Statewide effort to recruit home health workers, add job incentives

As Arizona’s senior population swells, Mercy Care and other agencies are teaming up to recruit, train, hire and retain thousands of workers over the next two years. 

Mercy Care alone has committed $2 million to hire, train and retain 6,000 to 10,000 home health workers by 2022. Seven other agencies have partnered with Mercy to help meet future demand for this workforce.  

With labor shortages locally and nationally in the direct care sector, the partners are collaborating to add incentives like pay raises, retention bonuses and career advancement opportunities to attract workers. They will also market to untapped employee groups, like men and veterans. 

“We know that Arizona’s population aged 60 and older is projected to grow more rapidly than any other in the state. And, in Arizona, experts expect a nearly 43 percent increase by 2025 of individuals 65 and older living with Alzheimer’s,” said Sarah Hauck, workforce development administrator for Mercy Care, a Medicaid health plan. “It’s important to us that all of these individuals can live with dignity and as independently as possible.”

The workers will be hired as personal-care aides, home-health aides and nursing assistants to deliver in-home services to individuals eligible for Arizona Health Care Cost Containment System (AHCCCS) and Arizona Long Term Care benefits.

Rapid-fire growth on the horizon 

Home health care is one of the fastest growing job sectors in the nation with the need predicted to be about 1.4 million workers by 2026, according to a report issued in January by the nonprofit Paraprofessional Healthcare Institute in New York City. 

Arizona will need 41,000 direct-care employees by 2026, according to the report, that is based on projections from the Bureau of Labor Statistics (BLS).

“The direct care workforce will grow more than registered nurses and fast food workers combined, which are ranked second and third for net job growth according to the BLS,” the report reads. “Of note, the total direct care workforce will be larger than any single occupation in 2026.”

Low pay, tough work, high turnover

There are a number of challenges facing Mercy Care and its workforce development partners. 

These are typically minimum wage jobs caring for patients including those with dementia, Alzheimer’s disease and severe developmental and physical disabilities. Direct care employees themselves often are living in poverty. Annual average salaries in Arizona and across the nation range from $21,000 to $28,000.

As a result, various studies show extremely high turnover rates in the field, ranging from 40 to 75 percent. And nationally, hundreds of thousands of people remain on waiting lists for Medicaid-funded home care. 

Arizona’s plan to elevate job status with incentives 

Largely a female workforce, the community partners plan to reach out to new potential employee groups: men, faith-based groups, retirees, transition-aged youth readying to leave foster or state care, refugees, tribal members, and others. 

They also hope to establish incentives including a path to health care careers for youth, using jobs as direct-care workers as stepping stones into nursing, physical therapy and other health care professions. 

Other incentives under discussion include:

• Referral and retention bonuses
• Community resources and support
• Monetary and career advancement opportunities 
• Mentor programs
• Specialty training 
• More flexibility over work hours and pay 

Workforce initiative partners     

The statewide work development initiative came out of the bidding process for a contract to serve long-term care population on AHCCCS. One piece of the state’s request was that organizations bidding on the contract propose ways to increase the number of in-home health care workers. 

After contracts were awarded, Mercy Care teamed up with seven other contractors to be workforce development partners: 

• Practical Training Solutions
• United Way of Southern Arizona 
• All Valley Home Health Care
• Devoted Guardians Home Care
• ResCare HomeCare
• Southern Arizona Family Services
• United Cerebral Palsy of Southern Arizona

Cost savings with in-home care 

Congress is also discussing solutions for the growing demand, particularly in rural areas.

Home care can offer considerable savings, experts testified. Studies on post-acute care discharge patterns have shown that appropriate deployment of home health care can yield potential savings of more than $32 billion over ten years.

“Expanding the long-term care workforce by as many as 10,000 employees – and that’s just Mercy Care’s pledge – will have a significant impact on our aging population’s ability to stay in their homes longer,” Hauck said. “In-home care for those AHCCCS-eligible members is also less expensive then housing them in a facility like a nursing home, and in-home care can prevent injuries and incidents that might lead to emergency treatment or hospitalizations, two other costly forms of care.”