June 11, 2014
Health reform and demographic changes are rapidly increasing the demand for home and community-based care. Reliable and affordable transportation is beyond the reach of many direct-care workers and health providers. In interviews, home care and health services employers described three transportation-related barriers to health reform.
1. Challenges to Providing Quality Care
Quality of care suffers when a direct-care worker is unable to get to her client on time or at all, due to the lack of reliable transportation. Appointments are missed, caregivers are stressed and distracted, and consumers are left with inferior levels of care.
2. Increase in the Total Costs
Transportation issues are increasing employer costs through loss of productivity and difficulty retaining good workers. Mental stress increases significantly when a worker does not know if she will be able to get to her job on time or at all. Transportation uncertainty results in employee absenteeism, tardiness, and staff turnover, forcing employers either to turn to costly temp agencies to fill the gap or to not be able to fulfill a request for services.
3. Difficulty in Training and Career Advancement
Workers are derailed from career advancement due to unreliable transportation limiting training opportunities. This barrier inhibits employees from meeting certification requirements and professional growth opportunities. It impedes employers from promoting from within and forces them to bring in new employees, resulting in a significant cost.
These obstacles aren't new to the direct-care and health workforces, but what is new is the speed at which the industry is transitioning to at-home care. There is also a rise in new jobs opening up to low-income workers like direct-care workers (median income of $17,000/year), who often lack financial literacy and have credit issues. These issues limit this expanding workforce's ability to purchase reliable cars at a reasonable interest rate to support both work and family priorities.
Take Terrie's story as described in the Boston Globe, for example:
Sixty-three-year-old Terrie Cherry, a personal care attendant, crisscrosses Worcester up to seven times a day on the local buses to reach her patients. She rides Route 6 in the morning, and if the bus is late, as it was twice last week, so are the clients and patients she helps care for when she prepares them for their doctor's appointments. "I could walk it if it wasn't all hills, and taking a cab means I'd have to give up at least one hour's pay," she said. "It is becoming a big problem."
Although Terrie is just one personal care attendant, the transportation challenges that workers in this field are facing are the same.
More Than Wheels, a nonprofit organization, is providing a solution to overcome unreliable transportation issues. By partnering with employers we are able to:
- Increase awareness of options regarding transportation and money management
- Incorporate our transportation and financial management knowledge into current workforce training programs
- Offer our car-buying program services
- Test innovative employer-paid benefits that address transportation issues at a reasonable cost
For employers, collaborating with More Than Wheels can reduce costs by reducing tardiness, absenteeism, and turnover, and by increasing overall productivity.
The program provides a valuable employee benefit that results in better morale and a more committed workforce.
More Than Wheels is also initiating research to better understand the cost and impact that unreliable and unaffordable transportation has on the health care sector.
For more information about the workforce transportation challenge and More Than Wheels, please email me.
-- by Jennifer Bonanno, Communications Director, More than Wheels