Gotham Gazette

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Let’s Thank All Caregivers, Not Just the Most Visible

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Thanking all caregivers is essential amid the pandemic (photo: Michael Appleton/Mayor's Office)

Long-term care is the fastest growing sector within the health-care industry in New York City, and with 1.2 million New Yorkers now over the age of 65, it will only continue to grow in size and importance over the next 10 years.

Nevertheless, this vital health-care workforce remains largely invisible as most paid long-term care services are provided by direct care workers to homebound individuals. Sadly, when it comes to long-term care, out of sight often means out of mind.

It’s time for our direct care workers — including home health aides, personal care attendants, direct support professionals, and certified nursing assistants — to get the respect and support they deserve. As the lowest-paid workers in the health-care system, typically earning just $21,000 a year, they perform strenuous, isolated work, often without benefits or opportunities for advancement.

Predominantly people of color and immigrants, they too have been rising to the challenge as they continue to care for hundreds of thousands of older people and people with disabilities in their homes and in nursing facilities through the COVID-19 pandemic.

These efforts have clearly helped to reduce the surge in hospitals. Yet, unlike doctors and nurses, who have deservedly received public recognition for their sacrifices, direct care workers have largely been left out of the conversation.

Despite these systemic challenges, there have been some signs of progress amid the COVID-19 pandemic. New York City has designated direct care workers as essential workers, is helping to supply them with personal protective equipment, has opened testing centers for these workers, and has made them eligible for hotel rooms should they need to self-isolate. Recently, the city partnered with One Medical to offer COVID-19 testing and telehealth services, and will prioritize 1199SEIU members and essential workers, many of whom work in long-term care.

Before COVID-19 challenged our systems, city government partnered with the New York Academy of Medicine (NYAM) to convene direct care providers, trade associations, and Local 1199SEIU (which represents approximately 103,000 direct care workers) to better understand and elevate the value of direct care workers in long-term care.

The strategies we developed to address training and recruitment, career pathways, better integration of direct care workers in health-care systems, improved Medicare/Medicaid reimbursement rates, and expanded rights and resources for the direct care workforce are more important than ever before. There is a lot of work left for us to do and it will not be easy. But in the interim, let’s start with the number one issue identified by both workers and providers: Respect.

As COVID-19 forces the nation to rethink and reform its approach to health care, direct care workers must be included as a critical part of a reimagined health-care system. For now, let us celebrate New York City’s direct care workers, and thank them for their service.

J. Phillip Thompson is New York City Deputy Mayor for Strategic Policy Initiatives and Judith A. Salerno, MD, MS, is President of The New York Academy of Medicine. On Twitter @NYCMayorsOffice, @DrJudySalerno, & @NYAMNYC.

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