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Low wages and insufficient work hours drive many direct care workers—including home health aides, personal care aides, and nursing assistants—to acquire second jobs. While holding multiple jobs allows these workers to piece together hours and income, it is unclear how their earnings compare relative to single jobholders who work commensurate total hours. Using the Survey of Income and Program Participation (SIPP) and random effects models, we evaluate whether there is an earnings penalty associated with multiple jobholding among direct care workers. We find that, on average, direct care workers who work two jobs earn about 12 percent less than single jobholders who work the same number of hours. In addition, this penalty is particularly pronounced among those who work two direct care jobs compared to those who hold their second job in a different occupation. These findings underscore how the structure of direct care work drives multiple jobholding and reinforces a cycle of economic disadvantage through this penalty. Despite the widely acknowledged direct care workforce shortage, these results highlight the need to address work hours in addition to improving wages to stabilize this workforce.