Maine has a shortage of home health workers. Is there any way to fix it?
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Maine is struggling with workforce shortages in the home healthcare industry, which means the state isn’t able to meet the growing demand, industry experts say.
The problem is far from unique to Maine.
“Like many home health providers across the country, we are experiencing a challenging workforce environment,” said Patty Buiocchi, chief operating officer for post-acute care at MaineHealth who also oversees their home health and hospice programs.
As Maine’s population ages, taking care of its older residents is becoming an increasingly urgent issue. From the stress of rural isolation to a shortage of workers to complicated federal Medicare guidelines, this guide helps Mainers learn about the services, technology and resources available to caregivers and the parents, spouses, neighbors and friends they’re caring for.
Nancy Polito, 78, of Portland, said she struggled to find the caregiving help her mom needed, especially after a stroke.
“It was hard to get anyone to come in and do anything,” said Polito, who was her mother’s primary caregiver until she died in 2010. “I couldn’t leave her alone, and couldn’t find anyone to come in.”
Polito said she’s heard the problem has only gotten worse.
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Shawna Ferris, a direct care worker from Mattawamkeag, said access to care and working conditions have worsened over the past two years.
“The cost of living has increased significantly, and the pay has not moved,” Ferris said. “You can go work in a different field and make the same or more money with less responsibilities.”
Home health includes a number of services, such as skilled nursing care for patients rehabilitating at home after a surgery, or patients who need help with daily tasks.
According to the Maine Center for Economic Policy, a progressive think tank, 23,500 hours per week of home health assistance go unfilled in the state because there aren’t enough workers.
“In the next 10-15 years, there’s going to be a lot more people 75 and older who are going to need these services. The demand for workers is growing while the number of people able to fill those roles is plateauing,” said James Myall, an economic policy analyst for the center.
Natalie Bullock, an occupational therapist, fills the trunk of her car with supplies at MaineHealth Home Health and Hospice in Saco. (Shawn Patrick Ouellette/Staff Photographer)
Myall said the 23,500 hours is an undercount because it only looks at people who signed up for Medicaid home health services. It doesn’t consider people who need the services but didn’t bother putting their name down because they know there aren’t enough workers.
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SOLUTIONS HARD TO COME BY
Myall said the state has an extreme shortage of direct care workers. Maine needs over 2,000 additional direct care employees, according to a Maine Center for Economic Policy analysis. Those are the staffers who help with daily tasks like cooking, picking up groceries, laundry, and helping people remember to take medications.
“The agencies have not been able to pay their workers enough,” Myall said. “They are getting outbid by retailers like Walmart.”
He said increasing the pay of direct care employees to 140% of the state minimum wage and then giving automatic cost-of-living raises would help alleviate the shortage.
Myall said the Maine Legislature in recent years has approved state reimbursement increases for the nonprofits that hire direct care workers, resulting in modest wage increases. But despite those efforts, wages in other industries, like retail, have increased by more, dampening the effectiveness.
Nonprofit agencies that provide home health services can currently pay their workers 125% of minimum wage, based on what the state’s Medicaid program will reimburse.
The state so far has not substantially increased wages for direct care workers, but lawmakers, including Democratic House Speaker Ryan Fecteau, have advocated for the boost to 140% of minimum wage. The state minimum wage will be $15.70 starting in January, so if that proposal passes, care workers could earn $21.98 per hour.
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The Maine Essential Care and Workforce Partnership, a group advocating for better working conditions for direct care workers, is also proposing to improve training, benefits and technology for workers.
DEMAND FOR HELP IS GROWING
Myall said the shortages result in a system where it’s primarily “relatives taking care of their family members, juggling work and caregiving,” Myall said.
“It forces some people out of the workforce,” he said.
Noël Bonam, Maine’s AARP state director, said having a strong home health system will help keep older Mainers from having to move to nursing homes and hospitals. It’s also healthier for them.
“You are keeping that person in the community, and having strong social connections, and that helps them thrive,” Bonam said. “It costs a whole lot less to keep them in the home than taking up a bed in a nursing home.”
Natalie Bullock, an occupational therapist for MaineHealth Home Health and Hospice, gathers supplies at the office in Saco for a home health visit. The need for more home health care workers like Bullock will only grow as the nation’s population ages. (Shawn Patrick Ouellette/Staff Photographer)
Buiocchi said they are able to run the MaineHealth program without workforce shortages, but they have advantages over other employers in that they can offer competitive wages and benefits and a flexible schedule. Also, because they’re a large employer, they have robust training programs and have many pathways for promotions.
Myall said much of the home health industry in Maine consists of nonprofits who don’t have the flexibility to pay higher wages.
Buiocchi said demand for home health services is expected to keep growing.
“The need has increased exponentially over the past five years,” she said.
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Tagged: aging, caregiver guide
Joe Lawlor writes about health and human services for the Press Herald. A 24-year newspaper veteran, Lawlor has worked in Ohio, Michigan and Virginia before relocating to Maine in 2013 to join the Press. More by Joe Lawlor
