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There are more than 2 million home healthcare workers in this country. That number continues to grow rapidly as more Baby Boomers need assistance. But the profession does not offer competitive pay and, ironically, most home care workers lack health benefits themselves. Sarah Jane Tribble of member station WCPN in Cleveland talked with some of them.
SARAH JANE TRIBBLE, BYLINE: Holly Dawson believes her job is a calling. Each day Dawson drives herself to several people's homes in the Cleveland suburbs. She manages their medications, help them with bathing, does the dishes and provides companionship.
HOLLY DAWSON: Hey George. I'm going to get you something to drink, OK?
GEORGE GRELLINGER: Like wine?
DAWSON: I think it's a little too early for wine.
TRIBBLE: Former client George Grellinger has dementia and recently fell down the back steps of his home. Dawson remains friends and regularly stops in to check on him.
GRELLINGER: Orange juice and orange juice.
DAWSON: OK, I'll be right back.
TRIBBLE: To remain living at home, Grellinger had to switch to an aide who is covered by his VA benefits. When Dawson did work for them, the Grellingers paid an agency $37 for two hours every day. Dawson took home $13 an hour from that - better than the average pay. And then she had to pay her own taxes and healthcare benefits. Dawson says she doesn't remember the last time she could afford health insurance, and that is pretty typical in the home health aide world.
UNIDENTIFIED PROTESTERS: (Chanting) We want change and we don't mean pennies.
TRIBBLE: During a recent labor rally in Cleveland, home health workers voiced their frustration with low wages and lack of benefits. Thirty-five year ol, Jasmine Almodovar earns $9.50 an hour, which is just above the average for a home health worker in Ohio.
JASMINE ALMODOVAR: 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.
TRIBBLE: Almodovar says her last raise was four years ago and she makes about $21,000 a year, so she doesn't qualify for Medicaid. Paying for a plan on Ohio's federal exchange doesn't fit in her monthly budget.
ALMODOVAR: 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 poverty.
TRIBBLE: Home care workers are mostly women. More than half are woman of color, and 1 in 5 are single mothers. A recent analysis by the Brookings Institution found that while the ranks of home health workers grew exponentially over the past decade, their earnings dropped when accounting for inflation. Martha Ross is with Brookings.
MARTHA ROSS: People aren't shocked about fast food workers not having health insurance, but someone who is in the healthcare sector, providing necessary healthcare, who does not have health insurance just, on the face of it, is wrong.
TRIBBLE: Under federal health reform there are financial incentives for hospitals and doctors to keep patients healthy. Ross says home care workers should be considered and compensated as vital front-line personnel in reaching the new goals.
ROSS: They can contribute to better care. 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.
TRIBBLE: And home care workers are often trusted advisers for the patients says Lisa Kristosik with the Visiting Nurses Association of Ohio.
LISA KRISTOSIK: People get real confused about how to navigate the health care system, and they know because I've seen it. They're in the homes, and they're in the homes for hours on end.
TRIBBLE: Back at George Grellinger's house, former home health aide and now friend Holly Dawson says she has been a home health aide for 31 years. She has never done it for the money, rather, to help people like George.
GRELLINGER: Knowing that I can play a part in making somebody's life better or I try to.
TRIBBLE: The U.S. Labor Department says more than a million new home care workers will be needed in the next decade. For NPR news, I'm Sarah Jane Tribble in Cleveland.
BLOCK: This story is part of a reporting partnership with NPR, member station WCPN and Kaiser Health News.
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