Sec. 2. Findings

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Congress finds the following: Nearly 25,000,000 adults in the United States require assistance completing self-care and other daily tasks due to physical, cognitive, developmental, or behavioral conditions. This number includes approximately 22,700,000 individuals living in the community, 1,300,000 residing in nursing homes, and 900,000 in residential care. According to the PHI, direct care workers provide most of the paid, hands-on care for older individuals and individuals with disabilities.

The assistance of direct care workers allows older individuals and individuals with disabilities to live with dignity and safety, and to exercise their right to live independently in their own homes and communities, in keeping with what is most appropriate for their needs and preferences. Older individuals and individuals with disabilities may also participate in the direct care workforce, further supporting their ability to live independently. The direct care workforce is diverse.

Almost 9 in 10 direct care workers are women, and 61 percent are people of color, with women of color growing as a share of the workforce across every long-term care setting between 2009 and 2019. From 2021 to 2031, home care occupations are projected to create nearly a million new jobs. Home care is also among the fastest-growing occupations, and with the projected growth in the population over age 65, this may underestimate the number of home care workers that will be needed to provide care for this growing population.

Due to transitions to other occupations or exits from the labor force, there will be an estimated 7,900,000 total job openings in direct care from 2020 to 2030. Many direct care workers lack access to a career pathway or advanced training opportunities. This limits their ability to build competency and expertise in their field that, when gained, may lead to an increase in their earning capacity. According to PHI, more than half of home care workers have completed no formal education beyond high school, making high-quality, transferable training essential to success on the job.

The median wage for direct care workers is $14.27 per hour, and wages and earnings for home care workers are even lower in rural areas. Because of low wages, variable work hours, and the inability to access workplace-based benefits, 40 percent of direct care workers live in low-income households, and 14 percent of the workers from such households live below the poverty line. Nearly half of direct care workers rely on some form of public assistance to support themselves and their families.

Direct care workers face high injury rates, as they are up to three or more times likelier to experience workplace injuries than the typical worker in the United States. The poor quality of these jobs contribute to high turnover, low job satisfaction, and workforce shortages. This impacts the quality of care and availability of supports for older individuals and individuals with disabilities. The Institute of Medicine found that to ensure that the United States is prepared to meet the health care needs of older individuals during the 21st century, it is essential that the capacity of the direct care workforce be enhanced in both the number of workers available and their ability to meet their own health care and quality of life needs.

Training has been shown to reduce worker turnover, reduce rates of injury, and lead to increased job satisfaction. Wraparound services, such as career navigation support, mentoring, and vouchers for child care or transportation, have been shown to have a positive effect on program completion and employment outcomes, like increased wages. Career pathways are an evidence-based approach to workforce development that aligns secondary and postsecondary education to labor market needs.

It involves articulated steps of education, training, and employment within an industry sector or occupation that leads to the progressive attainment of skills and wages.