Female healthcare worker assisting senior man in shaving at bathroom

The direct care workforce is projected to add 1.2 million new jobs over the next decade, with most of the growth in home- and community-based services. That is the finding from a new study released Tuesday by PHI National, which researches and supports direct-care jobs. 

The number of new jobs in home care and home health is expected to increase 37% between 2020 and 2030. PHI National forecasts residential care jobs to increase 22% over the next decade. However, it cautioned that projection is less certain due to a steadily decreasing number of nursing assistants. 

The diverging trends across the long-term care industry point to a nation of consumers preferring to age in place with help from expanded HCBS offerings. Funding for HCBS has been expanding over the past two decades, especially since the Biden administration’s COVID-19 American Rescue Plan pumped $12.7 billion into HCBS. The plan included a 10 percentage point increase in the Federal Medical Assistance Percentage (FMAP) to states. 

But that growth brings significant challenges for home care, according to PHI National. Last year, the median hourly wage for direct care workers was $14.27. The report noted that 40% of direct care workers live in low-income households and 43% rely on public assistance, such as Medicaid, food and nutrition assistance or cash assistance. As a result, the low wages are making it difficult for home care firms to recruit and retain workers. 

“These trends both reflect and perpetuate the racial and gender inequalities faced by direct care workers, who are largely women and people of color,” PHI National stated in the report. 

This latest report builds on previous analysis PHI National conducted on the direct care industry. In the previous decade, the direct care industry added 1.5 million jobs, raising the number of direct care workers nationally from 3.2 million to 4.7 million workers. PHI National estimated as direct care workers retire or switch to other industries, the nation will likely need nearly 8 million workers to care for the growing numbers of aging Americans.