California’s care workforce is at a critical juncture. State master plans on the aging population and on early care and education have underscored the need to expand the care workforce and better support the workers who provide essential services to young children, older residents, and people with disabilities. At a virtual event last week, PPIC researchers outlined a new report on the current realities of the care workforce and talked with state policymakers about the challenges of meeting future demand.
Report coauthor Daniel Payares-Montoya noted that direct care, early care, and education jobs comprise about 6% of California’s workforce. “This is similar in size to the construction and food service industries in the state,” he added. He also noted that demand for care will surge over the next decade—in particular, the state will need a lot more direct care workers: “Home health and personal care aide jobs are projected to grow 29% to more than 1 million jobs by 2030.”
Expanding the care workforce will involve grappling with current realities. Many care workers earn low wages, and more than half work part time. “Close to half of care workers rely on public benefits to survive; some of that is due to part-time work,” said Abby Snay, secretary for workforce strategy at the California Labor and Workforce Development Agency. Efforts to address these challenges are complicated by the high costs of care for both government and private payers.
What has California been doing to improve both worker outcomes and the quality of care? Shannon McConville moderated a discussion about what has been happening and what more could be done that touched on a range of issues—from training to collective bargaining.
Snay said that state efforts have been significant, but more work is needed. “We have to do more to meet the exponentially growing demand,” she said. “We have to grow the workforce and we also have to stabilize it and focus on retention.” While investments in training do help attract and retain workers, facilitating advancement to higher-level jobs is not the sole solution. “We want to support people on career pathways to get better jobs, but we still need a large workforce providing direct care,” she added.
Linda Asato, executive director, California Childcare Resource and Referral Network, noted that the pandemic underscored the importance of child care. Before that, she said, “it was almost seen as an individual issue.” During the pandemic, the state provided grants and stipends to help caregivers maintain their businesses and offered incentives for home-based caregivers to become licensed.
Snay and Asato agreed that rewards for work-based skill building could help make many jobs more satisfying and remunerative. Snay added that making care workers more integral parts of health care teams is another important way to improve direct care jobs. This might require changes to scope of practice for certain positions—for example, allowing home care aides to give meds or monitor devices.
Asato noted that many childcare providers could benefit from business support. “If you are a childcare home provider, you have to think about everything . . . from facility maintenance, to budgeting, to marketing,” she said. There are also longer-term issues, such as health insurance and retirement benefits. “If we’re looking at maintaining this workforce for the long haul, I think all of this needs to be considered,” she added. “And it’s not something that an individual can do for themselves.”
