In New York State, HCA’s data show that nursing shortages resulted in home health agencies being unable to accept 23% of cases while causing a delay in start of home care for 15% of cases. Equivalent numbers are shown for home health aide or personal care aide shortages. This is especially concerning given the growth expected from the home care sector in the coming decades. (See our report for details.)
These shortages are driven by many factors, and they affect certain regions and types of workers differently. The state has responded on a few dimensions, like the wage front (i.e., the home care wage parity law, yearly minimum wage increases, etc.). Also, the state’s Workforce Investment Organization initiative offers some supplemental training but it is exclusively focused on existing workers.
A more holistic, structural and evidence-based approach is desperately needed, including: strategic investments in gateways to home care careers, like professional/vocational schools; cross-training of the hospital and home care workforce to allow for nimbler migration of existing talent across sectors; and targeted supports that make home care a more viable or appealing option for employment.
HCA’s proposed budget amendments, already shared with the Legislature (see related story), include several new provisions that: target funds toward workforce shortage areas and disciplines; allow pilot projects for worker supports like transportation, child care, peer support, education, career ladders, etc.; and pave the way for workforce cross-training programs between home care and hospitals, realizing that one setting can be the gateway for the other – and that training in both settings greatly strengthens the existing pool of talent for the sake of the entire system.
New York also needs a better statistical understanding of the various home care and hospice market and labor needs statewide to more wisely direct reimbursement adjustments where they are needed, which is why our proposal also provides for a competitive market analysis to guide reimbursement decisions.
As you will read elsewhere in this month’s Capitol Report, one recent study shows the impact of nursing shortages on delayed hospital discharges for children, which is particularly troubling. What other service pressures could be resolved through an evidence-based approach and targeted workforce investments?