In Carson City, Nev., home health care workers will be at the statehouse on Tuesday asking lawmakers for a big raise, citing growing demand as the state's population rapidly ages.
It's the second such request in two years. A campaign in 2023 delivered a $16 minimum wage for home caregivers, who are employed by private agencies that are funded through Medicaid. Prior to that, their wages had been stuck between $10 and $12 an hour for more than a decade.
"It was just ridiculous," says Regina Brown-Ross, a home care worker and union organizer with SEIU Local 1107. "People can't function on $12 an hour."
In 2025, getting by remains a struggle for many caregivers, even on $16 an hour. Home care workers, who are mostly women and people of color, often lack health insurance. Like other low wage workers, they must contend with rising food and housing costs.
So now they're asking for $20 an hour, hoping that lawmakers will approve the request as part of the state's next budget bill.
Two years ago, the $16 minimum wage for caregivers was championed by Democrats, who still control both chambers of the Nevada legislature, but was eventually signed into law by Republican Governor Joe Lombardo.
Today, the workers also want the state to approve more hours of coverage for their clients, many of whom only qualify for part-time care.
"A lot of the clients — they don't have enough hours and they need more help," says Brown-Ross.
This would also be a benefit to the caregivers: If they could be paid for more hours with each client, they wouldn't need to take on so many, relieving them of long drives between clients.
Higher wages have reduced turnover
Their push for higher wages is shining a spotlight on a struggle that caregivers across the country face as demand for their services soars.
Already, there's evidence that the previous wage bump in Nevada, which took effect in January 2024, has reduced turnover. Before their wages rose to $16, half of home care workers in the state didn't last a year in their roles. In the four months after the new minimum took effect, turnover fell to almost nothing, according to Nevada's Department of Health and Human Services.
Since then, the ranks of home health agencies and SEIU Local 1107 have grown. Since 2023, more than 1,300 home care workers have voted to unionize in 12 consecutive elections, adding muscle to their latest fight.
Irma Nunez, a longtime caregiver who took part in the lobbying effort in 2023, says that at the time, they had a receptive audience among state lawmakers when they shared stories of bathing and feeding patients and helping them go to the bathroom. The need for in-home help struck a chord.
"People told us personal stories about their dads, moms, grandparents, family members," she says. "They knew what we were talking about."
To make ends meet, Nunez used to pick up as much work as she could, taking on multiple clients, driving from house to house, working a couple hours here, a couple hours there, seven days a week.
The bump she received in January 2024, from $11 to $16 an hour, allowed her to reduce her workload slightly and take better care of her own health. But $20 an hour would provide her a better safety net, she says, and allow her to start saving a bit for her own retirement.
Clients also support a higher wage
The push for higher caregiver wages has been cheered on by some of the seniors and people with disabilities who rely on the care, like Nunez's longtime client Thomas Draa.
A high school science teacher, Draa was in a car crash 20 years ago that left him unable to use his legs. Since then, he's needed help getting out of bed, washing, dressing, and getting in his van to go to school.
That help hasn't always been reliable. "We had people coming and going, or not showing up to get me up, and I wouldn't go to school that day," he says.
Then came Nunez. For the past 12 years, she's been at his house every day, arriving at 4:30 a.m. so Draa can make it to school by 6 a.m., an hour before the students arrive.
She returns in the afternoon to get him back into his house and back into bed. "I wouldn't be able to go to school or work if it wasn't for Irma," Draa says.
"I always thought it was just crazy," he says of caregivers' wages. "They make such a little amount of money, for what an important job it is."
Deserving of dignity in their own profession
Brown-Ross started working as a caregiver after a decades-long career as a singer, performing around the world in solo shows and as a backup singer to the likes of Gladys Knight, Ray Charles and Smokey Robinson.
But while touring in China in the early 2010s, she suffered damage to her voice.
"I couldn't sing my phrases. I couldn't hold a note. It was the most devastating time for me," she recalls.
She needed to find a job, and soon one came calling: Her mother-in-law had been diagnosed with Alzheimer's.
Determined to keep her at home, Brown-Ross began taking care of her, eventually getting certified as a caregiver and formalizing the arrangement through a state program that allows family members to be paid for their work. She was hired by an agency and paid the going rate, then $12 an hour.
"To go from working with Ray Charles and Gladys Knight, making money, to being a home care worker … was difficult for me," says Brown-Ross.
It wasn't just the meager wages. It was the lack of respect for caregivers and recognition of their work.
"They deserve to have dignity in their own profession," she says.
Brown-Ross's mother-in-law died in 2018. Since then, she's taken on other clients, including an elderly cousin who fought in World War II, a teenager with autism, and a woman with disabilities.
Recently, she's started to rehabilitate her own voice, and is getting back into singing — finding parallels between her two careers.
"I loved bringing joy to my audiences and taking them on a journey, helping them to feel better," she says. "I bring that same premise to my home caregiving. I help them to do the things that they're no longer able to do for themselves."
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