Rising Wage Benchmarks for Home Health Workers

By Josephine Wong

The influence of low-wage benchmarks raises many difficulties for home health workers to support a basic standard of living and achieve economic stability of care. The roles that home health workers play in society are extremely important, for they assist older adults and people with disabilities in their homes and communities who require constant healthcare services. This article discusses the central role that home health workers provide for our community, and how setting higher wage benchmarks and establishing state policies can help boost workers’ economic security and compensate for their vital performance in the home health industry.

In the US, home health workers have long been receiving low wages who typically make less than $12 USD per hour in the lowest paying states, and generally below $18 USD per hour in the highest-paying states. With how the COVID-19 outbreak heavily influenced the routine and daily operations of healthcare facilities, millions of American policymakers have proposed to divert more government support for home health workers since the employment rate has vastly decreased. “In the past decade, we’ve seen wages adjusted for inflation kick up a little bit,” said McCall. “But those wage increases really haven’t translated into widespread economic stability for these workers. This is particularly troubling given everything that they’ve faced during the COVID-19 pandemic, where they were literally laying their lives on the line … and are still providing critical services to older adults and people with disabilities”. Home health workers work around the clock to look after the elderly and individuals dependent on in-home supportive services, but their efforts go vastly unnoticed in our economy. In addition to performing their regular duties, home health workers are also assigned to assist in distributing infection control supplies, food, and medications beyond their usual workload. Low-paid home health workers, especially individuals who are sole caretakers, are more prone to experience financial, physical and emotional strain than those who have additional care for ageing adults. This is evidenced in the Senior Living 2021 Annual Report, which surveyed that 33% of American sole caretakers suffer from financial strain and 46% of them experience emotional stress. Here, it clearly indicates the catastrophic effects of low-income home health workers living in household crowding conditions with their families, and less likely to have a regular source of health care as well.

The worker economy security situation in the home health workforce is declining exponentially. State median wages for home health workers ranged from $8.76 to $17.45 per hour with a national median of $14.15 as of 2021, which is significantly less than the national median wage of $22.00. Their annual salary is only around $23,000 despite working exceedingly long hours every week. Many workers have extremely low wages with 1 in 6 home care workers living below the poverty line, where many of them have no choice but to turn to the government for aid due to the government policy set wage being so low despite their essential role in the healthcare industry, which in turn implies that the government will have less incentive to adopt good policies in the home health sector.

Illustration by Ariel Suen

The underlying reason why home health workers are so severely underpaid is because of the lack of labour protection available, as well as how we often undermine their workforce value in our society and economy. Another contributing factor is the systemic oppression of home care workers who are marginalised based on their gender and race. This is critical in understanding the devaluation of workers in this occupation and the low wages that they are paid. As the home health workforce is largely composed of women –– 88.6% out of all workers, many of them are immigrants and women of colour. Asian, Latino and Black women represent 60% of the home health worker sector, and these women caregivers usually have to bear the brunt of unpaid family care.

Home health economic security can be enhanced through several methods. First, delivering significant cost savings. Given that there is a significant staff shortage for home health workers, 1 million additional home health care workers are needed by 2029. Alternatively, higher wages would reduce short staffing in the healthcare workforce. Individuals who provide higher income tax given that they receive higher wages will increase in savings across government programs –– leading to $556 million worth of savings in Medicaid and $1.6 billion savings across benefit programs and tax credits. These cost savings entails the significant benefits that it could bring in the home health industry; not only can it provide more resources for patients, but also reduce the workload for home health workers given the amount of stress they are under. Secondly, enacting effective and lasting state policies, as it has a powerful impact by reimbursing services that create higher wages for home health workers. For instance, the Washington state Medicaid agency came to terms with worker unions of increasing worker wages. The economic policy institute has proposed wages that suit a more adequate level of living for each state in the US, which ranges from a minimum of $19.58 per hour in West Virginia to a maximum of $33.87 per hour in Washington. Although right now there are no states where home health workers meet this proposal due to the underlying reasons of it being an overlooked labour force, it serves as an accurate representation of the value of home health care workers, which can ultimately provide economic stability for the workforce that will certainly flourish in the future, allowing more workers to enter this profession in a state of greater economic growth.

Although more home health/personal care aide openings are predicted to grow by the end of the decade, there are some states that still significantly need more staffing increases. There is an inextricable link between the financial impact of economic instability on home health workers and their hurdles they face on a daily basis. By implementing nationwide government policies to set higher wage benchmarks for the workforce, as well as strengthening state Medicaid programs around home and community-based services (HCBS), home health workers can hugely benefit from this investment in home health care work and be able to enjoy an adequate wage that will thrive the economy.