Is Massachusetts Prepared to Care?

Last year, I had the opportunity to spend part of the day visiting with an elder resident in my community and the home care worker who helps her to remain in her home. My constituent is 102 years old, and with the help of Philomena Ahern, she lives independently in an apartment below her daughter.

We all hope to age with dignity, living in our homes with help from family and friends, and possibly paid caregivers as well. Unfortunately, for many residents of Massachusetts, this option is often not available. A recent report from AARP scores Massachusetts 40th in providing home and community-based options to our low-income residents. Instead, when these residents need assistance, they are moving to costly facilities that may take them far from the community support they need to continue living meaningful, engaged lives.

This situation must change. Not only is our current system costing us more than it should, Massachusetts is facing a significant demographic shift which will present an even greater challenge. By 2020, one in five Bay Staters — nearly 1.2 million residents — will be over 65. These seniors will demand better options for long-term services and supports, including both quality nursing homes and flexible home- and community-based services.

Notably, for a more robust, affordable system of home and community-based services, the state needs a more sophisticated infrastructure. In particular, we need to build a stable, well-trained caregiving workforce. Home care aides provide 70 to 80 percent of the paid, hands-on care that elders and people with disabilities need to remain healthy and independent.

Home care is hard work and it doesn’t pay well. Home and community-based direct-care workers are among the state’s lowest wage earners. On average, they earn about $12 per hour, considerably less than the states’ median wage of over $20 per hour. Adjusted for inflation, home care wages have actually decreased over the last decade. Wages for nursing assistants who work in facilities, by contrast, have increased and currently average $13.53.

Massachusetts has 60,000 home care workers, and is expected, by 2018, to need nearly 20,000 additional workers to care for people who are aging or living with a disability and want to live in home and community-based settings. During the same period, our nursing home workforce of 42,000 is expected to add another 4,000 direct-care jobs, making direct-care jobs among the fastest growing in the Commonwealth. At a time when our economy, and especially our low-income communities, are struggling to get back on track, this is good news — these are jobs that cannot be outsourced, that do not require years of higher education, and that will be here for Massachusetts workers.

But if home care continues to be so poorly compensated — and to lack training and advancement opportunities — few workers will want to take these positions. With an improving economy, we may find ourselves facing a significant “care gap.” As a result, Massachusetts families will be placed under even greater stress as they try to juggle children, aging parents, and jobs. Without a focus on training and supporting a qualified home-care workforce, there simply won’t be enough trained home care aides to help when work responsibilities and long distances make it nearly impossible for two-earner families to support their loved ones. Families will be forced to make gut-wrenching decisions about their own economic stability versus the well-being of an elder. These difficult choices reverberate through our economy, as our businesses face significant costs of lost productivity as employees are forced to take time away from work or leave the workforce entirely to care for their loved ones.

We can build a stronger, more flexible infrastructure for long-term services and supports by carefully assessing our current workforce policies and making improvements. On Tuesday, Nov., 15, there was a hearing on Senate bill S45, “An Act to Establish a Task Force Relative to the Direct-Care Workforce.” This legislation would provide a strong foundation for developing statewide workforce policies that improve the quality of direct-care jobs across all long-term care settings, making them attractive to Massachusetts workers. It is an important step towards ensuring that Massachusetts is prepared to care. The passage of the bill would a win-win for our communities, growing our economy while also providing security for Massachusetts families. Let’s hope the legislature acts swiftly in support of this critical workforce.

– Submitted by State Senator Patricia Jehlen (D-Somerville, Medford)