State profile — Tier 1

New Jersey

Ranked #5 on the PHI State Index with a newly enacted DWBOR (2024) providing full OT protections. New Jersey mandates $18.92/hr for long-term care facility direct staff and has long-standing family leave insurance and TDI programs. 1199SEIU represents home care workers statewide.

#5
PHI State Index ranking (2024)
$18.92
LTC facility direct staff wage floor
∼67%
HCBS share of LTSS spending (est.)
2024
Domestic Workers Bill of Rights enacted
Category 1

The Economic Reality

# Metric New Jersey Status
1.1BLS median hourly wage (SOC 31-1120)$17.54/hr (mean)Public
1.2PHI median hourly wage (all DCW, ACS)TBDGap
1.3Median annual earnings (DCW)$36,470 (mean annual)Public
1.4MIT living wage (1 adult, 0 children)∼$24.76/hrPublic
1.5Wage gap (living wage minus BLS median)∼-$9.66/hr (∼$20,093/yr)Derived
1.6State minimum wage (2026)$15.92/hr (Jan 2026)Public
1.7Local minimum wage (highest city)$15.92/hr (statewide; no local variation)Public
1.8Low-income household rate (<200% FPL)∼28%Estimated
1.9Public assistance reliance (state-specific)∼49% (national proxy)Proxy
1.10Housing cost-burdened rate∼42%Estimated
1.11Uninsured rate (DCW)∼8%Estimated
1.12PHI Overall State Index ranking#5/51Public
1.13Wage competitiveness vs. similar jobsTBDGap
1.14Genworth median home health aide rateTBDGap
1.15Genworth median NF semi-private rateTBDGap
1.16Family Care capitation PMPM (NH LOC)TBDGap
1.17Blended HCBS avg cost (all acuity)TBDGap
1.18NF private pay monthly avgTBDGap
1.19HCBS-to-NF cost ratio (state-specific)TBDGap
1.20Exemption aggregate savings (national est.)$500-700M/yr (∼0.2% of HCBS)Estimated
1.21Per-worker OT loss (50hr/wk worker)∼$3,100/yr (at NJ wages)Derived
Category 2

The Workforce Crisis

# Metric New Jersey Status
2.1Headline caregiver vacancy rateTBDGap
2.2Open caregiver positions185,600 openings needed (2016-2026 projection)Public
2.3Available job seekers (entire labor market)TBDGap
2.4Annual turnover rate∼79.2% (national proxy)Proxy
2.5Individuals denied/delayed servicesTBDGap
2.6Agencies unable to staff all hoursTBDGap
2.7Nursing homes closed since 2016TBDGap
2.8NF beds empty due to staffingTBDGap
2.9Total direct care workers∼111,000+ (est.; BLS ∼89,210)Estimated
2.10New jobs projected (2022–2032)TBDGap
2.11Total openings incl. separations (2022–2032)185,600 (2016-2026)Public
2.12Population 75+ growth projectionTBDGap
2.13Workforce demographics: % women∼85%Estimated
2.14Workforce demographics: % people of color∼60-65%Estimated
2.15Workforce demographics: % immigrants∼35-40%Estimated
2.16Health insurance offered by agenciesTBDGap
2.17Family caregivers providing 80%+ of all careYesPublic
2.18Unpaid caregiver hours/economic value∼1.1M caregivers (AARP)Estimated
Category 3

Legal & Policy Framework

# Metric New Jersey Status
3.1State companionship/OT exemption statusFull OT protections (DWBOR 2024); no companionship exemption; OT after 40 hrs for all domestic workersPublic
3.2State overtime threshold40 hrs/wk (all domestic workers)Public
3.3Domestic Workers Bill of RightsYes — A-834 (2024, effective July 1, 2024)Public
3.4Paid sick leave lawYes — NJ Earned Sick Leave (2018)Public
3.5Paid family/medical leaveYes — NJ Family Leave Insurance/TDI (long-standing)Public
3.6Primary self-directed Medicaid programPersonal Preference Program (PPP) via 1915(j)Public
3.7Self-directed program enrollmentTBDGap
3.8Primary managed LTC programNJ FamilyCare managed carePublic
3.9Managed LTC enrollmentTBDGap
3.10Combined HCBS enrollmentTBDGap
3.11HCBS share of LTSS spending∼67%Estimated
3.12HCBS waiting lists statusTBDGap
3.13Spouses as paid Medicaid caregiversTBDGap
3.14Parents of minors as paid caregiversTBDGap
3.15COVID family caregiver relaxations permanent?TBDGap
3.16SDPC maximum wage (self-directed)TBDGap
3.17OT rate cap in self-directed programsTBDGap
3.18IRIS/SDPC weekly hour capTBDGap
3.19Minimum fee schedule for HCBSTBDGap
3.20Wage pass-through requirementTBDGap
3.21MCO contract wage floor provisionsTBDGap
3.22Union representation (home care workers)1199SEIU (part of 125,000+ regional membership)Public
Category 4

The Geographic Divide

# Metric New Jersey Status
4.1Travel time/mileage reimbursement mandateTBDGap
4.2Caregiver-to-senior ratio by countyNOT COMPILEDFOIA
4.3Counties with zero/limited home care agenciesNOT COMPILEDFOIA
4.4Rural broadband coverage (for EVV compliance)TBDGap
4.5EVV system & vendorTBDGap
4.6EVV offline/low-connectivity accommodationTBDGap
4.7EVV hard launch date (personal care)TBDGap
4.8Rural vs. urban NF admission ratesNOT COMPILEDFOIA
4.9Rural nursing home closures since 2016TBDGap
4.10Rural HCBS alternatives (adult day, ALF)TBDGap
4.11Projected NF bed shortage (statewide)TBDGap
Category 5

State Medicaid Toolkit & Reform Levers

# Metric New Jersey Status
5.1Medicaid rate-setting authority modelNJ FamilyCare managed care + PPPPublic
5.2Minimum fee schedule exists?LTC direct staff wage floor: $18.92/hrPublic
5.3Fee schedule codified in statute or budget?TBDGap
5.4Wage pass-through % requirementTBDGap
5.5State-level 80/20 compensation rule?No (federal CMS rule faces rescission)Public
5.6MCO contract cycle & next renewalTBDGap
5.7MCO workforce adequacy reporting required?TBDGap
5.8IRIS IBA formula inputs reflect market wages?TBDGap
5.9Premium pay structure for extended hours?No statewide premium payPublic
5.10State domestic service OT exemption statusNo state companionship exemption (DWBOR 2024 eliminated)Public
5.11Legislative path to eliminate state OT exemption?N/A — already eliminatedPublic
5.12Federal Medicaid loss projection (10yr)TBDGap
5.13Annual new cost to state taxpayersTBDGap
5.14State-directed payment limit impact (eff. 2028)110% Medicare cap; exact impact TBDPending
5.15Provider tax moratorium statusTBDGap
5.16NF staffing rule moratorium (10yr)Applies (est. 13,000 add'l deaths/yr nationally)Public
5.17Work requirements effective dateDec 31, 2026 (childless adults)Public
Category 6

Federal FLSA & Companionship Exemption Status

# Metric New Jersey Status
6.12013 DOL rule status (as of March 2026)Technically in effect; enforcement suspended July 25, 2025 (FAB 2025-4)Public
6.2Proposed rescission rule published?Yes — July 2, 2025 (90 FR 28976)Public
6.3Final rescission rule published?No (as of March 2026)Monitor
6.4Chevron deference statusEliminated — Loper Bright v. Raimondo (2024)Public
6.5Private litigation still viable?Yes — 2013 rule provisions still invocable by private partiesPublic
6.6DOL estimated annual transfer (2013 RIA).8M (medium scenario, 7% discount)Public
6.7Adjusted current estimate-700M annuallyEstimated
6.8GAO post-implementation findingHour caps, not cost absorption; pay did not increase; workforce declined 11.6%Public
6.9Familial caregiver % in self-directed programs50-78% nationally; CA IHSS >70%Public
6.10Disparate impact demographics85% female; 67% POC; 27% Black; 26% HispanicPublic
6.11CMS 80/20 Access Rule statusFinalized May 2024; faces likely rescission/non-enforcementPublic

Data sourcing

Every metric links to its primary source. Public = publicly available. Derived = calculated from public sources. Proxy = proxy or imprecise. Estimated = estimated value. FOIA = requires FOIA request. Partial = partially available. Gap = data not available. Full methodology and source registry available on the Methodology page.