Bill Dombi speaks before a screen.
Bill Dombi, president of the National Association for Home Care & Hospice, presents a legislative and regulatory update Monday, the opening day of the Home Care 100 conference. Credit: Home Care 100

The Biden administration’s plan to pump up home- and community-based services (HCBS) funding could be back on the front burner again. National Home Care & Hospice President William Dombi suggested this Monday at an opening session of the Home Care 100 conference in Orlando. 

Dombi said the administration is likely to revive Build Back Better, which could provide billions in federal funds to address the direct caregiver shortage in HCBS by boosting worker wages.

“It will come back in 2023, but it won’t be any easy climb getting it passed,” Dombi told the audience. 

Build Back Better stalled in the U.S. Senate at the end of 2021. The legislation aims to funnel up to $150 billion into HCBS for better wages, training and education for the direct care workforce.

Despite Dombi’s optimism about Build Back Better, he warned providers that Congress alone will not solve the caregiver crisis. He also called on them to find ways to recruit and train the estimated 6 million workers the Bureau of Labor Statistics estimates the industry will need by the end of the decade. 

Addressing the caregiver crisis

Some of the larger national home care and hospice firms at the conference shared ways they are tackling the caregiver shortage during a separate conference session Monday on future growth strategies.

CenterWell Home Health, a division of Humana, is partnering with the University of Houston, Clemson University and the University of North Carolina to provide nursing students clinical rotations in home health. The company also launched a simulation laboratory at Emory University in Atlanta that educates student nurses on what it is like to work in home-based settings.

“They are going to learn about social determinants of health, how to really look at the patient in their homes, diet, loneliness in the home — all aspects that impact patient well-being,” CenterWell Home Health President Susan Benoit told the audience. 

Enhabit CEO Barbara Jacobsmeyer told attendees during the session that training nurses to work in home healthcare is only part of the equation. She said providers also need to be training clinicians to become future leaders.

“Most of us through our clinical training never received any leadership training,” Jacobsmeyer said. “We need to give [clinicians] a good foundation to not only be strong local leaders, but give them opportunities anywhere in the organization.” 

Focus on company culture

Still other large providers are looking at ways to improve company culture in order to recruit and retain employees. Right at Home President and CEO Margaret Haynes told the audience during the growth strategies session that caregivers working at home can often feel like they are marooned on a remote island, so emphasizing inclusivity is vital.

“How can we break down what their experience is like and find a way to make it a little more special?” Haynes asked the audience. 

The industry leaders also said leveraging technology and flexible scheduling will also make home care jobs more appealing and accessible.