Could Increasing Minimum Wage Wipe Out Our Ability to Care for Our Most Vulnerable Populations?

Direct care providers work with some of our most vulnerable citizens, such as the elderly and people with disabilities. But recruiting and retaining quality caregivers like Taylor Reynolds is becoming increasingly difficult in West Virginia.

Reynolds has been working as a caregiver for people who have severe Autism for five years and says she loves her job at a care provider called Autism Services. But three years ago, she went back to school to prepare for different work.

“I like working for Autism Services, but I don’t want to stay there forever because I can’t really make enough money to do things like buy a house,” she said. “I mean I’m making a car payment right now and paying rent, and that’s almost too much for me. So I’d like to have a better job that pays me more, even though I like my current job.”

Taylor makes $11.75 an hour doing everything from helping clients with bathing and getting dressed, to taking them to doctor’s appointments, to taking medications and eating meals.

“I could work other places and get paid more and it would be nice, but at the same time, I enjoy what I’m doing,” she said.  

The starting pay at the local Aldi’s, for instance, is $12 an hour, according to a Google search. At $11.75 an hour, Reynolds is at the top of the pay scale for Autism Services.

“We have about 1,200 vacancies just within our membership across the state of West Virginia,” said Mark Drennan, executive director of the West Virginia Behavioral Healthcare Providers Association. But in behavioral health, the problem often lies with Medicaid’s pay scale.

“We had a rate increase in 2011,” he said. “It was a significant rate increase, which increased our ability to recruit and pay a generous wage to people at that rate.”

Direct service providers are generally reimbursed through Medicaid, which has a maximum amount they will pay for providers. To pay a care worker like Reynolds more, the State Legislature actually has to pass a waiver rate increase as they did in 2011.

The loss of caregivers like Drennan began when the Legislature passed a 20 percent minimum wage increase in 2016.

“And in this field, you really have to stay a couple dollars, three dollars, ahead to really be able to draw those folks in, or then you lose them to the Sheetz of the world or fast food or Walmart,” Drennan said. “And so when that 20 percent rate increase took place, it really restricted our ability to pay for those positions.”

Drennan said the reason for that is because the work providers like Reynolds do can be really difficult. It also requires training and a special kind of personality. Not to mention workers can’t have a criminal record and must be able to pass a drug test. When wages don’t make the work financially appealing, it’s difficult for places that provide services to the elderly and disabled to compete.

“Some people may not even bother applying when you make more at Chick-fil-A or Aldi’s starting out,” said Reynolds.

Or when you want to buy a house or not live paycheck to paycheck.

“You know, sticking around and being there for those people when you end up caring about them is the reason I’m still there,” Reynolds explained.

But when Reynolds graduates from college, she plans to move on. She said if the job paid more, she would continuing doing it indefinitely.

In 2019, the WV House of Delegates introduced a bill that would raise the minimum wage to $12 an hour by 2022. The bill didn’t pass, but it was sobering for people like Drennan. He said that for the state to continue caring for its rapidly aging population, it needs more workers. And to recruit more workers, the pay for direct service providers has to stay ahead of the minimum wage.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from Marshall Health and Charleston Area Medical Center.