Everyone cared for at home, in a group home, or in a long-term care facility, is supported by a workforce that often is unseen or undervalued. Yet without these direct care workers, our health care system would collapse. At the Quality Institute, we know that achieving safer, more accessible, and higher-quality health care must include support for those who care for our state’s older adults and people with disabilities. The workers taking care of our most vulnerable residents include Certified Nursing Assistants (CNAs), Home Health Aides, and Direct Support Professionals — all of whom generally make just above minimum wage for their essential and challenging work.
CNAs mostly work in nursing homes; Home Health Aides work in homes; and Direct Support Professionals work with people who have developmental disabilities. While these direct care workers often serve in different settings, their shared experiences and challenges make their collective voice more powerful. Nationally, a coalition, Essential Jobs, Essential Care, was launched in 2020 to bring these workers together to advocate for improved wages and career pathways, including increased access to training.
The Essential Jobs, Essential Care Coalition is led by PHI, a national organization focused on the direct care workforce. The Coalition began in Michigan, North Carolina, and New Mexico before coming to New Jersey in 2022. The Quality Institute co-leads the Essential Jobs, Essential Care New Jersey Coalition, working alongside PHI and many of our members to elevate and amplify the voices of direct care workers. More than 90 organizations form our Coalition, including workers and worker representatives, advocates for older adults and people with disabilities, educational institutions, nursing homes and home health care agencies, and representatives from state agencies.
Today, while the need for the direct care workforce is growing, the number of people going into the profession is decreasing. Families struggle to find consistent caretakers for the people they love. In 2024, the New Jersey Collaborating Center for Nursing (NJCCN) published the Home Health Aide Data & Analysis report that found a 15 percent reduction in the number of home health aides in New Jersey from 2017 to 2023. The reasons for the decline include an aging workforce, barriers related to language, transportation, and access to training. Data show these workers are predominantly female and predominantly women of color, with a high percentage speaking Spanish or Haitian Creole. Many report seeing no career pathways and leave their positions for slightly higher-paying jobs elsewhere.
The Coalition’s goal is to change this dynamic and improve the working environment and opportunities for the direct care workforce. Change will include easing regulatory barriers and simplifying the state licensure and certification processes. For instance, it should be easier for workers to move from working in nursing homes to home health positions. The Coalition also supports programs that create apprenticeships and provide more access to training.
Many direct care workers came to their positions after a personal experience of caring for a loved one and, despite long hours and physically demanding work, are committed to the work. We need direct care workers and want to know that these caring professionals will be there for the people who need them.
We are excited to announce the launch of our new website: www.essentialjobsnj.org, a hub for resources, updates, and ways to get involved with the Essential Jobs, Essential Care New Jersey Coalition.
If your organization would like to learn more about our work or join our coalition, I welcome you to reach out to me at tminniear@njhcqi.org.
Funding for this work was provided by The Henry and Marilyn Taub Foundation.