Do we truly believe that our elders -- and those living with disabilities or chronic ailments -- deserve to live with as much dignity and independence as possible? If so, it will be interesting to see whether we change our public policies as more and more Pennsylvanians reach the age of 65.

Tracy L. Lawless is Pennsylvania coordinator for the Healthcare for Healthcare Workers Campaign (tlawless@paraprofessional.org).

Between 2000 and 2030, the number of elderly in Pennsylvania will increase by 51 percent. Meanwhile, the number of women aged 25 to 44 -- the group from which most health-, home- and long-term-care workers have come -- will decrease by 12 percent. Improving the quality of these essential jobs is critical to attracting the workers who will be needed.

So what should we be doing?

For starters, we need to learn more about the people who provide the services that tens of thousands of Pennsylvanians depend upon each day to maintain their health and independence: the personal-care attendants, home-care aides and other direct-care workers who perform similar duties.

As we age, many of us may come to depend on these workers to maintain our self-sufficiency -- whether we're living at home or in a long-term care facility. Let's hope they will be more valued in the future than they are today.

Thanks to their low wages, lack of health insurance, limited training and few advancement opportunities, there already is a serious "care gap" in Pennsylvania, even as the demand for direct-care workers grows each year. Clearly, something must change. We must attract new workers to the field -- and retain existing workers -- to ensure adequate care for our elderly.

Most of us probably don't realize that many of the workers who provide hands-on health services for the elderly go without health-care coverage themselves. Nationally, more than two of five direct-care workers lack health-insurance coverage. In Pennsylvania, this translates into approximately 50,000 workers.

What happens when direct-care workers lack health coverage? Many are forced to seek better-paying jobs with health benefits so they can care for themselves and their families. Who suffers? Pennsylvanians who need long-term care.

Providing health coverage to these workers is one critical way to help stabilize and grow this essential workforce, while ensuring the quality of care for Pennsylvania consumers.

Gov. Ed Rendell's health-care plan might help bring coverage to this overlooked segment of the state's low-wage workforce. The governor's "Prescription for Pennsylvania" would help lower the cost of health care, improve its quality and expand coverage to those who can't afford it. Direct-care workers would benefit because the plan targets small operations where many direct-care workers are employed.

The proposal would subsidize workers who earn less than 300 percent of the federal poverty level ($19,000 for an individual and $60,000 for a family of four). The average wage for a direct-care worker in Pennsylvania is $9 an hour, which means most would qualify for subsidies.

The Prescription for Pennsylvania also would address those in this income bracket who live with chronic conditions, such as diabetes and back injuries. Direct-care workers are more likely to experience back injuries (from lifting clients) than workers in other sectors, second only to truck drivers.

State representatives from the Pittsburgh area are holding public hearings in Allegheny County to address health- and long-term-care reform in Pennsylvania. Please contact your legislators and let them know that you support the governor's "Prescription for Pennsylvania." We must start covering caregivers today if we want to preserve long-term-care choices for ourselves and our loved ones in the future.