Employment and Jobs

Amanda Ream, Job Quality Fellow

April 15, 2020  • Economic Opportunities Program

Amanda Ream

Strategic Campaigns Director, UDW/AFSCME

The current long-term care system, which provides services to older adults and people with disabilities, is facing a crisis. In California, costs are expected to balloon – by 2030, the number of Californians over the age of 65 is expected to triple compared to 2013 numbers, in large part due to rapid growth in the aging population. The cost of care is already out of reach for many Californians, who must spend down a lifetime of savings or assets before they can qualify for public services. At the same time, the supply of home health care workers is not keeping pace with demand, as many are leaving the profession for better wages and working conditions. Home health care workers earn a median income of $13,800, and face high rates of injury and violence on the job.

United Domestic Workers of America (UDW/AFSCME) is working to transform California’s long-term care system in ways that expand access to affordable care and improve the quality of the jobs it creates. The union represents over 100,000 home health care providers, one of the fastest-growing occupations in the country.

“Our existing membership is 90% women and 70% people of color,” says Amanda Ream, UWD strategic campaigns director. “It’s our task to dignify their labors and commitment to care by making the case to the public, and their elected leaders, that caregiving is a vitally important job to the health of families, and caregivers should earn enough to support their own families’ needs.”

Ream leads UDW’s Care Agenda, which brings together UDW members, seniors, people with disabilities, and other domestic care workers to advocate for universal long-term care and improved working conditions for caregivers in California. Ream also supports efforts in communities across the country to enforce employment standards won in recent years, including minimum wage increases and overtime and sick pay.

Leveraging public long-term care plans to improve caregiver job quality

The cornerstone of UDW’s Care Agenda is the creation of a long-term care benefit plan in California. Such plans can expand care by enabling more people to afford needed services, such as mobility assistance or other medical supports. These plans can also improve job quality for care workers by setting increased wage and training standards in the private market. Policymakers can include pay for individuals who care for their own family members and create meaningful work opportunities for undocumented immigrants. “California needs a bold new approach to dignifying care jobs and for allowing immigrant workers, who do many of these jobs already in the informal market, into the public sphere and careers of the future,” says Ream.

Currently, Ream and UDW are part of a coalition of consumer, provider, disability, aging, and labor groups that advocates for long-term care benefit legislation. For Ream, raising caregiver wage and training standards would play an important role in improving job quality.

“If California passes a long-term care benefit, wages will increase because of the standards in the plan, and many workers will join the union, giving them access to training and other benefits,” says Ream. “Health insurance will become an industry standard and workers will stay in their jobs longer because the jobs will be more sustainable financially, affording workers the dignity they deserve.”


As our population gets older, our supply of home health care workers is not keeping pace with demand. At @UDWA, #JobQuality Fellow Amanda Ream is working to make long-term care more accessible for recipients and more supportive of workers.

“At @UDWA, we’re working to address the care crisis by ensuring that caregiving jobs are good jobs… with wages, with benefits, with job security and secure retirement.” #JobQuality Fellow Amanda Ream

“Caregiving is a vitally important job to the health of families, and caregivers should earn enough to support their own families’ needs.” #JobQuality Fellow Amanda Ream @UDWA

At @UDWA, #JobQuality Fellow Amanda Ream is advancing legislation to support long-term care, including raising wages and training standards for caregivers and creating meaningful work opportunities for undocumented immigrants.

Our economy needs more quality jobs. Learn how leaders like Amanda Ream of @UDWA are innovating to boost opportunity in communities across the country.

Learn more

Amanda Ream is a member of the Job Quality Fellowship, Class of 2018-19. The Job Quality Fellowship is a project of the Aspen Institute Economic Opportunities Program.

The Economic Opportunities Program advances strategies, policies, and ideas to help low- and moderate-income people thrive in a changing economy. Follow us on social media and join our mailing list to stay up-to-date on our work, including publications, events, blog posts, and more.

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