Commentary

Homecare workers in every North Carolina county earn too little to make ends meet

Home healthcare workers are earning wages that pay far below what it takes to make ends meet across every county in North Carolina, according to a new brief from the Workers’ Rights Project. This wage gap is weakening the overall economy and damaging the quality of long-term care seniors receive in their homes.

Direct homecare occupations like personal care aides, home health aides, and nurses assistants are some of the fastest growing in North Carolina’s economy—a trend that will only accelerate as demand for home healthcare services expand with the aging of the state’s baby boomer generation, the report finds. The population over 65 is projected to more than double by 2050, indicating a growing need for direct care that allows seniors to continue to live in their homes with dignity. Unfortunately, these growing occupations pay some of the lowest wages in the economy.

Caregiver - 3 maps together-ALLAN

Specifically, the report finds that:

  • Homecare workers aren’t earning enough to afford the basics. It takes $16.20 an hour ($33,700 a year) to cover the basic costs faced by a family of one adult one child in North Carolina, according to the Living Income Standard. Yet the median wage for the state’s caregivers ranges from $9.84 an hour for Personal Care Aides to $9.12 for home health aides and $10.84 for nursing assistants—almost $7 an hour less than what it takes to make ends meet.
  • Median homecare wages in every county in North Carolina fall short of it really takes to make ends meet—by as little as $2.84 an hour and as much as $10.35 an hour, depending on where these workers live. The report provides a detailed look at this wage gap in every county for which data was available in 2015.
  • The state’s fastest growing urban areas are facing some of the most crippling wage gaps. The Research Triangle region and Mecklenburg County have some of the largest pay gaps for personal care aides and home health aides. Part of this is due to the regions’ higher costs of living, but it is also driven by the especially low wages paid to homecare workers in the state’s most affluent counties.
  • The rates at which Medicaid reimburses private caregivers for the long-term care services they provide seniors and individuals are a major factor behind caregivers’ low-wages. North Carolina’s Medicaid program, which sets the framework for many private providers, reimburses homecare expenses at just $13.88 an hour, leaving little room for both workers’ wages and homecare agency operating expenses.
  • The low wages paid to home healthcare workers threaten the stability and continuity of the care seniors receive by increasing employee turnover and interruptions in scheduling. Homecare workers often have to work two or more jobs to make ends meet, so it is no surprise that so many leave the profession or struggle to juggle multiple schedules
  • North Carolina must raise the wage floor for paid caregivers in the context of the state’s Medicaid program and look to best practices in states like Montana and Maine that tie wage-improvement strategies to reimbursement rates.

It’s time for North Carolina to take hard look at how Medicaid reimburses provider agencies for the care provided to seniors and explore how those reimbursements can be improved to provide workers with quality wages.

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