By Sarah Hauck | Thoughts on Innovation
Not all heroes wear their capes on the outside.
Direct Care Workers (DCWs) – individuals focused on supporting the well-being of the growing number of older adults and people with disabilities – look just like you and me.
These everyday heroes provide hands-on support to people who need assistance with daily living activities like bathing, dressing, eating, moving around, medication management, appointments, and household chores. Thanks to specialized training, many also provide more complex care, such as physical therapy or wound care.
DCWs also provide social interaction and emotional support to their clients, helping them combat isolation and loneliness.
These workers are crucial for preserving the quality of life and independence of those they serve.
But every hero needs a little help sometimes.
According to the Arizona Health Care Cost Containment System (AHCCCS), which is Arizona’s Medicaid agency, State 48 will need more than 190,000 new DCWs by 2030. There are about 30,000 working today, and many are struggling.
Why?
As with any hero’s journey, there are many challenges facing those in the industry.
Many individuals who require home services only need DCWs with them a few hours a day. It is often hard to bundle a worker’s week to ensure he/she/they is able to get to 40 hours. Transportation is also an issue. Given that these workers must travel for their jobs daily, sometimes for over an hour each way or more, they must have access to a working vehicle. And even if they have a working vehicle, given there is no “work from home” option, issues like a blown tire can wreak havoc on their full workweek.
Another major challenge is the gravity of the work, which often means navigating chronic and terminal conditions.
Over time, the emotional toll results in burnout, depression, and anxiety. A 2022 Centers for Disease Control study found that 46% of healthcare workers reported feeling burned out often or very often, a substantial increase from 32% in 2018.
It can also result in compassion fatigue, which is a state of emotional, physical, and psychological exhaustion that occurs in individuals who regularly witness or work with others experiencing trauma, suffering, or adversity. This fatigue can manifest itself through irritability, headaches, memory issues, and even tummy or bathroom issues.
There can be a more direct physical toll as well. Given the physical nature of the job itself, injury is not uncommon. Unfortunately, in some cases, there are also harassment issues, often from clients who are looking to blame someone or just release their own frustration on the nearest person at the time.
So, what can we do? How do we support these everyday heroes?
We need to invest in programs that are actively developing solutions, as well as providing continuing support and additional training to those who provide such critical service to our loved ones.
Mercy Care is proud to support the Arizona Community Health Workers Association (AZCHOW), which provides an opportunity for all community health workers, regardless of how they are identified within their organizations, to develop a collective voice for addressing policy issues, methods of becoming financially sustainable, and the expansion of their professional standing in Arizona. Currently, they are mapping the existence, types, and needs of the community health workforce across Arizona so they can enhance the geographic distribution and strengthen the capacity of community health workers and the organizations that support them.
The United Way of Tucson and Southern Arizona has a Direct Care Workforce Resource that recruits, vets, pays for training and connects new DCWs with employers. This one-on-one support from an advocate, provided by a respected, trusted agency, is the key to our success in growing this critical workforce.
The Phoenix Bioscience Core now has a new full-time position to convene the three Arizona public universities and key community colleges, including rural college representation, to work with their internship, clinical rotations, practicums, coordinators and job placement support to identify and connect the next generation of health workers to internships/job placement opportunities.
Mercy Care is also a member of the Arizona Workforce Development Coalition (AWFDC), which includes the eight Medicaid Managed Care Organizations in Arizona. The Coalition has developed a Healthcare Network Employee Questionnaire, which is a statewide data collection tool used to help the Arizona Network by gathering information, analyzing data, and assessing the current and future needs of the workforce.
Tools like this also help us understand the need for support such as transportation vouchers, upskilling programs, self-care workshops, formal mentorship, and even training in supporting clients’ family members and loved ones to be better caregivers, because DCWs cannot be around 24 hours a day.
Direct care work can be one of the most meaningful and rewarding jobs in the world. It can also be one of the most stressful and draining. We need to continue to collectively look at ways to effectively recruit, train, retain, and support these everyday heroes.
Editor’s Note: Sarah Hauck is a workforce development administrator at Mercy Care, a not-for-profit Medicaid managed care health plan, serving AHCCCS members in Arizona since 1985.
