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Using Debit Cards to Improve the Recruitment and Retention of Caregivers for Home Care Agencies

To say that home care agencies and their clients face an existential threat due to the shortage of qualified caregivers is more than stating the obvious. Even though agencies are pursuing nearly every “modern” human resource technique to solve this problem, the struggle to recruit and retain quality caregivers persists in Florida as well as nationally. So, what else can an agency do to attract and keep those key people? It always helps to look at other industries to see what new methods of human resource management are being employed to help solve recruiting problems. An interesting but underutilized model is the use of debit cards to deliver benefits and wages and help those employees at the lower end of the pay scale to achieve financial wellness.


Many human services industries, especially in the restaurant and retail space, are increasingly and effectively turning to debit cards, also referred to as payroll or pay cards, as a foundational component of financial wellness programming for employees. JCPenney, Kansas State University, and Wendy’s franchises are among the many employers who have reduced operating costs and improved employee satisfaction by implementing a debit card-based benefit and payment system. The immediacy of action of these programs appeals to specific markets and creates a sense of trust between the cardholder and the card manager.


Now the question becomes how can home care agencies use a debit card-based program to help recruit and retain caregivers and improve the quality of the care they provide? Three approaches immediately stand out as potentially valuable additions to an agency’s existing total benefits program for caregivers.


The first one is earned wage access (EWA), sometimes referred to as on-demand wage access. Providing access to earned wages is not a new idea, but in a traditional approach, employers allow employees to borrow money from the company to meet pressing financial needs. However, this model has some drawbacks that a debit card program can help resolve. The first is the “embarrassment” factor of an employee needing to approach the employer for a loan. As human services people, we never underestimate the power of stigma to interfere with good decision-making. Asking for a loan says, “I can’t manage my life week to week,” and might have the undertone of “You don’t pay me enough, and I have to ask for my own money early.” Neither helps build the relationship between the agency and the caregiver.


By using a debit card that is issued to the caregiver along with a web-based portal or mobile app, the EWA program can enable a caregiver to initiate a request to “draw” from their already earned pay and gain immediate access to those funds via their debit card. No negotiation is necessary. The draw is then deducted from payroll on the regular payday.


The simplicity of this model can efficiently fuel a word-of-mouth recruitment and retention campaign as happy employees eagerly share their experiences with current and potential employees.


Offering rewards and incentives (R&I) to caregivers is a deceptively simple idea that can quickly become mired in complexity. In a well-designed R&I program, caregivers earn meaningful rewards for taking actions that improve the quality of care for the clients they serve. However, too frequently, the reward arrives long after the caregiver completes the qualifying activity.


A debit card-based R&I program can eliminate this issue by enabling immediate access to earned rewards. Perhaps for your agency, attendance is critical. With a debit card-based R&I program, a caregiver could receive an automatic reward when they check in to five consecutive appointments on time. The reward would be posted to the debit card without waiting until payday.


There is strong psychology between action and reward and using a debit card makes that connection possible. The program’s design is up to the needs of the agency and its clients. The only limiting factor is one’s imagination.


Finally, it is not uncommon for a caregiver to encounter situations where they need quick, accountable access to funds. They might be asked to go to the grocery store to purchase on behalf of a client, or they may need gas money to cover an unexpected shift.


In either case, funds can be deposited on the caregiver’s card for a particular purpose, and the caregiver can purchase as needed and directed. The clear advantage to this is the accountability and transparency it provides. The amount spent is documented and charged back as appropriate with no mystery about how much was spent on what.


This mechanism could even help to address the issue of first-day no-shows. This issue comes up often in discussions about recruiting, and it has been suggested that a small first-day incentive (say for gas money to make it to your first client visit) posted on a caregiver’s debit card before their first shift could reduce the number of no-shows. This approach is not without potential issues but is an example of a creative strategy that could be easily piloted with a debit card-based caregiver benefits program.


The above are just a few ideas about how a debit card-based benefits program could improve the recruitment, retention, and financial wellness of qualified caregivers. Although the number of disruptions is minimal, it is not “frictionless.” It requires a thoughtful approach and expert assistance. There are specific legal issues to be mindful of, and it goes without saying that an R&I program must be built on equity and fairness. Also, one must always be aware of how incentives can be abused. However, a successful debit card-based benefits program will set an agency apart from its recruiting competitors and create a better place to work.