“Even working three jobs I still have to live check to check because my wages are not enough,” said Adarra Benjamin, who has worked as a home care worker in Chicago since she graduated high school seven years ago.

Benjamin, 25, currently works to care for three different clients, with her work day starting around 7am and ending at 11pm, seven days a week. Her hourly pay ranges from $13 to $13.48 an hour, depending on the client.

“I deserve to make the cost of living. I should be able to afford what I honestly need. I shouldn’t have to decide if I’m going to get to work or if I’m going to eat for the week. I shouldn’t have to decide if I have medication for the month or if I’m going to pay my rent for the month,” she said.

Benjamin, a member of the Service Employees International Union (SEIU), is pushing to improve the wages, benefits and working conditions of home care workers through union organizing and legislative efforts. Due to union efforts, she noted 49,000 home care workers in Illinois received back pay for a 2017 minimum wage increase of 48 cents that was blocked for two years by the former Republican governor Bruce Rauner. Without union support, Benjamin said she would be making less than $13 an hour.

A September 2019 report conducted by the not-for-profit Paraprofessional Healthcare Institute (PHI) found that nearly 2.3 million home care workers in the United States receive a median wage of $11.52 an hour and only $16,200 annually. These dismal wages force more than half of home care workers in the US to rely on some form of public assistance. Nearly nine out of 10 home care workers are women, 62% are people of color and 31% are immigrants.

“Between 2018 [and] 2028, the home care workforce will need to fill 4.7m job openings, that includes over 1m new jobs due to rising demand, 3.6m jobs that will become open as people leave the industry or labor force altogether,” said Kezia Scales, director of policy research at PHI.

Scales noted those projections don’t take into account changing demographics in populations requiring home care assistance, existing shortages in filling job positions in the industry and the lack of robust data on employee turnover within the industry. The demand is already outpacing the number of workers in home care, as thousands of Americans in need of Medicaid-funded home care services are currently on waiting lists.

“It has to be a career worth having or we’re not going to get young people to do it,” said Rebecca Sandoval, 62, a home care worker for 17 years in Medford, Oregon, and board member of SEIU Local 503. In Oregon, about 35,000 home care workers represented by SEIU recently won a new union contract with the state that will raise their minimum hourly wage to $15 an hour on 1 January 2020 and create a 401(k) retirement fund. “The senior population is going to double by 2050. We’re barely meeting needs now, and if it doubles and we don’t have the workforce, we’re going to be in trouble. That’s why there’s a sense of urgency in developing the wages and benefits to attract people into this kind of work.”

Earlier this year, several home care workers joined state attorneys in California, Oregon, Massachusetts, Connecticut and Washington in lawsuits challenging a Trump administration rule change that denies about 800,000 home care workers who are paid through Medicare and Medicaid services from using paycheck deductions to pay union dues or health insurance premiums.

“The rule is a blatant racist attack on home care workers who are mainly low-income women of color,” said Carmen Roberts, a home care worker of 12 years in Los Angeles and a plaintiff in the lawsuit. “They are trying to disallow us from paying our union dues and be a part of a union which helps us have a voice.”

Home care workers who are represented by unions receive better wages and benefits than non-union workers, but even their wages and benefits still lag behind what workers need to make ends meet and union contracts don’t cover all clients.

Lynnette Dockery, 56, a home care worker for 23 years in Meriden, Connecticut, recently won a new union contract that increases her hourly pay to $15.50 an hour. But Dockery takes care of two to three clients at any given time, including for a private agency where her pay is still $11 an hour. She also travels 35 to 40 minutes back and forth to each of her clients, and doesn’t receive any health benefits, sick days or paid time off.

“All we want is to be respected and appreciated for what we do. We need to be paid our worth,” Dockery said. “We have bills, we have to put food on the table. Out here working three or four jobs, I never see my house sometimes. I walk in at night, and in a minute the morning is here, then wake up and out the door.”