COVID Great Reckoning hastens a crisis of caregivers shortage

Millions of workers have left their jobs in the wake of the COVID-19 pandemic, the Great Resignation. But a more apt term for what workers have been experiencing is a Great Reckoning – with the conditions that they have been forced to settle for, including long hours, lack of benefits, impossible levels of stress, poor compensation and a dearth of advancement opportunities.

Epitomizing these concerns are those workers who provide caregiving support and services to older adults and people with disabilities, at poverty-level wages. Even prior to the pandemic, turnover was high: 1 in 4 nursing assistants and 1 in 5 home health aides reported that they were looking for new jobs.

This Great Reckoning has hastened a nationwide crisis of care: The number of people over 65 is expected to double by 2060, and by 2029, there will be 7.4 million job openings for care workers nationwide. Meantime, Congress has yet to fully fund care services to help meet the need.

Care worker shortage to get worse without help

We have spent our lives building power with millions of American care workers, including hospice workers, nursing home workers, home care providers and domestic workers. In our roles as secretary-treasurer of the Service Employees International Union and president of the National Domestic Workers Alliance, we’ve seen how the work of those we organize with is taken for granted. NDWA organizes the nannies, house cleaners and home care workers working in private homes, and has passed domestic workers bill of rights legislation in 10 states. SEIU is the largest union of health care workers and represents 750,000 home care workers across the nation.

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In our positions, we’re observing alarming trends in the care sector. As a result of the conditions they face, half of nursing home workers and 1 in 5 home care workers we surveyed in California are considering leaving their positions within the next year; 8 in 10 are concerned about staffing shortages.

Nationally, 420,000 long-term care workers have left their positions in the past two years. Without systemic change, this workforce shortage will get worse, and quickly.

It is unsurprising that care workers can no longer bear their circumstances. Nationally, the average wage for direct care workers is $13.56 per hour; a large share of workers are not provided health care benefits, retirement benefits or paid sick leave; and training and advancement opportunities are few and far between.

At the outset of the pandemic, many already strained workers were expected to perform their duties without access to personal protective equipment. Workers with the least amount of resources were asked to risk it all in our time of greatest need. And they did, with little improvement in compensation.

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Workers providing care under these conditions are a majority women of color, including many immigrants. The daily duties of care workers were once performed by enslaved Black women and later underpaid domestic workers. Today, 61% of workers in the care sector are people of color and 87% are women. Addressing the crisis in care is fundamentally a matter of racial and gender justice.

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Dignity for clients and workers alike

Workers in this sector make it possible for their clients to live with dignity. They dress, bathe, cook for and administer medical care to their clients. They transport them to appointments and errands, often at their own expense.

Most home care workers are paid from Medicaid reimbursements, an underfunded and fundamentally inadequate part of our nation’s health care system, while many others are paid informally. This is why investing in Medicaid home and community-based services has been a core part of President Joe Biden’s economic agenda.

Even so, the sector has yet to see meaningful change – critical funding was left out of the recent budget reconciliation bill.

Meantime, workers are fighting to implement worker standards boards, which would allow them to participate in setting standards for the quality of jobs. Members are also fighting for a $20 wage floor.

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But we must transform our care system. For example, Washington state has created a social insurance program via a payroll tax that funds care benefits to families, while providing additional resources to workers. California has the opportunity to create its own revenue stream to realize universal, statewide care, which will benefit workers and clients who require their services. California has also recently expanded Medicaid coverage, which also presents an opportunity for state-level transformation.

At NDWA, we’re fighting to pass the Domestic Workers Bill of Rights Act, to establish basic rights for domestic workers, addressing long-standing exclusions in the labor laws, dating to the New Deal of the 1930s, and extending paid sick days and protection from discrimination and harassment. In July, the House Education and Labor Committee held a historic hearing on the legislation.

In the midst of this Great Reckoning, workers are demanding safety, dignity and fair compensation for themselves. It is a moral imperative that these changes are made to sustain the care sector.

Ai-jen Poo is executive director of Caring Across Generations and president of the National Domestic Workers Alliance. April Verrett is secretary-treasurer of the Service Employees International Union (SEIU). Both were part of MIT’s Community Innovators Lab Mel King Fellows Program and are supporting the 2022-24 fellows to advance policy and investment strategies to transform the care industry.

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This article originally appeared on USA TODAY: Help caregivers who help older adults and people with disabilities