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Expanding public funding, increasing the minimum wage and unionizing workers are the first steps toward improving wages and working conditions in the residential long-term care industry, according to the authors of a new report.

“The state of the residential long-term care industry,” from Washington, DC-based think tank Economic Policy Institute, covers employment trends in the industry and suggests interventions to try to ensure that long-term care services are accessible, affordable, safe and enriching for those who need them.

“The deficiencies in access, quality of care and quality of life for residents and their families are inseparable from the struggles and deficiencies in job quality, societal recognition, public funding and voice on the job for long-term care workers,” EPI State Economic Analyst Marokey Sawo, a co-author of the report, said in a statement. A “dignified collective future” can be achieved only with “adequate public funding that simultaneously improves conditions for care workers and ensures adequate care access and quality for those in need, regardless of their income or wealth level,” Sawo added.

According to the report, the vast majority of residential long-term care workers —  residential care facility and nursing home staff — are women (80.9%), with a disproportionate number of them being Black (22.4%) and immigrant (12.8%) women. They earn a median hourly wage of $15.22, below the US median hourly wage of $20.07, and 7.2% live in poverty, compared with 5.3% of all workers. 

“For too long, our society has devalued the elderly and people with disabilities, as well as the workers who help them lead more enriched and independent lives,” said Julia Wolfe, former EPI state economic analyst and a report co-author. “It is no coincidence that women — particularly women of color and immigrants — perform much of this hands-on care work, both paid and unpaid, in homes and in residential long-term care settings.”

The EPI report said this revelation presents an opportunity to improve employees’ working and living conditions.

Solutions from funders, policymakers

The report calls for expanding public funding to provide higher pay and improved working conditions for care workers, which the authors said will lead to better recruitment and retention of an “experienced and committed workforce.” 

The authors also called on policymakers to pass legislation to raise the minimum wage and strengthen protections for workers seeking to unionize. They also recommended that states and localities establish industry-specific worker standard boards to recommend changes to industry minimum wages and working conditions.

“Employment levels in the long-term care industry have failed to meet demand, and the shortfall is expected to grow. Yet long-term care workers do not receive adequate pay for their work, and many live in poverty,” said EPI Research Assistant Sebastian Martinez Hickey, another report co-author. “If we are to ensure that those who need care receive quality care, we must be able to attract more workers to this profession and ensure that those workers have the pay, benefits and support they need.”