Retain employees during the labor shortage

How Agencies Can Reduce the Effects of the Labor Shortage

The United States labor shortage is creating stress for employers across the country, but especially for providers serving the I/DD and behavioral health communities. Their work is crucial to the communities they care for, but they are struggling to fill positions. The situation appears more critical by the day. Fortunately, it is possible for an agency to hire and retain employees, even if it cannot raise wages.

What is Causing the Labor Shortage?

The labor shortage does not have one simple cause. The American Network of Community Options and Resources (ANCOR) released a report in 2017 to address some of the reasons for the shortage, and some of them are surprising.

For example, take a look at a United States Supreme Court case called Olmstead v. L.C. In this case, two women with mental illnesses received treatment at state-run institutions. Eventually, mental health professionals said the women were ready for community-based programs, where they could lead more “normal” lives. However, the women were kept institutionalized for years afterward. They sued, and in 1999, the Supreme Court decided that separating disabled persons from society longer than necessary violates the Americans with Disabilities Act.

Since that decision, the federal government has made policies that encourage more home and community-based care for people in the I/DD and behavioral health communities. The problem, however, is that these policies are not backed with an appropriate increase in funds. If more people want home-based care, more workers need to take jobs as care providers. But if the states are unable to expand their budgets proportionally, wages are stretched thin.

Another reason for the labor shortage is that the working population is shrinking. Too few people are entering the workforce to replace retiring baby boomers. Even worse, the primary direct support professional (DSP) demographic (working-age women) is getting smaller. This means that even if DSP wages increase, there will still be a shortage of workers from the typical DSP demographic.

At the same time, the need for DSPs is rising fast.  The Bureau of Labor Statistics predicts that the job outlook for home health aides and personal care aides will grow 40% between 2016 and 2026 – that is much faster than the 7% average growth rate for all jobs.

How is the labor shortage affecting human service agencies?

Providers are feeling the sting of the labor shortage most of all in their turnover rates. The DSP turnover rate is at 45%, according to the ANCOR report. A 2015 survey by National Core Indicators found that more than half of DSPs leave their jobs within a year, and about a third leave within six months. A rate this high means that clients don’t have time to get to know and trust their caregivers before they leave.

Turnover isn’t the only adverse effect. As noted earlier, job vacancies will rise in the coming years, causing extra agency expenses. The ANCOR report says that every unfilled position costs an agency between $4,200 and $5,200 in direct and indirect costs. Even worse, job vacancies could affect your agency’s DSP-to-client ratios and incite hefty fines.

As positions remain unfilled, employees need to work extra hours to fill shifts. This often leads to overtime. USA Today reported that worker shortages across the country have “quietly provided a financial boon to many full-time employees, who are notching lots of overtime, and part-timers, who are toiling more hours or shifting to full time.” This is nice for people eager to work more hours, but it is costly to their employers.

Most importantly, the labor shortage hurts the people within the I/DD and behavioral health communities. Many clients rely on provider services to live healthy lives. Without enough employees, agencies can’t take care of their clients properly. This is obviously disastrous for clients as well as providers.

How Can Human Service Agencies Cope With These Effects?

These stats are sobering for any business, but particularly for agencies that rely on state and federal funding. Even though most providers are at another’s mercy for funding issues, there are still ways for them to boost retention and cut costs.

Promote a work-life balance for employees

“Work-life balance” is a buzzword in most workplaces today, especially among younger generations. According to the 2017 State of the American Workforce report by Gallup, 53% of employees say that greater work-life balance and better personal well-being is “very important” when  considering a new job. This attribute ranks higher than job security, significant pay increase, and company reputation. The percentage may also increase in the coming decade, since millennials and Gen Xers assign more importance to this than baby boomers.

An excellent way to ensure your employees have a good work-life balance is to manage their schedules well. One of the biggest complaints employees have is lack of advance notice for their schedules. Poor scheduling or last-minute schedule changes can cause conflicts with employee’s home lives and cause them to seek alternative employment, even at a lower pay rate. It is important to track employee preferences and restrictions when creating the schedule. Doing so will maximize employee satisfaction and help you avoid a hassle. Allow enough time between shifts for employees to go home and rest, and avoid calling employees back in when they have just finished a shift.

Also, take advantage of the internet to simplify scheduling. Publish schedules online so employees can access them anytime, anywhere. Save time for everybody by letting employees see not just their own schedules, but also who they are working with, open shifts, their PTO balances, etc. Allow employees to request PTO online, avoiding telephone/email tag.

Empower employees

All employees need to feel respected in the workplace. One way managers can respect their employees is by giving them a certain amount of autonomy. Researchers from the University of Birmingham recently found that employee autonomy directly correlates to job satisfaction. For women, in particular, autonomy translates to scheduling and location flexibility.

One way to give employees a sense of autonomy is to allow self-service. Self-service means employees have some control over their schedules, PTO requests, training requirements, and benefits information. This can mean allowing them to change their schedule preferences online, giving them full-time access to their PTO balances, letting them receive notifications whenever extra shifts are available, and setting up automated alerts so they are always aware of their training deadlines. Self-service can also mean enabling employees to request corrections to their attendance records (like forgetting to clock out). When employees have some autonomy, they are more likely to feel respected—and it reduces the administrative burden on managers!

Improve time and attendance

A high turnover rate causes payroll costs from overtime and position vacancies. While overtime can never be eliminated, using an insecure time and

attendance system encourages poor attendance and low-level payroll fraud. Save your agency from additional costs by using a secure time and attendance system.

Biometric fingerprint readers, for example, eliminate the risks of buddy punching and fraud. These errors can add up to 1-3% of an agency’s payroll-related costs. That does not even take into account the lost productivity from payroll calculations and data entry. Since the cost of biometric fingerprint readers has dropped in recent years, they can give agencies a great return on investment.

For in-home programs, where fingerprint scanners are not feasible, telephone timekeeping is effective. Use voice authentication to inhibit buddy punching, and use location-based caller-ID to prevent fraud. Telephone timekeeping also allows for more advanced features, such as no-show alerts and employee HR alerts at clock-in.

Recruit creatively

Another way to cope with the labor shortage is to get creative with recruiting. Since the number of women in the workforce is shrinking, agencies need to expand their horizons when looking for employees.

Millennials are the up-and-coming group to dominate the workforce. According to LinkedIn’s 2015 Talent Trends Report, they will comprise 50% of the workforce by 2020, and 75% within a decade. Millennials like social media, so link to your job applications on Facebook and Twitter. Offer paid or unpaid internships, open houses, and career days to attract job seekers. Also, emphasize your mission – millennials, in particular, want to feel like they are contributing to the greater good at work.

Additionally, find ways to speed up your recruiting process. For example, try using a web-based system to track the entire applicant process. An online system can save you time by automatically notifying passive job seekers of new positions, parsing resumes, and tracking every step of the way, among other things. It can also make the process more intuitive for applicants, which makes a good first impression (millennials, especially, expect clean and user-friendly websites).

While the labor shortage continues, the employment outlook for your agency may appear grim. But even if your agency’s budget isn’t as flexible as you’d like it to be, you can take steps to rise above the competition by attracting and retaining valuable workers.

Minnesota DHS Recommends Hybrid Implementation Model

The Minnesota Department of Human Services published a lengthy legislative report detailing the state’s considerations on EVV. In this report, DHS recommends the hybrid model, in which the state purchases an EVV system that any provider may use but also allows providers to choose an alternative system that meets requirements.

Colorado Gives Providers 6-Month Grace Period for EVV Implementation

Colorado providers will have a 6-month grace period after the January 1, 2019 EVV implementation. During this time, they are expected to use their EVV systems correctly, but their claims will not be affected. After the grace period, their claims will not be reimbursed unless they are EVV compliant.

Colorado has contracted with Sandata for a statewide EVV system, but providers are free to use any EVV system they choose, as long as it meets federal guidelines and is capable of communicating with Sandata through a data aggregator.

Programs Affected: Personal care and home health services

New Hires

Tips for Competing with Walmart and Others During the Hiring Process

Walmart and other retailers or fast food outlets use aggressive marketing tactics to attract, hire, and retain employees. Agencies must compete with these industries in order to build and retain the best workforce they can.

One way to make your organization stand out among competing employers is to compile a checklist of advantages your agency offers. Communicate these benefits to all prospective new hires through your job listings, and feel free to share with existing employees as well!

Here is a sample list you can use to market your agency for new hires and existing employees:

  • We have a mission to help others
  • The average weekly pay for a direct support professional is ____
  • Minimum 40-hours a week
  • Overtime available
  • Any qualified employee can request extra hours from our website
  • Never miss a shift! We remind you by text of your next shift
  • 150% to 200% extra pay for working on any of the ___ holidays per year
  • Fixed schedule with the option to pick up more hours
  • View your schedule anytime, anywhere
  • See who you are working with
  • Earn paid time off
  • Receive unpaid time off with no penalties
  • Get 6-month reviews
  • Structured career path

Speed Up the Process with myApplicants

The labor shortage has a dramatic effect on human service agencies. Higher turnover and extra overtime make things even harder. In times like this, we know that applicant tracking and onboarding are more important than ever. That’s why MITC is pleased to announce the addition of myApplicants to Agency Workforce Management!

myApplicants is a robust, web-based, end-to-end hiring solution complete with applicant tracking, pre-employment assessments, background checks, and drug screens. It even has the ability to push your new hire data right into MITC Time & Attendance with just a click.

Contact info@mitcsoftware.com or read this free fact sheet for more information on myApplicants.

Fill out the form below to be emailed the download link.

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Florida Has State Contract for EVV, But Allows Third-Party Integration

The Florida Agency for Health Care Administration has a contract with Centric Consulting, LLC to provide an EVV system to fee-for-service providers. Centric’s EVV solution is called Tellus EVV. Training materials are available online.

Providers using a different EVV system may continue to use it if the system integrates with Tellus and meets state requirements.

Programs Affected: Home health services (home health visits, private duty nursing and personal care services)

Connecticut Implemented EVV Way Ahead of Time

The Connecticut Department of Social Services implemented a mandatory statewide EVV system for clients in three programs in 2016 and 2017. The state has not announced any changes to the mandate since then.

Programs Affected: CT Home Care Program (CHC), Personal Care Assistant (PCA), Acquired Brain Injury (ABI)

Several States Yet to Publicly Confirm Implementation Models

CMS guidelines indicate that Kansas, Mississippi, Montana, South Carolina, and Washington have chosen to mandate a statewide external vendor for EVV, but the states have not publicly confirmed this.

CMS indicated the Maryland has chosen to mandate a statewide in-house vendor, but the state has not publicly confirmed this.

CMS indicated that Massachusetts has chosen to mandate a statewide in-house model or an open vendor model, but the state has not publicly confirmed either of these.

CMS indicated that New Jersey has chosen to use an MCP choice or open vendor model, but the state has not publicly confirmed either of these.

CMS indicated that New Mexico has chosen to use an MCP choice model, but the state has not publicly confirmed this.

CMS indicated that Alaska, New York, and Utah have chosen to use a provider choice model, but the states have not publicly confirmed this.