Can We Head Off A Caregiving Crisis In Oregon?

Jul 27, 2017

Everybody needs care at some point in their lives. If not as elders, or when injured or sick, then certainly as children. But a study of what it calls the “care economy” in Oregon says the state is failing to invest in the social infrastructure needed to make high quality care available to everyone who needs it, at whatever stage of life.

Paula Allomong welcomes me into her home near Merlin, in Josephine  County, as her elderly dog Wally checks out the visitor.

“I just came from doing 48 hours – getting paid for 32 --  but being in the person’s home for 48 hours,  so that the family members could get a break,” she says.

Allomong settles wearily into a lounge chair … She loves her work; helping people in need gives her a deep sense of satisfaction. But, she says, it’s hard.

“I haven’t had a shower in two days,” she says. “Y’know, you wake up at six or seven o’clock in the morning, and you don’t go to bed until ten o’clock at night.”

Dealing with someone elderly, or developmentally disabled, or mentally ill, she says, that’s what the job requires.

“When you’re a care giver, you come second. And the care needs of the person you’re with come first.”

Despite those demands, the pay is modest. Allomong says that without her husband’s income, she couldn’t manage.

“If you’re single, you’re not going to be able to support yourself,” she says. “Because these jobs don’t pay, There’s just no money in it.”

Lili Hoag, director at Oregon CareWorks, says that’s true.

“Folks working in paid care jobs are making on average ten dollars an hour, with very limited access to benefits,” she says.

Hoag’s group commissioned the study of Oregon’s “care economy.” CareWorks is a project of the non-profit group Family Forward and the Service Employees International Union Local 503, which represents, among others, care workers. Hoag says the study found there are about 70,000 paid care workers in the state. Nearly all are women and are disproportionately women of color.

“Which means these are also people who likely are providing unpaid care at home for their own children,” she says. “So we have an entire economy focused around women providing paid and unpaid care, and we’re not valuing it on either side.”

The study also found care workers were much more likely than American workers as a whole to be receiving government benefits such as food stamps.

While care givers are poorly compensated, the cost of hiring care work is very high. For example, infant care in Oregon costs an average of $14,000 a year. That’s more than half what an average single-parent family makes.

So, the woman who earns ten dollars an hour doing home health care for elderly people typically can’t afford to pay for day care for her own children when she goes to work. Hoag says all these factors contribute to high turnover among care workers.

“Sixty percent in the long-term care field. In group homes, we’re averaging 90 percent.”

And, Hoag says, that has a predictably negative effect on the availability -- and quality -- of care.

Laura Dresser says all this points to the need for Oregon – and the U-S as a whole -- to enact policies to make caregiving more sustainable for both providers and receivers.

“A substantial, systemic investment in infrastructure for child care and home health care systematically can change the way your economy works,” she says.

Dresser is with the Center on Wisconsin Strategy at the University of Wisconsin Madison and a co-author of the Care Economy study. During the recent session of the Oregon Legislature, Dresser told the Senate Workforce Committee that care is a social good and, if properly supported, has broad social benefits.

"We know that investments in kids pay off in the long run, not only for the kids and their families but also for the economy in general,” she said. “And the same for women and having that support.”

Dresser said policies on paid family leave, flexible work schedules and fairer compensation for care workers would go a long way toward easing economic stress on families giving and receiving care.

In 2015 Oregon lawmakers boosted pay and benefits for some home care workers. Last session, they made sure increased funding for care agencies led to better pay for care workers.

Back in her living room after that 48-hour shift, Paula Allomong says she’s seeing growing demand on the care system.

“This is going to be the biggest industry, with baby boomers. And it’s not going to go away,” she says.

If boomers expect to get the quality care they’re going to need, she says, changes will have to be made, and fast.