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Anthony Cirillo

ParaProfessional HC Institute (PHI) Reports Shows Poverty Wages for Those Closest to the Care

By February 15, 2013

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The annual PHI analysis of wage trends for personal care aides (PCAs) -- the fourth fastest-growing occupation in the nation - shows that wages continue to be low and stagnant for these workers who provide services and supports to elders and individuals with disabilities in home and community-based settings.

In 2011, the national median hourly wage for PCAs was $9.49 - an increase of less than one percent from the previous year, researchers report in the PHI State Chart Book on Wages for Personal Care Aides. Wages declined in 16 states the same year.

By comparison, for all jobs in the economy, the average hourly wage increased from $16.27 to $16.57 in 2011.

As many as 33 states reported average hourly wages for PCAs that fell below 200 percent of the Federal Poverty Level. Wages below 200 percent of the federal poverty level ($10.47/hour) are low enough to qualify workers for many state and federal public assistance programs.

"Yet again, two-thirds of states report very low wage levels for personal care workers," said Dorie Seavey, PHI director of policy research who conducted the analysis with Abby Marquand, PHI policy research analyst. "Even more disturbing, wages for PCAs in very few states have actually kept up with inflation over the last decade. The economic security of hundreds of thousands of caregivers who make it possible for others to live independently is at stake," Seavey continued. "It will be very difficult for our country to meet the rapidly growing demand for personal assistance workers without improving these wages."

In 2011, there were 820,600 PCAs employed by home care agencies. With the increasing demand for PCAs, the occupation is projected to grow by 71 percent over the decade, creating an additional 602,000 PCA jobs by 2020.

The PHI chart book tracks PCA wages in all 50 states and the District of Columbia, and presents data from 2001 to 2011. Findings include:

  • In 2011, nominal median wages within the continental U.S. ranged from $8.22 in West Virginia to $12.24 in North Dakota.
  • Over the 10-year period, 41 states showed a decline in real median wages (adjusted for inflation) for PCAs. Ten states saw real wages fall by 10 percent or more. Hawaii and Rhode Island saw real wages fall by more than 20 percent.

Home care workers, including personal care aides, have been excluded from minimum wage and overtime protections under the Fair Labor Standards Act since 1974, under what is known as the "companionship exemption." In December 2011, the U.S. Department of Labor issued a Notice of Proposed Rulemaking to reduce the scope of this exemption.

"It is unlikely that narrowing the exemption will result in an instantaneous improvement in PCA wages," Seavey said, "but evidence has shown wages for low-wage workers are lifted by setting a minimum wage. Narrowing the exemption will also end the second-class status of these jobs."

Other recent efforts to improve the nature of these jobs have centered around training. While there are no federal guidelines or standards for PCA training, several states have been engaged in improving training standards through the federally funded Personal and Home Care Aide State Training (PHCAST) demonstration grants.

PHI is a staunch advocate for front line workers. Owners and operators in turn would argue that shrinking reimbursements prevent them from paying higher wages. But then looking at the balance sheet and the pay for executives paints a different story. There is a middle ground and blame to go around. Bottom line is that these workers are the front line staff and therefore both your Chief Experience Officer and your Chief Marketing Officer. Shouldn't they be compensated fairly? I would think so.

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