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How Can Matching Service Registries Help Consumers Find Trained Workers?

February 12, 2019

Editor’s note: This article is the first in a three-part series highlighting online matching service registries around the country.

In recent decades, Washington State has dramatically improved access to home care services. As a measure of this shift, from 1992 to 2017, the proportion of Medicaid enrollees who receive long-term services and supports in the community, rather than in nursing homes or other residential settings, rose from 53 percent to 85 percent, according to the Washington State Department of Social and Health Services. Most of these enrollees directly hire and manage their home care workers, who are known in the state as “individual providers.”

However, as the growth in older adults who need home care in Washington strains the supply of available workers, consumers struggle to recruit and retain qualified workers. As demand for their services rises, many workers leave the field because they cannot find enough hours of work, among other reasons. What causes this paradoxical trend? Many workers and consumers miss opportunities to maximize their work hours and services because they lack tools to connect with each other.

Enter Carina, a web-based, nonprofit matching service registry. Designed to facilitate connections between consumers and independent providers, Carina offers online tools such as job postings, provider profiles, and secure messaging. Unlike other registries, Carina integrates Medicaid and worker certification databases to ensure easy access for eligible consumers and workers.

Since the online matching service registry launched in 2016, Carina has empowered thousands of consumers and workers, improving choice and promoting access to full-time jobs. Carina’s overarching goal is to reduce worker turnover and strengthen the state’s home care sector.

I spoke with Eva Owens, Communications and Outreach Manager at Carina, to learn how they started, what they’ve achieved, and their hopes for the future.

How did Carina get started?

Within the past several years, we have seen rapid growth in the number of private registries for home care services, but they often charge steep fees to users. Also, most of these registries do not verify their users, require credentials for the workforce, or make their user experience accessible. The local home care union, SEIU 775, conducted market research in 2014, which showed that home care clients and independent providers would value these features. As a result, the state of Washington and the union created a new benefit in 2015 for an online referral service, which is now Carina.

What were the main barriers you faced in getting your registry off the ground?

As a first step, we spent time learning about employment challenges through in-depth interviews with workers and consumers. We also discussed systemic challenges with the state’s Department of Social and Human Services, worker and consumer advocates, training experts, and state case managers. From these conversations, we learned that Medicaid enrollees were struggling to find workers who meet the state’s training requirements. The challenge for us was to build a way to verify worker qualifications into the registry without introducing too much delay.

How did you address those challenges?

Our close partnerships with the state and labor union allowed us to seamlessly verify workers’ credentials and consumer eligibility through web-based integration with external databases. Those partnerships also generated natural venues to advertise our services. (For example, state case managers know they can refer consumers to our platform.) We strengthened our recruitment strategy further with targeted digital marketing.

Also, we launched Carina region-by-region across Washington State. While we were eager to become a statewide service, this measured, iterative approach allowed us to make improvements and fine-tune accessibility features along the way.

What has been the impact of your matching service registry?

We are already seeing strong results, with approximately 10,000 workers and consumers now using Carina. The connections that users make through Carina lead to life-changing relationships. As one example, one consumer found a perfect match on Carina: on top of providing excellent care, her worker tracked down her long-lost brother. Here is the story.

What have you learned through launching Carina?

We’ve learned the value of partnerships. We relied on the expertise of key stakeholders to build an exceptional platform. Also, our relationships with the state and the union have helped us recruit new users and quickly verify their eligibility to work or receive services.

Do you have ideas for the future of Carina, based on your experience so far?

We have started taking on a few additional partnerships aimed at growing and improving online matching services for other states’ home care systems.  We believe that technology, when done right, can help boost efforts to strengthen the long-term care system, creating win-wins for all involved.

What is one hope you have for the future of consumer direction?

Two-thirds of caregivers have jobs that are only part time or part of the year. At the same time, many home care consumers struggle to find experienced and qualified caregivers.  Supporting consumer choice requires access to a pool of qualified workers. For workers, improving access to job opportunities can lead to stable, full-time income, which is key to their retention and success. We can achieve this vision for consumers and workers through innovative, stakeholder-informed online matching services.

For an online map of matching service registries around the country, click here.

This blog series was funded with support from the National Institute on Disability and Rehabilitation Research (Grant No. H133B130034/90RT5026) through the Community Living Policy Center at the University of California, San Francisco.

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