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Texas Faces A Critical Shortage Of Personal Care Attendants

Taylor Jackson Buchanan/Texas Standard
Nancy Crowther laughs with her sister (not pictured). With the help of personal care attendants, Crowther, who has a form of muscular dystrophy, was able to graduate from college and pursue a 25-year career. She is now retired.

From Texas Standard:

Texas is at the epicenter of an aging boom. Texans are getting older, but older folks from other parts of the country are also moving here. With age comes failing health, and an increased need for assistance with performing daily living tasks at home. Many people with physical disabilities also need this kind of assistance. And the people who provide attendant care in Texas are among the lowest-paid in the nationOnly Mississippi pays less.

Did we mention Texas also has some of the most expensive cities to live in?


The history of poorly-paid, undervalued personal care attendants is a long one. According to the Paraprofessional Healthcare Institute, more often than not, these attendants are women. And they are mostly women of color.

“I’ve been an attendant for like twenty years. I plan on working at least another three years, if my health permits,” Shirley Eason says.

Eason is no taller than 5 feet. At this moment, she’s making iced coffee for Gene Rodgers.

“I’m a quadriplegic, which means I’m paralyzed in all four limbs,” Rodgers says. “I need Shirley to do everything for me.”

She sets the coffee next to Rodgers. He drinks from a straw, unable to hold or lift the cup.

Eason does more than make the morning coffee. She bathes Rodgers and cooks for him. She brushes his long, gray hair into a ponytail, helps him get dressed and carries him to his wheelchair. As she works, I learn she’s 71, almost a decade older than Rodgers. She’s at the age where she will need help soon too.

Eason and other personal care attendants allow people like Rodgers to live independently, hold a job, own a home and contribute to the economy.

That’s exactly how Nancy Crowther was able to graduate from college and have a successful 25-year career.

“Attendant care was a critical part of being out and about,” she says. “They would help me get up, help me get dressed, help me get my coffee, pack my lunch, get me going and send me off.”

When Crowther was a girl, she was diagnosed with a form of muscular dystrophy. Doctors gave her a grim prognosis. They said that she would be institutionalized and would probably die by the time she was 20.

Instead, she worked for Austin’s transportation authority.

“I loved my job and I really was very well respected in what I did,” Crowther says. “But if it weren’t for the attendant care, I wouldn’t have gotten out of bed.”

Demand for home-based health care is high and growing. Many attendants are managed through subcontractors hired by the state. But there’s a critical shortage of workers.

“People don’t look at this as prestigious, but we do work hard. And someday, we’re all going to need people to take care of us,” Savannah Mitchell says.

Mitchell is one of about 300,000 attendants in Texas. With a base pay of $8 an hour and no benefits, she could be making more at any fast food joint.

“Pay is a big reason why they can’t find workers,” Mitchell says. “Sometimes the pay isn’t enough, and how do they expect you to pay your bills?”

According to the National Low Income Housing Coalition, in Texas, you’d have to make around $18 an hour or work 101 hours a week at minimum wage, just to afford an apartment. But it’s worse in big cities like Austin, Dallas or Houston where you’d need to make $23 an hour.

There’s little appetite to champion a livable wage for attendants.

In the 1930s, when the federal minimum wage was established, domestic workers were not eligible for it. In the ‘70s, Shirley Chisholm of New York, the first black woman in Congress and the daughter of a domestic worker, was able to pass legislation giving domestic workers the minimum wage. But personal care attendants were excluded again. People thought of them as babysitters.

Back at Rodger’s apartment, the coffee has cleared the morning fog from his head. He’s wide awake and tells me he wishes Shirley Eason was seen as he sees her, valued and paid fairly.

“We should lobby our legislators and tell them we think it’s important to raise wages for attendant care,” Rodgers says. “My goodness, they get absolutely nothing.”

There’s a lot of good will in the Capitol. Representative John Zerwas (R-Richmond) says lawmakers value the work of personal attendants.

“We do look at this every time and we do hear some very passionate pleas to do something to enhance the wages out there,” he says.

In the 85th legislative session, Zerwas introduced a bill to raise the wages of personal care attendants. It didn’t pass.

“It’s not ideal. We understand that it’s not ideal,” Zerwas says. “But perhaps when we’re not in quite a budgetary crunch like we were this last legislative session, then perhaps we could look at a wage increase that would help them.”

In the meantime, Shirley Eason makes more coffee, hoping for a jolt to the system.

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