Caregiver wearing stethoscope takes pulse of home health patient

Among the consequences of the pandemic are a gaping hole in data available on the direct care industry, according to Robert Espinoza, vice president of policy for the advocacy group PHI. It must be plugged, he says. 

Robert Espinoza, PHI

“At the height of the pandemic, we often got questions from state leaders who would say ‘we have a COVID hotspot in this part of the state, can you tell us if there are available workers nearby?’ Espinoza told McKnight’s Home Care Daily. “The answer was no because states don’t collect that data which would allow them to see the concentration of workers in different regions of the state.”

Improving data collection is among 47 recommendations PHI outlined in a report to the White House, Congress and key federal agencies in an effort to transform the direct care industry. While recommendations to raise worker wages and improve training have been in the spotlight for months now, improving data collection plays a key role in supporting the care economy.

Espinoza said there is inadequate data state by state on the number of direct care workers, credentialing and compensation. He believes the dearth of relevant data makes it difficult for policy makers to make decisions on improving jobs and wages.

Funding to capture data

PHI is recommending the federal government provide funding to states to build out infrastructure to capture that data. Espinoza said it is also crucial that the industry understands the size of the so-called gray market, which includes workers who are paid cash and usually don’t pay taxes.

“There is no data on the gray market for workers or consumers of home care,” Espinoza said. “The Department of Health and Human Services should take the lead in funding a representative national survey to get an idea of what consumers are dealing with, what workers are dealing with and the kinds of issues they’re facing. From that, we can understand what the solutions are.”

PHI estimates about 4.6 million people work in the direct care industry, which is projected to grow to approximately 7.4 million people by the end of the decade.

Other recommendations

PHI’s recommendations also include training, workforce interventions and financing. The organization is backing the WISH Act, which would create a public-private fund to pay for long-term care. Espinoza says such a program would not only benefit seniors, but caregivers as well.

“We have a system now that relies heavily on Medicaid and that is untenable. So many Medicaid budgets are strapped now,” Espinoza said. “Often providers say they don’t have the resources to deliver effective services, much less to improve jobs. So, we do need to imagine a stronger alternative financing system.”