business

As state lawmakers look for ways to create new jobs in an era of high unemployment, they may be overlooking ones that are hiding in plain sight.

According to the Minnesota Department of Employment and Economic Development, the top three job vacancies in the state are for registered nurses, personal care assistants and home health aides. The case can be made that home care is the economic engine of many Minnesota communities. More than 70,000 Minnesotans of all ages currently receive home care services and the sector accounts for 200,000 state jobs. It's a growth industry that affects far more people than hospitals or nursing homes and is sure to be even more in demand as more than 78 million baby boomers approach retirement.

Yet home care is an invisible industry. Unlike hospitals or long-term care facilities, there are no brick-and-mortar buildings or high-profile fund-raising drives. By contrast, home health aides, skilled nurses and personal care assistants quietly go about their work in the privacy of clients' homes. That's why, even though home care is both cost-efficient and preferred by patients, reimbursement rates from the state fall short of the actual value of services provided.

The state training requirements for home care workers are extensive but the pay doesn't correlate to these requirements. In fact, pay is a third less than what it should be, based on a Minnesota Department of Employment and Economic Development compensation equation. Gov. Tim Pawlenty's latest $370 million Health and Human Services budget cuts include a 2.5 percent cut in pay for home care aides and personal care assistants, putting wages for these jobs even further behind the 8 ball.

The conventional argument is "we have to live within our means." Why not offer a living wage for the many service jobs that can easily be created in this ever-growing field? They may not be politically correct green jobs or infrastructure jobs with tangibly visible results, but home care jobs nonetheless serve a vital role in our health care system.

And home care saves taxpayer money by offering a viable alternative to more costly inpatient care. It's also been proven to prevent unnecessary or prolonged ''revolving door'' hospital stays and emergency room visits for those recuperating from illness or surgery.

Hidden costs to employers

And there are hidden costs. Not many people realize that elder care now accounts for more lost employee work hours than child care. The average length of family caregiving for elderly parents or relatives is 4.3 years. This is while these family members work full time at their own jobs. So if professional home care services aren't available, there will be a negative economic ripple effect on businesses large and small.

A new MetLife study entitled "Working Caregivers and Employer Health Care Costs'' drives home the urgent need for employers to actively address the bottom-line impact of employees providing elder care for their family members. Findings include:

•Health care expenses for caregiving employees is estimated as costing U.S. employers $13.4 billion each year.

•Average additional health costs to employers is 8 percent more for those workers who have elder care responsibilities.

•Employees providing elder care were more likely to report depression, hypertension, diabetes and other chronic diseases.

About one in every five of today's workers is caring for an elder. Demographic trends indicate that more and more employees of all ages will assume the role of family caregiver as our population ages.

If reimbursement rates for home care services continue to fall, there will be fewer home care providers, posing an access issue for people who qualify for such services under state health care guidelines. There will also be a quality drain as more experienced service providers stop offering services or eliminate select programs like medical assistance.

Home care is the preferred care choice for 95 percent of seniors recently polled by AARP. Demand for home care services is going to grow. So why don't state decisionmakers make the long-term policy decision to strengthen this sector by paying a living wage? Home care offers a win-win solution of needed jobs and cost-effective health care that we can't afford to ignore.