New York Needs a Home Care Jobs Innovation Fund

A home care administrator would like to reward her workers with a bonus after six months of service.

A home care aide would stay on the job if she had help accessing affordable child care.

A family caregiver would be better able to secure home care for his mother if workers were reimbursed for their travel costs.

In our conversations with partner organizations across New York and the country, PHI has heard countless stories like these – stories that illustrate how a better investment in home care jobs could improve the stability of the workforce and consumers’ access to care. However, funding for recruitment and retention strategies – such as those suggested above – is rarely prioritized within the home care system. This budget season, PHI strongly recommends that New York take the lead in addressing this gap by creating a “Home Care Jobs Innovation Fund” to support efforts that strengthen the home care workforce.

Attracting and retaining home care workers is a priority, given the growing demand for home care – New York will need an estimated 125,000 new home care aides by 2024, a 38 percent increase from 2014. Meanwhile, as the economy improves and more job opportunities become available, potential workers are opting for other occupations—such as retail or fast food—that offer similar wages for less physically and emotionally demanding work. Further, over half of direct care workers leave their jobs each year, largely due to low wages, irregular or insufficient hours, limited advancement opportunities, and poor job quality overall. Increased demand coupled with low recruitment and high turnover have led to a workforce shortage in many areas of the state. On the ground, this translates into longer and costlier hospital or nursing home stays, as individuals cannot access the care they need at home.

It is time for New York to take action.

The proposed Home Care Jobs Innovation Fund is one way for New York to address the workforce shortage, by supporting pilot projects that aim to boost the number of workers that enter and remain in the home care field. A range of entities could be eligible to apply, including but not limited to: home care agencies, workforce development organizations with experience in home care, and organizations that support consumers in the Consumer-Directed Personal Assistance Program. PHI recommends that eligibility for the funds not be restricted to entities that are registered with Medicaid.

Each pilot project could test a different strategy for improving workforce recruitment and retention. For example, a home care agency could apply for funding to reward workers with a cash bonus after six months of service. A workforce development organization could apply to partner with a day care center to provide affordable childcare for workers. A consumer advocacy group could apply to create a transportation fund to help cover car maintenance and insurance costs for personal assistants in the consumer-directed program. Robust evaluation of the pilot projects would enable the state to decide how best to invest in recruitment and retention statewide.

The state has begun addressing home care quality and access by establishing the Medicaid Managed Long Term Care Workforce Investment Program to improve workers’ training. However, as we enter the budget season, it is imperative for the governor and state legislators to go further by investing in other innovative strategies for improving worker recruitment and retention. Combined, these efforts can inform a comprehensive plan to improve home care jobs and access to care for consumers across the state.

Learn more about PHI’s Home Care Jobs Innovation Fund proposal.

This is the second in a series of four articles about PHI’s New York 2018 budget recommendations. Read the first article.