For immediate release:

May 31, 2017

Contact: Sabrina Siddiqui,

NEW GEORGETOWN REPORT: Expanding Investments in Caregiving is Key to Improving Economy and Creating Jobs  


WASHINGTON – On the heels of the Trump Administration’s recently released budget, which sharply cuts Medicaid and a wide range of other programs critical to American families, the Georgetown Center on Poverty and Inequality released a report on the importance of investments in caregiving jobs. The Administration’s budget and policies, including their paid family leave plan, fall short of addressing critical issues affecting American families.

Instead of sharp cuts, the report highlights policy that expands investments in caregiving, including early care and education as well as support for older Americans and people with disabilities. These types of well-designed investments can greatly improve the wellbeing of those receiving care and their family members who often forgo work due to demands of care, thereby improving the overall economy and creating jobs, the report finds.

“Our report proposes investments in caregiving jobs that address two national needs: the pressing need for caregiving and the equally pressing need for good jobs,” said Georgetown’s Nina Dastur, lead author of the report. “In the debates around infrastructure and tax reform, policymakers should consider well-designed investments in caregiving – these programs could create jobs and boost the economy.”

“Child care providers are underpaid and undervalued. By investing in early learning, providers like me will be able to take care of our own families and stay in the profession we love,” said Tonia McMillian, child care provider, SEIU Local 99 Treasurer, & Raising California Together Co-Chair, from Bellflower, CA. “Parents and providers understand that quality child care starts with raising pay. Parents and providers also understand that we need meaningful investments to make quality care more affordable for families.”

“Home care workers are the backbone of America’s healthcare system, helping seniors and people with disabilities live in their homes for as long as possible. Yet at $9 an hour, I can barely afford to care for my own family or go to the doctor when I get sick,” said Sepia Coleman, home care worker in Memphis, Tennessee, and Fight for $15 activist. “As America ages, home care work is more in-demand than ever— yet we’re still some of the lowest paid workers in our country. If policymakers are serious about strengthening the caregiving workforce, they should respect our right to a living wage and a voice on the job.”

Addressing The Need For Jobs

While the U.S. economy has officially recovered from the Great Recession, almost 3 in 4 Americans still rate the economy as only fair or poor, with two-thirds (66 percent) saying that there are not enough good jobs available and almost half feeling that their incomes are falling behind the cost of living.

Finding a job is still a challenge for both younger and prime age workers, especially those with limited education, for women, and workers of color. These populations fill many jobs in the early care and education and long-term care fields. Creating more of these jobs and improving their quality could provide significant opportunities to employ these workers, and others, and improve the U.S. economic outlook overall.

Addressing The Need For Care

While high-quality caregiving benefits both those receiving care and their families, the expense of this care currently puts it out of reach of too many families. The average working parent in America misses five to nine days of work each year attributable to child care problems alone, at a productivity cost to U.S. businesses of $3 billion annually. Further, estimates suggest that the value of wages that parents forego to care for young children is about $96 billion annually. As costly as early care and education is for families, its expense pales in comparison with the cost of long-term services and supports: in 2015, the national median annual cost of 44 hours of care each week by a home health aide was just under $45,800, significantly exceeding the median annual income for older adults.

Policy Solutions To Address The Need For Jobs & Care

The new report released today, “Building the Caring Economy: Workforce Investments to Expand Access to Affordable, High-Quality Early and Long-Term Care,” outlines several key policy recommendations aimed at job creation, including:

  • Increase pay for caregivers. By funding a wage pass-through to federally funded caregivers to raise incomes, policymakers can promote equity and improve worker retention without reducing the availability of formal care. The federal government could leverage its position to improve the quality of existing caregiving jobs by increasing payments to states that are specifically designed to raise wages for workers providing services pursuant to these programs, a vehicle known as a “wage pass-through.” Establishing and funding these federal wage floors for care workers based on their training and educational attainment would address the lack of sufficient pay and inadequate benefits that are uniformly identified as the major obstacles to joining the field and the biggest challenges for those who want to continue, without redirecting existing resources that might result in reduced services.
  • Increase public investments to create new jobs for caregivers by expanding children’s access to high-quality care. Devoting new federal funding to cover the labor costs associated with staffing new early care and education classrooms with high-quality caregivers, with states and/or localities providing funding to cover ancillary related costs, would increase access to the kinds of care that parents prefer. This is the care that can also be best expected to promote children’s intellectual, social and emotional development, but is currently out of reach for many families. Vouchers could be used to target families in need of care during nontraditional hours or in remote areas through home-based care or other arrangements. Parents would pay no more than 7 percent of their income toward the costs of care. At full enrollment of this cohort, the program cost would be approximately $62 billion per year and would directly create approximately 1.3 million permanent jobs. We estimate that this program could generate around $70.9 billion in short-term impact on federal tax revenues, reduction in the use of public benefit programs, and increased local economic activity.
  • Expand and streamline access to long-term care, including support for increased training and apprenticeships. Establishing more extensive training standards for Medicaid-financed services, especially those provided by personal care attendants, and provide funding to achieve them, would help ensure that workers are prepared to deliver high-quality services to patients. Including pre-service training as a reimbursable Medicaid expense—as it is for Certified Nursing Assistants in institutionalized care—either as part of administrative spending or as part of payment provider rates, would help support meeting new training mandates. Alternatively, Medicaid reimbursement, particularly if made at an enhanced federal match, could be used in the absence of a training mandate to incentivize states to increase their training requirements. We recommend expanding support for Long-Term Care Registered Apprenticeship Programs for Home Health Aides, a competency-based apprenticeship that begins with entry-level training followed by a supervised practical module that exceed the federal requirements. Participants receive Certificates of Training or Interim Credential and incremental wage increases as they complete different levels of specialization. Successful implementation of the apprenticeship model in Washington State through the SEIU Healthcare NW Training Partnership supports the allocation of funding to replicate the program more broadly.
  • Promote recruitment, retention and economic mobility of the caregiving workforce with investments in workforce development. Across both early care and education and long-term care, enhanced opportunities for training and education can improve the quality of caregiving jobs, the quality of care that is provided, and the possibilities for career advancement for formal caregivers. Standardizing and financing pre-service training infrastructure and investing in training and professional development for incumbent workers will improve quality for all involved in caregiving.

Georgetown Center on Poverty and Inequality

The Georgetown Center on Poverty and Inequality works with policymakers, researchers, practitioners, and advocates to develop effective policies and practices that alleviate poverty and inequality in the United States. The center’s areas of work include national, state, and local policy and program recommendations that help marginalized girls, promote effective workforce and education policies and programs for disconnected youth, and develop policies to combat deep poverty.

Our strategies are to partner with federal agencies and nonprofit organizations to host national conferences, produce and widely disseminate in-depth reports, engage in public speaking, and participate in national coalitions and working groups.

Economic Security and Opportunity Initiative

The mission of the Georgetown Center on Poverty and Inequality’s (GCPI) Economic Security and Opportunity Initiative (ESOI) is to expand economic inclusion in the United States through rigorous research, analysis, and ambitious ideas to improve programs and policies. Further information about GCPI’s ESOI is available here.