At NDWA, we're addressing the Care Crisis by advocating for increased investment in care systems including Home and Community-Based Services (HCBS) and childcare programs, raising care worker wages, and enhancing protections for care workers.
1 in 6
Almost 1 in 6 home care workers live in poverty, earning an average hourly wage of just $14.50.1
$13.42/hr
Childcare workers earn a mean hourly wage of just $13.42. In 2022, there were only 5 occupations with wages lower than this.2
692,000
692,000 Americans are on waitlists (for an average of 3+ years) to receive home services through Medicaid.3
As we journey through life, the need for care touches us all, whether it’s nurturing our children, supporting aging parents or disabled loved ones, or ensuring we are able to age with dignity in our own homes. Care work is work done in the service of others, can be paid or unpaid, and encompasses a variety of roles from family caregivers to home care workers to childcare providers to nannies and more. Care work is, and has always been, essential because it makes all other work possible.
Despite its pivotal importance, care work faces significant challenges — including low wages, poor conditions, and widespread exploitation — resulting in workforce shortages. With the demand for care expected to soar in coming years, addressing these issues has become more urgent than ever to ensure a sustainable and equitable future both for those providing care and those who need care.
Families can’t afford care, care workers aren’t paid enough to feed their families, and our most vulnerable loved ones — children, aging parents and family members with disabilities — can’t get access to the care they need to thrive. Simply put, our country is facing a care crisis.
For direct care workers and childcare providers, low wages and poor job quality are leading to high turnover and worker shortages.
Direct care workers provide essential services and care to older adults, people with disabilities, and children with complex medical needs in various settings. They might be called Home Health Aides, Personal Care Aides, Homemakers, or Direct Service Professionals, depending on where they work and who they help. Home care workers are a type of direct care worker who assist people at home or in their communities, not in places like nursing homes.
Despite their essential role, direct care workers struggle to earn a living wage – exacerbating the inequities already faced by women, people of color, and immigrants. Home care workers earned a median hourly wage of just $14.50 in 2022 and annual income of $20,599.
Similarly, childcare workers earn an average hourly wage of just $13.42, with an annual wage of $27,920. In 2022, there were only five occupations with median wages lower than those of child care workers. As childcare wages remain low and wages increase across other occupations, it has become more difficult to hire and retain childcare workers.
Beyond low wages, direct care jobs are physically and emotionally demanding and often characterized by heavy workloads, scheduling challenges, inadequate supervision, and limited training and career advancement prospects. Additionally, many home care workers work only part-time (less than 35 hours per week) due to both personal reasons and economic conditions at their workplaces. All of these challenges contribute to high poverty rates among home care workers, with 15% living below the federal poverty level. Over half of home care workers rely on public assistance due to low incomes, while housing costs burden 37% of them. Furthermore, 15% lack health insurance, and 43% rely on public coverage, primarily Medicaid, underscoring the financial strains and vulnerabilities they face.
Similarly, childcare workers are faced with many challenges that affect the sector and that result in high turnover and workforce shortages. In addition to low wages, childcare workers experience limited access to essential benefits like health care and retirement plans, with twice as many lacking health insurance compared to the general workforce, and only a fraction receiving retirement benefits. The workforce is predominantly female and disproportionately comprised of women of color, who face substantial wage disparities. Union membership among childcare workers is low, impacting their collective bargaining power. The job itself is demanding, both physically and emotionally, with high rates of depression reported. Despite the importance of professional development, childcare workers often bear the costs themselves, exacerbating financial strain from already low wages.
For families who need care for a loved one in their home, direct care worker shortages mean that almost 692,000 Americans are on waitlists, waiting an average of over 3 years, to receive home services through Medicaid. By 2060, the number of people 65 and older will nearly double, and the number of adults 85 and older will nearly triple – exponentially increasing the need for quality care and care workers in the US. States already struggle to recruit and retain enough direct care workers to meet escalating demand, and it is estimated that from 2020 to 2030 the home care sector will have 4.7 million total job openings.
For families who need childcare in order to go to work and earn a living, burdensome childcare prices coupled with a lack of providers has made access to childcare even more difficult. Child care can cost more than $15,000 a year with prices ranging between 8 – 19.3 percent of median family income per child, which is well above the Health and Human Services’ recommended 7% of income benchmark for affordable childcare.
Additionally, childcare demands skilled workers to ensure safe and quality care, particularly in programs for infants and toddlers with strict safety standards. However, providing high-quality childcare is costly. Without state or federal funding to supplement their expenses, childcare workers and providers often incur the cost of maintaining operations through reduced wages, hours, or services, which adversely impact program quality.
Chart Source: U.S. Census Bureau. 2017. 2017 National Population Projections Datasets, Projected Population by Single Year of Age, Sex, Race, and Hispanic Origin for the United States: 2016 to 2060; analysis by PHI (June 2023).
Our population is growing exponentially and aging.
Due to an exploding growth in our aging population and increasing demand for childcare, we are seeing an exponential increase in the need for quality care and care workers in the US. However, our country’s current approach to care fails to adequately value care work or address the cultural and policy changes needed to meet these escalating needs, which means the care crisis will only get worse.
We must act now to prioritize care, recognizing its indispensable role in supporting families, and ensure that dedicated caregivers get the dignity, respect, fair wages and benefits they deserve. By investing in care and care workers, we can make care jobs good jobs and ensure that families across the country can access the care they need.
We need investments in our care systems that include comprehensive support and services for care workers. AND, we need policies, resources, and services necessary to help families meet their caregiving needs.
Families are already overburdened with increasing home care and childcare costs. That is why we must prioritize investments in our care systems. By adequately funding care systems, we can ensure that caregivers receive fair wages, benefits, and working conditions, while also making care services more accessible and affordable for families in need. Investing in care not only supports caregivers but also promotes economic stability, social equity, and the overall well-being of our communities. It’s time to prioritize care as a fundamental aspect of our society and invest in its sustainable future.
At NDWA, we are working to tackle the home care crisis by:
Our strategies to grow funding for care systems such as home and community-based services and childcare will allow more care recipients access to independence and critical care supports as well as increase wages for care workers, helping to stabilize the workforce and lead to better quality of care. Through our organizing and advocacy work, we are building a future in which every family has access to quality care.
Home Care | Federal Campaign
Join us to show your support for the Better Care Better Jobs Act and help improve the quality of care jobs while ensuring affordable, accessible care for all.
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Child Care | Federal Campaign
Contact your senators and demand they reject harmful amendments and pass the Child Tax Credit expansion in its current form as soon as possible.
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Child Care | Federal Campaign
Tell your elected officials to prioritize and invest in child care as they debate emergency funding and annual spending bills. Funding to address our country's child care crisis is more urgent now than ever before.
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Home Care
We're pushing for the approval of the governor's Medicaid Home and Community-Based Services (HCBS) budget and urging the Legislature to ensure fair wages for direct care workers serving all Medicaid recipients.
Home Care
We are ensuring that agency-employed personal care aides are not illegally misclassified as independent contractors as well as laying the groundwork for increasing home care wages.
Home Care
Together with the New Mexico Caregivers Coalition, we're building on past successes to establish a guaranteed minimum wage for publicly-funded home care workers and conduct essential studies on HCBS rates to ensure fair pay.
Home Care
We’re educating domestic workers about the rights they won with the New Jersey Domestic Workers Bill of Rights and expanding our base of home care workers to advocate for increased state investment in home care jobs.
Home Care
As part of the NY Caring Majority, we are organizing to oppose the Governor’s harmful budget cuts and redirect Medicaid funding to worker wages, not Managed Care Organization profits.
Child Care
NDWA’s North Carolina We Dream in Black chapter, along with the Child Care Services Association (CCSA), launched the “Business Side of Child Care” (BSCC) program, which includes business training, coaching & mentorship, grants, and support for new family child care homes.
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Home Care
We’re working to include amendments to the Current Operations Appropriations Act of 2023 to ensure that increases to Medicaid Personal Care Service rates go to wages of direct care workers. We are also working to secure a comprehensive rate study across HCBS programs to support our future fights for increased funding.
Home Care
We're pushing South Carolina legislators to establish a Long-Term Care Study Commission to study the state’s care access crisis, and address low industry wages.
In 2023, we hit a major milestone towards transforming the way this country treats care and caregivers when President Biden signed an executive order for care and a proclamation for care workers.
The Biden-Harris Administration’s executive actions to improve care were the most comprehensive set of actions in the history of the United States. The executive order includes more than 50 directives to federal agencies to utilize existing funding to expand access to quality, affordable care, and provide support to family caregivers and care workers, including domestic workers.
These executive actions recognize the critical importance of care work, including paid and unpaid responsibilities such as child care, elder care, and disability care. It acknowledges the challenges care workers face, who are often undervalued and underpaid, and aims to improve their wages, benefits, and working conditions.
Also in 2023, the Biden-Harris Administration announced a White House Proclamation declaring April as Care Workers Recognition Month, highlighting the Administration’s continued commitment to strengthening the care economy and marking a critical step forward for direct care workers, caregivers, early childhood educators, and child care workers to live and work with the respect and recognition they deserve.
This proclamation represents a turning point in our country – public recognition of work often invisibilized and undervalued, made possible by the women of color who have organized for decades to achieve transformational change in the care industry.
Every April, join us as we celebrate Care Workers Recognition Month and honor the millions of Black, Brown, Latinx, and immigrant care workers who support our families and communities every day!
As we strive to address the challenges faced by caregivers and ensure a brighter future for all, staying informed and connected is crucial. Sign up for NDWA’s email list today to receive updates on our ongoing efforts, opportunities for action, and ways to get involved in advocating for caregivers and those they support. Together, we can build a more equitable and compassionate society where care is valued and accessible for all. Join us in making a difference!
Jun 08 2023
Speak out in support of the federal proposal to guarantee that a fair share of Medicaid funds go to wages of workers who provide the hands-on services and direct care!
Learn More Aprende MásApr 18 2023
BREAKING NEWS: the Biden-Harris Administration announced the most comprehensive set of executive actions to improve care in the history of the United States!
Learn More Aprende MásMar 31 2023
We have AMAZING news to celebrate: the White House has just formally designated April as Care Workers Recognition Month!
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