Catholic Health joins $20M effort to recruit, retain ‘front-line’ caregivers

April 10-- Apr. 10--Catholic Health System struggles to recruit and retain some of its lowest-paid but highly visible workers: home health aides and certified nursing assistants.

These "front-line" caregivers sometimes face challenges with their transportation or child care. The emotional strain of the work can be heavy, too, on top of taking care of their own families.

But with jobs paying below-average wages at a time when low unemployment makes finding workers difficult, hiring is a challenge and turnover is high.

The issue is not unique to Catholic Health, or to the Buffalo Niagara region. But Catholic Health will partner with the Cleveland Clinic and Ascension Southeast Michigan to tackle the problem, with financial backing from the Ralph C. Wilson Jr. Foundation.

The Wilson Foundation will provide more than $15 million in grants to support a new program called THRIVE, short for Transformational Healthcare Readiness through Innovative Vocational Education. The program, estimated at a total of $20 million when including investments by the three health systems, was conceived by the Cleveland Clinic. Over the next three years, the three systems will work together, sharing ideas and tracking results.

Their goal is to remove barriers that can cause entry-level caregivers to drop out of training or quit their jobs within the first year, and provide those workers with support to cope with the pressures. The three health systems hope to develop a recruiting and retention model that other parts of the country can one day follow.

Joyce Markiewicz, president and CEO of Catholic Health's home and community-based care, said the program will address the needs of caregivers who work in people's homes, as well as in nursing homes and hospitals.

Catholic Health aims to train about 400 new workers a year under the new program, Markiewicz said.

The state's rising minimum wage is one challenge to recruiting, Markiewicz said. The intense competition for workers is adding to the pressure, with stores, fast-food restaurants and other entry-level employers now routinely paying more than the minimum.

"We were always above the minimum wage; we could always ride a little bit higher," Markiewicz said.

Catholic Health's home health aides and certified nursing assistants earn anywhere from $12.72 per hour to $18.02 per hour, but the range rises to $14.29 to $20.67 when including shift differential and weekend premium pay. Catholic Health currently has 800 employees working as nursing assistants, certified nursing assistants and home health aides.

Would Catholic Health have more success with recruitment and retention if it paid the front-line caregivers substantially more?

"I don't think that it's just the pay," Markiewicz said. "I do really believe that it's all of the other issues that these individuals face on a day-to-day basis."

Nationally, demand is rising for these types of workers, but employers face competition for recruiting new hires, and report annual turnover rates of 25 percent to more than 50 percent, depending on the study. It's an echo of other industries that struggle to attract entry-level talent, especially at a time of low unemployment, when candidates have more job options.

The THRIVE program targets some of the region's lowest-paying health care jobs, according to state Department of Labor data.

The Labor Department said in the first quarter of 2018, home health aides earned a median wage of $25,930, which was about 30 percent below the median wage of all jobs in the Buffalo Niagara region during that period. Nursing assistants earned a median wage of $29,500 during the same period, according to state data.

The challenges that caregivers face resonated with Wilson, the late owner of the Buffalo Bills.

"In the latter years of his life, he built a lot of relationships with different caregivers and people that were helping and assisting him," Markiewicz said. "He got to know them, and he got to know some of the plight they suffered with, trying to manage their jobs, their personal lives, taking care of others and then coming to work and doing that as a profession."

Wilson "really had a desire to see if there was a way that we could help people that were coming into these professions to have a better life, and help them with some of the personal issues they deal with every day," she said.

The THRIVE program will include training programs already approved by New York State, as well as "life skills" for workers, such as managing their money from one week to the next, and how to have a first conversation with a new person they are caring for.

The program will also provide practical support, like paying for ride-hailing trips to get workers to and from their jobs, if transportation is a problem, or vouchers for child care. Coaches will be assigned to small groups of workers, and will stay with those employees over the course of a year, offering advice for handling the stresses of the job.

"The goal within the first year of employment is to really help support them, both with education and social support, so they can be successful in that first year and get their feet under them and learn how to really be a good employee," Markiewicz said.

With the three health systems collaborating on THRIVE, "there's huge opportunities to learn from each other, do things a lot more quickly, and on a scale that none of them would be able to do on their own," said Amber Slichta, vice president of programs for the Michigan-based Wilson foundation.

Slichta said $1.5 million of the foundation's $15 million commitment will go toward hiring an independent evaluator of THRIVE. The evaluator will look at the financial return on investment, whether the organizations are changing their culture to "value the positions even more," and whether patient outcomes are staying the same, if not improving, she said.

"I think our North Star in all of this is to see the [employee] retention rates go up," she said. "And there's a lot of evidence out there that by improving retention rates, you do see a real financial return on investment."

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