Homecare Jobs

Case Study

Homecare Jobs

Homecare workers are the unsung heroes of the healthcare system, ensuring that New Yorkers experiencing illness or disability can live full and independent lives from the comfort of their own homes.

Despite growing demand for these workers—who already number more than 300,000 in New York City—these jobs continue to be underpaid, emotionally and physically taxing, and generally undervalued both within the healthcare system and in society at large. As a result, the subsector is plagued by high turnover and chronic labor shortages that threaten continuity of care for our communities’ most vulnerable.

At a business level, homecare agencies are also under enormous financial strain, with costs rising faster than increased revenue, which in many cases is dependent on the state Medicaid program. This means that even well-meaning, high-functioning employers find it difficult to sustain investments necessary to improve job quality. Based on expert industry feedback from our Partners Council and employer stakeholders, NYACH identified four principal factors that drive home care job quality and worker retention challenges: 1) low pay; 2) lack of full-time hours availability & unpredictable schedules; 3) insufficient training and job preparation; and 4) poor supervision and support.

Enhanced Training Model

In 2012, New York State began encouraging long-term care services to migrate from a traditional fee-for-service model to a managed care model. Hearing from partners about the resulting need for homecare workers to have new skills and how better training can improve job quality, NYACH became an early investor in enhanced homecare worker training, partnering with PHI, a leading national authority on the direct care workforce and a member of NYACH’s Partner Council.

Beginning in 2013, NYACH invested in this enhanced training, working with PHI to deploy and test the model in two different settings: locally at participating employer sites and separately in partnership with CUNY, the city’s community college system. The program ultimately certified more than 1,200 home health aides through a high quality, learner-centered training model, resulting in 77% of trainees finding immediate subsequent employment.

Read more about homecare jobs in our 10-Year Anniversary Report, and in the learnings shared from the enhanced training program in our 2019 industry brief.

Supporting Homecare During COVID-19

NYACH later brought its pre-existing understanding and relationships with the homecare sector into a number of pandemic emergency response efforts, stepping up to perform a range of operations, communications, and urgent workforce roles.

Read more about our work on the Pandemic Response page and in our 10-Year Anniversary Report.

Learn More

Read our 2020 report about the emergency workgroup NYACH launched for long-term care during the pandemic, and learn more about our 2020 emergency hybrid-virtual Home Health Aide training by reading this 2020 industry brief.