Editorial: Give elder care workers ‘enough pay to stay’

  • State Rep. Paul Mark, D-Peru addresses elder care issues at a policy breakfast held by LifePath in Greenfield, April 12. STAFF PHOTO/JOSHUA SOLOMON

Published: 4/19/2019 6:42:41 AM
Modified: 4/19/2019 6:42:29 AM

There are many facets to the elder care crisis in the Bay State: First, is the fact that 70 percent of nursing home residents have their care paid for by MassHealth or Medicaid, rather than the slightly higher-paying Medicare reimbursement. But because MassHealth uses cost estimates from 2007 for reimbursements, homes are consistently underfunded, according to the Massachusetts Senior Care Association.

Secondly, there are more options for keeping seniors out of nursing homes – good for seniors, but bad for nursing homes when their occupancy rate drops below a sustainable level. That results in nursing home closures across the state and, consequently, fewer beds available for seniors who eventually need this level of care.

Underpinning it all is the low rate of pay for elder care workers.

The average salary for a Caregiver/Companion is $12.68 per hour in Massachusetts, which is 6 percent above the national average. Salary estimates are based on 58 salaries submitted anonymously to Indeed by Caregiver/Companion employees, users, and collected from past and present job advertisements in the past 36 months.

The average salary for a Personal Care Assistant, which is the first step on the educational ladder, is $15.34 per hour in Massachusetts, which is 26 percent above the national average. Salary estimates are based on 338 salaries submitted anonymously to Indeed by Caregiver employees, users, and collected from past and present job advertisements on Indeed in the past 36 months.

In both categories, the typical tenure for a caregiver is less than one year.

That situation prompted a recent policy breakfast at LifePath to sound the alarm to local elected officials, who attended the meeting in the middle of one of the busiest days of their year, with budget bills due on Beacon Hill. “There’s just not enough workers to go around,” said LifePath Case manager Therese Fitzsimmons. “The workers are being stretched very thin.”

So thin that workers typically need second jobs or work more than 40 hours a week to make ends meet. “You have to do a bartending job or a waitressing job to be a CNA,” Helen O’Gorman, a full-time certified nursing assistant at Springfield-based O’Connell Care at Home, told reporter Andy Castillo last year. O’Gorman also picks up private home-care clients and runs a cleaning business, logging between 60 and 70 hours of labor among the three jobs each week. If CNAs relied on just one job, “we’d all be broke.”

Ella Arial of Gill, another CNA, told Castillo that she works 60 hours a week to earn a living wage. “Honestly, you cannot live on a 40-hour-per-week salary doing this job,” she said. “There’s a lot of turnover. A lot of people who go into this work find out they don’t have the heart for it. If you don’t have the heart, you won’t stay.”

That makes this job a labor of love – “It’s the best job in the world,” said Catherine Burnett, who works with Catholic Charities – but one which has a higher on-the-job injury rate than construction workers.

“To hear them talking about their struggles about being underpaid,” state Rep. Paul Mark, D-Peru said at the policy breakfast, “it breaks your heart.” Also attending were state Rep. Natalie Blais, D-Sunderland, and Elena Cohen, district director for state Sen. Jo Comerford, D-Northampton.

Bills that advocates pushed for include intensive case management, increased availability of home care services to middle-income elders, and increased wages for home-care workers, known as “Enough Pay to Stay.”

“We having trouble recruiting, retaining workers because the rates are just too low,” Mass Home Care Executive Director Lisa Gurgone said. Studies point to an approaching crisis in 2030, when a national work shortage, coupled with aging Baby Boomers, will lead to a drastic shortfall in workers to take care of the elderly.

Part of the answer is increased Medicare and Medicaid reimbursement rates for health-care businesses so that they can offer elder care workers “Enough pay to stay,” because there’s no future for a career that depends on a labor of love.


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