State-level policies targeting direct care workers made a difference during the pandemic — over and above federal support provided to long-term care providers. But long-term transformation is necessary for the future of the workforce, according to a new PHI report.
Although only 4% of direct care workers lost or left their jobs during the first wave of the pandemic, many more reduced their hours to quarantine or to care for themselves or family members.
PHI documented how states responded to the challenges of the country’s 4.6 million direct care workers — personal care aides, nursing assistants and home health aides — and other essential workers during the first 18 months of the pandemic (March 2020 to August 2021). The report specifically focused on hazard pay and paid sick leave policies across the country.
“The full impact of COVID-19 on direct care workers is difficult to quantify, but impossible to ignore,” report co-authors PHI Senior Director of Policy Research Kezia Scales, Ph.D., and Data and Policy Analyst Stephen McCall wrote. The economic effects on workers was “devastating,” they added.
More than half of the states did not support direct care workers with hazard pay and / or paid sick leave policies, they found. Overall, 17 states implemented at least one hazard pay policy, and four states implemented new paid sick leave policies during the study period. Of the 14 states that had existing paid leave policies in place, four amended those to issue supplementary policies.
Only 10 states implemented both hazard pay and sick leave policies: California, Connecticut, Massachusetts, Michigan, New Jersey, Oregon, Rhode Island, Vermont, Virginia and Washington state.
Lessons learned
Improving direct care jobs and stabilizing long-term services and supports for the future means implementing livable wages for direct care workers and establishing a national compensation strategy for direct care workers, according to the report authors.
“As the long-term care sector recovers from the tragic impact of the COVID-19 pandemic, it is imperative that we document and learn from what happened and how the sector responded,” the authors wrote. “With this knowledge, we can take steps to build better jobs and better services to meet the needs of older adults and people with disabilities — now and into the future.”
PHI also recommended adopting universal policies across direct care occupations and settings, including public health emergency clauses in paid sick leave laws, and creating state or regional paid care advocates to educate workers on their employment rights.
States also need to monitor any direct care workforce-related policies to ensure that they achieve their intended effect on workers and on the delivery of quality care.
PHI previously released a report indicating that a public education campaign would improve the public’s understanding of the direct care workforce, help recruit more workers, empower those workers to tell their own stories and publicly recognize this workforce.
