Conclusion: We Can Alleviate This Crisis

Each day, more of our nation’s paid caregivers decide they can no longer afford to provide the care they love to provide—and hundreds of thousands of direct care staff who do remain must rely on public subsidies to care for their own families.

Our nation’s "staffing crisis" is falsely named, because there are many individuals who would do this difficult work if they were adequately compensated. It should more accurately be identified as a wage crisis. This crisis leaves our loved ones exposed to care that is often hasty or delayed, and increasingly, care that is dangerous.

Therefore, the American Federation of State, County and Municipal Employees and the Paraprofessional Healthcare Institute urge both our state and federal governments to re-structure our nation’s long-term care system based on a foundation that adequately values the vital services provided by direct care workers.

The new system would:

1) Provide direct care workers a wage that can sustain their families without over-reliance on public subsidies, and certainly, provide all health care workers access to health care coverage.

2) Provide direct care workers’ with supports to improve their effectiveness and productivity. These supports include training, adequate staffing levels, career ladders, child care, transportation and reasonable schedules.

3) Respect direct care workers’ right to form a union. Recognize the contribution their voice can make in improving the long-term care system.

4) Improve coordination between the Medicaid and Medicare programs and change payment policies to achieve both better wage and employment standards for direct care workers and compliance with quality outcomes for patients.