Surveys of Home and Community-Based Providers Reveal Several Employment Hurdles
May 20, 2013 04:28 PM
On May 9, PHI Michigan announced the results of statewide surveys of home and community-based (HCBS) providers reimbursed by Medicaid. PHI Michigan conducted the three surveys in 2012, encompassing 1) the Medicaid MI Choice HCBS Waiver (MI Choice); 2) the Community Mental Health (CMH) Waiver; and 3) the Home Help personal care program.
In total, 300 provider organizations responded to the surveys, which in turn represented approximately 17,000 direct-care workers. The providers overall felt that low wages, part-time hours and the lack of training were significant barriers to recruitment and retention.
Low Wages: The surveys revealed average starting hourly wages was $8.73 in the CMH program, and $9.09 for both the MI Choice and Home Help programs.
Part Time Hours: Sixty percent of direct care workers - averaged from all surveys - were working part-time, with those workers working less than 36 hours per week.
Lack of Transportation Reimbursement: Two-thirds of HCBS providers surveyed did not reimburse direct care workers for transportation costs travelling between participants.
Turnover and Vacancies: Annual turnover rate of direct care workers averaged 34 percent. Providers averaged four direct care job openings at the time the surveys were conducted.
Lack of Affordable Health Care: Only 58 percent of providers offered health insurance to their direct care workers. Those that were insured demonstrated low participation because of high cost.
Unavailability of Sick Leave: More than half of providers did not provide paid sick leave to their full-time employees.
Despite Michigan authorizing overtime for companionship services, direct-care workers are no better off. These still experience low wages, part-time hours, a lack of benefits, and a high turnover rate.
The National Council on Medicaid Home Care (the Council) promotes efficient use and strives to ensure an adequate supply of qualified home care and hospice personnel. To that end, the Council also advocates for sufficient home care and hospice payments so that agencies can provide appropriate benefits to clinical staff. See page 38-42 of our 2013 Policy Blueprint, here.
Home health providers are encouraged to keep abreast of federal and state efforts to reform Medicaid, and to contact the Council with any questions or concerns. The Council urges home care and hospice advocates to ask their Members of Congress to protect access to home care and hospice for low income Medicaid beneficiaries by opposing proposals that would reduce federal Medicaid funding.
For a link to NAHC’s Legislative Action Network (LAN), as well as a link to NAHC’s Medicaid issue brief and talking points on NAHC’s LAN page, click here.
For a link to the full PHI Michigan survey results, click here.