Ep.4: The Top 5 Challenges the Care Industry is Facing—And How Agencies Can Respond

Linda Leekley (00:08):

Hi, everyone. Good to see you. So many of you joining us. I’m Linda Leekley, Chief Clinical Officer at hcp. And

Amanda Sternklar (00:16):

I’m Amanda Sternklar, our Director of

Linda Leekley (00:18):

Marketing, and you are listening to Vision. It’s the podcast for leaders and forward thinkers in the care industry. And today we’re gonna discuss this, a big topic, the top five challenges the care industry is facing, and how agencies can respond. Now to tackle this big subject, we are so lucky to be joined by Kristen Wheeler, and many of you probably know her in the healthcare industry since 1990 and in home care since 2006. Kristen is currently the Executive director of Private Duty Services at NAHC. Kristen, thank you so much for joining us today.

Kristen Wheeler (00:54):

Thank you so much for having me, ladies. I really appreciate the invite. I love being here.

Amanda Sternklar (00:59):

It’s great to have you. Before we dive in, I just wanted to remind everyone listening that you can be the first to hear these episodes by joining us for Vision Live every other Tuesday at 2:00 PM Eastern Standard Time. And you can go to homecarepulse.com/podcast to register. While you’re there. You can also find all of our previous episodes or you can find them wherever you listen to podcasts. For folks who are joining us live right now we’ll have some time where you’ll be able to ask questions of Kristen a little bit later. And you’re also welcome to add them in the chat at any time. And when we pause, we can ask them out loud. Kristen, thank you again so much for joining us. Can you tell us a little bit more about your background in the industry before nac? What did that look like?

Kristen Wheeler (01:38):

So, so yeah, it was, it’s, it’s kind of a strange little journey that’s not to quote the Rocky Horror Picture Show, but it is October after all

Amanda Sternklar (01:47):

<Laugh>.

Kristen Wheeler (01:49):

So I think for a, it, it happens for a lot of us that we just sort of find ourselves in private duty, home care, Like it’s a, it’s bizarre, but you just end up there, right? So I was, I worked way back when, when I got into health in the healthcare industry itself. I was in fundraising and event management for a large not-for-profit healthcare system in Southeast Michigan way back when. And my husband and I moved to Key West in 2005, and he went to work for a certified home health agency and hospice organization down there. About a year after we moved there, they invited me to, to come to work with them and start their, their, what they called their private duty program. And I know before I even go in further with the words private duty, I’d like to just say that when I use the words private duty, I use them as all-encompassing with whether it’s skilled private duty care, or just home making and companionship.

Kristen Wheeler (02:51):

I use, I use that term as a bucket blanket for all of it, just to be on the safe side. I know that different parts of the country call private duty different things, so bear with me until we come up with a better phrase for the whole industry. But in any case, so I went to work for, for a certified agency, started their private duty program, ultimately spun off and opened my own home care agency that was specifically non-medical home care, only then went to work. After a few years, I sold out my part of the business, went to work for the Home Care Association of Florida as their director of private duty services. And then earlier this year went to, came to work with Mac as the executive director of private duty there. So it’s been a, been a long winding road <laugh>, I’m just full of quotes today.

Amanda Sternklar (03:43):

Linda’s laughing cause you were having the same discussion about how to refer to private duty care in <laugh>

Linda Leekley (03:50):

Ago. We were terminology <laugh>.

Kristen Wheeler (03:52):

It’s, it’s a huge deal because it’s so states and that’s, that’s the, the, the thing about private duty at its core, right? That it’s very state specific. You can’t look at private duty from a federal point of view necessarily. There are certainly some things that translate across all states from a federal perspective, but by and large it’s by the state. So, you know, every state calls things just a tiny bit differently. And, and then don’t even get me started on how many states don’t license it at all. So <laugh>, that’s a whole nother podcast.

Linda Leekley (04:23):

I, I, I hear you <laugh> as a nurse educator. Yeah,

Kristen Wheeler (04:29):

Right, bet.

Linda Leekley (04:32):

And you’ve also, Christian worked with the Home Care Workforce Alliance. Can you tell folks a little bit about that?

Kristen Wheeler (04:37):

Yeah, so, so the World Care Workforce Action Alliance, it’s official title or hwa, if you, if you like, H C W A, was a collaborative effort between NAC and the Home Care Association of America. You know, our two executive dry, our two presidents, Bill DBE and Vicky Hoke really realized that we can’t really work in silos anymore. This crisis is not going away. Everyone that’s involved in the industry has to partner together to solve this crisis. And in an effort to do this, the, the Alliance was born. So so they came together, or we, we all came together earlier this summer to create I to create and identify four individual work groups. Two, that will focus on home care aides or direct care workers, or again, that’s another title that everybody calls something different. And then two, that will focus on nurses and the shortage there to come up with some really actionable steps to move forward and, and try and solve some of this.

Linda Leekley (05:44):

Okay. And from, from what I understand from the, the website you’ve identified five critical issues that are affecting the industry right now. So if we kind of go one by one on these issues, can you give a brief rundown of these five problems and, Well, let’s start with the big one. Employee shortages.

Kristen Wheeler (06:04):

Yeah. Yeah. So, I mean, you know, we’ve already said it because you can’t talk for five minutes in, in the, in the healthcare industry or in the workforce industry at all without talking about how everybody’s looking for staff, right? But so the five, the five issues that, that were identified from the alliance are really all very intermingled. It’s a very chicken sort of egg situation. But, but obviously we have a critical shortage of frontline healthcare workers for us. And anybody that’s been in the industry from before covid, we all know that this was a problem pre pandemic, but but it’s certainly been punctuated now. Providers are reporting something like 50% of referrals are being turned down at this point, bec solely because they can’t stop them. Not because it’s, you know, that it’s not a case that they’re comfortable with or they can’t go that far, or it’s an area they’re not in. This is simply because they can’t staff it. So that’s just massive, just a huge, huge problem.

Linda Leekley (07:07):

Let’s talk about compensation and how that fits into the picture.

Kristen Wheeler (07:11):

Sure, sure. So compensation again, notoriously low for, and, and if, if everybody on, on today or who’s listening is involved in home care, again, preaching to the quieter, no notoriously low in home care wages really need to be lined up with the value of the role. And we’re gonna talk about value of this, this population again in just a little bit. But I think that’s, that’s sort of the bottom line. But if you look at, say, so let’s take nursing wages first. If you look at nursing wages in home care, generally speaking, and home care Pulse obviously has great data to support this, but nursing wages are, any nurse could go work in a facility, whether that’s a hospital, a skilled nursing facility, whatever, and generally make more money. So it’s really, we really have to look at other areas of why it’s so, it’s so much better to work in home care.

Kristen Wheeler (08:10):

What’s, what’s more rewarding about it? What’s better about the flexibility of it? Any number of things, right? The same is true for home health aide and caregivers. Many areas, these workers are still being paid minimum wage. So again, leaves very, very little incentive to come into the industry at all when you can look at, okay, so if I can make ju let’s just use around number 10 bucks working for this home health agency, or I can make 10 bucks at the gap, maybe I’ll go work at the Gap. You know, I, so it’s just, we need to be a little bit more creative here.

Linda Leekley (08:46):

Well, so that sort of leads into the next bucket, if you will, of the five mm-hmm. <Affirmative>, which is training issues. My, my passion. So <laugh> Yeah, that’s Hear your take, take on that

Kristen Wheeler (08:55):

<Laugh>. Yeah. Yeah. And I’d love to hear, Yeah, feel free to jump in too, Linda. My goodness, I know you’ve got, you’ve got plenty of experience here, but I, you know, certainly there absolutely needs to be more opportunities for these folks to develop, to improve their skill set. Study after study shows that more home care workers are incentivized by career opportunities or career ladders, if you will, just as much, or nearly as much, at least as compensation. It’s not just all about compensation, though. Compensation is very important. But you see the providers that offer continuing education or other opportunities like that at, they’re the ones that end up keeping the staff the longest.

Linda Leekley (09:37):

You know, Kristen, we hear a lot these days from from folks that we talk to at hcp, agency owners and, and managers who say that they just need compliance training that all their staff, all their employees, all they want is compliance training. They don’t wanna deal with anything else. How do you respond to that?

Kristen Wheeler (10:02):

So I think that it’s, I I think that more agency owners and more employers need to need to get to know their staff a little, a little bit better. Maybe there are some folks out there that that’s all they’re interested in or, or does that really just boil down to we’re talking to a business owner that wants to do the bare minimum Yeah. And say, Okay, so OSHA says I have to do this, so I’m gonna do this, or my state standards say I have to do X, and that’s all I’m gonna do. And so I’m offering, you know, I’m offering education. That’s bottom line. I get it. Right. I get it. I was an agency owner, It was a small agency. I, my census was only around 120. And I did most everything by myself. So when you’re talking about that kind of perspective of like, I don’t have time to worry about this. Well, you don’t have time not to anymore, unfortunately. You just somehow or other that you’ve got to find ways to incentivize, incentivize these people, especially the rock stars that you find, cuz you know, we’ve all found some where you just will do anything you can to keep them. Well, then that’s what you have to do is find the things that that will make them stay

Linda Leekley (11:23):

Individualize training too, to, to some extent that would.

Kristen Wheeler (11:27):

Exactly. Yeah, Sure. Not every, not every home care aide wants to go on to become a nurse, although some do not everyone wants to stay in this industry forever, although some do. So I, so I was gonna mention this towards the end. I’ll throw in this sort of shameless plug now. More so because of how interesting it is, not because I’m trying to plug Na <laugh>, but <laugh>, but we are just about ready to launch this incredibly fascinating data study that was done as a partnership between NAC and Mission Care collective that identified several hundred data points among 67,000 home care direct care workers. It ultimately identified seven individual personas and dug way deep into the weeds on, on all the differences between these personas. And each of the seven personas is recruited very differently, and each is, is retained very differently. And so un once you see, it’s, it’s super fascinating. Once you see this, you realize, I’ve only been recruiting a certain, like, one of these personas rather than five of these or whatever. So it’s, it’s a, a total eye opener to to really see that, that it’s not a one size fits all anymore at all across the board. So so yeah, we’re, we’re, we’re formally releasing that this weekend at next annual conference in expo.

Linda Leekley (13:04):

That sounds fascinating. I can’t wait to,

Kristen Wheeler (13:08):

It’s really

Linda Leekley (13:09):

Very excited for that. Well, so that, that sort of leads to the next, which is the professional perception.

Kristen Wheeler (13:18):

So professional perception, you know, and I think we can look at this as, as a sort of twofold from the industry perspective and from the public perspective mm-hmm. <Affirmative> because it, the perception is, is incorrect on a, a number of levels on, on from both areas, right? From a public’s perspective. And, and right now I’m talking about more of the home care aid population as opposed to the nursing population. Because when you call somebody a nurse, when you say she’s a nurse, then people say, Oh, okay, well, she’s got a license and she went to school mm-hmm. <Affirmative>. And, you know, that’s not the, the, the going thought when you talk about home health aides or personal care aids or certified nursing assistant, certified nursing assistant gets a little bit of a bump mm-hmm. <Affirmative>. But, but when some, you know, if you talk about the caregiver homemaker population, you know, if you ask a client what their home health aide does or what their home health aide’s title is, you’ll get any a whole host of responses from cleaning woman to housekeeper to grocery shopper to, you know, But so, so the perception is that that’s such a, and I, I hate to say this, but it’s such a low level of, of service and it’s really one of the most critical levels of service that person spends the most amount of time with these clients or patients, or again, whatever they’re being called, they know them more than any of their, their professional, like their therapist, their nurses, you know, not to disappoint dis discredit what therapists and nurses do, because they’re amazing.

Kristen Wheeler (15:08):

But I think the role of the caregiver absolutely has to be elevated. It is a professional job. Sure. Maybe you don’t have to go to school for years to learn how to do it. But you certainly do have to hone your skills over time to do it right. And to be really good at it. And, and they’re a huge part of the team, no matter how you cut it.

Linda Leekley (15:33):

Absolutely. And as you know, I say that as a nurse who’s work, who worked with, with direct care workers CNAs, home health aides, companions side by side with them you know, I knew if you asked those, those clients or patients, would you like to give up? If you had to give up your nurse or your, your aid or your caregiver, which one would you choose? They’d probably say, I’ll give up the nurse. I’ve gotta have the caregiver, right? Mm-Hmm. <affirmative>. So, you know, PE people understand the importance, but the professional respect is not there. And that’s something I’ve been fighting for, for 25 years Yeah. With my training company to try to elevate and now with HCP to elevate the professionalism of, of that population and, and give them the respect that they so richly

Kristen Wheeler (16:26):

Deserve. Absolutely. Yeah. Yep. It’s getting there, but it’s, there’s still a, a long road to hoe.

Linda Leekley (16:34):

You know, it’s also interesting when I, when I, you know, back in the day, first started nursing, if you got, you know, you had to go to the hospital when you first graduated, right? It was, you gotta start out in acute care, med surge if you wanted to go to home health, you were thought of as not quite a nurse by the acute care nurses. So even among, even among the nurses, there was this

Kristen Wheeler (17:04):

Yeah. You know, which is so crazy when you think about it. Like, I mean, I feel like, and I know I’m horribly biased, I understand. But but I feel like working in home care is so much harder. There’s no one there to ask. I you are on your own <laugh>, you know, you have to know what you are doing to be able

Linda Leekley (17:26):

To the creative thinking and thinking outside the box, and Yeah, absolutely.

Kristen Wheeler (17:30):

Not to, not to mention some of the houses you walk into in the state of things and the way that some people live. Like we all have those horror

Linda Leekley (17:38):

Stories. Yeah. You don’t have a, you know, a janitorial crew coming behind you <laugh>. Right,

Kristen Wheeler (17:43):

Right. Exactly. Right. It’s

Linda Leekley (17:46):

Crazy. So yeah, it’s all part of perception and I think it’s a really important conversation, obviously, to continue. So the last bucket of the five is the impact on families.

Kristen Wheeler (17:59):

Well, sure. And I think that it, it almost goes without saying, right? So like I, I mentioned earlier, we’ve got providers saying that they’re turning down, you know, a full half of the referrals that they’re getting because they can’t staff them. So what does that mean for those families? And, you know, obviously they’re having to look for alternate ways to care for this loved one. So many people are having to, you know, quit jobs or work less to take care of their own family members, et cetera, et cetera. So it’s, it’s huge. I think the last number I saw that estimate, it said that there would be an estimated need for 8.2 million more jobs to keep up with the demand of people aging. And I mean, obviously people wanna stay home, you know, I mean, if the pandemic showed us nothing, it was that people don’t wanna go into facilities anymore. They wanna age at home. No offense to the facilities, but I mean, people would prefer to stay home.

Linda Leekley (18:55):

Right. Absolutely.

Amanda Sternklar (18:58):

Well, we’ve talked a lot about the impacts of all of these individually, which is nothing to snee that. But when we combine all five of these issues that you’ve identified, how do you see them impacting the care industry as a whole?

Kristen Wheeler (19:13):

Well, again, and I think I, I just sort of said it, you know, that, that with staying at staying home is key. And I think that there’s, there needs to be ways that people can achieve that goal, to be able to age in place, to have some quality of life still in their own homes, and to be able to afford it. You know, home care can’t just be for those that are wealthy enough to, to afford it. It, it can’t, It’s not, it’s not right. It’s not fair. People should have access to be able to stay in their homes. They’ve, however, they ended up with their own home, they worked for it one way or another, and it’s theirs, and they should be able to stay there. And, but if the workers aren’t there, we’re just not gonna be able to sustain it.

Amanda Sternklar (20:00):

Very well put, I feel like we’ve identified, you know, a lot of the issues. And frankly, a lot of the folks on this call are probably painfully aware of all of these and may feel like it’s, it’s kind of obvious. Can you speak a little more to why raising awareness of these issues is so important, even if it feels pretty obvious to to agency owners and providers?

Kristen Wheeler (20:22):

Well, I think, I think that we need to make people that are potentially interested in even going into the industry aware that it’s a viable career, that home care is rewarding, and it can be something that people do for a living and can make a living. But I mean, we have to, we have to get there for un for certain levels. But in order to do that then the opportunities, like I said earlier, for further education for career ladders or Pathways or whatever the case may be, they just need to be in place. And I think that, I think that the awareness at, on the industry level, like you said, Amanda, is is already there. There’s, there can’t possibly be somebody on the call today that, that isn’t aware of it, that the workplace issues aren’t aware. Yeah. Like what I would love to, I have so many staff, I dunno what to do with them. Yeah. But, but it’s, I think it’s the people that aren’t quite sure about getting into the industry that we need to, we need to raise the awareness of yes, there are issues, but there are ways to make it better. The other people that need to be made aware of it are legislators. And we can probably talk about that a little bit, <laugh>.

Linda Leekley (21:48):

Yeah. Well, and, and let’s, so let’s transition to that. You know, the Workforce Action Alliance is an advocacy group, right?

Kristen Wheeler (21:56):

Absolutely.

Linda Leekley (21:57):

So how can folks listening, agency owners, what, what can they do to help advocate for the changes that that, that we have to do in order to continue?

Kristen Wheeler (22:11):

Well, so there’s, sure, there’s a, there are a number of legislative actions that are kind of floating around out there that have little legs under them, but they’re not all there quite yet. Mm-Hmm. <Affirmative>. So I think that’s, that’s the first way to, you know, start by urging your elected officials to support a number of these legislations. I don’t know if you want me to, to mention each of the, the, I can if, if you want me to talk about the, the various legislative items that are out there, potential legislations.

Linda Leekley (22:44):

Sure. Yeah. Let’s hear it.

Kristen Wheeler (22:46):

So so number one in, and this was on nas priority list for our, our recent advocacy day at on the Hill. One of our asks was to support the Better Care Better Jobs Act that legislation would permanently increase funding for home and community based services through state’s Medicaid programs by 10%. It would, it would also require states to include personal care family caregiver supports and rested care among those services that are allowable. Mm-Hmm. <Affirmative>. So it, it’s, the money follows the person, if you’ve heard that. So it would be through that FMAP funding that that would that would happen. So that’s the Better Care, Better Jobs Act o Otherwise, we, The other portion that we really need to look at and should probably talk about is immigration reform. It needs to be considered foreign born citizens make up like 30% of the direct care workforce right now.

Kristen Wheeler (23:49):

So there are three, I think potential legislation out there. There’s Citizenship for Essential Workers Act, which would establish a mechanism. This would be for non non-citizens who worked during the public health emergency as an essential worker. It would be a way for them to obtain permanent resident status. Then there’s the Essential Workers for Economic Advancement Act, I believe that would establish a new non-immigrant visa for temporary workers to fill jobs that have gone unfilled for some time. It does put a little bit of onus on the employer to require them. They have to show that they tried to fill those roles with US workers and things like that. But that’s, that Bill is out there. And then the Healthcare Workforce Resilience Act is a visa program for foreign-born nurses and physicians specifically to allow them making it easier for them to practice in this country. So all of that could be looked at and considered to, to help ease some of this burden.

Linda Leekley (25:00):

Okay. So let’s say an agency owner isn’t quite sure how to tackle being an advocate. What’s, what’s the easiest step? How do you, how do you reach the right

Kristen Wheeler (25:11):

People? Absolutely. Join either your state home care association. Every state has one. Join one of the national associations. Again, I will say that I’m biased cuz I am, but <laugh>, but by all means, all of the, that’s what it, that’s what your association’s main function is. We do a lot of other things besides just advocating, but all of us at our core, our advocacy groups, we all have lobbyists that we work with. We all have very I’m, I can’t speak for everyone’s website, but most I’m sure have easy ways to identify who your legislators are. Probably with a click or two, you can send an email off to your legislators encouraging support of various bills, whatever’s being followed in your state.

Linda Leekley (26:03):

So, Kristin, I’m going to sound a little like a devil’s advocate, just a little, what would you say to someone who said, Well, November’s coming up, things are gonna change. None of these bills will pass. What’s the point of all this? What do you say to people who are skeptical about really any change happening?

Kristen Wheeler (26:24):

Well, I say that, you know, we’re all voters, right? So so regardless of what, what industry you’re in or what party lines you follow or whatever we all, we all have a voice. And I think skepticism just leads to complacency in a lot of ways. Mm-Hmm. <affirmative>. So, so I say we’re the only ones that can be that change and squeaky wheels get heard, et cetera, et cetera, et cetera. So, <laugh> I think that we have to make enough noise. And finally the noise is being made that, you know, like I said at, at the beginning of all of this, any of us that have been in this industry for any, any length of time, any longer than two years, let’s just put it that way, knew that this was a problem a long time ago. Right? We’ve, it’s always been a problem.

Kristen Wheeler (27:18):

Finally, the whole rest of the world realizes it’s a problem, and finally it’s being looked at as if it’s a very real problem. Part of it’s probably because everybody’s getting older and they’re like, Ooh, wait a second. Now I need, I might need somebody. What are we gonna do <laugh>? But hold on. But but yeah, I think that now is the time that we can actually affect this change. And if we don’t do it now, we’re gonna be talking about this 20 years from now, and all of us are going, we’ll be sitting in our, you know, skilled nursing home, talking to each other about it. Like, Boy, wish I was home. So I think we, it’s, it’s time for all of us to, to speak our minds and get out there and, and vote for, for some real change. So be this squeak, be this squeaky wheel, huh? Be the squeak. I love that. We should trademark it. <Laugh> be the squeak you wanna hear <laugh>.

Amanda Sternklar (28:13):

I love that. I think we’ll get, we’ll get right on that. We’ll make some, some images for the, this episode for, I agree that it’s, it’s extremely important not to get complacent and to, to think of yourself as part of the larger change. But while after they’ve agency owners and providers have done all of that if, if they want to kind of look inward work at a more micro level if an agency wanted to do a self evaluation, for example, what’s the first area you’d recommend? They look at and, and reconfigure what can agencies do individually

Kristen Wheeler (28:51):

Well? And, and actually that’s, that makes a, that brings up a really good point, Amanda, before I even even try and tackle that answer. So, so, you know, maybe we can’t affect change everywhere immediately, but what we can do is affect change in our own companies. And so to, to your question, I’d say first sort of look at your company culture, see what’s going on. How are you showing your frontline workers that they are valued? Are, are you losing people by at the same level as, you know, the, the statistic, the median is, whatever that is. Mm-Hmm. <Affirmative> like half, isn’t it? Is it half like 50% of of direct care workers leave annually or something like that? It’s a huge number. I know that

Amanda Sternklar (29:38):

It’s a bit, it’s a bit over that. I think it was in the mid

Linda Leekley (29:43):

64

Amanda Sternklar (29:43):

Or, or low sixties this year. Wow. It’s crazy going over annually,

Kristen Wheeler (29:47):

Right? So if you’re anywhere near that number, you’re seeing those kind of numbers, or if you’re even higher than that try and I, it’s, it’s a hard look, right? So you have to look at, especially if you’re the owner of the business, it’s, it’s really tough to, to look at your own stuff and say, What am I doing wrong here? Why don’t these people love this place like I do? So, so you’ve gotta ask yourself some of those really hard questions. But like I said earlier about this, the study that’s coming out this weekend, maybe your, your employees all need something different from you mm-hmm. <Affirmative>. And again, we can talk about not having enough time to do those things, but that’s somehow or other, you’ve gotta find the time to, to identify how these, how your folks each want to be valued, what makes them feel valued, what makes them, what would make them want to be part of, of your group forever, or for as long as they’re going to be with, you know, with you, whatever the case may be.

Kristen Wheeler (30:53):

And just make sure that you’re doing that. You know, I remember way back in the day having a manager pass out like a little survey and I’m sure it was still on paper, and we had to check off like ways that we like to be appreciated mm-hmm. <Affirmative>, and it was like a hug or a $5 gift card or, you know, random, random things. And we were all like, this is so dumb, but <laugh>. But ultimately it sort of let that leadership know what everybody really was looking for. And I don’t think it’s the worst idea in the world to, to take a look and say, Okay, what can we do differently?

Linda Leekley (31:35):

Yeah. And I think, you know, talking to about you know, public perception and pro professional perception, I think that starts with all of us too, right? You know, it’s, I think it’s probably human nature when you’re having trouble hiring or your staff is calling out at the last minute, or, you know, not showing up for interviews to get really frustrated with the entire demographic of the people you’re trying to hire. But that just ultimately hurts you or your agency, right? I mean, you’ve got to stay, stay, have a positive perception, and like you say, treat people as individuals,

Kristen Wheeler (32:21):

Right. And you sort of, and it’s, it’s way easier said than done, but you have to sort of tuck away your biases, you know? Mm-Hmm. <Affirmative> where somebody walks in the door for an interview and they’re not dressed exactly as you think that, you know, they should be, or they don’t <laugh>, maybe they don’t present as well, well, as you would hope or who knows what, but but sort of dig a little deeper and see where, where the, why this person’s coming to you with the, why this person is thinking about going into this field if they’ve done things, you know, before or whatever. But yeah, there’s ways to keep people. They’re just, they’re just not, there’s just not one right answer.

Linda Leekley (33:04):

Yeah. That makes sense. Agreed.

Amanda Sternklar (33:08):

I can see we’re having some great discussion in the chat here of, of some other folks who are experiencing some of the legislative issues that you’ve brought up. If anyone has any questions that they’d like to ask, I’d like to open the floor now. You’re welcome to put them in chat or if you’re feeling a little more brave, wanna come off of mute. If you raise your hand, I can allow you to unmute and ask your question out loud.

Linda Leekley (33:28):

Someone had her hand up earlier, it seems

Kristen Wheeler (33:31):

Like maybe that was when I said raise your hand if you have no staffing issues.

Linda Leekley (33:34):

<Laugh> no.

Amanda Sternklar (33:36):

Whoever that was I’d like that to be the next person on this podcast, <laugh>. So we wanna hear all of their secrets.

Linda Leekley (33:42):

Right. You’re booked, you’re booked for the next podcast,

Amanda Sternklar (33:46):

<Laugh>.

Linda Leekley (33:49):

I was gonna ask Kristin what your thoughts are about you. You mentioned it touched on it just briefly, but and I’m sure you’re a simpatico with my thoughts, but on mentorship and career ladders, me and the value, the value that they bring to

Kristen Wheeler (34:05):

You. Yeah, I think mentorship is so great and if you can structure something like that, it it within your company I think that’s sort of the wave of the future. Mm-Hmm. <Affirmative> if you can, like I, I mentioned those rockstar employees earlier you know, identify some of some of those to become your mentors to mentee your newer staff or whatever the case may be. It’s, I think it’s, it’s a great move when it, it works really, really well. It gives the mentors some, you know, some sort of personal connection with the company and gives your new people, again, it’s a, it’s a a time saver for you too, that you don’t have to, you know, for lack of a better word, coddle all your new employees. If you’ve got someone that’s sort of identify to, to take care of them and make sure that they, all their questions are answered and any struggles they’re having are, are handled, et cetera, et cetera. So Yeah. Absolutely. I’m a huge fan.

Linda Leekley (35:12):

Yeah. I mean, and you can, you, I I’m sure people could say, Well, I don’t have time to, I hardly have one person to send to a, a client or a patient’s house, let alone too. Right. But if you don’t keep the one new one, then you’re gonna have to start all over again. Right, Right. So to me, this mentorship increases the chances you’re gonna keep that new employee and, and then, you know, not have to worry about staffing that case

Kristen Wheeler (35:40):

Right. Again, in the future. Well, and it doesn’t have to be for months, you know, it’s No,

Linda Leekley (35:45):

Exactly.

Kristen Wheeler (35:46):

So we’re not talking about sending out people to, you know, to people to a client for, for weeks on end. Right. you know, just making sure that it, it goes, it’s along the same lines as when you have a client that, that could benefit from having a physical therapist come over if you have that capability mm-hmm. <Affirmative> at no charge to identify maybe some exercises that the aid could be doing with that person or something like that. I mean, there’s, there’s all kinds of ways to make sure that people feel supported and like they’re part of an actual team. It’s home care’s a lonely business. When you’re out there on your own, you know, you, you don’t have necessarily, like, it’s not like hospice where they have IDT meetings and they at least pull the teams together, you know? And at home healthcare they do generally mm-hmm. <Affirmative>. But in privity home care, you could, I mean, there were times when I had my agency, there were times when I didn’t see a staff member for months. And thank goodness I was still on paper <laugh> so long ago. This was, but that was the only time I saw they draw. You

Linda Leekley (36:59):

Had to turn in Yeah.

Kristen Wheeler (37:00):

<Laugh> so every two weeks, you know, but then they just started leaving it in the mailbox. Even then I didn’t see ’em. So, you know, ways of, of having, you know, some connection with your people, so there’s not this like big gap between the people in the office and the people in the field. There, it just needs to happen.

Linda Leekley (37:21):

Well, and the mentorship could include little touches, like a FaceTime call from the mentor. It doesn’t always have to be them in the same place at the same time. But I think, you know, if you structure a a program like that, you’re, you’re gonna be really well off in the long run. Absolutely. Absolutely. And it’s a career path for that mentor.

Kristen Wheeler (37:44):

Sure.

Amanda Sternklar (37:44):

Sure. I was gonna say, I know Kristin, you were talking a lot about making sure that you’re doing different things to retain those rockstar staff as well. And for folks who get that sense of accomplishment from watching somebody else grow from like being involved, you’re giving them a stake in the success of another employee. And I think if, if they’re the right persona, you know, I’m, I’m excited to see that <laugh> report you mentioned, but if they, I feel like at least one of those personas, probably more given our, our industry that would be a real draw for them to stay with your agency and, and really see the results of, of their mentorship.

Kristen Wheeler (38:27):

Yep. Yeah, for sure. For sure. Yeah. And I mean, technology lends itself to this being much easier now. You don’t have to have people come into the office, make phone calls, you know, actual phone calls. It’s so much easier to connect with people now than it, this should not be painful for anybody, so it’s totally doable.

Linda Leekley (38:52):

Kristen Michael Mitchell is asking, do you see clients moving toward private care versus agency care?

Kristen Wheeler (39:02):

I feel like I feel like people are going to need all of the care ultimately. So Michael, I assume you mean private care, like hiring somebody privately versus going through an agency. So I’ll address that if I’m wrong, just pipe in or, you know, jump in and let me know. But so I think, again, we’ve gotta, that goes back to public perception and public education. I think when it comes down to if you’re gonna hire somebody privately I don’t think that the vast majority of people that hire privately understand the liability that they’re setting themselves up for when they hire privately. I am totally guessing here, but my guess is that the vast majority of private hired caregivers are not set up as a business, are not caring liability insurances and, and, you know, whatever else they, they’re supposed to carry bonded and insured, however, whatever that’s called.

Kristen Wheeler (40:07):

So, you know, so ultimately you’re setting yourself up as an employer and then are, you know, liable for their taxes if they fall down at your house, et cetera, et cetera. So I think that that is an important piece for the home care industry to, to make sure that the public understands. And that’s been an uphill battle to, to get that. And, and of course, you know, of course for some people it’s just gonna come down to the bottom line. Like whether it’s, you know, this much an hour or this much an hour, I’m going with a cheaper one, right? Mm-Hmm. <affirmative>. But but it, I think that, you know, it, it’s getting there. I, I don’t know that I would say that I feel like more people are going to move toward private care versus agency care. I don’t know that I would agree with that completely.

Kristen Wheeler (41:03):

Now if the money isn’t available for these types of services to be there for people that can’t afford them privately then there’s gonna be a lot of people that are just gonna go without care completely. So that’s why, you know, the Medicaid monies, the home and community based services monies just it, they have to be increased. They have to be they have to be earmarked for more, more home care because people need ’em. There’s a huge jump in the number of Medicare Advantage plans coming onto the market in 2023. Mm-Hmm. <Affirmative> I’m sure a lot of, a lot of you have seen this, but it’s, it’s almost double what it is currently. So obviously those plans are identifying that, that there’s people out there that will take advantage of it. So they’re all out there

Amanda Sternklar (42:05):

While folks are are typing. Kristen, if, if questions jump to mind immediately after we hang up, as I feel like happens a lot, where’s the best place for folks to reach out to you to learn more about nac?

Kristen Wheeler (42:18):

So you can reach me at my email address is the first letter, K wheeler, w h e e l e r, at nac.org. So by all means, feel free, Michael, I’m just looking at your chat about the workers’ Bill of rights. There’s also a domestic worker’s Bill of Rights legislation that they’re trying to pass on a federal level. Right now it’s not getting any any real steam under it. So, but, but no in advance that we are keeping a very close eye on that. And because it do, it would put a huge burden on providers. So we are well aware of those, those workers’, Bill of rights, bills of rights that are out there. I get what they’re trying to do, and it, it, I know that, that they’re trying to protect the worker and we’re by no means trying to not protect the worker, but we also are trying to protect the providers. And they just need to make sure that the language reflects that. So, so yeah. We’ll, we’ll we’re on top of that one for sure.

Amanda Sternklar (43:22):

If you have a story that you’d like to share on the podcast or you have a request for any topics we can cover I’m most easily reachable on LinkedIn as Amanda Stern Clark, s t e r n k l a r. And Linda, where can folks find you

Linda Leekley (43:36):

Also on LinkedIn? The name you see on the screen, Linda Leafly, l e e k l e y. My email is my full [email protected]. So feel free to email me as well. What are some websites that you would recommend people check out?

Kristen Wheeler (43:55):

So, like I said earlier, go to like, check out your state associations. There, most state association’s websites are just a fountain of information. If you wanna look at the legislative stuff, by all means, [email protected]. You can follow what any one of the legislative items I mentioned. If you wanna check out the Home Care Workforce Action Alliance we can be [email protected]. And of course, you can find anything about the National Association for Home [email protected].

Amanda Sternklar (44:30):

Thank you.

Linda Leekley (44:31):

Okay, everybody, be the squeak. You wanna hear

Amanda Sternklar (44:34):

<Laugh>.

Amanda Sternklar (44:36):

And just a reminder to any folks who are listening to this as a podcast later that if you’d like to be one of the folks asking questions, you can join us for Vision Live and meet every other Tuesday at 2:00 PM Eastern. And you can go to home care pulse.com/podcast to sign up if you’re one of the folks listening live and you want to be able to listen to this great conversation again this recording will be up as a podcast next week. Again, you can find [email protected] slash podcast or wherever you get your podcasts. Thank you, Kristin, again, so much for joining us.

Linda Leekley (45:10):

Oh, yes, Kristin, what a, an amazing conversation. Thank you for taking time on us today.

Kristen Wheeler (45:15):

Oh, thank you so much for the invite. It was lovely to see you both. I know I won’t see you too in St. Louis, but looking forward to seeing the HCP rock stars over there too. And call me if you need me. Thanks

Linda Leekley (45:27):

So much. Thanks for joining us.

Kristen Wheeler (45:29):

Bye.