5 Ways Providers Use Incentive Plans to Improve Performance

Incentive plans can help an agency boost its performance and improve quality of care by motivating employees and managers to increase their efforts toward achieving agency goals. For example, if any agency wants to maximize client care authorizations, it may offer employees a bonus if they are able to reduce their non-billable hours.

In order for an incentive plan to work, the provider must have measurable, self-financing plans that deliver major, identifiable benefits to the agency. The defined goals should be achievable for at least half of your workforce. Such goals might include:

  • Staff-wide behavior changes
  • Greater accountability
  • Overtime reductions
  • Increased billing and productivity

Providers across the country have achieved these objectives (and many more) from their incentive plans. The following examples of incentive plan models are based on real experiences.

Objective 1: Control Overtime

Overtime costs in group homes and HCBS programs have been rising in recent years due to the labor shortage. While you may never eliminate overtime completely, an incentive plan can help you reduce it. Overtime control plans provide a continual reminder that minimizing overtime is always important and shares the savings with those who did the most to make a difference.

To measure your progress, it is important to have a time & attendance system that provides detailed overtime reports. Also, managers should use a scheduling solution that can highlight available employees already in or approaching overtime.

To control overtime through an incentive plan, follow these steps:

  1. Measure the average level of overtime in all locations (including pay periods with holidays when overtime is usually higher).
  2. Decide on a goal, such as reducing overtime by 5 percent.
  3. After implementing the plan, calculate the total payroll savings from the reduced overtime levels (don’t forget to deduct any additional software costs acquired to implement this plan).
  4. Re-distribute a portion of the payroll savings to the managers whose locations had the least amount of overtime.

Objective 2: Increase Revenue

Many HCBS programs involve authorizations and budget caps. But some providers may fail to maximize the authorization or, even worse, exceed the authorization. An incentive plan focused on increasing revenue, with the help of integrated time & attendance and scheduling solutions, will encourage managers and staff to maximize authorizations without exceeding them.

To increase revenue through an incentive plan, follow these steps:

  1. Divide each authorization into manageable periods, like weeks or months. During each period, track the percentage of authorizations that are under-served or over-served.
  2. Be sure to compare scheduled hours and actual service hours to the authorization. Any goals achieved by unscheduled overtime should be ineligible for reward.
  3. Give a portion of the extra/saved revenue back to the managers with the least under/overruns.

Objective 3: Increase Productivity

Staff who work in HCBS programs often need to travel between clients. Since travel time is non-billable, providers need to keep it to a minimum. To do this, providers use smart scheduling solutions to map out shifts for minimum travel time and an automated time & attendance solution to track billable vs. non-billable hours. But sometimes, a little incentive can help managers use these tools more effectively.

For example, a provider in New York noticed that staff were spending a lot of time on non-billable travel around Long Island. So the agency promised a bonus to managers who could reduce travel time by adjusting schedules and routes. The plan worked. Through simple schedule changes and route-mapping, the agency significantly reduced non-billable travel time.

To increase productivity through an incentive plan, follow these steps:

  1. Track billable vs. non-billable hours for a month. This is your baseline.
  2. Ask managers to try reducing non-billable hours through scheduling and route-mapping. Track their progress for another month.
  3. Give a portion of the savings back to the managers who reduced non-billable hours by the highest percentage.

Objective 4: Strengthen Time & Attendance Compliance

Reliable attendance is crucial for agencies, especially when one employee’s tardiness turns into another’s overtime. While employees may occasionally forget to clock in or out, 95% of an organization’s attendance records should be correct. An incentive plan encourages prompt attendance and reduces the risk of fraud.

To strengthen time & attendance compliance through an inventive plan, offer bonuses, gift cards, staff lunches, or other special recognition to employees with perfect attendance in a given period (no missed punches, no edits, no late arrivals or early departures). Even better, if you reward employees in groups (i.e. the entire group home staff must have perfect attendance to receive a bonus) they will encourage each other to be on time.

Objective 5: Hire and Retain Qualified Staff

One of the best sources for recruiting is an agency’s own staff. Employees often know of others in the same field who might be interested in a new opportunity, and they can speak to their character. Incentive plans can motivate them to reach out to their network and guide them toward agency job openings.

To hire and retain qualified staff through an incentive plan, offer referral bonuses, track retention by manager, and reward managers who have the highest retention rates over a quarter.

Summary

Performance incentives are designed to influence behavior and result in positive gains for the agency. When implemented correctly, incentive plans can bring measurable improvements to consumer care, like reliable attendance, long-term relationships with faithful employees, and fully-utilized authorizations.

However, an organization needs effective tracking methods to implement an incentive program. If you would like to learn how your organization can reliably track time & attendance compliance, overtime by individual/group, client authorization utilization, billable vs. non-billable hours, and more, reach out to info@mitcsoftware.com.

Quiz for HR Professionals

This short quiz helps determine which workforce management solution best fits the needs of your agency, from an HR perspective.

Human Resources professionals have a surprising amount of insight into the health of an agency. You regularly work to increase hiring and retention success. You may manage employee training and payroll. And you often get a glimpse into time & attendance, billing, and even scheduling. If anything is amiss, you are usually among the first to notice.

Take the quiz to test your knowledge of the agency and learn where you may have a weak spot.

How Agencies Cope with Inclement Weather Article

How Agencies Cope with Inclement Weather

As the warm weather clears up and gives way to the cold, providers start to plan for inclement weather. Will the snow and ice cause road closures, power outages, or slippery conditions this winter? How can we prepare ahead of time?

Weather is a bigger concern for some areas than others. For example, last winter sent four nor’easters whirling through New England, causing mass power outages, cancelling flights, and creating dangerous or impossible driving conditions. Providers in the affected areas had to scramble to alert their staff of closures, delays, schedule changes, and special accommodations.

For those in warmer areas, conditions like hurricanes, tornadoes, or high wind can also disrupt regular services. Regardless of the climate, all providers should have a system in place to send immediate communications to the staff.

Bad “Solutions” to Inclement Weather Alerts

Many providers have already adopted systems to deal with inclement weather (and similar emergencies). However, these solutions require a lot of time and resources, and they are usually ineffective.

system in place to send immediate communications to the staff. Bad “Solutions” to Inclement Weather Alerts

Providers will often reach out to staff by phone in the event of emergency weather conditions. Some providers keep a big list of staff cell phone numbers; when the weather strikes, managers pull out the list and start a phone campaign to reach everyone. Other providers set up an old-fashioned phone tree, where managers call a small pool of employees, who are then responsible for calling several more, who are then responsible for calling several more, until the entire agency has been contacted.

Both of these phone methods have several problems. First, they are inordinately time-consuming. If an agency has 100 employees, and each phone call takes about 2 minutes, it will take four managers almost an hour to contact everyone. That can increase to multiple hours if the agency is larger, if fewer managers are available to sit at their phones, or if employees lengthen the phone calls by asking questions. Providers rarely have that much time to spare in emergency conditions.

Another problem with these phone methods is that they are hard to maintain. In a high turnover industry, managers have to remember to update the phone lists constantly. One error could make the whole system fall apart. Also, in the case of the phone tree, managers cannot confirm that all employees receive a call. One person in the tree may get distracted and forget to call the others, creating a big hole.

The last thing providers need is extra stress during a weather emergency. Instead of phone campaigns, they need a faster, more reliable way to contact employees.

A Better Way to Communicate

automated alert systemAn automated alert system, such as Agency Workforce Management’s eNotify, eliminates the problems of a phone campaign. Instead of a mass network of phone calls, a manager can send just one alert to everyone within seconds. Alternatively, the manager can send alerts to specific groups of people; for example, if a notification only affects group home staff, the rest of the agency will not receive it. The benefit of eNotify is that it saves time – allowing employees to take action more quickly – and it eliminates the burden of maintaining contact lists.

Since eNotify is so easy and convenient, agency staff can receive quick “heads-up” alerts, even in non-emergency situations. For instance, if the weather report threatens snow but the forecast is uncertain, managers can send weather updates and coordinate next steps ahead of the storm. A phone call system is too cumbersome to handle this much communication.

With eNotify, providers can also ensure that employees receive up-to-date information straight to their smart phones. They do not have to worry that an employee will miss a call and forget to check voicemail, or that someone will forget to call someone else.

Take Communication to the Next Level

eNotify’s limitation is that it only supports one-way communication. While that is fine for many providers, some prefer real conversations. Maybe a few employees are better prepared to brave the elements than others, and they can offer to cover extra shifts. Or perhaps managers want staff to send updates about certain areas. Whatever the case for two-way communication, Agency Workforce Management has a solution.

myCommunications is a multi-way communication platform that is secure and accessible remotely. By facilitating the exchange of information among all employees in a secure, HIPAA-compliant way, myCommunications keeps staff connected on administrative, personal, or individual care-related issues.

No one can control the weather, but providers can control their emergency weather procedures. When the weather is bad, staff need to receive updates and instructions right away; managers can provide information immediately and can send as many updates as necessary with an automated alert system. This ensures that services continue despite the elements.

Why We Resist Technology in the Workplace

People have been resisting technological advances for hundreds of years. Nowadays, we wonder why people ever avoided mechanical farming equipment or doubted the usefulness of personal computers. But as far as we venture back into the history of technology, someone is always hesitant to adopt something new, even if it simplifies their work. The human services industry is no exception to this.

Here are a few common reasons agency staff resist technology and some considerations to ease any doubts you may have:

“It’s Not the Way We Do Things”

Many are wary to introduce technology into their workflow because it means change. Change is hard. Especially when it means moving away from familiar tools like pen and paper and Excel spreadsheets toward the unknown complexities of technology. But if an organization cannot adapt to anything new, it will not thrive.

Workforce management technology is designed to make things easier for an organization. After the initial shock of unfamiliarity passes, you will find that the new way of doing things is simpler and more streamlined. Instead of typing all your time and attendance data into the payroll system, you can import it in seconds.

“Implementation Takes Too Long”

Technology implementation can be a pain, especially in large agencies set in their ways. But the truth is, implementation does not have to take forever.

The biggest barrier to a successful implementation is poor staff compliance. This can occur when managers and executives do not clearly describe the benefits of the new technology or provide adequate training. Most implementation snafus are easily avoidable with a strong compliance plan. As an example, read the story of an agency in Pennsylvania that fully implemented a new time and attendance system in a few weeks.

“We Can’t Afford It”

If you look at the dollar expense of new technology, you may be tempted to write it off. Who needs another cost when resources are already strained? But the truth is that technology has high potential for return-on-investment.

If you have trouble visualizing the long-term savings of effective technology, consider the ways technology saves money:

  • Time – Technology reduces data entry and other manual tasks that eat time. The people who previously performed those tasks can focus their efforts on more meaningful work.
  • Productivity – Agencies can achieve higher goals with technology. Workforce management software can produce complex results and analyze them in minutes to tell you how to maximize the organization’s potential.
  • Employee retention – Technology gives employees more access to their work and more power over their benefits. This helps them stay engaged and happy in the organization.

When implemented correctly, technology can save your organization far more than it costs up front. For more tips, read this eBook and learn six best practices for introducing new technology in your organization.

Your Billing Integration Options with Agency Workforce Management

Could a typo cost you thousands of dollars? When it comes to Medicaid audits, yes. If your organization manually enters data into a billing system, it is not only wasting time but also making itself vulnerable to costly errors.

But data entry is not the only option. Billing integration software ensures billing accuracy and speeds up the billing process by importing time and attendance records directly to your billing software. The software automates calculations, tracks state requirements, and gives your billing system all the information it needs for compliance. It also lets you off the hook for hours of data entry.

Integrate with Your Billing Software

Providers have significantly more options to manage payroll and billing with Agency Workforce Management than with any other software vendor. Agency Workforce Management provides revenue cycle management for many billing systems, including:

  • Amber Clinic
  • Annkissam
  • EZClaim
  • Fund E-Z
  • HSys
  • Millin
  • OnTarget
  • PrecisionCare

Direct exports are also available to a number of state systems and EVV data aggregators.

Additionally, Agency Workforce Management can import data from EHR providers such as Therap and Foothold to reconcile billing with time and attendance. This works with attendance records from Agency Workforce Management or records imported from any other time and attendance system such as ADP or Kronos.

 

Don’t Forget About Payroll Integration

Which payroll service do you use? No matter what it is, it will integrate with our software. Agency Workforce Management can speak to any existing payroll system, period. This means that the same advantages of billing integration – like time savings and error avoidance – can apply to your payroll process, too.

Time Theft: An Agency’s Secret Payroll Expense

When most people hear about company theft, they picture an employee smuggling monitors home or padding expense reports. Most people do not think about the often subtle act of time theft. Perpetrators may consider it a harmless way to maximize time off the clock, but it can severely hurt an organization in the long run.

What is Time Theft?

An employee commits time theft by accepting pay for time not worked. They can do this either by working the payroll rounding rules or by fudging timesheets. For example, if Elise is paid in 15-minute increments, she could clock in 7 minutes late and clock out 7 minutes early without receiving a penalty. Employees who fill out paper timesheets have even more opportunities to record false hours.

A little stolen time, which is not a big deal, turns into a big deal over time. If Elise continues her habit of stealing 7 minutes on both ends of the day for 5 days, she will have over an hour of stolen time. In the course of a year (assuming she works 5 days a week), that adds up to about 60 hours. With a $15/hour pay rate, the total value of her stolen time will hit approximately $900. If Elise is not the only employee to do this – if perhaps 30 employees do the same thing – the stolen time value skyrockets to $27,000.

Wondering if you need to worry about time theft in your organization? Well, time theft is more widespread than you may think. The American Society of Employers estimates 20% of every dollar earned by a US company is lost to employee time theft. Furthermore, the American Payroll Association says 75% of companies lose money from buddy punching, the most widespread form of time theft.

Factors that Encourage Time Theft

Agencies can inadvertently encourage time theft in several ways. These three factors are not the only causes of time theft, but they are the most prevalent.

Paper timesheets

Paper timesheets provide no security. It is incredibly easy for employees to write fraudulent times. Even if they do not intentionally steal time, they may not realize how much they round and how quickly it adds up.

Poor employee engagement

Unengaged employees are not interested in their work or the good of the company. If presented with the opportunity to work less without suffering wage loss, their disinterest in the company may fuel their temptation to take the opportunity.

Poor scheduling 

If an employee is overworked, has too little time between shifts to take a proper break, or is scheduled when unavailable, the employee is more likely to show up late for work or take extended breaks. This type of time theft is not always malicious – overtired employees may just have a hard time staying on schedule.

How to Prevent Time Theft

If you realize that your agency enables time theft, you can take several simple steps to reverse the error.

Biometrics

Biometric devices, such as fingerprint readers, eliminate all kinds of fraud. Buddy punching is impossible,  unless someone has detachable fingers, and so is lying since biometrics record the exact punch time. Fingerprint readers can also operate without an internet connection, so employees cannot make excuses about poor connectivity for missing an attendance record.

Management alerts

Automated alerts help managers detect time theft at the earliest signs. An effective time and attendance solution will notify managers when an employee clocks in late, clocks out early, or takes too long of a break. Since a few of these instances are permissible, an effective solution will also run reports on attendance records over time so managers can see whether certain employees have more offenses than others.

Engagement efforts

Re-engaging disinterested employees will do wonders for time and attendance compliance. If you suspect time theft in your agency, provide contexts to evaluate employee engagement. Maybe your employees don’t understand the larger purpose of their work, so they are looking for ways to get out early. Or maybe they don’t have enough paid time off, so they feel burnt out. The results of an employee engagement survey might reveal the underlying reasons for time theft at your agency.

Effective scheduling

schedules

A scheduling solution should have more functionality than pen and paper. It should filter available employees by availability, preferences, and hours so managers don’t overload one person while another begs for more work. Good scheduling software will also ensure employees have enough break time between shifts and sufficient travel time between locations.

Conclusion

Time theft is a nearly-invisible cost on your agency’s payroll that can hinder organizational growth and employee morale. But solutions do exist to help your agency spot time theft and stop it at the source. A productivity increase of 20% is worth the effort!

Infographic: The Workforce Crisis in Wisconsin

Wisconsin has faced a caregiver shortage for years, but the crisis continues to grow in severity.  A group of Wisconsin health care organizations conducted a study this year to examine the current state of the workforce crisis.

These results were gathered by the Wisconsin Health Care Association, the Wisconsin Center for Assisted Living, the Wisconsin Assisted Living Association, LeadingAge Wisconsin, and the Disability Service Provider Network.

Infographic: The Long-Term Care Workforce Crisis in Wisconsin

mySeries

8 Standalone Solutions for Your Agency

Every provider faces a unique set of workforce challenges; some suffer from high turnover, while others struggle to communicate with their employees, and still others can’t be sure their overnight workers are staying awake. Because providers have such a variety of needs, there is no one-size-fits-all solution. That is why Agency Workforce Management includes a set of standalone solutions called the mySeries.

mySeries solutions are all standalone systems, but they also integrate with each other. This allows providers to choose as many or as few solutions as they need. Just need a quick fix to a single problem? Great! Maybe you want two? No problem. Each solution in the mySeries targets a different area of workforce management.

myApplicants – Applicant Tracking System

Amidst this labor shortage, many providers are short-staffed. They are also facing tough competition for employees, resulting in high turnover rates, especially for direct service professionals. Turnover also leads to more overtime, as employees work long hours to cover shifts for those who quit.

myApplicants is a powerful applicant tracking system designed to raise staffing levels, reduce turnover, and slash overtime. It does this by expediting the recruiting process, expanding job description viewership, and helping agencies choose the best fit for each position.

 

myAttendance – Time & Attendance for EVV Compliance

By the end of the year, every provider of personal care services will be subject to an EVV mandate. The details vary by state, but some providers will have the freedom to use an EVV vendor of their choice. Many of those providers just want to become EVV-compliant without revamping everything; myAttendance is the simple solution for these providers.

myAttendance is an EVV-compliant timekeeping solution that supports telephone timekeeping with caller-ID and web clock with GPS geo-fencing and out of area alerts. It can also produce in-depth reports and integrate with billing and payroll. Providers in states that already have active EVV mandates, such as Louisiana and Missouri, have successfully adopted myAttendance for timekeeping and visit verification.

 

myCheckIn – Overnight Awake Safety

Staying awake during an overnight shift – especially if all the clients are asleep – is difficult. Almost as difficult, as a manager, is ensuring your employees are awake and onsite even when you are asleep at home. Providers may take precautions to keep overtired employees off the night shift, but they rarely have concrete assurance that this is enough. That is, unless they have myCheckIn.

myCheckIn requires overnight workers to, well, check in at regular intervals, such as every 30 minutes. This proves they are awake and in the right location throughout the night. Not only does myCheckIn give managers peace of mind about the clients’ safety, it also provides third-party verification that the provider meets staff-to-client ratios at night.

 

myClients – Client Attendance and Billing

Medicaid providers manage a lot of client activities and requirements. Rather than tracking everything in disparate systems, providers can keep all their client information in one place with myClients. This is convenient and it reduces the probability of mistakes.

myClients is a provider’s hub for its clients’ activities, billing, and payroll. On top of client attendance in day programs, myClients can capture documentation, generate billing reports, integrate with a third-party billing system, and track client work activity in vocational programs. It is available in four tiers of functionality, so providers never have to buy more than they need.

 

myCommunications – Employee Communication Portal

One of the top reasons employees leave their jobs is lack of communication. When agencies do not open a clear path of communication between employees and managers, workers start to lose focus. They may eventually disengage from their jobs if they lack consistent direction and insight.

myCommunications is a two-way messaging system designed for providers to replace email. Providers can use it to order supplies, report problems, report incidents, or send general notifications. Also, since email lists are difficult to maintain, especially in a high-turnover industry, myCommunications automatically adds employees upon hire and blocks them upon termination.

 

myMaintenance – Safety and Inspection Tracking

Client safety is paramount in group homes, day programs, and service vehicles. But the most important factors of a safe environment – inspections and maintenance – are easily rushed or overlooked. Or, when providers capture inspections on paper, they are easily lost. Providers with poor or missing inspection records can inadvertently allow maintenance deadlines to lapse, thereby endangering their clients.

myMaintenance helps providers easily track inspections, service requests, scheduled maintenance, repairs, and more. It generates reminders if a service request is open for too long, automatically schedules recurring work orders, and ensures inspections are thoroughly tracked. Providers can easily access all these records in an online portal without fear of losing them.

 

mySchedules – Staff and Client Scheduling

Is overtime a constant problem for your agency? You are not alone. Many providers are struggling to fill all their positions due to the labor shortage, resulting in overtime for current employees. To make things worse, some still create employee schedules in Excel or even on paper; these providers have no visibility into overtime rates, schedule/timesheet variances, or employee availability without analyzing all their records manually.

mySchedules is an automated scheduling solution that gives managers the insight necessary to reduce overtime. With mySchedules, providers can post staff and client schedules immediately, update them from any web-enabled device, set reminders, and run powerful reports. The solution can also filter employees by hours, location, training status, schedule preference, and more; this allows managers to quickly choose the best employees for each shift without overloading anyone.

 

myTraining – Training and Certification Tracking

An agency is not audit-ready unless all its employees are up-to-date on required licenses and certifications. However, tracking this information is often time-consuming. And making sure employees complete their re-certs before the deadline is even more difficult.

myTraining is a solution that tracks training requirements and employees’ certification status. It sends reminders, automates training class enrollment, and provides a central web location to advertise classes and tests. With myTraining, managers can view the status of their employees in just a glance.

How to Survive Provider Audits

How to Avoid Getting Slammed with Medicaid Repayments

Over a hundred providers in Ohio owe a combined $33.3 million for non-reimbursable Medicaid services.

The Ohio Auditor of State, Dave Yost, audited 121 Medicaid providers between 2011 and 2017. He found that home health providers are responsible for 62 percent of the overpayments. Independent personal care aides and HCBS services are responsible for 5 percent.

In February, Yost released a special report to address these overpayments. According to the report, the three primary causes of overpayment were: inadequate provider qualifications, incomplete documentation, and lack of service authorization.

Providers in all states can remain audit-ready by using targeted workforce management tools to avoid these common causes of overpayment. All providers are at risk; although some intentionally manipulate their processes to receive more money, others simply have disorganized or inefficient processes. Even honest organizations are susceptible to documentation mistakes or billing errors.

Training and certifications

“It takes an unparalleled level of trust to place your life or that of a family member into the hands of a stranger,” said Yost. To ensure agency employees are worthy of the trust they receive, auditors pay careful attention to their licenses and certifications.

If an employee delivers a service that he or she is unqualified to perform, that service is not reimbursable under Medicaid. Yost busted several agencies for this, including Personal Touch Home Care of Ohio, which employed almost 80 personal care aides who were not certified in first aid.

When agencies keep track of employee certifications on paper, the certifications can easily lapse without anyone noticing. An online training portal prevents unnoticed expirations by sending alerts to employees and managers when certifications are about to lapse. Employees can then take immediate action by signing up for re-cert classes directly from the training portal. Also, managers can always see the training and certification status of all employees at a glance.

Documentation

Providers must keep complete service records detailing the aid a client receives during every visit. If a provider cannot provide correct documentation, an auditor may determine that all or part of the reimbursements were overpayments. The same can happen if a provider’s documentation is incomplete.

In 2016, an Ohio provider had to pay back 98 percent of its reimbursements because of incomplete or incorrect documentation. Other agencies have been cited for billing multiple clients in different locations for the same service or billing for a service that was never delivered.

A documentation solution, in tandem with an automated time and attendance system, can solve these documentation problems in several ways. First, it can prompt employees to submit notes about services provided when they clock out. This ensures that staff document services immediately, since they cannot clock out without providing the notes. A paper-based time and attendance system, or one that does not generate documentation prompts, does not guard against forgetfulness.

Second, it can require employees to answer questions about the services provided, ensuring that the service documentation is complete. The system may ask how much progress a client made on an activity, whether the client was fed or bathed, what the client’s temperature or blood pressure was, or how many meals the client ate.

Automated time and attendance solutions also prevent agencies from double-billing. If a provider’s service records show overlapping services – such as multiple services billed at the same time for the same client, or one employee providing simultaneous services to clients in different locations – an automated system will highlight these discrepancies before they are processed for payroll and billing.

Service authorization

Providers cannot bill Medicaid for any services not covered in the plan of care, even if they are authorized in the future. For example, a home health care provider called Healing Touch Health Care Ltd. in Dayton billed for 430 tested services before a physician signed off on the plan of care. The provider must now repay Medicaid for these services.

Agencies can use the same software they use for documentation to compare service activities with each client’s plan of care. They can also track service hours by client to make sure they do not exceed the amount of budgeted hours for any given service.

 

While these capabilities help providers catch fraud and mistakes, they also help maximize the amount of authorized billing. Therefore, not only does a documentation solution prevent fraud, it also helps agencies get the most out of their funding.

Conclusion

The Ohio audits are just a few among waves of audits occurring around the country. Therefore, all providers need to prepare to withstand one. Providers with unqualified staff, missing or incomplete documentation, or poor service authorization can deploy workforce management solutions that specifically address these issues.

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.