70,000 Oregonians – nearly the population of Medford – work in caregiving and personal support jobs, providing services to seniors, people with disabilities, and children. The COVID-19 pandemic exposed significant gaps in long-term care and support staffing and in emergency planning and preparedness, as well as the lack of transparency about outcomes. These gaps affect consumers and families as well as caregivers and support staff, including those in facilities and home settings. Now is the time for bold action to address these challenges.
For centuries, women have performed caregiving as an expectation. As caregiving has become a profession it has been women, specifically women of color, who have filled the jobs caring for seniors, people with disabilities, and children. Caregiving has lived in the shadows, often unpaid or as low-wage, no-benefit jobs. The history of sexism and racism is the reason this profession is overlooked and undervalued.
Over the next decade, long-term care will be the fastest-growing profession in the United States. In Oregon, there will be a 36% increase in the need for long-term care workers and by 2030 there will be a 55% increase in the number of people over the age of 85. Unless we address issues in the long-term care system, the largest share of new jobs entering the labor market will not support strong families or build strong communities.
Consumers of long-term care are also in crisis. The cost of care is out of reach for most people. The quality of care offered to consumers varies, but in many facilities, it does not match the needs. In order to achieve a vision where consumers have quality care and caregivers have jobs with fair wages, benefits, and respect, workers will have to be able to form unions or non-traditional forms of worker-centered and worker-led organizations.
Government funds and regulates the long-term care and support industry. 73% of the industry is funded directly through Medicare and Medicaid. Oregon must create contracting standards, training standards, and wage standards, while also increasing public investment. If elected officials want the support of caregivers, they must lead on these issues.
When caregivers are able to join together and make their voices heard, there are immediate results. The quality of care improves, with a dramatic impact on people’s lives, and families supported by caregivers are lifted out of poverty. In Oregon, there is a clear link to when homecare workers organized a union and results that helped consumers and caregivers. During the COVID-19 pandemic, our union was able to win historic wage increases for caregivers.
One of the biggest needs care and support providers have is high-quality training and economic opportunities to continue in the work past one consumer and one job. However, the systems either don’t exist or fail to meet the need. Many employers are also faced with staffing shortages, and potential caregivers – particularly young people – do not see the opportunity for a career in this industry. To meet this challenge, caregivers should have a voice in designing and implementing workforce development programs that provide career development, training, flexibility, job stability, and job growth. Currently, we are building coalitions that could help set workplace standards and expectations for long-term care workers, like we do with public works contracts.
Public works contracts require wage and training standards, and the jobs associated with the industry are good ones with longevity and career development opportunities. There is no justification for other tax-paid services not to have such systems in place, especially a sector that is mostly women and people of color who do the hard work of caring and providing support for Oregon’s most vulnerable people. A prevailing wage has been attached to public works projects since 1959, and the Legislature continues to add jobs often held by men to the list of public works jobs that should abide by a prevailing wage session after session. It’s time Oregon starts focusing on the jobs usually held by women and people of color.