Hundreds of thousands of older New Yorkers and people living with disabilities rely on home health aides to carry out daily tasks many of us take for granted. From bathing and dressing to meal preparation, routine cleaning, shopping, and even going to school or work – they fill the gap and exponentially improve people’s quality of life. The problem is, the need is growing, and recent revelations in our state’s care and funding threshold make the disparity between qualified aides and demand feel more like an endless void. The COVID-19 pandemic has increased demand for home care even more, while further depressing the labor supply. In a fall 2020 survey, 85 percent of participating New York State home care agencies reported worsening staff shortages.

How do we recruit and retain these essential workers in the middle of a pandemic?

Before we talk about solutions let’s build some more context. While the challenges we are up against may feel overwhelming, we have to understand the problems to fix them. In New York, the number of home health aide and personal care aide jobs is projected to rise to over 700,000 by 2028, driven by employment in home care agencies, private households, and public programs like the Medicaid Consumer Directed Personal Assistance Program (CDPAP). High turnover adds to the problem: employers across the state need to recruit an average of 26,510 new aides each year just to keep up with the growing demand for care, as well as an additional 71,680 workers each year to replace the thousands of aides who leave these occupations or exit the labor force entirely.

Below we are breaking down some of the most critical suggestions laid out by patients, families, providers, aides, and advocates. We will also link different support sites we encourage you to visit if you want to learn more or support the growing need to fill the aide gap in New York.

Provide financial care sustainability

• Organize support for new legislation aimed at raising wages for home care workers, like the newly launched Fair Pay for Home Care
• Currently, the median hourly wage for home-care workers in New York is $13.80, and the median annual income is $22,000. The bill looks to bump home-care wages to $22 hourly, or $44,000 yearly in New York City; $19.25 or $35,000 on Long Island and in Westchester; and $16.50 hourly or $30,000 in the rest of the state.
• A new report examining the impact of raising wages for home-care workers concludes that economic benefits, such as income and sales-tax revenue, would far exceed the costs. Experts estimate it would cost $4 billion annually to fund increases, which represents just over 1 percent of total annual spending within New York’s healthcare system.

Address urgent home care and hospice workforce needs

• Create opportunities across state funding pools and other sources to address core barriers to home care workforce supply (e.g., transportation, childcare, peer collaboration, professional development, and reduction in administrative burden).
• Support capacity increases through state law and regulatory changes that create new training opportunities, entrants, and case assignment options.

Continue and expand COVID-19 era regulatory relief

• Establish a process to continue, expand and/or make permanent areas of COVID-19 era flexibilities that are beneficial to worker and patient safety, efficiency, service capacity, access, and quality, including telehealth flexibility.
• Make the cost of personal protective equipment and related safety protocols ongoing components of the state’s health care reimbursement.

Nearly 1,000,000 positions must be filled to meet the demand for aides over the next decade. A 2018–2019 statewide survey of home care agencies found that, on average, 17 percent of home care positions were left unfilled due to staff shortages. You don’t need to be an accountant to recognize that these realities are not sustainable. Because home care work is physically and emotionally stressful, the path towards viable recruitment and retention is clouded at best. However, we believe by considering the suggestions above, real progress can be made, and this essential industry can attract more compassionate, fulfilled professionals. At RBT, we understand the diverse and complicated world of healthcare. Feel free to contact our dedicated team for more information on our healthcare services.