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Staffing shortages are perhaps the most unifying factor within the home-based industry. It’s usually not a question of if a provider is dealing with these concerns; it’s how they are dealing with them.
Often, conversations around staffing come down to the fact that providers must improve retention, since recruitment pipelines show few signs of improvement. While I agree that retention must be a top priority, I don’t think these efforts are sufficient to make a significant change in the staffing status quo. And it’s not a matter of just “recruit harder” – while providers see success from overhauling their recruitment efforts, whether that’s leveraging AI or building employee referral systems, the buck can’t stop there.
Staffing hurdles have only worsened in recent months. The implementation of strict immigration policies has already stripped caregivers of their employment, taking workers away from the older adults who need in-home care.
Caregiving is not an easy career. Workers struggle with the complications of traveling to and working in clients’ homes. While the job can be exceptionally emotionally rewarding, it also often comes with small paychecks. Low wages mean that direct care workers earn a median of less than $26,000 annually, with 36% of direct care workers living in or near poverty, according to PHI. Almost 50% rely on public assistance programs – meaning that reductions to Medicaid’s budget threaten the people who deliver in-home care, as well as care access. The government shutdown has led the Trump administration to stop issuing Supplemental Nutrition Assistance Program (SNAP) benefits effective Nov. 1 – even though reserve funds are available. The ceasing of SNAP benefits puts hundreds of thousands of direct care workers, and the people they provide care for, at an “unacceptable risk,” according to PHI.
All this to say, it’s a difficult career to attract people into. To improve recruitment strategies, providers have to think outside of the industry’s typical techniques. In my view, the next step in recruitment strategies must go beyond attracting people who are already ready to be caregivers; it must involve attracting people to the career in the first place and facilitating training protocols.
In this week’s exclusive, members-only HHCN+ Update, I’ll share my take on the recruitment techniques set to transform the industry and offer analysis and key takeaways, including:
– Why the old ways of recruiting caregivers are insufficient
– Why training programs and educational partnerships are the wave of the future
– The world of benefits awaiting reinvigorated recruitment pipelines
What providers are already doing
Staffing issues are not a new concern for home-based care, so savvy providers have continually innovated their recruitment and retention techniques. The problem is that the math just doesn’t work to have sufficient caregivers to take care of an aging population. And caregivers who are already employed in caregiving roles are not staying. PHI estimates that in a decade, there will be 6.1 million total job openings in the home care industry due to workers leaving the labor force.
Some home care providers have begun to experiment with training programs in partnership with educational institutions. One Home Helpers franchise, for instance, launched a program in partnership with Ocean County Vocational Technical School in Toms River, New Jersey, earlier this year.
“Home Helpers needs highly skilled CHHAs and OCTVS has the resources to help get these folks trained and into the community,” Melissa Magabilin, nursing director for Home Helpers, previously told HHCN. “By joining forces, both organizations are helping fill the gap between at-risk populations in our community, not having qualified caring people available and training the right people to fill those needs.”
Through the program, adult students complete 60 hours of classroom instruction and 16 hours of hands-on clinical practice and emerge ready to work as a certified home health aide.
As another example, in September, Delaware-based Silver Lining Home Healthcare opened a home health aide academy.
Programs like these mark the future of the home care worker recruitment strategy, in my view. They don’t just get workers on board; they create new ones.
The long-term benefits
Changing the way the industry recruits won’t just change the current status quo; it will help future-proof the industry. It increases the pool of qualified caregivers for the entire industry, not just the provider that develops the program.
Of course, that raises the question of whether the investment is worth it, if caregivers may not stick around with the provider that invested the time and resources into developing such a program. But it seems like these programs would give home care providers first pick of a selection of new workers. For Home Helpers’ program, students are equipped to work at any home care agency, or they may be hired directly by Home Helpers.
These programs also benefit the educational systems involved.
“Partnering with industry provides the most current lessons in meeting the needs of its consumers,” Jeremy Dusza, principal of adult education at Ocean County Vocational Technical School, previously told HHCN. “It also creates a short pathway from classroom to career by establishing relationships with hiring personnel and the people they serve. Educational institutions partnering with businesses to provide community services sustainably have proven to be a model for success, and we aim to do our part.”
I also imagine that becoming a caregiver through such a program could be a unique boon to caregivers, as they get assistance with tasks like completing application processes and getting connected with care providers that are hiring. I’ve previously been told that getting a caregiver to work as soon as possible after completing orientation helps with recruitment. I imagine that having help moving quickly from the education process to the hiring process would have a similar benefit.
Expanding the home-based care recruitment process to increasingly include educational partnerships can also reduce hospitalizations and the overall cost of care.
“Expanding the workforce could increase access to care and reduce the need for costly services, such as institutional care (hospitalization or nursing home care),” a fact sheet from the U.S. Government Accountability Office reads.
Home Helpers’ Magabilin told HHCN that she would love to see such a program implemented on a state or national level. Establishing a national training program for home-based care workers would be both practical and urgently needed; such an effort appears unlikely in the current policy climate. Federal support for the industry continues to erode – Medicaid’s budget has been slashed and home health reimbursement rates face an unprecedented threat. These challenges underscore the broader need for policymakers to better understand the crucial role of home-based care.
Until then, at-home care providers can and, in my view, must intensify efforts to build partnerships with educational institutions, fostering a stronger pipeline of caregivers and ensuring the long-term sustainability of both their organizations and the industry as a whole.
