2019-2020 Emerging Fellow Kevin Cao examines how Illinois can take steps to ensure the well-being of those requiring care and those providing it by advocating for the economic security of direct care workers.
Illinois will experience an unprecedented demand for care services for older adults and those requiring long-term care as the state’s aging population grows in the coming decades. Direct care workers are a driving force in ensuring that older adults and those requiring long-term care receive medical and non-medical services. These home health aides, certified nursing assistants, and personal care aides provide flexible care in homes and personal living settings that combine independence, comfort, and professionalism. If Illinois seeks to equitably and responsibly expand its direct care workforce, the state of Illinois should lead in charting a path towards meaningful worker protections and career advancement opportunities.
Direct care is an integral part of long-term care. As a part of the healthcare continuum from hospital to home, direct care workers will be an anchor in Illinois’s strategy for responding to the shifting care demands of the next decades. However, direct care workers today are at the mercy of a turbulent gig economy and the outdated understanding of their workforce potential. Direct care workers are asked to provide critical medical and non-medical care needs in the most intimate care settings, but still face poverty wages, confusing training standards, and stagnant career ladders. Worker recruitment and retention should be top priorities for meeting Illinois’s goal of creating 35,000 new direct care jobs by 2022, and reforming the state training standards and pathways can create tangible career incentives and fairer working standards for current and future direct care workers. More specifically, Illinois can lead this change through four initiatives:
- Standardizing training curriculum and updating certification requirements;
- Authorizing more advanced direct care roles with incentives for further training and higher pay;
- Creating formal pathways for more advanced direct care roles, transferable hours, and experience into allied healthcare careers; and
- Investment in a statewide training and career development fund that is responsive to changing direct care needs.
By advocating for the economic security of its direct care workers, Illinois can take steps to ensure the well-being of those requiring care and those providing it. Using the following policy framework, the direct care industry can begin a revitalization that will both seek to professionalize direct care roles and create accessible economic ladders for workers. The first half of this paper (sections I, II and III) provides background and context for the nature of direct care work, the profile of the workforce, and current problems facing workers. The second half (sections IV and V) introduces past examples of how private and state actors have addressed training and workforce development, the motivation behind these efforts, and their key takeaways. These insights ultimately inform the prescribed policy changes in the final section, and how they can be implemented in Illinois.