Long Term Care Professional Boom is Coming, Presenting New Challenges

Workforce development and long term care professionals met earlier this month in Washington, D.C. to address the challenges that direct-care workers face today and will continue to face in the coming years. The gathering, initiated by the Aspen Institute Workforce Strategies Initiative, featured a panel of experts who sought to answer the question of why many of these jobs are low-wage, but not low-skill.

A May report from the Paraprofessional Healthcare Institute (PHI) recapped the findings: the approach to direct-care workers needs improvement. Featuring input from Steven Dawson, PHI president; Marki Flannery, Partners in Care president; and Laine Romero-Alston, Ford Foundation Program Officer, PHI reported the following: 

Maureen Conway, executive director of the Aspen Institute Economic Opportunities Program, framed the conversation by explaining that 40 percent of the jobs created since 2010 are low-wage jobs and direct-care occupations are the “lowest-paid jobs” with “uncertain hours.” She asked whether poor quality, direct-care jobs had “to be that way?”


Dawson explained the employment and income characteristics of the direct-care workforce and that personal care aides and home health aides were projected to be the first and second fast-growing occupation in the nation by 2020.

He highlighted the particular challenges of home care workers, such as working in isolation and the need to have “emotional intelligence” to navigate a client’s home and the relationships within it.

“These are low-wage jobs but certainly not low-skill jobs,” Dawson said.


Flannery reported that her agency employs 9,800 home health aides — the largest licensed home care agency in the country — and described the profile of people seeking jobs as home health aides since the economic downturn.

Partners in Care has a turnover rate of 23 percent — significantly lower than the 60 percent national average, Flannery said. She attributes her agency’s high retention rate to its training partnership with PHI.

Read the original PHI report

Written by Elizabeth Ecker

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