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How Do We Value Dignity?

Only one logical path leads us out of this crisis: We must truly care for caregivers. And to demonstrate our caring, we must make certain policy changes:

  • Pay a self-sufficient wage. This wage will vary by state and region, but it must be adequate enough to lift caregivers and their families out of poverty.
In the past few years, several state legislatures have increased their Medicaid rates for long-term care services and have earmarked these increases for direct-care worker salary increases. These "wage pass-through" laws constitute a big step forward, but are still only a down payment toward self-sufficient wages for direct-care workers.
  • Provide health insurance to workers and their families, as well as vacation pay, sick pay, paid holidays, retirement benefits and family medical leave.
  • Require balanced and safe workloads. For those seeking full-time home care work, jobs should offer a minimum of 35 hours per week without overuse of off-hour shifts. In facility-based work, overtime should be optional and staffing levels should be improved.
  • Adopt higher training standards. Paraprofessional entry-level training should be updated and expanded to reflect current care needs and clinical realities.
  • Create opportunities for advancement and professional development. To attract and retain qualified workers, the direct-care system must offer pathways for career development.
  • Provide additional employee support. Direct-care work frequently necessitates off-hour, shift work and this creates the need for specific employee supports such as special-hour child care and transportation.
  • Respect direct-care workers’ right to form and join a union. The collective strength of their voices can be invaluable in improving the long-term care system.

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