazard pay and sick leave policies varied greatly during the first 18 months of the COVID-19 pandemic. Only a third of the states implemented any type of hazard pay for direct care workers, according to the authors.

“Persistently low wages and limited benefits are a reality for all direct care workers — and the acute physical, mental, emotional, and financial toll of providing care during the COVID-19 pandemic reverberated across this entire workforce,” the report noted. “Yet many hazard pay policies enacted during the first 18 months of the pandemic were restricted to individual Medicaid programs or provider types, reflecting the fragmented nature of long-term care financing and service delivery.”

The starting date of hazard pay policies ranged from March 1, 2020 to Dec. 1, 2020. Seventeen states implemented at least one hazard pay policy, and four states implemented a new paid sick leave policy during the study period, PHI found. Of the 14 states that already had an existing paid sick leave policy in place, four amended them or issued supplementary policies.

Ten states implemented both types of policies: California, Connecticut, Massachusetts, Michigan, New Jersey, Oregon, Rhode Island, Vermont, Virginia and Washington. 

In addition to a national compensation strategy, PHI suggests:

  • Extending supportive policies across direct care occupations and settings.
  • Sustaining short-term wage enhancements for all direct care workers. 
  • Establishing permanent paid sick leave laws.
  • Incorporating supplemental public health emergency clauses into paid sick leave laws.
  • Creating a state or regional paid care advocate.
  • Evaluating the implementation and effects of direct care workforce-related policies.