Providing Care But Lacking Their Own Health Coverage

There are an estimated 2 million home care workers nationwide.

The U.S. Bureau of Labor Statistics predicts that the workforce will need to grow nearly 50 percent by 2022 to meet aging Baby Boomer's needs.

During a recent labor rally in Cleveland, home health workers voiced their frustration with low wages and a lack of benefits. You can hear them chant for change: "We want change and we don't mean pennies. We want change and we don't mean pennies."

Thirty-five year old Jasmine Almodovar arrived early that day - before 6 a.m.

"We work really long hours, really hard work. A lot of us are barely home. 'cause if we don't go to work, we don't get time off. We don't get paid vacations. And some of us haven't had raises in years," she says.

Almodovar says her last raise was four years ago. She earns $9.50 an hour. And makes about $21,000 a year - just over the cusp of qualifying for Medicaid.

"I don't have a retirement plan, I don't have life insurance, I don't have medical. Because by a government basis, I'm 90 percent above the poverty level - but I'm in povert," she says.

Home care workers are mostly women, more than half are women of color, and one in five are single mothers, according to the Paraprofessional Healthcare Institute.

A recent analysis by the nonpartisan Brookings Institution found that while their ranks grew exponentially in Northeast Ohio and nationwide over the past decade, their earnings dropped when accounting for inflation.

The irony of a person working in health care earning so little that they can't afford health care is not lost on the Brookings' Martha Ross.

"People aren't shocked about fast food worker not having health insurance but someone who is in the health care sector providing necessary health care who does not have health insurance, just, on the face of it is wrong," says Ross, who is a fellow at the Brookings Metropolitan Policy Program with a focus on the labor market and increasing the skills and earnings of low-income people.

Many home care workers are employed by agencies that send them out independently. They learn of a doctor or hospitals' instructions from the patient. And they are paid by the hour, which is generally a portion of the hourly fee-for-service rate the agency receives from federal programs like Medicaid or Medicare.

Ross says that's the wrong set up. The workers should be part of a hospital or doctor's caregiving team - and paid accordingly.

"They can contribute to better care," Ross says. "Down the line that can contribute to reduced costs through reduced hospitalizations or going back into a nursing home. And over time you can take those savings and put them into increased earnings for that home care worker."

Lisa Kristosik is chief operating officer of the Visiting Nurse Association of Ohio, which employs aides in three different programs for thousands of patients in Northeast Ohio.

Kristosik says changing the system, makes sense.

"Because the aides I see, many times they don't work up to their skill set. Some of them have great skills that they could be utilized in different ways to help in health care navigation. People get real confused about how to navigate the health care system. And they know because they've seen it. Because they're in the homes. And they are in the homes for hours on end," Kristosik says.

On a recent weekday morning, home health aide Holly Dawson stopped in to see former client George Grellinger and his wife Joan. She recently stopped working for the family but still regularly checks on them.

George has dementia and recently fell down the back steps of his Avon Lake home. As Dawson talks with George's wife, Joan, George asks for help with a bandage on his leg.

Dawson quickly responds.

"She does a good job, better than I could do," Grellinger says.

Dawson says she would have like agencies to pay better. But, she says, that's not George's fault. Even without being compensated as part of a medical team, Dawson is willing to do what it takes to help him feel better.

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