Help Wanted Sign 1,” Kevin McGuire

March 16, 2018; San Francisco Chronicle

A 30-year-old program providing caregivers to seniors in the South Bay is closing, citing workforce problems. Pathways Home Health and Hospice will lay off its 100, mostly per-diem, workers for that program while maintaining its other services.

NPQ has often written about the misuse of this workforce, which is largely made up of women and people of color paid a minimum wage and kept on part-time hours, which can necessitate their use of public benefits. In this case, those who might take such employment in a not-so-great job market cannot afford housing in the area.

“The whole industry is under stress,” Georgia Rock, the chief strategy officer, says. “We’ve been having increased difficulty finding caregivers over the last few years. We don’t want to be taking clients if we can’t staff the shifts.”

Dustin Harper of the Institute on Aging says, “When the Bay Area had more neighborhoods next to each other, where the lower-income population is not that far from higher-income populations, that makes the matching of those resources a little easier. As folks on the lower-income side are being pushed further and further away from core areas, it makes travel a little more difficult.”

A study by the Home Care Aide Council in Massachusetts provides a recent snapshot of the trend in this field, where Medicaid and Medicare payments tend to set the pay standards. As a reporter for the Republican reports on

The survey found that the home care workforce is almost entirely (98 percent) female. The aides generally work part-time, are middle-aged and have limited education. Close to half the workforce was born outside the US, and a similar number have other caregiving responsibilities, like caring for a child.

Almost half of home care aides work more than one job. Yet nearly 80 percent of them have household incomes of less than $40,000 a year.

The average pay reported by home care aides was $12.77 an hour. Sixty-three percent of agencies offer vacation time to full-time aides, and fewer offer vacation to part-time aides.


The report includes information about wages but does not include data on how home care agencies spend their money. The union wants agencies to report that information to the state.

“We are advocating for a number of reforms to improve transparency and oversight, including greater authority for the attorney general to investigate agencies and expanded financial reporting,” says Tim Foley, acting executive vice president at 1199SEIU United Healthcare Workers East. The union represents state-paid personal care attendants. “This report importantly highlights the great demand for homecare services and it also showcases the need for greater oversight of this growing industry—particularly when it comes to financial reporting, executive compensation and agency overhead costs.”—Ruth McCambridge