Caregivers’ group calls on lawmakers to address low wages

An organization representing front-line caregivers in Iowa nursing homes and other facilities called on state lawmakers Friday to improve workers’ wages.

The nonprofit organization Iowa CareGivers, which represents many of the certified nurse aides who provide hands-on care in nursing homes and other facilities, reported less than 5% growth in direct-care wages since 2019.

The organization says that 72% of the CNAs working in nursing homes leave their jobs every year, adding $123 million in costs for employers and for Iowa taxpayers who help pay for Medicaid-funded care.

The data appears in the organization’s 2024 Direct Care Worker Wage and Benefit Brief, which shows that the median wage for certified nurse aides is now $14.42 per hour, which represents a 62-cent increase over the past four years. The data is culled from the states’ most recent labor market study.

Iowa CareGivers said the findings illustrate why Iowa’s caregivers rely heavily on various state worker supports such as childcare assistance, the Supplemental Nutrition Assistance Program (SNAP), and the Children’s Health Insurance Program (HAWK-I).

“As the direct care workforce continues to decline in numbers, more Iowans will struggle to access care and support,” said Elisabeth Buck, Iowa CareGivers board chairperson. “Direct Care Workers can’t live on current wages and, despite being passionate about caring for the individuals they serve, they are leaving the professions to find work with livable wages. We need legislators to lead the charge on wage increases for direct care workers.”

The wage study coincides with legislative debate over a bill that would effectively cap wages for caregivers who are employed through temp agencies. Republican lawmakers say the bill will provide needed financial relief for the corporate owners of care facilities, but some Democrats fear it will lower wages and exacerbate a growing workforce shortage in the field of health care.

Last month, House lawmakers approved House File 2391 on an 80-17 vote. The bill would cap what temp agencies can charge nursing homes at no more than 150% of the statewide average wage. Iowa CareGivers has not taken a position on the legislation.

According to Iowa CareGivers, the most recent data, which comes from the organization’s 2019 Direct Care Worker Wage and Benefit Surbey, highlight troubling signs for businesses that rely on direct care workers:

— 56% of direct care workers in Iowa have been employed in direct care for six years or more, including just over 16% who have worked in the field for more than 20 years.

— 28% of the workers reported holding more than one job.

— 78% the workers who were looking for jobs outside the field of direct care said they were doing so to obtain higher wages.

— Nearly 10% of the workers said they planned to retire in the next five years – although more than half of those individuals said they would consider staying in the field if their wages were increased.

Iowa Caregivers has called on state lawmakers to increase Medicaid reimbursement rates for all care providers and tie that additional funding to requirements that the new money be used to enhance caregivers’ wages.

The organization has also called on lawmakers to back legislation that would help ensure that people with disabilities collect enough Medicaid assistance to retain caregivers that will help them remain in their own homes and communities.

The wage study was conducted in partnership with Iowa Workforce Development. Unlike previous surveys, data for the study wasn’t collected from employers but from the employees themselves.

Direct care workers include certified nurse aides, home health aides, personal care assistants, patient care technicians, direct support professionals, hospice aides, and others who provide at least 80% of direct hands-on care to Iowans in private homes, group homes, assisted living centers, nursing homes, hospitals and other facilities.

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