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Study: Lack of 'living wage' exacerbates labor shortages for some of Maryland's health care workers

A sign points visitors toward the financial services department at a hospital.
David Goldman/AP
A sign points visitors toward the financial services department at a hospital.

Some of the region’s lowest paid health workers across Baltimore say they are underpaid and overworked as the COVID-19 pandemic that has lingered for the past three years, continues to stress the medical system.

Social justice organizers with Maryland Direct Services Collaborative surveyed individuals known as direct-care workers, such as nursing assistants, medicine assistants, home care aides.

These workers often provide patient care to individuals with disabilities and older adults and say the wages offered by medical providers are simply too low to survive.

The median salary for these health care workers range between $23,000 to $27,000 which makes it difficult to make ends meet, according to a new study from the Maryland Direct Services Collaborative, a group of organizations representing frontline workers.

For example, Rhonda is a certified medicine aide in Baltimore at a long-term elder care facility. WYPR is shielding her name and place of work for fear of retaliation

Rhonda is constantly on her feet, sometimes taking care of 20 patients at one time.

“We made a lot of sacrifices on the frontlines for the COVID 19 pandemic,” she said. “And since then, a lot of people were forced to leave healthcare due to low wages. We make about $13 or $14 an hour. It impacts our mental and physical health. You come to where you have to pick and choose when you buy your food, gas and electric, medicine and your water bill.”

There are about 55,000 workers across Maryland who care directly for patients. The job is filled overwhelmingly by Black women, according to the study.

About 84% of home care workers are women, as well as 85% of workers at assisted living facilities, and 95% of workers in nursing homes. A total of 68% of home care workers, 80% of workers at assisted living facilities, and 76% of workers in nursing homes are Black.

“Nearly everyone recognizes that they do not make enough money,” said Meg LaPorte, one of the authors of the study and executive director of the Maryland Direct Services Collaborative. “If you look at the MIT living wage calculator, they're either at or just below living wages.”

Assisted-care facilities and people needing home care are having trouble recruiting and retaining people to work. Part of the issue is Medicaid reimbursement rates, LaPorte said.

Medicaid is the largest funder of home care in Maryland. However, the report found that reimbursement rates don’t cover what is needed.

“Home care employers that rely on Medicaid reimbursement to pay for services are having a much harder time finding and keeping staff,” Caitlin Houck, executive director of Maryland National Capital Homecare Association, said in the report. “The Medicaid rate for home care in Maryland does not cover the cost of care. It prevents us from being able to keep pace with competitors both inside and outside of the home care industry, and it’s not going away anytime soon.”

LaPorte said one of the recommendations made in the report is that Baltimore and Maryland negotiate for better Medicaid rates.

There are already some initiatives underway.

Last year, Maryland set up the Direct Care Workforce Innovation Program, which sets aside at least $250,000 in grants for novel programs that increase the workforce or retention.

The grants are awarded in $50,000 increments.

Despite the issues, Rhonda, medicine assistant in Baltimore, she’s not giving up on the job.

“My heart is there in what I do,” she said. “I advocate for them, somebody's got to pay attention. I would want somebody to take care of me. I wouldn’t give it up for nothing. Until the breath come out of my body. I'm still going to take it as rather than regardless of money.”

Scott is the Health Reporter for WYPR. @smaucionewypr
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