The hardest parts of Grace Diaz鈥檚 caregiving job are the sleepless nights and aches and pains. And the time away from her family.
Even when Diaz鈥檚 client, an elderly Alzheimer鈥檚 patient, gets a good night鈥檚 sleep, Diaz wakes up at her slightest rustle or groan. Diaz鈥檚 shoulder bothers her because she often lifts her client from bed to wheelchair.
She lives with her client in Westminster, a city in Orange County, seven days a week, making $15.50-an-hour and sending some to her children back home in the Philippines, from which she emigrated 20 years ago.
Diaz, who is 56, worries that when she needs care, she won鈥檛 be able to afford it.
鈥淲e take care of the elderly, but I鈥檓 not even sure that, if I stay here, I鈥檓 going to have the same care that I鈥檓 giving right now 鈥� if I鈥檒l be able to afford it,鈥� said Diaz.
Like many of California鈥檚 caregivers, Diaz says she needs a living wage, safer working conditions and benefits.
That鈥檚 important not just for in-home workers, advocates say, but for California鈥檚 Baby Boomers, who will need to hire them.
California鈥檚 caregiver workforce is already too small, experts say, and many are aging immigrants like Diaz, earning near-minimum wages. A few state lawmakers have introduced bills to protect workers and encourage growth in the workforce.
鈥淭he need for care is going to more than double in the next 12 years here in California, and it鈥檚 happening across the country,鈥� said Arnulfo De La Cruz, president of the Service Employees International Union (SEIU) Local 2015, which represents long-term care workers throughout California. 鈥淲e鈥檙e a country that鈥檚 aging, and how do we want to care for people when they age?鈥�
California caregivers undervalued, underpaid
By 2030, will be age 65 or older, according to the nonprofit Public Policy Institute of California. The state will be facing a shortage of as many as said Susan DeMarois, director of the California Department of Aging.
Caregiving has been an undervalued field, largely because its workers are predominantly immigrant women, said Fernando Torres-Gil, director of the UCLA Center for Policy Research on Aging.
鈥淲e don鈥檛, as a society, value or honor persons that do caregiving,鈥� Torres-Gil said.
In California 80% of care workers are women, 74% are people of color and 47% are immigrants, , a New York-based research and elder policy nonprofit.
Caregivers who work in homes or nursing centers often earn minimum, or close to minimum, wages, Torres-Gil said, and they lack benefits and safety protections typical of 9-to-5 jobs.
That makes careers in long-term care a hard sell for young people, he said.
The solution is two-pronged, said Aquilina Soriano Versoza, executive director of the Pilipino Workers Center of Southern California. Long-term care workers should receive living wages and benefits good enough to attract and retain them, she said, and government systems should help Californians pay for the care they鈥檒l need as they age.
鈥淚t鈥檚 a shortage of good jobs,鈥� she said of caregiving. 鈥淧eople are not going into care work, even though it鈥檚 one of the fastest growing jobs, because of the conditions and what it鈥檚 paid.鈥�
Caregivers鈥� pay
The state and counties help set that pay. The state鈥檚 In-Home Supportive Services Program serves 700,000 Californians, paying for in-home care for low income residents age 65 and older and others who are disabled.
It鈥檚 funded with a mix of government money. A state audit in showed California contributing $4.5 billion, counties $1.6 billion and the federal government $7.2 billion.
The in-home program pays caregivers, who help people stay in their homes. Caregivers鈥� pay rates are negotiated by the counties where they work and the unions that represent them.
Workers often complain about slow negotiations stymied by regional politics.
In Kern County, for instance, six years of bargaining for a new contract yielded a recent county offer of 50 cents an hour more on the $15.50 base pay. Sandy Moreno, who left a career in labor to care for her grandmother, said showing up at county supervisors meetings didn鈥檛 change things.
鈥淚t just feels like they don鈥檛 really care about IHSS providers,鈥� she said. 鈥淣o matter how many times we go to their sessions to talk about our work, to let them know we need to invest in this program, it just feels like we鈥檙e at the end of their list.鈥�
The Fresno County Public Authority and SEIU Local 2015 also are in active negotiations for caregiver contracts. Sal Quintero, the only Latino Fresno County supervisor, said he supports organized labor and caregivers 鈥� his brother was a caregiver 鈥� but 鈥渨e have to be careful with our county budget and see what鈥檚 affordable for us as well.鈥�
Statewide bargaining?
A few state lawmakers introduced bills designed to improve pay and working conditions for caregivers.
Assemblymember Matt Haney, a Democrat from San Francisco, earlier this year to shift collective bargaining for publicly funded caregiver contracts from counties to the state. Labor supporters said that would make contracts more fair across the state and allow care workers to move across county lines.
鈥淲ho would you want caring for someone you love,鈥� asked De La Cruz, 鈥渟omeone who鈥檚 making poverty wages, no retirement and little benefits? Or someone who has a living wage and is able to have benefits to care for their own families?鈥�
The bill passed the Assembly, but Haney said he pulled it before a Senate vote after agreeing, in discussions with Gov. Gavin 狈别飞蝉辞尘鈥檚 administration, that the state needs time to flesh out logistics and finances for statewide bargaining for caregivers.
for a working group on the issue. Haney said he expects its findings in 2025. Newsom also agreed to increasing state fines for counties that fail to promptly reach contract agreements with caregivers.
The United Domestic Workers said in a statement, 鈥淭his is a vital first step towards bringing equity and a true living wage鈥� to in-home caregivers.
Opponents of Haney鈥檚 proposal said counties have varying needs and costs of living that statewide rates likely won鈥檛 address. Assemblymember Bill Essayli, a Riverside Republican, said in a statement he voted against the bill because it would impose a one-size-fits-all approach.
鈥淭he way we can actually support these workers is by focusing on policies in Sacramento that address our affordability crisis,鈥� he said. 鈥淔or example, stopping the upcoming gas tax increase July 1 would greatly benefit IHSS workers, who drive more than other workers.鈥�
In-home worker safety
Senator Mar铆a Elena Durazo, a Democrat from Los Angeles, to include home caregivers in the state鈥檚 oversight of workplace safety. Her bill, which targets a variety of domestic workers, passed the Senate and is in the Assembly Appropriations Committee.
Currently, California鈥檚 safety work rules don鈥檛 apply to domestic workers, including caregivers in private homes. If approved, Durazo鈥檚 bill would It鈥檚 her third bill to improve domestic worker safety.
In 2020 she proposed extending the Division of Occupational Safety and Health (Cal/OSHA) protections to domestic workers, .
In 2021, taking feedback from Newsom, she proposed creating an advisory committee on domestic workers for Cal/OSHA. That led to California鈥檚 first for domestic workers.
If Durazo鈥檚 latest bill becomes law, Cal/OSHA would have the authority to develop and enforce its health and safety guidance for employers, making in-home work safer and more desirable, she said.
鈥淚t鈥檚 a very isolating job, to be one caregiver in a person鈥檚 home,鈥� Durazo said. 鈥淭hey鈥檙e vulnerable to exploitation. So we want to make sure 鈥� they would have the same rights as other workers.鈥�
That sounds like a good idea to Diaz, who said it would help caregivers in difficult employment situations. Caregiving is not for the faint of heart, she said. It requires physical and emotional strength.
Sometimes her client yells at her out of the blue, she said. On better days, they do arm exercises in the garden or listen to soothing music in the living room.
Diaz likes her work. With her own family thousands of miles away, Diaz said her client has become like family.
鈥淪he鈥檚 like a mother to me,鈥� Diaz said.
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