By Robyn Stone
Workforce development is a business investment, not a business expense, writes Robyn Stone.
When we hear the term “ROI,” most of us in the field of aging services think about the return on investment we hope we’ll receive after our organizations adopt a new technology, expand a service line, or develop a new community. We wonder, and rightly so, “Will this investment pay off—and by how much?”
In contrast, we’ve traditionally viewed employee wages, benefits, training, and other workforce development initiatives as expenses—the necessary costs of doing business that, our accountants warn us, should be kept as low as possible.
I’ve long viewed workforce development as a business investment, rather than a business expense. That view was validated recently during a webinar sponsored by the Maryland Direct Services Collaborative, of which I am a founding board member.
The webinar offered a startling revelation. Prominent Marylanders—including James Rzepkowski, assistant secretary of the Maryland Department of Labor’s Division of Workforce and Adult Learning—are designing and implementing workforce development programs that have been shown to offer a hefty return on investment for the state’s economy, healthcare sector, and job seekers. An ROI analysis of one state-sponsored workforce development program was so compelling that it convinced legislators to double the program’s funding at a time when other state programs were experiencing funding cuts.
This is great news for those of us who believe that we must make short-term and long-term investments in our workforce. Without those investments, we have little chance of meeting the care needs of our growing older population. In particular, we have to invest in the certified nursing assistants (CNA), home care aides, and personal care assistants who provide between 60% and 80% of all the hands-on care in this country. As the coronavirus pandemic made abundantly clear, we cannot do our work without them.
What kind of investments does workforce development require? Here’s my list:
- Pay and benefits: We must figure out a way to pay a living wage and offer essential benefits to our professional caregivers, who are woefully undervalued by our sector. See our recent report, Making Care Work Pay, to learn about the impressive ROI we’d enjoy.
- Basic training: Individuals who are new to our sector need strong, competency-based training so they have the skills and knowledge they need to do this challenging work.
- Orientation: I’m not talking about a few hours of orientation on the first day of work. Research shows that a week or two of orientation, followed by a year-long relationship with a peer mentor, reduces turnover among aides and improves quality outcomes.
- Ongoing training: Training never ends. But we can’t simply make CNAs watch boring training video that fulfill their in-service requirements. Rather, our best return on investment will come from developing interactive in-service training that addresses the specific needs of a particular caregiver or group of caregivers.
- Practice: We must take the time to encourage professional caregivers to put into practice what they have learned during training. Without this ongoing support and direction, these caregivers are likely to forget what they learned, and our investment in training will be lost.
- Career lattices: Many aides love their profession and do not want to become nurses. Career lattices can help these aides advance in their careers by developing specialties in dementia care, medication management, behavioral health, or oral health. Offering these specialty training programs requires an investment, but the payoff would be tremendous: aides with more advanced skills who are much better prepared for the work they do.
- Career pathways: Just like the rest of us, aides want to leverage their skills and experience to get better and better-paying jobs. Many experienced aides are skilled at building relationships with residents and clients. A logical career path would lead aides to other jobs that require the same interpersonal skills: jobs in social work, therapy, or human resources, to name a few. The possibilities are limitless. We need to be much more creative about helping professional caregivers explore those possibilities.
These steps all require time, energy, and money. But they also represent a smart investment in your organization’s future. It’s pretty simple:
Creating attractive, competitive job opportunities is the only way to grow your pipeline of professional caregivers.
Offering those caregivers robust training and opportunities for career advancement significantly reduces costly turnover.
Lower turnover is associated with better quality of care and better quality of life for residents and clients—which can help you meet federal standards and differentiate yourself in the marketplace.
If that’s not a healthy return on investment, I don’t know what is.
Robyn I. Stone, DrPH, is senior vice president of research at LeadingAge, and co-director of the LeadingAge LTSS Center @UMass Boston. Her widely published work addresses long-term care policy and quality, chronic care for people with disabilities, the aging services workforce, affordable senior housing, and family caregiving.