Liza Berger headshot
Liza Berger
Liza Berger headshot
Liza Berger

It’s not quite clear yet how President Biden’s massive infrastructure plan that offers up to $400 billion for home- and community-based services will play out. 

As of this writing, it seems there are two paths forward: a bipartisan agreement that excludes the so-called care economy component, or a budget reconciliation package that would allow Democrats to pass the package with the funding for home care without any Republican votes. (The catch on the latter of course is all the Democrats must fall in line.)

One likely path forward is that a trimmed-down infrastructure plan passes and provisions for home care appear in a separate piece of legislation.

The question holding up a bill and creating consternation on the Hill, of course, is what constitutes infrastructure? Republicans are adamant that building a home care workforce is not the same as constructing roads and bridges; progressive Democrats feel otherwise.

However the proposal ends up, it is clear that while money is a big part of the solution — in terms of wages and benefits and hiring — it is not the only answer to the massive home care workforce shortage.

Innovation is another solution. Two stories that appeared in McKnight’s Home Care Daily this week revealed as much.

In one about home care workforce retention and recruitment woes, the head of the New York State Association of Health Care Providers Inc. spoke about a one-year peer-to-peer mentoring program with strong retention results. Caregiver turnover rates in the first 90 days of employment showed that nonpilot agencies had a 170% higher caregiver turnover rate as compared with pilot agencies.

In another story about a LeadingAge California blueprint, the organization has come up with several ideas to help solve the workforce shortage. Among them, redefine caregiver roles so that CNAs and home health aides receive the same certification, and create a guest worker program to allow qualified foreign workers to fill jobs in high-demand sectors.

Mentorship? Redefined job role? Guest worker program? These ideas are not necessarily revolutionary concepts anymore, but they still represent nontraditional thinking about home care.

With the infrastructure proposal kicking up the dust in Washington, it may just be the right time to put unconventional on the table.

Liza Berger is editor of McKnight’s Home Care. Follow her @LizaBerger19 and email her at [email protected].