The Unsung Heroes of Our Community:

Direct Care Workers and the Lifeline of the American Rescue Plan Act

As the backbone of our healthcare system, direct care workers include home health aides, nursing assistants, personal care aides, and other professionals who provide essential services to those in need. They offer hands-on care to Baltimore's aging population, people with disabilities, and individuals with chronic illnesses. Baltimore’s direct care workforce often subsists on low wages. A Maryland Regional Direct Services Collaborative study states, “Inadequate compensation is the single biggest factor driving the workforce crisis.”[1]

In addition to longstanding challenges related to compensation and long hours, direct care workers and front-line healthcare personnel also faced increased health risks during the COVID-19 pandemic.  In July 2020, frontline healthcare personnel accounted for 18 percent of COVID-19 cases reported to the U.S. Centers for Disease Control and Prevention (CDC). The World Health Organization reported in September 2020 that one in seven cases worldwide were among frontline healthcare personnel.

Who Are Direct Care Workers?

The Maryland Regional Direct Services Collaborative study cites Maryland’s direct care and services workers as overwhelmingly Black women. Women make up 84 percent of home care workers, 85 percent of workers at assisted living facilities, and 95 percent of workers in nursing homes, while Black workers make up 68 percent of home care workers, 80 percent of workers at assisted living facilities, and 76 percent of workers in nursing homes.[2] According to a 2022 report titled Direct Care Workers in the United States: Key Facts, this population of workers receives median annual earnings of only $21,700 due to low wages and part-time hours.[3] More than half (53 percent) rely on some form of public assistance; a quarter have Medicaid benefits (26 percent) or use supplemental nutrition assistance program (SNAP) benefits (24 percent). About one in five lack health insurance. More than half are middle-aged or older (30 percent over the age of 55), placing them at higher risk for infection with COVID-19. They are unlikely to have sick leave if they become ill.[4]

Although direct care work is often difficult for those in the field, the need continues to grow. Between 2015 and 2050, the projected population of 65 and older will nearly double from 47.8 million to 88 million.[5] According to PHI, a nonprofit that works to transform eldercare and disability services, from 2011 to 2021, the direct care workforce added nearly 1.5 million new jobs, growing from 3.2 million workers to 4.7 million.[6]

ARPA Funding Direct to Direct Care Workers

In September 2023, Mayor Brandon M. Scott, alongside leadership and members of 1199SEIU, the local labor union chapter that includes direct care workers, announced an ARPA-funded investment to provide Baltimore’s direct care and service workers with needed relief funds. A $2 million ARPA grant was provided to 1199SEIU Training and Employment Funds (TEF), operating on behalf of the Healthcare Industry Grant Corporation, which is issuing the funds to direct care and service workers.[7]

Meet Sharon F. | Direct Care Worker Grant Recipient

“The pandemic impacted my financial situation as a direct care worker a lot. While serving as a direct care worker, I got COVID-19 and became so sick that I was unable to work. After 17 years as a healthcare worker, I retired during the pandemic. I applied for the grant and had no issues with the process. The grant helped me with the little things that I needed to do. I was able to use my bank card to pay bills online and purchase groceries from the store.”

Meet Serena J. | Direct Care Worker Grant Recipient

“I have been in the healthcare field for over 30 years. Caring for someone who can’t care for themselves makes me happy. This grant assisted me very well. It allowed me to buy food and cleaning supplies for my home. I appreciate it. It was a great help, not only to me, but I am sure it was also for other helpers.”

Meet Janet C. | Direct Care Worker Grant Recipient

“I have been a direct care worker since 1991. The pandemic affected me a lot because I started getting backed up on bills; it was really harsh for me. Once I received the grant, I used it immediately for bills. I know direct care workers who are very appreciative of this grant. I found out [about this grant] through another direct care worker. Luckily, they also received the grant, and we had no issues applying for the money.”

Meet Brianna G. | Direct Care Worker Grant Recipient

“I have been a direct care worker for 15 years. One of the biggest things that impacted me during the pandemic was childcare. It was difficult because school turned online, but when you are a healthcare worker, you have to leave the home and work elsewhere, and the pandemic made it very inconvenient to do my job.”

“With the grant, I could purchase food for my kids and gas to get back and forth to work. I mainly used it for food because food is very expensive. The money came at the right time. It was like a huge weight lifted off my shoulders.”

“Direct care workers need better access to resources such as housing and food in order for us to recover from the financial issues of the pandemic.”

Continuing the Work | Moving Quickly to Distribute Grant Money to Direct Care Workers

The American Rescue Plan Act's support for direct care workers is not just an investment in these essential workers—it's an investment in the health and well-being of our entire community. By ensuring that direct care workers are adequately compensated, supported, and protected, we can help guarantee that those who rely on their services receive the high-quality care they deserve.

As reported by the Recovery Office, as of June 30, 2024, 1199 SEIU Training and Employment Fund paid 1,448 direct care, a one-time $500 payment, and has already preapproved 302 applicants to schedule an appointment to finalize eligibility verification and receive payment in the coming months since the first distributing funds to eligible applicants. 1199 SEIU plans to make total incentive payments to 3,257 eligible applicants by December 31, 2024.[8]

As we continue to navigate the challenges of the pandemic and beyond, we must recognize the invaluable contributions of direct care workers. They have been, and continue to be, the unsung heroes of our community. With the support of the ARPA, we can ensure that they receive the resources and recognition they deserve.