In the decade spanning from 2018 to 2028, the in-home care industry will need to fill an estimated 4.7 million home care jobs, according to a new report released by PHI. The estimate — slightly higher than previous projections — is yet another reminder of the workforce pressure nearly all U.S. home care providers face.

PHI, a New York-based direct care workforce advocacy organization, released its first report of a five-part series on the direct care industry, its workers and their future on Tuesday.

The number of job vacancies in the direct care industry is projected to reach more than 8 million over that same time period. PHI defines direct care workers as “personal care aides, home health aides and nursing assistants who provide assistance with daily activities in private homes, communities, nursing homes and other formal settings.”

There will be over 1 million new jobs created in home care by 2028, which would grow the current home care workforce by 46%, according to the report. The other millions of job openings will come at the hands of current workers either leaving the field or leaving the workforce altogether.

Even though direct and home care workers are and will be highly sought after moving forward, they’re still often undervalued and underpaid. That needs to change to avoid serious shortage troubles in the industry in the near future, PHI Vice President of Policy Robert Espinoza told Home Health Care News.

“The primary takeaway from our report is that the demand for direct care jobs continues to surge,” Espinoza said. “We’re anticipating 8.2 million job openings in direct care by 2028, largely in home care and mostly because workers are leaving the workforce entirely or the direct care field for other industries. Unless we dramatically improve these jobs, we won’t have enough workers to meet demand.”

Those other industries include retail and sometimes even fast food. Amazon has raised its U.S. minimum wage to $15 per hour, for example, while at least one well-publicized Chick-fil-A location has raised its minimum wage to $17 per hour.

PHI plans to release a fuller slate of policy and practice solutions over the next year as it unveils its five-part series of reports. For now, the organization suggests improving compensation and creating viable career paths for workers as a good starting point in terms of recruitment.

The direct care industry will create the most jobs out of any sector in the United States economy, the report projects.

“I think many readers will be surprised to learn that direct care jobs are the largest-growing job occupation in the country,” Espinoza said. “We should be asking, as a country, what does it mean that our largest-growing job occupation pays about $12 an hour and impoverishes so many workers?”

The median wage for direct care workers is $12.27 and median annual earnings are just over $20,000, according to the Bureau of Labor Statistics. It’s also worth mentioning that 86% of workers within the industry are female, and 59% of them are people of color.

A great deal of these workers live in low-income households or completely in poverty due to their pay, according to the PHI report. 

While the projections won’t be perfect, it is clear that the home care industry could reach a dire state if recruiting and retention troubles are not curbed sooner rather than later.

“These workers face a variety of barriers on the job, in their lives and under the law,” Espinoza said. “But the good news is that these workers are also steadily becoming more visible in the aging, disability and workforce spheres — and in the public at large. Greater visibility can lead to positive reforms and hopefully a transformation in the long term. We just need to be intentional with our solutions … ”

The caregiver crisis isn’t flying under the radar for health care policymakers.

Last year, the Administration for Community Living (ACL) announced it is working to establish a “caregiver Peace Corps,” a new government program meant to mobilize volunteers to serve America’s aging population.

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