With a poverty base wage, Texas suffers from a shortage of home care workers

Proponents say the problem has reached a critical juncture, leaving home care workers overworked and underpaid for their bone-crushing work.

Austin, Texas – Editor’s note: Watch this full KVUE Defenders report tonight at 10 p.m. on KVUE News

For more than two decades, Gene Rodgers has depended on a community-based caregiver to come to his home to assist him with life support care, to help him get in and out of bed, get dressed, and help him prepare meals.

It keeps the 67-year-old as independent as possible after breaking his neck when he fell off a cliff while hiking in his native Ohio 50 years ago as a teenager.

Rodgers, who has lived a life of travel and adventure, relocated to Texas in the late 1990s for a strong disability advocacy community.

But in recent years it has become increasingly difficult to find the care he needs. He blames an unprecedented shortage of nursing staff in the community, fueled largely by poverty wages set by the Texas legislature that have not kept pace with earnings from other — sometimes less demanding — jobs.

Proponents say the problem has reached a critical juncture, leaving homecare workers overworked and underpaid for backbreaking work like assisting clients with daily needs, which include administering medication and bathing. And the situation puts Rodgers at risk of potentially not receiving the necessary care to help him stay healthy and independent.

Lawmakers have failed to meaningfully increase the current reimbursement rate of $8.11 for homeworkers in a decade, at a time when fast-food jobs are offering several dollars more per hour and are enticing workers away.

Rodgers is among tens of thousands of Texans with intellectual and developmental disabilities who, through a Medicaid waiver, rely on the services to receive care in their homes or small group homes instead of living in a nursing home or state facility.

“The Legislature thinks we’re expendable, in my opinion,” Rodgers said.

Rodger’s daily ritual

Rodger’s daily routine begins around 9:30 a.m. when his 76-year-old home caretaker, Shirley, arrives at his downtown Austin apartment.

“The first thing he needs to do is get his temperature checked and then get ready to get dressed,” Shirley said.

Once she’s dressed him for the day, she helps him transition from his bed to his wheelchair.

“Life in an institution is not an option for me,” Rodgers said. “I would hate to say what it would amount to if I was left alone with it.”

He said Shirley makes $10.50 an hour — about the state average for a janitor — because the agency she works for supplements the state’s base wage.

Although Shirley has worked with Rodgers for about five years, he has had trouble finding janitors for evening and weekend shifts — to the point where he has had to call firefighters or paramedics to help him out of bed or out of his wheelchair.

Thousands of vacancies

With Texas now estimating about 5,200 foster care openings statewide, advocates say the low pay has now led to massive labor shortages.

“It’s the lowest paying job in Texas,” said Dennis Borel, director of the Coalition of Texans with Disabilities. “If you ask people with disabilities who their main healthcare providers are, very few will name their doctor or their therapist or their nurse. They’ll tell you it’s the lowest paid person on the totem pole, the parish clerk.”

According to that US Bureau of Labor StatisticsFor example, the national median wage for home care and personal attendants was $14.50 an hour — $4 more an hour than in Texas.

The state has known about the issue for years, most recently reporting it in a November 2020 report that said, “Community workers across Texas are often faced with financial insecurity due to low wages, lack of benefits like health insurance… coping with these and others with it.” related challenges faced by the community-servicing workforce requires a coordinated, nationwide approach.”

Seven days a week

In a home outside of Georgetown, Serena Acfalle provides 24-hour care for four women with disabilities.

“I work seven days a week,” she says.

She keeps these hours because her employer has trouble finding other caretakers for the shifts.

“We’re very short staffed, so those who are left have to cover all shifts,” she said.

Acfalle makes $11.50 an hour because the agency squeezes money from other operating expenses.

Legislative measures?

Raising the base wage for janitors to $17 an hour by 2025 — proponents are calling for it — could cost Texas more than $3 billion.

But proponents point out that it will ultimately save Texas money by having people in their own homes instead of more expensive nursing homes.

State Assemblyman James Frank chairs the House Health and Human Services Committee.

“As a state, I would like more money to be spent on this,” he said. “Ultimately, I think that in almost every company — state or privately owned — less money goes to the people doing the actual work than it should.”

With Texas now about three months away from its biennial legislative session, proponents say they will press lawmakers again to raise janitor salaries.

Meanwhile, Rodgers trusts the home care worker who has stayed by his side and hopes the state will match her money.

“She’s a really caring person, very compassionate,” he said.

And that being promoted to home caregivers will increase his sense of security that he’s still getting the home help he needs to survive.

“The state thinks, ‘Well, there are committed people out there. Regardless of what we pay them, they will be there,” Rodgers said. “I don’t know how long they can hold on to that notion.”

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https://www.kvue.com/article/news/investigations/defenders/texas-home-health-caregiver-shortage/269-24f9c4ce-2f71-4947-a7b2-ce8cacc81a6a With a poverty base wage, Texas suffers from a shortage of home care workers

Laura Coffey

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