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STUDY: Minnesota Needs to Invest in Direct-Care Workforce

January 10, 2013

A new PHI analysis of Minnesota’s direct-care workforce found that the state’s long-term care system faces a looming workforce crisis. As a result of the state’s rapidly growing elder population, the report predicts a “care gap” of thousands of direct-care workers over the course of the decade.

In “Home Care at a Crossroads, Minnesota’s Impending Long-Term Care Gap,” PHI researchers report that while home care worker positions are projected to account for more than 10 percent of the new jobs expected in Minnesota over the next 10 years, the core labor pool from which the state’s direct-care workers are traditionally drawn — women aged 25-54 — is expected to decline by nearly 2,000 workers.

“Due to the poor quality of direct-care jobs, Minnesota faces the challenge of making these jobs competitive so that enough people will be attracted to this work to meet increased demand,” said Gail MacInnes, PHI national policy analyst and a co-author of the report. (Listen to MacInnes’s interview with KFAI-FM on the analysis.) 

“Uncompetitive wages, part-time work, and a lack of employment-sponsored health insurance coverage are all barriers to establishing a stable home care workforce in Minnesota,” MacInnes said.

MacInnes and co-author Dorie Seavey, PHI director of policy research, also found that like elsewhere in the nation, Minnesota’s direct-care workers are predominantly female, middle-aged, employed less than full-time, and living near poverty. 

More than a quarter of Minnesota direct-care workers receive health coverage through a public insurance program, such as MinnesotaCare, and more than 40 percent of Minnesota’s direct-care workers live in households that rely on some form of public assistance, such as food stamps or Medicaid.

“These are serious problems for our long-term care system, and they are only going to become more severe if we do not address them now,” said State Representative Tina Liebling, who endorsed PHI’s recommendations for building an adequate direct-care workforce at the January 4 Minnesota State Capitol press conference where the report was released.


PHI recommends the following strategies to address Minnesota’s direct-care workforce crisis:

  • Invest in quality jobs by increasing wages and benefits, as well as training and creation of advancement opportunities
  • Build workforce infrastructure such as matching service registries
  • Monitor the workforce and make data publicly available in order to assess adequacy of workforce recruitment and retention
  • Continue and increase supports for family caregivers both as paid and informal caregivers
  • Promote training and credentialing to ensure workers have the skills needed to provide quality services and supports

The PHI analysis was made possible with financial support from the Service Employees International Union (SEIU).

— by Deane Beebe

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