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Reports Document Need, Challenges of N.H. Direct Care Workforce

By Beth Potier, Media Relations
September 16, 2009

With a population that is aging at a faster rate than the national average, New Hampshire’s demand for home-based care workers outpaces supply, new data shows. At a meeting with state legislators today, UNH researchers presented several reports outlining the critical role and primary challenges of these direct care workers in New Hampshire.

Coordinated by the New Hampshire Coalition for the Direct Care Workforce, the Carsey Institute at UNH presented a recent survey of the direct care workforce – those who provide hands-on care for older adults and those with disabilities. The coalition, in conjunction with the New Hampshire Institute for Health Policy and Practice and the Institute on Disability at UNH, made policy recommendations in a white paper.

“The direct care workers are the unsung heroes in communities across our state. They perform extraordinary tasks caring for our loved ones receiving, on average, less than a livable wage and piecing together work to make ends meet. The NH Coalition for the Direct Care Workforce worked with the University of New Hampshire to conduct a survey to understand the scope of the issue. The results call us all to the table to reduce existing barriers to support and expand this field. The New Hampshire Department of Health and Human Services is committed to making home and community services a viable option for everyone,” said Nick Toumpas, commissioner of the N.H. Department of Health and Human Services, which has staff members serving on the coalition.

Using data from the New Hampshire Direct Care Workforce Survey, Carsey Institute family demographer Kristin Smith, a research assistant professor of sociology at UNH, authored “Home Care Workers: Keeping Granite Staters in Their Homes as They Age.” Key findings of the policy brief include:

  • Direct care workers earn less than other workers in the state. The median hourly wage for home care workers in New Hampshire was $10.00 in 2008, whereas the median hourly wage for all New Hampshire workers was $16.48 in 2007 and $17.25 in 2008.

  • Twenty-nine percent of home care workers in New Hampshire typically work full-time hours for their home care agency. By cobbling together part-time jobs, 46 percent attain full-time hours, but they lack benefits and face a wage disadvantage compared with those who have full-time hours at their home care agency.

  • Very few home care workers receive paid time off; in fact, 67 percent have no paid leave of any kind. Full-time workers are twice as likely to have paid leave as part-time workers.

  • One-third of home care workers in New Hampshire lack health insurance, primarily because it is too expensive for the employees.

  • Home care workers were asked to name all the features that would make their job better. Higher wages was the leading factor, followed by better access to benefits, such as health insurance, more paid time off, and more opportunities for advancement.

To attract and retain a vital direct care workforce, the New Hampshire Coalition for the Direct Care Workforce made the following policy suggestions in a white paper:

  • The N.H. Department of Health and Human Services should establish a rational rate-setting and reimbursement process that will enable home care agencies to pay a livable wage to direct care workers.

  • N.H. stakeholders should work with the Congressional delegation to create federal reimbursement for the training of home and community-based workers.

  • State home care agencies should implement a steady work week, create loan repayment programs for their direct care workers, and improve the quality of staff supervision.

The policy brief “Home Care Workers: Keeping Granite Staters in Their Homes as They Age,” is available to download at http://carseyinstitute.unh.edu/publications/PB_NH_HomeCare_09.pdf. The white paper, “Strategies to Invest in the Future of the Direct Care Workforce,” is available to download here: http://realchoicenh.org/NHCDCW.html.

The Carsey Institute conducts policy and applied research on vulnerable families and on sustainable community development, giving policy makers and practitioners the timely, independent resources they need to effect change in their communities. Visit their web site at http://carseyinstitute.unh.edu/.


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