States turn to parents to fill a home care workforce gap

Worker-owned home-care cooperatives are emerging as an alternative to the for-profit agencies that dominate America's direct-care sector. In these cooperatives, professional caregivers earn an average of $2 more per hour than the industry standard, share in business decision-making, and stay on the job at nearly double the rate of workers at traditional agencies. Patients also stay with co-op agencies twice as long, suggesting higher satisfaction and quality of care.

The Arizona Fellows in Election Administration program taps college students to work in county and state election offices, with the goal of creating a pipeline for positions that are often difficult to fill. During the 2024 presidential election cycle, 18 students and recent graduates participated in the program, and three went on to take permanent positions in their respective election offices.

Atrium Health’s pediatric hospital-at-home program allows patients to recover from the comfort of their own homes, rather than a hospital bed, combining visits from paramedics and virtual check-ins with doctors and nurses to provide continuous hospital-like care. 142 health systems in 39 states have been approved to provide home-hospital care, and some studies show patients receiving care at home have better health outcomes than those in hospitals.

The Ohio District 5 Area Agency on Aging hires state-tested nursing assistants (STNA) to act as community care specialists and provide in-home care to seniors. This care provides respite for unpaid family caregivers and allows seniors to continue living independently in their homes. In 2023 alone, the program served 130 residents, providing 2,371 hours of in-home care.

The Gonzales Youth Council, which allows young people to advise local government on issues that affect them, has inspired other youth councils to sprout up in neighboring communities. Youth commissioners participate in a paid summer fellowship to learn about city and school district processes, and the council has made several recommendations that have gone on to become ordinances, including fines for adults who facilitate underage drinking.

Direct care workers, including certified nurse assistants and home health aides, provide personal care to help aging or disabled individuals remain independently at home. There are approximately 165,000 of these workers across the state that serve more than 100,000 families with daily activities like bathing and meal preparation.

Several government programs and funding measures are emerging to improve home care options for families in need, such as increasing wages and benefit opportunities for providers. There are also nonprofits like All Things Home Care that provide transportation to area home care workers and represents its workers with a union to afford them better treatment to ensure those in need can still receive necessary care at home.

The Michigan state legislature temporarily boosted the pay of direct caregivers working with seniors and people that have disabilities by $2 an hour in recognition of their essential and sometimes risky services during the coronavirus pandemic. With about half of direct caregivers living at or near poverty, the pay bump was temporarily renewed at the slightly higher rate of $2.25 an hour, but it is set to expire again in September 2021. The governor has proposed making permanent a pay raise of $2 an hour, which helps the caregivers meet their own basic needs a little better.

The 2016 exemption to Ventura County's strict farmland protection laws has enabled the development of nearly 700 affordable housing units for farmworkers. These rent-controlled apartments on former agricultural land provide stable housing regardless of immigration status.

The Niger State Health Care Fund offers a voucher program that helps cover the cost of antenatal care and family planning services for women in rural areas and IDP camps. The voucher scheme, alongside community engagement programs and technological resources, has improved access to contraceptives and reproductive health services, but the state’s rate of contraceptive prevalence is still below the national average.