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Open Access Publications from the University of California

Lives & Livelihoods: California’s Private Homecare Industry in Crisis

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Presently, over 700,000 Californian workers — primarily immigrant women and women of color — provide homecare for nearly three million older adults and people with disabilities. Researchers examined homecare in California by surveying 500 workers and 103 consumers, conducting in-depth interviews with workers and consumers, and reviewing homecare agencies and residential facilities for the elderly.

Lives & Livelihoods: California’s Private Homecare Industry in Crisis finds that the California homecare industry is facing critical issues that strain workers and consumers alike, amid growing demand that further intensified during the COVID-19 pandemic. Among other findings, the report notes how the lack of infrastructure in homecare leaves both consumers and workers struggling. Over half of consumers determined employment terms on their own or turned to their friends and family for guidance. Only 22% of workers reported ever taking paid sick leave. Nearly two-thirds of homecare workers did not earn enough to cover their daily expenses and 74% reported they did not have any type of personal retirement savings.

Many families need financial support through public investment in order to pay their homecare workers a living wage. Three quarters of consumers stated they would like to pay higher wages and 85% of consumers strongly supported a universal long-term care insurance program in California.

Meaningful and timely public investment in the state’s homecare workforce and infrastructure is imperative to the sustainability of the industry over the next decade and beyond. Report authors provide the following recommendations: 1) Make it easier for consumers to find care and workers to find fair employers 2) Formalize the industry and make workers rights real through education, tools, and increased enforcement efforts 3) Address the crisis of low wages, and 4) Increase public investment in long-term care to help consumers access and afford homecare and other long-term care.

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