By Debra Lancaster
New Jersey’s home health aides are an essential lifeline for thousands of seniors and people with disabilities, assisting with bathing, dressing, meals, medications, and other daily activities. They check vital signs and watch for the early symptoms of illnesses such as COVID-19. And they provide needed companionship and emotional support to those who live alone.
Yet, these skilled healthcare professionals are among the lowest-paid workers in our state.
The average yearly salary for home health aides in New Jersey ranges from about $23,000 to $25,000, according to federal statistics. We rank in the middle nationally, but even top-paying states average is no more than $35,000.
Many home health aides are forced to rely on public assistance to fill the gaps between their salary and their basic household needs. It is typical for these workers to go without health insurance and retirement savings.
Like many other undervalued jobs, this one is disproportionately done by women and people of color. Our recent analysis at the Rutgers Center for Women and Work finds 95% of home health aides in New Jersey are women; more than half are immigrants; and almost 70% are black or Latina.
While some home health aides are hired directly by families, perhaps to live with a client and provide 24/7 support, the vast majority work for agencies and visit multiple clients daily. For-profit firms now dominate the landscape, including mom-and-pop agencies, franchises, and large corporations.
With its low pay and high stress, the industry struggles to retain workers. The turnover rate reached an all-time high of 82% in 2018, according to a national study. A number that large should be a red flag in any field, but especially one that is charged with caring for vulnerable people.
A constant churn of workers means employers are focused on hiring bodies, with less time to invest in supportive supervision, staff development, and quality of care. It’s also a challenge for clients and their families. Having different workers in and out of your home can be unsettling.
The COVID-19 pandemic is shining a light on structural inequalities, weak social safety nets, and vulnerabilities in our institutions. Home health aides are emblematic of these issues. How we value the work of home health aides is indicative of how we value women’s care work, our seniors and our neighbors with disabilities.
The home health care industry should pay a living wage and provide benefits including health insurance. Regulators and policymakers should hold the industry accountable by ensuring appropriate compensation for this essential workforce and Medicare and Medicaid reimbursement rates that support quality care.
Now, more than ever, it’s time to revalue the important work of home health aides.
Debra Lancaster is executive director of the Center for Women and Work at Rutgers, the State University of New Jersey.
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