Somehow they failed to notice the once and future SEIU dues skim our Governor just signed back into law. An immediate pay cut for home health care workers, who were already woefully underpaid:
Why is Michigan facing a growing shortage of home health aides?
By Justin P. Hicks - November 28, 2024Burnout and a lack of fulfillment led Nate Volk to end his legal career and seek another path.
Striving to do something more meaningful, he began helping his elderly family members with their day-to-day tasks. That work vaulted him into a 17-year career as a home health and personal care aide in the Bay City area.
Volk, now 50, said he likes the flexibility and variety of tasks that come with the job. It gives him a sense of purpose helping others in need.
Volk has no plans to leave the profession, but he understands why the job is projected to face a shortage of more than 170,000 workers over the next decade.
“I think the pay would be my No. 1 guess,” Volk said. “Some people also aren’t built to be in service-oriented positions; they don’t have that nature. It’s hard and certain aspects of the job aren’t for everyone.”
Home health and personal care aides are facing the largest expected shortage in the health care industry, according to the 2024 Michigan Healthcare Workforce Index published this spring by the Michigan Health Council.
This year’s workforce index was the second iteration of the report, which debuted in July 2023. Craig Donahue, vice president and chief operating officer for the council, said it wasn’t created to determine which health care jobs are best or worst.
He said it is meant to help guide community leaders to creating a strong and sustainable health care workforce.
Home care aides handle various levels of clinical and non-clinical duties based on the needs of their clients, who are often elderly, veterans, and/or people with disabilities or chronic illnesses. Patients either live at home or in a group home.
Work can vary from cooking and cleaning, to bathing and changing clients. Licensed professionals can offer medication administration, wound care, feedings, assessment of body function, glucose monitoring and range of motion exercises, among other services.
According to the workforce index, aides are facing some of the worst forecasted worker shortages and turnover. That’s despite facing some of the best wage growth since 2012 (up 40%).
A college degree isn’t required to be a home care aide, which is one of the lures of the industry. Workers typically have gone through a certification program including classroom hours and some clinical work to learn basic personal care needs and medical care.
There are also avenues for additional training/certification for specialties like Alzheimer’s or Parkinson’s disease. Some enter the field on a path to another health care job, while others transition to it later in life.
“A lot of times they took care of their grandparents or parents and they liked their aide and want to provide that care to someone else,” said Elizabeth Laming, vice president of the Michigan In-Home Care Association.
The work itself can be rewarding, but difficult. There are unruly clients, overbearing family members, and unstable hours if a client dies or cancels service, prompting the search for a new client.
Laming, who has run Great Lakes Home Care Unlimited since 2011, said caregivers in a hospital can step outside for a minute if a patient is being unruly. That’s not the case when you’re working in their home.
“It’s not easy to walk into somebody’s home,” she said. "People think it’s their house, their rules, which is true to an extent but we have to follow medical rules.
“A good portion of it is dealing with people with Alzheimer’s and dementia. They’re going to swear at you, they may throw their feces at you. They have crazy family members who are going to stop by and start telling you to do things totally different than you were told.”
Pay remains a significant roadblock.
Nationally, the median salary for home health and personal care aides was $33,530 as of May 2023, or about $16 per hour according to the U.S. Bureau of Labor Statistics.
Other healthcare settings like hospitals, nursing homes and physician’s offices can pay more than home health companies, or even offer sign-on bonuses. That’s hard to compete with as health systems compete for workers amid caregiver shortages.
“I can’t offer you $20 an hour to come to one person’s home,” Laming said. “If you’re in assisted living, you have one person covering like eight people. So all those peoples' money goes into paying that one aide. We’re one on one.
To pay her workers more, Laming would have to increase costs for her clients, some of whom are already priced out. Clients who need 24-hour care will settle for less and piecemeal a care plan with help from family members.
“We’re getting to the threshold if we keep pushing how much we pay, which is what the state of Michigan seems to think the problem is, the people are not going to be able to afford us,” Laming said.
One of the most common hurdles Laming hears from workers is childcare. People quit because they can’t afford daycare, or don’t have access to a regular night sitter if clients need evening care.
If state leaders want to help combat the high rates of turnover with home heath care, Laming proposed increasing access to affordable childcare. She said training programs also need to be more realistic when preparing workers to become home care aides.
“They say you’re going to make $25 an hour and it’ll be so rewarding and they’re not real with them,” she said. “They don’t get a realistic picture.”
For Volk, who doesn’t have kids to provide for, the job allows him to work 30-35 hours per week as a caregiver, and still have time to coach baseball at his alma mater, John Glenn High School in Bay City.
He pitched it as a job you can get into quickly without paying big money for schooling. Once in it, he enjoys going into different houses and interacting with people of different personalities who like to talk about different things.
“I like the variety,” he said. “When I get done at the end of the day, I can say I did something substantial. You feel like you did something meaningful and you left someone in a better place.”
Still, he agreed the job would be more attractive if lawmakers would notice the benefits of funding home care aides to improve pay and help keep more people out of expensive care systems.
“Look at a bill when someone goes into a care facility, it’s massive,” Volk said. “That’s either covered by what money they have or by the taxpayer. If people in the government can iron out a structure, you’ll see (the industry) explode. It’s what’s holding it back.”
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