As we age, many prefer to stay at home instead of somewhere like a nursing home.
Personal care aides, or homecare workers, can help with cleaning, bathing, running errands and companionship, among other things.
However, Nevada's homecare workforce isn't growing fast enough to meet the increasing demand from an aging population. According to a 2020 report from the Guinn Center for Policy Research, the state currently has more than 13,000 homecare workers and needs to hire more than 5,000 additional workers by 2026 to keep up with demand.
But, despite a recent increase in state hourly rates for homecare workers, low wages, poor working conditions and lack of retention continue to hinder growth in this field.
The shortage threatens to leave many elderly Nevadans without the necessary support to live comfortably and safely at home.
THE CHALLENGES
Malu Lopez, 58, has been a home healthcare giver with local agency Absolute Home Health Care for more than five years. She was getting paid $12 an hour right before the state raises kicked in earlier this year, which increased her wages to $16 an hour.
But, she says it’s still not enough.
“It's a better living,” Lopez said. “But still, I’m always trying to have another job in this industry, because at $16 … if I were working only the eight hours a day, you do the math. In the end, who can pay a decent rent with that?”
One of Lopez’ clients is Diane Wohlman, 61. Lopez has been taking care of Wohlman for more than six months and sees her 12 hours a week, following a stroke Wohlman suffered that affected the left side of her body.
Wohlman said it impacted her ability to do everyday things.
“It affected my left hand, shoulder and leg. I use a walker just to be safe since a couple of weeks ago I fell. I'm just learning how to peel potatoes again, and chop vegetables.”
From trips to the nail salon and helping her bathe, to squeezing fresh orange juice for her, Lopez does things for Wohlman that far exceed care-giving. She makes life easier, and even provides emotional support.
“I count my blessings every day,” Wohlman said. “I realize how much the good Lord has done for me. He sent me Malu and I'm grateful. This is a very important service, that someone's coming in to check on me and make sure I’m okay.”
Lopez said raising client hours is something she’d like to see implemented.
She currently sees three clients, but she said the ideal number for a homecare worker is two. More hours for each client can lead to better care.
“I would love to spend more time, because I can see the results,” Lopez said.
“Unfortunately we don't have plenty of hours. Even with the commute, it’s almost one hour to come and one hour to go home for me. But, I would love for my client to have more hours in her recovery.”
THE SOLUTIONS
On May 30, dozens of unionized Nevada homecare workers, union leadership and several Nevada dignitaries gathered at an event at the Springs Preserve in Las Vegas to talk about potential legislative and union backed plans in the pipeline for homecare workers.
The Service Employees International Union Local 1107, who organized the event, lobbied and were behind the state’s first homecare employment standards board, as well as the January raises.
The union plans to lobby for an increase to $20 per hour for workers, better training, more hours for clients and making the homecare employment standards board permanent.
A statement from the Nevada Department of Human Services, the department who oversaw the board when it was active, read in part:
“The job of the Homecare Employment Standards Board was to make recommendations for the improvement of working conditions in the home care industry. The state is working to ensure an adequate workforce to support the health care needs of Nevadans. Home care workers are an important component of the workforce that helps individuals stay in their homes while receiving the support they need.”
State Senators Dina Neal and Rochelle Nguyen, who were the main legislative force behind past homecare worker initiatives, stressed addressing the state’s homecare worker crisis as soon as possible.
They plan to support the union’s proposals for the 2025 legislative session.
“At the end of the day,” Neal said, “how is it that (a worker) can give you their best selves — their best mental space in the job — when they're worried about whether or not there's going to be an eviction notice when they come home?”
“It's not easy work,” said Nguyen. “It's emotionally difficult, and it can be physically difficult. And so, trying to retain them, I think having better training, increased wages; all those kinds of supportive services can lead to making sure that we have a robust workforce in this area.”
Jeff Schofield, one of the head administrators for local homecare organization Everyday Miracles, said he supports better working conditions and raises for workers, but that today’s work culture is part of the problem.
“People just won’t show up sometimes. And then the next day you’re like, ‘Hey, are you alright?’ And they’ll be like, ‘Oh, I’m fine, just this came up.’ And then I say, ‘Well next time just let us know, we’re happy to help.’”
Schofield continued, “We really try to bend and twist to keep our people happy. Sometimes we’re keeping some people that we probably shouldn’t, but we need them.”
Additionally, Schofield said that while the homecare industry is not the most lucrative one, increasing the state medicaid reimbursement rate is key to raising wages for workers.
Chief Policy Deputy for the State Treasurer’s Office, Erik Jimenez, works with the state budget and said he’s hopeful more positive change will come to the homecare industry in the future.
“A lot of it is going to depend on the budget, right? But, thankfully, we’ve had overperforming revenues over the last several years. The state’s general fund balance is also the highest it’s ever been,” Jimenez said.
“I think if there was ever a time to have a systemic conversation on how we improve our broken healthcare system, it’s right now.”
Guests: Jeff Schofield, administrator, Everyday Miracles; Erik Jimenez, chief policy deputy, State Treasurer's Office
