Economic stimulus package should invest in direct-care workforce

Share this content:
Steven Edelstein
Steven Edelstein
As Congress continues to debate the specifics of an economic recovery package, many long-term care stakeholders, including PHI, are pressing for new investments in eldercare.

America is aging. In the next decade, we will need one million new direct-care workers to provide services for these older Americans. At 4 million in the year 2016, this workforce will outnumber most other occupations, including teachers K-12 (3.8 million) and registered nurses (3.1 million).  

The federal government is the primary payer for eldercare services, contributing 70 cents for every dollar. Now is the time for the government, which needs desperately to create jobs, to invest in growing and stabilizing the workforce needed to care for an aging America. By doing so, the government can jumpstart its economic recovery and at the same time make a down payment on America's caregiving needs.

What makes this a good economic strategy? Direct-care is among the fastest (and at the moment, one of the few) growing occupations in the country. These jobs provide work that is relatively recession-proof. They also put money into the hands of women who are supporting families. This means that these workers spend their wages quickly on goods and services. This is exactly the economic boost we need, particularly in hard hit low-income communities.

For direct-care jobs to provide a real boost to the economy, however, new public dollars need to be used to improve the quality of these jobs. Currently, because of low pay and inadequate training, direct-care positions have extraordinarily high turnover, costing employers an estimated $5 billion annually. In addition, 40% of direct-care workers live in households that have such low incomes that they rely on some form of public benefits—e.g., Medicaid, food stamps, or housing assistance.

For these workers and the millions of Americans struggling to hold down jobs, provide for their families, raise their children and care for their aging parents, we can do better. And with millions more who will face the same challenge over the next decade, we must.

That is why PHI is calling on Congress to use this current crisis to invest in not only shovel-ready infrastructure jobs, but jobs that prepare America to care for our elders in need. This means not just adding more jobs with low pay and high turnover, but investing in better wages and benefits and improved training opportunities. Specifically, the federal government could use the economic recovery package to:

* Improve direct-care jobs by improving compensation, with a target of ensuring that all direct-care workers earn at least $12 an hour and have health insurance.

* Target the eldercare/disability services industry in sectoral and workforce development efforts, directing federal training money toward direct-care worker training, job placement, and retention activities.

* Provide grants to states to enhance and upgrade the content of direct-care worker training and to expand and improve their training infrastructure.

The needs of America's economy provide a unique opportunity to improve the quality of care for America's elders by improving the quality of direct-care jobs. A decade from now, when the economy has improved and demand for services has grown to record heights, we will not regret having invested in building a stable, quality caregiving infrastructure upon which all of us can depend.

Steven Edelstein is the National Policy Director for PHI (, a national nonprofit committed to improving the quality of eldercare/disability services through improving the quality of direct-care jobs.

Next Article in Guest columns

Guest Columns

Guest columns are written by long-term care industry experts, ranging from academics and thought leaders to administrators and CEOs.