A Workforce Board Can Solve Colorado’s Home Care Woes

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Workforce boards—also known as wage boards or workers’ boards—bring together representatives of workers, employers, and the public to make recommendations regarding minimum compensation, safety, and training standards for an industry.1 By convening a workforce board for Colorado’s home care industry, the state could overcome barriers to coordinated problem-solving and address several of the challenges facing the sector, support frontline COVID response workers, and ensure that the state’s seniors and people with disabilities have access to high-quality home care now and in the future.

Background on workforce boards

Workforce boards are empowered to make recommendations on a broad range of interrelated issues rather than focusing on a single problem such as low wages. They often conduct hearings and outreach activities as well as issue reports on their findings. Unlike most commissions and other bodies, their recommendations carry significant legal weight and trigger governmental review and action.

Workforce boards can also help workers come together and gain a stronger voice to advocate for themselves. Indeed, the process of workers exercising their right to call for a board to be empaneled can help unify workers and drive the industry forward. In addition, because workers’ boards promote similar pay for similar work, they encourage firms to compete based on productivity and innovation rather than low compensation and ensure that high-road firms that provide good wages and benefits are not undercut by low-road companies.

Workforce boards have proven successful in a number of industries and regions. For example, in 2019, the city of Seattle created a Domestic Workers Standards Board for domestic workers, employers, private households, worker organizations, and the public to consider ways that poor working conditions such as low wages and inadequate protections can be improved.2 Similarly, the state of New York brought together representatives of workers, employers, and the public in a wage board to raise wages for fast-food workers in 2015 and recently established a farm labor wage board.3

Workforce boards would strengthen the home care industry in Colorado

The need for home care workers to help Colorado residents with daily living activities—such as bathing, eating, toileting, and mobility—will increase by roughly 40 percent over the next 10 years and could increase significantly more as the COVID-19 pandemic spurs demand for in-home care over institutional options.4 Public funding currently pays for most home care services.5 Yet without policies to help attract and retain home care workers, the state is unlikely to be able to meet the growing demand.

Home care workers in Colorado earn $17,000 per year at the median, have few benefits, and commonly rely on public assistance.6 Not surprisingly, turnover in the industry is very high, with more than half of home care workers leaving the job within one year.7 Low job quality and high turnover are closely linked with poor-quality health care.8 Furthermore, the coronavirus crisis has highlighted gaps that some parts of the home care industry face in providing workers with adequate safety equipment and training. Because of these safety concerns, turnover problems may continue to increase. Indeed, several news reports have highlighted how the pandemic and the associated economic fallout have exacerbated the home care worker shortage in Colorado, causing seniors and people with disabilities to suffer significant health consequences from lack of care.9

Employers, worker advocates, customers, and government agencies recognize these challenges and understand that something needs to be done. Yet in part because home care is so disaggregated, there has not been a sufficient industrywide response. More than 500 different agencies employ home care workers throughout Colorado; workers do not have common worksites; consumers operate independently in their own homes; and state oversight is spread out across multiple government agencies.

A workforce board would create a forum for all parts of the home care industry to evaluate working conditions and discuss solutions. Additionally, by standardizing compensation, it would limit opportunities for discrimination and thereby help close pay gaps faced by women and people of color. This is especially important in Colorado, where 88 percent of home care workers are women and 34 percent of home care workers are people of color.10 Colorado has a long-standing though little-used law that would enable the creation of a workforce board for the home care industry.11 This law could empower key stakeholders to make recommendations that can attract and retain a workforce sufficient for the demands of the state.

Creating a workforce board would be a major step toward addressing key challenges in the home care industry in Colorado. The Center for American Progress Action Fund can help advise policymakers on adopting and implementing workforce and similar boards.12

David Madland is a senior fellow and the senior adviser to the American Worker Project at the Center for American Progress Action Fund.

Endnotes

  1. Kate Andrias, David Madland, and Malkie Wall, “Workers’ Boards: Frequently Asked Questions” (Washington: Center for American Progress, 2019), available at https://www.americanprogress.org/issues/economy/reports/2019/12/11/478571/workers-boards-frequently-asked-questions/.
  2. City of Seattle, “Domestic Workers Standards Board,” available at http://www.seattle.gov/domestic-workers-standards-board (last accessed October 2020).
  3. New York State Department of Labor, “Fast Food Wage Board,” available at https://labor.ny.gov/workerprotection/laborstandards/wageboard2015.shtm (last accessed October 2020); New York Senate Bill 6578, 2019-2020 Leg., Reg. Sess. (2019), available at https://legislation.nysenate.gov/pdf/bills/2019/S6578.
  4. Projections Central, “Long Term Occupational Projections (2018-2028), Personal Care Aides,” available at https://projectionscentral.com/Projections/LongTerm (last accessed October 2020).
  5. Kirsten J. Collelo, “Who Pays for Long-Term Services and Supports?”, Congressional Research Service, August 22, 2018, available at https://fas.org/sgp/crs/misc/IF10343.pdf.
  6. PHI, “Direct Care Worker Employment, 2009 to 2019,” available at https://phinational.org/policy-research/workforce-data-center (last accessed October, 2020).
  7. Kate Bradford, “Shoring Up the Long-Term Care Workforce” (Denver: National Conference of State Legislatures, 2019), available at https://www.ncsl.org/research/health/shoring-up-the-long-term-care-workforce.aspx;
    Genworth, “Cost of Care Survey 2019: Median Cost Data Tables” (Richmond, VA: 2019), available at https://pro.genworth.com/riiproweb/productinfo/pdf/282102.pdf.
  8.  Yaa Akosa Antwi and John R. Bowblis, “The Impact of Nurse Turnover on Quality of Care and Mortality in Nursing Homes: Evidence from the Great Recession,” American Journal of Health Economics 4 (2) (2018).
  9. Bret Hauff, “For Colorado’s rural seniors, coronavirus strains access to home-based care — just as it’s needed most,” The Colorado Sun, September 16, 2020, available at https://coloradosun.com/2020/09/16/rural-home-care-seniors-colorado-covid/; Kristin Jones, “Home Care Providers Are Worried about Catching and Spreading COVID-19,” The Colorado Trust, April 3, 2020, available at https://www.coloradotrust.org/content/story/home-care-providers-are-worried-about-catching-and-spreading-covid-19.
  10. PHI, “Direct Care Workers by Gender, 2018: Colorado,” available at http://phinational.org/policy-research/workforce-data-center/#states=08&var=Gender (last accessed October 2020); PHI, “Direct Care Workers by Race and Ethnicity, 2018: Colorado,” available at http://phinational.org/policy-research/workforce-data-center/#states=08&var=Race+and+Ethnicity (last accessed October 2020).
  11. Weissman v. Crawford Rehab. Services, 914 P.2d 380 Colorado Court of Appeals (March 18, 1996), §§ 8-6-109 through 8-6-112, available at https://www.courtlistener.com/opinion/1130187/weissman-v-crawford-rehab-services/.
  12. Kate Andrias, David Madland, and Malkie Wall, “A How-To Guide for State and Local Workers’ Boards” (Washington: Center for American Progress, 2019), available at https://www.americanprogress.org/issues/economy/reports/2019/12/11/478539/guide-state-local-workers-boards/.