Caring for the City’s Caregivers

That wise woman Rosalyn Carter once said, "There are only four kinds of people in the world. Those who have been caregivers. Those who are currently caregivers. Those who will be caregivers, and those who will need a caregiver." We all have a stake, one way or another, in caregiving and in what happens to the individuals who provide that valuable service. And here in New York City, caregivers, quite simply, deserve better care from all of us.

A City in Need of Assistance

New York City turns to its not-for-profit human services sector for essential caregiving for people without homes, parents, or job prospects and, of course, for caregiving services that enable older New Yorkers to age in their communities, living independently with the assistance they need to stay connected to friends and meaningful activity. According to the city's Department for the Aging (DFTA), there are approximately 1.64 million older adults currently residing in the city's five boroughs. As these individuals age, their need for a range of services will grow, and the role that not-for-profits like JASA play in providing those services will become ever more critical.

The continued health of not-for-profit human service organizations relies heavily on employees who interact directly with their clients. Navigating the complexities of the legal, social services, and healthcare systems, not to mention simple life activities, can be challenging at times for any senior, but for those struggling with health, housing, and other issues, it can be overwhelming. There is a real need for the work my organization does, and that need continues to grow.

At the heart of our work are the relationships we build. The key to providing quality services hinges on being able to recruit and retain individuals who genuinely care and are able to establish a connection to the client that fosters trust. Finding skilled individuals is the first challenge. It is not uncommon in 2019 to hear not-for-profit employers say there are more jobs out there than qualified applicants to fill them.

The second, and perhaps even more critical challenge, is retaining good people once you've brought them into your agency. This is particularly true when speaking about social workers, case workers, home health aides — anyone advocating for, providing a necessary service to, or offering older adults assistance in navigating the many challenges they typically face as residents of a large city with a complex and often confusing network of services.

Client trust is key to what we do, and as they say, it is something that must be earned. A revolving door of individuals who continually need to re-familiarize themselves with a client's unique situation tends to breed hostility and distrust. Those feelings, in turn, make it harder for a caregiver to fully learn and understand the challenges that a client faces, and to identify solutions that will benefit her. There's also an added burden on staff when colleagues leave and there are fewer individuals to share the workload — a too-common occurrence that tends to increase stress and reduce an agency's ability to provide quality services, which may prompt still more staff turnover.

Building a Network of Support for Caregivers

There are many dimensions to engaging and retaining good employees. Meaningful work may be the biggest draw — because, to be candid, no one ever went into social work for the money. But there are other incentives, including:

• having a supervisor who respects you and listens to what you have to say
• getting recognition for your contributions
• feeling part of the organization and knowing that it appreciates what you do and what you care about
• mentoring and professional development

And, of course, compensation that is fair. This is always a challenge. As a not-for-profit agency, we stretch every dollar we take in to provide the critical services New York City's seniors need. Having to rely on government contracts makes it especially difficult. State and city requirements for program staffing and salaries, as well as indirect program costs, stress our bottom line. The burden of ever-increasing accountability adds to the financial challenges we face.

The city's commitment to an increased minimum wage is a good start in terms of bolstering hiring and fostering retention, in that it helps individuals on the lowest end of the pay scale. But there are knock-on effect to a higher minimum wage. Individuals who are supervising minimum-wage employees who are earning more money as of January 1 may find themselves at the same pay level as the people they supervise. Don’t they deserve a pay raise? Where does an agency, hamstrung by inflexible state and city contracts, find the dollars to create a fair pay scale for all its employees?

New York City not-for-profit agencies quite simply find themselves between a rock and a hard place. Advocating for increased wages for hourly workers makes good sense and is the right thing to do. Higher salaries tend to result in a more skilled, committed workforce and better employee retention rates, and ultimately result in a better service model. But if government isn't adequately compensating agencies that provide services, those agencies inevitably will seek out philanthropic dollars to make up the shortfall — and that, as we know, is not something that can be counted on as a consistent, steady source of income.

Here in New York, in addition to inadequate government contracts, employers also face the issue of a higher-than-average cost of living. The reality is that many workers in New York City simply cannot get by doing the work they are trained to do.

A recent report from the New York City comptroller Scott M. Stringer asserts that New York City is suffering from an affordable housing crisis, with individuals at the low end of the pay scale being forced to devote up to 74 percent of their income on housing. We certainly see it affecting the city’s older adult population, with our affordable housing units for seniors having, in some cases, a ten-year waiting list.

And we hear it from our employees as well.

Mayor Bill de Blasio is working to create more affordable housing units in the city, an effort that is to be applauded. Affordable housing is critical to attracting employees to the social services. But the sad reality is that the mayor’s actions to date are not enough. Employees earning minimum wage cannot afford New York's "affordable" housing. And if workers cannot afford to live here, where will agencies find the employees they need to meet the demand for and provide ever-more-critical services?

In his report, Stringer lays out several steps the city could take to help align affordable housing to the need, including working more closely with nonprofit developers to create affordable housing units on city-owned property. But that is only part of the solution. Common sense tells us that a more comprehensive, coordinated government effort is needed if we are to move the needle on this issue. The city and state desperately need federal dollars to address the city’s housing crisis — a crisis that grows more serious by the month for not-for-profits that provide vital community services.

At the end of the day, attracting and retaining workers who provide care to elderly and other vulnerable populations is not just the responsibility of the not-for-profit agencies who employ them; it also the responsibility of government — city, state, and federal — and the officials we elect to represent us.

Kathryn Haslanger was appointed chief executive officer of JASA, a nonprofit agency serving older adults, in November 2012. The organization's services, which include affordable housing, adult protective services, elder abuse prevention and intervention, legal services, health promotion, mental health, home care, and home-delivered meals, are designed to keep seniors — of all races, religions, and economic backgrounds — living safely in their own homes, in familiar surroundings, with independence, dignity, and joy.

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