Conservatives Join Push to Pay Care Workers More

Nearly every day for the past seven years, after dropping her daughter off at school, Maria Medina has driven to the home of Renee Lopez, a woman to whom she bears no relation but has come to know almost as well as family.

Medina is Lopez’s personal attendant. That means Medina, working seven days a week, helps Lopez fix breakfast, bathe and get dressed. She pitches in around the house, checking for mail and cleaning up, and when needed, helps Lopez, who has a disability and uses a wheelchair, go to the bathroom.

In return, the state pays Medina about $8 an hour.

About 150,000 Texans rely on low-wage personal attendants in public community care programs, according to the Coalition of Texans with Disabilities. Advocates for the elderly and people with disabilities have long pushed for higher wages for personal attendants like Medina, who are typically paid through Medicaid-contracted companies.

This year, the cause has been newly championed by a group of fiscally conservative state leaders, led by Republican Gov. Greg Abbott.

“If it hadn’t been for that one person who came in in the morning to get me out of bed, I wouldn’t have been able to work,” said Lopez, a former state employee. “I was able to be a taxpaying citizen, able to contribute to society.”

It’s a message that has apparently resonated with the state’s Republican leadership. In Abbott’s proposed budget for the next two years, he asked the Legislature to dedicate $105 million to raise personal attendants’ pay by 5 percent. Republican lawmakers in the House and Senate are expected to file legislation reflecting his request, though no bill has yet been filed. 

“Home and community care is a growing and critical need for the state’s aging population and people with disabilities,” Abbott wrote in the budget proposal.

The turnover rate for attendants is dramatically high, a product of the job’s strenuous demands and low pay, advocates say. According to the governor’s office, the current wage set for personal attendants varies but is usually $7.50 per hour, 25 cents more than minimum wage.

There are also no benefits to speak of, and given the job’s strange hours, it can be difficult to work full time. For Medina, a breast cancer survivor and single mother, that has meant a constant struggle to make ends meet.

“It’s pretty rough with whatever little money we get, and I think we should at least be able to get paid a little bit more,” she said. “I do it because I like it. I know I’m going to get to that age one day where I’m going to need somebody to help me.”

Abbott’s proposal seeks to save money in the long run by reducing the number of Texans living in large state institutions, which are expensive to run, in a shift to home care.

And as the state ages, more Texans are likely to seek personal attendants. In 2010, elderly Texans made up about 10 percent of the population. The state demographer predicts that by 2050, nearly one in five Texans will be elderly as the adult population over 65 adds about 5.2 million people.

Republican lawmakers have consistently dismissed efforts by Democrats to raise the state’s overall minimum wage, saying the move would hurt the Texas economy. But in recent years, demand for personal attendants has severely outpaced supply — leading to long waitlists for state programs. Disability rights advocates say many state-contracted attendants quit to take more lucrative jobs with private institutions, like nursing homes, where an average worker might earn as much as $15 an hour.

According to the Department of Aging and Disability Services, people seeking to enroll in the state’s Community Based Alternatives program in 2014 faced waiting lists of up to a year. Other state programs for people seeking attendant care, like the Home and Community-Based Services Program, have wait lists up to 12 years long. 

But advocates say the 5 percent pay raise — worth about 37 cents an hour for an attendant earning minimum wage — will hardly make a dent in the shortage of personal attendants. Disability rights groups like ADAPT of Texas have called on the state to raise the minimum wage of personal attendants to $10 an hour. 

At a Feb. 19 meeting of the Senate Finance Committee, Kyle Hannah, the chief financial officer of a company that employs about 85 personal attendants, said the current wage floor was too low to be competitive.

“Dairy Queen pays more than I do,” Hannah said. “My staff wipe bottoms, they have to feed people through a tube in their stomach, they get punched, bit and kicked — and they make less than the Dairy Queen folks.”

This story was produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.