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Five Opportunities to Invest in New Jersey’s Direct Care Workers

By Amy Robins (she/her) | November 1, 2022

In New Jersey, nearly 108,000 direct care workers provide essential services and supports to the state’s population of older adults and people with disabilities. These workers are often a lifeline to these residents, assisting them with activities of daily living across the spectrum of long-term care settings.

As the number of people age 65 and older continues to grow in New Jersey, so will the demand for these workers. Between 2020 and 2030, the direct care workforce is expected to add more new jobs than any other occupational group in the state except for hand laborers/material movers (such as warehouse workers) and fast food workers.

Yet, this is a workforce in crisis. Despite their profound value, direct care workers face persistently poor job quality including insufficient compensation, inadequate training, limited advancement opportunities, and a range of gender and racial inequities that harm a mostly female, people of color workforce.

These conditions have compelled PHI to join forces with New Jersey Advocates for Aging Well to transform the state’s direct care workforce, an initiative funded by the Henry and Marilyn Taub Foundation. (Read more below).

Unless New Jersey takes more action, such job challenges will continue to drive workers away from these essential occupations, potentially leaving millions of vulnerable residents without care. Here are five opportunities for New Jersey’s policymakers to invest in the direct care workforce.

Improve wages competitiveness

Although wages for this workforce have increased modestly in the last 10 years, they are still substantially lower than for other occupations with similar or lower entry-level requirements such as janitors, retail salespersons, and customer service representatives. According to PHI’s latest research, the median hourly care wage for direct care workers in New Jersey was $15.31, more than three dollars less than the median wage of $18.53 for these competing occupations. Unless direct care worker wages are increased to a competitive level, recruiting and retaining workers will remain a challenge.

Reduce Turnover

Poor job quality contributes to a high turnover rate in these jobs. PHI’s research shows that while New Jersey will add more than 19,000 new direct care jobs between 2020 and 2030, it will—at the same time—need to fill 158,000 jobs in this workforce as existing workers leave their occupations or exit the labor force altogether. High turnover impacts the quality of care for older adults and people with disabilities, incurs preventable costs on employers, and further destabilizes the state’s long-term care system.

Boost Local Economies

As a result of low wages and high rates of part-time work, our research demonstrates that 34% of New Jersey’s direct care workers live in poverty, 44% lack affordable housing, and 36% depend on some form of public assistance to make ends meet. Inadequate reimbursement rates under Medicaid are often at the root of this problem. But unfortunately, when workers aren’t paid well and employers aren’t resourced enough to raise wages, the economy suffers in other ways, including through increased public assistance dollars and reduced consumer spending. Implementing strategies that put more resources into workers’ pockets can save costs and improve local economies.

Support workforce equity

According to our research, New Jersey’s direct care workforce is predominantly made up of women (89 percent), people of color (82 percent), and immigrants (52 percent), populations that face unique and additional hardships on the job and in their daily lives. Given these realities, an intentional approach to diversity, equity, and inclusion is central to job quality. Employers need policy supports to help them set and achieve equity-focused hiring, retention, and advancement goals. Recruitment and training strategies should be funded to meet the needs of the state’s culturally and linguistically diverse populations of workers. Expanding recruitment efforts to reach underrepresented populations in this workforce such as men and COVID-displaced workers will also require targeted interventions.

Improve advancement and growth opportunities

Career lattices and ladders within direct care occupations as well as pathways to advanced health occupations can improve job satisfaction for workers, recruitment and retention for employers, and care for older adults and people with disabilities. To help create these advancement opportunities, the state should fund and incentivize direct care-focused partnerships and demonstration projects among employers, training entities, workforce development groups, and community-based organizations, among other stakeholders.


With funding support from The Henry and Marilyn Taub Foundation, PHI and New Jersey Advocates for Aging Well (NJAAW) launched a multi-year policy advocacy initiative in New Jersey in March 2022 called Essential Jobs, Essential Care™.

Through this state-based advocacy initiative, New Jersey joins Michigan, New Mexico, New York, and North Carolina in working on three main policy goals: improving compensation for direct care workers, driving workforce innovations (such as training and advanced roles), and strengthening workforce data collection.

If you live in New Jersey and are interested in learning more and getting involved in advocating for policies that strengthen the direct care workforce, we would welcome your engagement in this initiative. Please reach out to Amy Robins, Director of Advocacy at PHI (, or Cathy Rowe, Executive Director at NJAAW ( for more information.

Below are a few key resources:

  • Check out the New Jersey EJEC brochure
  • Read PHI’s 2020 Report on New Jersey’s Direct Care Workforce >>
  • Watch a recorded virtual event on NJ’s Direct Care Workers >>

This initiative has been made possible through generous support from The Henry and Marilyn Taub Foundation.





Amy Robins (she/her)
About The Author

Amy Robins (she/her)

Senior Director of Policy
As PHI’s Senior Director of Policy, Amy Robins is responsible for designing and leading PHI's historic and growing nationwide advocacy approach.

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Our new policy report takes an extensive look at today's direct care workforce—in five installments.

Workforce Data Center

From wages to employment statistics, find the latest data on the direct care workforce.