A caring crisis
Caregiver Majid Sulemana shaves resident David G.'s face inside the bathroom of the Diane Road group home in Mendota Heights, Minn. the morning of Monday, June 19, 2017. Photo by Evan Frost | MPR News
by Andi Egbert, Sr. Research Associate
A caring crisis
Who will care for us (and our children and our parents) when the economy lures away the workforce?
A tight labor market and a strong economy yields many positive gifts, trumpeted in headlines appearing throughout the past year: unemployment falling to lows not seen in decades, more prime-age workers returning to the labor force, a long-awaited rise in real wages.
Following its peak at 10 percent following the Great Recession, the graph of plummeting unemployment since then looks like the descent the Grinch made down the mountain en route to plunder Whoville. The latest monthly report for September 2018, showed unemployment fell to 3.7 percent nationally, now a hair below the latest previous trough in April 2000. One would have to travel back to the late 1960s to find a lower official unemployment rate for the United States.
As the demand for labor intensifies, workers have greater leverage in pay and benefits and more opportunities to choose among jobs that help them capitalize on the economy’s gifts. For workers, this economy is a boon. But for those on the receiving end of some occupations, it’s nothing short of painful.
Where will the workers come from to fill these essential roles? Immigration is an obvious solution, but current federal policies are moving in the opposite direction. Notably, between 9 to 17 percent of these caregiving occupations in Minnesota are filled by immigrants or refugees already.
Many of society’s employed caregivers—assisting children, the disabled, and older adults—perform physically and emotionally demanding work for little pay. Here in Minnesota the median annual wage for child care workers and personal care aides (PCAs) is $25,000 (or less than $13 hourly).
Given the low wages offered and other job prospects abounding, is it any surprise then that Minnesota’s latest Job Vacancy Survey shows the number of unfilled positions for these roles growing? Vacancies for PCAs have swelled to nearly 6,700, and child care workers to almost 1,200. Compared to the statewide job vacancy rate of 5.2 percent, the rate for child care workers is 10.3 percent and for PCAs, 9.3 percent.
Note: The Job Vacancy Survey is conducted in the second and fourth quarter of each calendar year. Quarterly results have been averaged and displayed as a single year in the above graph, with the exception of 2018 Q2, the final data point.
Data courtesy of Minnesota Job Vacancy Survey
With roughly 1 in 10 of these caring jobs standing open, community members needing care face the consequences.
According to the Minnesota Council on Disability’s “March 2018 Fact-Sheet,” the PCA shortage has resulted in health and mental health consequences for those reliant on their care: “Those lacking appropriate care can develop severe pressure ulcers, breathing problems, urinary and other infections, as well as a host of complications requiring costly hospitalization and nursing home placement. People have had to stay in bed over holidays, or slept in their wheelchairs overnight because they could not find PCAs to fill needed shifts. Some people have died due to the lack of qualified staff.”
Minnesotans with disabilities have also been forced into institutional settings because they cannot find workers to assist them in their homes.
While many have heralded Minnesota’s low unemployment rate (now nearly a point below the nation’s at 2.8 percent in September), it is contributing to this “caring crisis.” For every one available job in this state, there are only 0.6 unemployed people seeking jobs.
PCAs are among the top 10 occupations in demand in Minnesota. And due to the continued aging of Minnesota’s population, the need for their services is multiplying. PCA jobs for are expected to grow more than 30 percent between 2016 and 2026, outpacing nearly every other occupation in the state, including hot jobs such software developers, nurse practitioners, and information security analysts. And yet, the salaries in those other high-demand industries will serve to attract workers.
Not so for the ranks of the caregivers. PCAs’ wages are dependent on the state’s Medicaid reimbursement rates. The economics of the child care industry are also notoriously difficult to remedy, with many families paying large shares of their income for care, while centers have low margins and workers have low take-home low pay.
Many low-paid jobs are seeing high vacancies rates in Minnesota's tight labor environment. Data courtesy of Minnesota Job Vacancy Survey
Where will the workers come from to fill these essential roles? Immigration is an obvious solution, but current federal policies are moving in the opposite direction. Notably, between 9 to 17 percent of these caregiving occupations in Minnesota are filled by immigrants or refugees already.
Hubert Humphrey, the former U.S. Senator for Minnesota, Vice President, and unsuccessful Democratic candidate for President in 1968, once said, “…the moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in the shadows of life, the sick, the needy and the handicapped.”
In a strong economy, we must consider how to better compensate or otherwise find staff to give essential care, or we will only lengthen those shadows.
-Andi (@DataANDInfo)
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