Caring in America: A Guide to America’s Home Care Workforce

Key Workforce Facts

December 2011

More than 2.5 million home care workers

Source: Caring in America, p. 4.

Performing tasks in 4 realms

• Self-care assistance

• Everyday tasks

• Social supports

• Paramedical tasks

Among the fastest growing jobs in the country, 2008-2018

Source: PHI, Facts 1: Occupational Projections for Direct-Care Workers, 2008-2018.

Among the jobs adding the most new positions (due to growth), 2008-2018

Source: PHI, Facts 1: Occupational Projections for Direct-Care Workers, 2008-2018.

Home care worker demographics

• Mostly female (88% female)

• Older (50% over age 45)

• 60% non-white

• 55% with high school education or less

• A quarter foreign born

Source: Caring in America, p. 10.

Main employers

• Home care agencies providing non-medical personal care services

• Consumers and families

Growth in home care business locations (“establishments”)

Source: Caring in America, p. 20.

Estimated industry revenue (millions of dollars)

Source: Caring in America, p. 22.

Wages are low and stagnant

Source: Caring in America, p. 53.

Uncompetitive wages

Source: Bureau of Labor Statistics, Occupational Employment Statistics, 2010.

Part-time work common

Source: Caring in America, p. 61.

High rates of uninsurance

Source: Caring in America, p. 55.

Public subsidies required to meet basic needs

Source: Caring in America, p. 58.

Turnover endemic

• Small-scale studies show PCA turnover at 44 - 65%

• 2007 National Home Health Aide Survey: 35% of home health aides intend to quit in next year (~56,000 workers)

• Turnover “predictors”– Low wages– Not enough hours– No reimbursement for travel costs

Source: Caring in America, Section 10.

Incidence of overtime modest

9% percentage of home care workers nationally that report working more than 40 hours/week

Why so low?• Most states are “low-hour” Medicaid states

• Many agencies use staffing and scheduling practices that minimize overtime

Source: Caring in America, Section 8.

Involuntary part-time work -- a far bigger problem

Source: Caring in America, p. 61.

Agencies charge nearly twice what caregivers are paid

Source: National Private Duty Association (2009) State of Caregiving Industry Survey. 

Type of Service National Average Cost of Services (per hour)

National Average Starting Pay for

Caregivers (per hour)

Companionship $18.75 $8.92

Homemaker Services $18.90 $9.10

Personal Care $19.82 $9.69

Home Health Services $22.37 $11.78

For more information, contact:

Dorie Seavey, Director of Policy Researchdseavey@phinational.org ● 617-630-1694

Abby Marquand, Policy Research Associateamarquand@phinational.org ● 718-928-2062

Visit PHI PolicyWorks at: www.phinational.org/policy