LTSS Worker Wage Competitiveness

Workforce shortages persist in the LTSS field across states, and low pay is one reason there are not enough direct care workers joining and staying in the field. A new indicator that measures the gap between the median hourly wage of direct care workers and other occupations with comparable or lesser entry requirements helps detect where direct care jobs are competitive within the market of each state. Measuring the shortfall of these wages is important to understand the workforce because in practice, job seekers who may be considering the direct care field are not looking at potential opportunities to work in direct care across several states. The median wage for workers across all states fell short of other occupations, although some states had much closer gaps than others. 

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The dollar amount shortfall between the average hourly wage rate paid for direct care jobs and the average hourly wage rate paid for other comparable jobs in each state. In every state, the average hourly wages paid to direct care jobs are lower than the wages paid for other jobs used for comparison. The larger the value, the larger the wage gap. PHI’s analyses are based on Job Zones, as defined in the O*NET database. Occupations with similar entry-level requirements to direct care jobs are categorized in Job Zone Two: Some Preparation Needed, whereas jobs with lower entry-level requirements are captured in Job Zone One: Little or No Preparation Needed. Wages for occupations with similar or lower entry-level requirements were calculated as weighted averages of median hourly wages for all occupation in each job zone.

Meaningful change over time for this indicator is defined as an improvement (lower value) or decline (high value) in the metric value that is 10% or more of the reference year hourly LTSS worker wage.

Underlying data from: US Bureau of Labor Statistics, State Occupational Employment and Wage Estimates

Data analyzed/compiled by: PHI ( based on Job Zones as defined by Occupational Information Network (


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