Everywhere I go, people are talking about how the high price of gas is affecting home care workers and agencies. Organizations are contacting me and my colleagues for ideas on how to deal with it, so I’d be very interested to hear from people in other parts of the country. How are employers and workers and clients dealing with it? Are any states planning a response to this crisis? If so, what’s being considered?
Four-dollar-a-gallon gasoline exacerbates all recruitment and retention problems, and I fear that it forces workers to make some very difficult choices. Employers are calling workers to offer them cases and having the workers do the gas calculations and say “I can’t afford to take this one.” Home care aides are seeing their co-workers go to other jobs where they don’t have such stressful transportation issues.
Here in Michigan, in the waiver program that funds home care for people who are eligible for nursing home services, I’m hearing that the only time a worker must be paid for transportation is when they’re driving the client, taking them shopping or the doctor or the pharmacy or something like that. People aren’t getting paid for all the driving they have to do just to get to their clients.
I’m also beginning to hear about agencies that are looking at per-trip payments. I was told about one that was giving $2, and I just read about another that’s paying $5.
Gas is already a lot higher than $4 a gallon some places. Agencies in the Upper Peninsula are having a hard time finding people to take cases. People just can’t afford travel costs in rural areas. My concern is that, at some point, many more home care aides are going to say: “It’s more expensive for me to take this case than to turn it down.”
I’m also worried about home health aides who have worked with the same clients for a long time and developed personal commitments to them – the pressures on them to choose between paying their electric bill or filling up their gas tank so they can get to those clients. I don’t know how they’re handing it. What sorts of sacrifices are they making? What does it feels like to tell a client: “I can’t afford to serve you any more”?
I don’t know self-directed consumers and their attendants are dealing with the high price of gasoline. In Michigan, the consumer-directed Home Help program does not pay for any transportation costs for these providers of services and supports.
I wonder if clients or agencies are getting calls from aides to report “I ran out of gas,” or “I’m on empty and I don’t have money to put gas in the car.” Are gas prices causing more no-shows? Are more workers leaving home care to work in facility-based services?
A friend of mine asked, are agencies figuring out a way to schedule more efficiently, so there’s not as much driving? But she’s a consumer advocate, so she also said that suggestion would take us right back to the problem of scheduling services at the convenience of the agency or worker rather than the consumer.
But what’s the alternative? To go without services altogether because there’s not enough money in the system to send out a worker? We now have to schedule in a way that saves gas – or that matches the bus schedule.
I wonder: What did people in home care do in ’78, when there was a national gasoline shortage?
I’d really like to hear how aides, agencies, and consumers are handling the $4+ a gallon gasoline. Has any state or other body stepped forward to address the issue?
Hollis Turnham, Michigan State Director, PHI
hturnham@phinational.org
I own HomeHealthRecruiter and am a co-founder of QuietHire. We are soon going to be doing something very tangible to address this issue. We’re not ready to announce it, but please stay in touch.
David Chilcote II, MSW
Owner – HomeHealthRecruiter.com, Inc.
Co-Founder/EVP – QuietHire.com, Inc.
Bill coming to help home health providers cover gas costs…
David Chilcote
QuietHire.com
HomeHealthRecruiter.com
“Johnson says the bill should be introduced soon”
I’m glad they are doing something. Wish they could get it passed a bit faster though.
I know this issue is a real big one causing some greatly increased turnover at my workplace. Several co-workers have started taking the bus or sharing rides with others.
Unfortunately, that’s only a few of them. We lost our last two managers yesterday and the company hasn’t been able to find replacements yet. The position requires a lot of driving and the reimbursement rate hasn’t kept up with the gas prices. We have some higher ranking managers filling in for now, but I have also noticed a lot of other staff cutting hours back or switching/transferring to sites closer to their homes. I’m looking for something closer to home myself and have taken to biking instead of driving. (Bus is nice when it rains!) Activities that involve transportation have been drastically cut back also.
Hopefully the bill gets passed soon.
This is a topic that has been the 500 lb gorilla in the room for home care agencies ever since gas prices have been on the rise and the US economy has been in a lull – especially for waiver funded agencies where there is no reimbursement infrastructure in the state to support home care worker travel (like Michigan, apparently, and Pennsylvania, where we operate). I’m thrilled you are putting it out in the open with this article.
Any effort an individual agency takes will only be a short-term effort in such an environment, as logic dictates the fixed funding source can only go so far before collapse, and there is no forseeable slowdown for the increase in gas prices. While our agency is examining the possibility of permanently increasing wage rates to off-set inflationary costs, we are also trying to make headway with the hand that feeds the system – the state medicaid agencies that fund waiver programs.
Let’s not forget that gas prices are not the only rising prices that have adverse effects on the direct care workforce – workers are feeling the pain of rising food prices as well. State medicaid agencies and governments cannot insulate themselves from this situation any longer by placing the burden on the agencies that implement their programs. We will be pulling together advocacy efforts with similar companies to get the system in line with the new realities of the environment.
I’m anxious to hear other thoughts that may come out of your blog.
In my state, NH, a city is considering shortening the school week next yr to four days vs. 5 because the district fears it cannot cover the costs of gas for the buses. The school day would be longer of course.
In a city, major commercial bus services have been cut back their runs, and the charges have increased.
In larger medical type facilities, HR dept have made up lists of employees who live in the same towns/cities- in hopes that employees will car pool. This isn’t really an option for home health care as I see it.
Back in the 70′s we didn’t have nearly as many people being served in their own homes; nursing homes were the popular choice then and families didn’t do much when it came to taking care of their own. Those days are gone sadly…
I don’t think the government should be subsidizing the costs of gas- because WE are all the government in the aspect it’s our tax dollars paying. If they’re gonna pay for miles driven to and from work for HHA, why not for CNA’s who work in nursing homes? Or, nurses and doctors and widget makers at the local factory? Or the florist? Transportation costs are the responsibility of each of us. When we except employment from an agency that requires travel, we except this responsibility. It’s not the popular thought, but I believe it is the right one.
Sales persons can take the cost of transportation off their Federal income tax or in some cases their company may reimburse them for gas. That might be one solution. With income tax the issue is that it is not very timely. I do feel this is an issue across the country for HHA.
Hi Hollis,
I am currently trying to find some resources for a woman who wants to take the Basic Healthcare Class and then the CNA training that the Direct Care Worker Career Pathway program is offering at no cost to the learner or the employer. As you know, completion of these two courses would definitely prepare a person and provide them with a certification in to work in all areas of long term care. The woman lives approximately 50 miles from Cadillac and there is no one else from that area for her to carpool with. She estimates that gas would cost her $100 plus per week, which comes to over $500 for 5 weeks; her income is $210 per week and she has two children. She cannot afford transportation to get the training. She said to me, “I know this is an opportunity of a lifetime”…and she doesn’t know how she can do it.
Of course we are trying to help her find funding…this issue not only hits potential learners, incumbent workers but we in the rural north are very concerned about holding meetings and asking people to drive. We know that providing trainers to conduct the training deliverables will cost more for the trainer and for us. You know I ride my bike religiously but realistically walking and bike riding are a miniscule solution to a problem that we have not really begun to address.
As always, you are bravely leading the way to bring attention to the big picture. We are in trouble and this is bigger than convincing a church to help provide funding for a single mother – we need assistance now or there will be some pretty scary consequences for a lot of us in many realms.