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Matching Service Registries Are Declining. But There’s Hope.

By Stephen Campbell | November 4, 2019

Over one million older adults and people with disabilities are enrolled in publicly funded consumer-directed programs in the United States. However, given the low unemployment rate and tight competition among employers, many individuals in consumer-directed programs are struggling to recruit and retain enough workers to meet their needs. At the same time, many workers are finding it difficult to secure enough shifts to make ends meet.

Matching service registries help bridge this gap. These online registries enable consumers to post open shifts online, often also allowing them to specify the qualifications that they seek. Workers can use the registries to find shifts that fit their availability, and in some cases can create profiles showcasing their skills, training, and experience.

PHI recently released new research on matching services registries, to continue raising awareness about these important online tools and to disseminate lessons learned and best practices. We found that there are 14 public or nonprofit matching service registries nationwide, a marked decline from the 24 registries that we inventoried in 2017—but we also observed new interest in matching service registries in states across the country.

Lessons in Sustainability

The downward trend that we discovered raises a pressing question—what factors are critical to the success of matching service registries? In our research, we uncovered two primary factors.

First, sustainable funding is essential. Large statewide registries often rely on funding from the state, but strong advocacy is required to ensure this funding remains available over time. In Oregon and Washington, local home care unions have played a strong role in securing registry funding through collective bargaining and legislative advocacy. In non-unionized states, we recommend that registry operators leverage outcomes and impact data to demonstrate the need for continued financial support from state legislatures.

For registries that are supported by grants, renewed funding is not guaranteed either. Grant-funded registry operators have devised creative methods to generate revenue and thereby strengthen their financial sustainability. Rewarding Work registries, which are active in three states, allow home care agencies and private-pay consumers to pay modest subscription fees to join the registry.

As well as funding, a second key factor for success is targeted and ongoing recruitment of new registry users. Like any similar marketplace, registries are only useful when they have large pools of consumers and providers. Each successful registry has devised innovative strategies to increase their user numbers. Statewide registries often rely on broad-based recruitment strategies; for example, Carina, a statewide registry in Washington State, has successfully recruited more users through social media campaigns. Smaller, local registries often adopt a more personal recruitment approach. At the Silicon Valley Center for Independent Living, staff recruit QuickMatch registry users through outreach at community events.

New Interest in Matching Service Registries

Although the total number of matching service registries has declined, we identified two new statewide matching service registries in our recent research. With funding from a legislative appropriation, Massachusetts has established a new registry called the Mass PCA Directory. Minnesota’s new registry—called Direct Support Connect—is legislatively supported as well, but the registry was created through a collective bargaining agreement between the state and SEIU Healthcare Minnesota, the local home care union.

More state-sponsored matching registries may be on the way. Some current registry operators told us that that they have been contacted directly by other states about the feasibility of establishing new registries. Some states are exploring matching service registries through more formal, public channels; the newly formed Governor’s Task Force on Caregiving in Wisconsin, for example, has been charged with exploring the possibility of establishing a registry. Similarly, the legislature in Texas recently asked the state’s Health and Human Services Commission to study the feasibility of establishing a new registry. The ensuing report described the start-up costs of a new registry, its potential benefits, and operational best practices.

PHI’s research indicates that sustainability remains a key challenge for matching service registries, but that states and nonprofit organizations still recognize registries as powerful tools to address workforce recruitment and retention in consumer-directed programs. As consumer-directed programs continue to expand, states and localities could consider matching service registries to promote quality jobs for workers, and to ensure consistent access to care for consumers.

Stephen Campbell
About The Author

Stephen Campbell

Data and Policy Analyst
Stephen Campbell is a Policy Research Associate at PHI. In this capacity, he contributes research, analysis, and writing on issues affecting the direct care workforce with the goal of impacting state and national policy.
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