ALBANY — The devastation wrought by COVID-19 on New York’s nursing homes has made headline news for over a year now, and spurred several big-ticket reforms that are expected to make facilities safer through increased spending on staff and patient care.
But frustrating many advocates is the lack of attention that’s been paid to the home care industry — a sector where long-held workforce shortages forced thousands of elderly and disabled New Yorkers out of their homes and into potentially deadly congregate settings in the first place.
After a Senate proposal to invest $624 million into the industry was dropped from the final state budget this spring, advocates and lawmakers say they remain unswayed in their efforts to convince state leaders that home care is a crucial component of long-term care. The overlooked sector needs attention now, they argue, if New York wants to prevent what is already a crisis-level workforce shortage from getting even worse.
“This is an urgent need that the state is going to have to address,” said Ilana Berger, co-campaign director of the New York Caring Majority, a coalition of care organizations that formed five years ago to advocate on behalf of the industry.
“It’s not going away — not for the millions of people who every day feel the crunch of having to find workers and not for the workers trying to live on less-than-minimum wage,” she said.
Indeed, advocates are worried that the final phase of New York’s plan to step up the minimum wage to $15 an hour for fast food workers this summer will spur an even bigger exodus from the home care industry, where workers make a minimum of $12.50 an hour across much of New York. That amounts to annual earnings of just $21,300, and helps explain why over 40 percent of workers in the industry live in or near poverty.
“The challenge with that is it doesn’t go up for all the other minimum wage workers, which includes home care,” Berger said. “The workforce shortage is already worse upstate and that’s just gonna exacerbate it.”
New York currently has the worst shortage of home care workers in the nation. A 2019 survey of home care agencies in the state found roughly 17 percent of care positions were left unfilled that year because of staff shortages, which led to delays in patients being able to access care or an inability to access services altogether.
Even before the pandemic the industry was expected to be one of the fastest-growing sectors in the state, thanks to the aging of the Baby Boomer population and growing age-in-place movement.
The state Department of Labor in 2018 projected home health and personal care aide jobs would grow by more than 65 percent in the next decade from 440,000 to over 700,000. Another analysis found that employers across the state will need to recruit roughly 26,510 new aides a year just to keep up with demand, and another 71,680 workers a year to replace the thousands who leave due to low pay and stressful working conditions.
“At current levels of recruitment and retention, the state is already unable to keep pace,” a recent report by the City University of New York concluded.
Meanwhile, the loss of over 15,000 nursing home residents to COVID-19 has caused many New York families to rethink institutions for their loved ones. A survey of 77 home care agencies last fall found that 65 percent experienced an increase in home care referrals during the pandemic, 85 percent reported worsening staff shortages, and 76 percent were forced to delay or deny new referrals due to staffing shortages.
“It’s very hard to recruit people into these jobs,” said Sen. Rachel May, a Democrat who is sponsoring a package of bills to boost pay for home care workers.
One of them — the Fair Pay for Home Care Act — would purportedly help lift over 200,000 home care workers out of poverty by raising home care wages to 150 percent of the minimum wage. This would allow workers to make at least $35,000 a year on average.
“They have a lot of responsibility,” May said of in-home aides. “These jobs are sometimes physically very demanding and emotionally they can be demanding, too. So we have to recognize that the work they do is hard and essential and should be valued at a higher rate than it is.”
Advocates also argue that raising wages for home care workers would help reduce racial and gender pay inequities in the state, since New York’s care sector is 91 percent female and 77 percent people of color.
“If you invest in home care, you are lifting up a workforce that is largely women of color,” Berger said.
While the Fair Pay bill didn’t make it into the state budget, advocates were able to get $624 million into the Senate’s one-house budget bill for the industry with the support of Majority Leader Andrea Stewart-Cousins, May said. Unfortunately, she said, it was dropped from the final deal — allegedly over concerns about making sure the money would go directly to workers.
The recent report by CUNY concluded the state would see sizable ripple effects on the economy if it boosted home care wages.
The report looked at two targets. The first would raise annual home care wages to $30,000 upstate (and even higher in New York City, Long Island and Westchester) and cost about $4 billion a year with health coverage and payroll taxes included. The combined value of new savings, tax revenues and economic spillover effects would easily exceed that — producing economic benefits of around $7.6 billion, the report found.
The report also looked at a second target which would raise annual home care wages to $40,000 upstate and more in and near the city. That would cost the state about $6.3 billion a year, but produce economic benefits of $12.9 billion, it concluded.
May said she hopes to hold several hearings on the topic of long-term care later this spring, including one devoted entirely to the home care industry. In the meantime, she said she intends to keep building support for legislation that would raise wages so that by next year’s budget season it stands a better chance of passing.
“All around the world people are doing innovative things to care for elders, including shifting them away from nursing homes altogether,” she said. “So I think we need to be looking holistically as a state at the options that are out there so we can steer New York in the direction of something that’s more healthy and humane and desirable for people as they age.”
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N.Y. home care industry has 'urgent need' for more workers, advocates say - Times Union
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