Staffing shortages have been a problem for disability service agencies for years, and managers have become accustomed to dealing with high turnover, unfilled shifts, and last-minute call-offs.
As this lack of staff persists due to COVID-19, some agencies are experimenting with new approaches to staffing and scheduling.
One agency that is leading the pack is GoodLife Innovations, a disability service agency in Kansas. GoodLife Innovations began testing alternative staffing approaches nearly four decades ago. Through their partnership with the University of Kansas (KU), they have developed unique solutions for hiring, scheduling, pay, and service delivery — and today, they are teaching other intellectual and developmental disability (IDD) agencies how to do the same thing through GoodLife University.
We sat down with Dr. Mike Strouse, the CEO of GoodLife Innovations and faculty member at the University of Kansas, to learn more about these solutions and how they’re helping agencies compete with companies like Amazon for employees.
The following excerpts have been edited for conciseness and clarity.
GoodLife Innovations has a pretty unique workforce strategy — but you haven’t always run your schedules the way that you do now.
Dr. Strouse: The goal has always been to develop service models that can make an impact on the quality of life of the people that we serve, and to continuously improve those service models. And of course, one of the most important components of the service model is staff who are stable.
Across four decades, our service models have progressively changed. The models that we adapted for use at GoodLife were the ones that were developed by our group at KU many decades ago for Boys Town. We adapted some of that for GoodLife, and then we began helping other agencies do what we do.
Some of the schedules we use are unconventional, but they’re very effective. For example, there’s what I call our ‘shared living’, or live-in, live-by, and live-near strategies, where professional staff live in a neighborhood or in a home or next to people they support, and we pay for their housing and salary. It’s very competitive, and the turnover rate is exceedingly low — anywhere from 3% to 15%, which is incredibly low from a national perspective.
[Editor’s note: The national turnover rate for DSPs is 43%, according to Relias.]
What was the driver for your organization to start testing these unconventional schedules? Was it turnover?
Dr. Strouse: I think turnover is a really bad measure. Turnover looks at the turning over of positions, but it doesn’t include a lot of other things like chronic vacancy rate, call-offs, PTO, or training days. The measure that we rely on is the number of different people involved in care across time, because it includes all of those other measures in addition to turnover.
What we did is look at certain metrics that we didn’t like — for example, perhaps the most troubling measure out there for direct support workforce in the IDD industry is the percentage of part time staff. Nationally, the average is about 32% part time staff, which makes it really impossible to deliver a professional workforce. And so, one of the things we tried to do is change the percentage of part time and full time staff.
One of the scheduling strategies you talk about in the GoodLife U video series to reduce the amount of part time staff is the three day workweek. How does that work?
Dr. Strouse: We have what we call a ‘front/back half’ workforce, where there is a front workforce of three 12-hour days and a back workforce of three 12-hour days and we handle the swing day differently. The front is given a Sunday and two days, and the back is given a Saturday and two days, so they’re very equal. That’s our base staffing, and we overlay that with other staffing patterns to fill out the ratio that’s needed.
Then, our premium pay is designed so that people don’t ever call off on a Saturday or Sunday, when you’re least able to replace them. In fact, before the pandemic, we actually had a waiting list of staff work willing to work extra on the weekend.
We also help agencies create their own relief strategy that uses the front/back half workforce. We figure out how many vacancies they have, and build a relief staff that equals about 85% of that. It all works together to provide very good staffing, and the overtime rate is miniscule. By making those changes — getting rid of part time, offering premium pay, having a relief staff strategy — we’ve been able to increase pay for GoodLife DSPs between $2 and $2.50 an hour within the same budget.
Then we also have our ‘shared living’ strategies, which I mentioned before. Those positions are really helpful because they reduce the number of shifts we need to hire. If it wasn’t for those non-traditional positions, we would have to have to hire about 350 more staff than we currently have now.
Knowing that there are so many benefits to non-traditional scheduling, what do you think is the biggest hurdle that prevents people from actually implementing these strategies?
Dr. Strouse: The biggest hurdle is that people are bailing water so fast, they don’t have time to fix the boat. Some of the agencies we talk to have a 30-35% vacancy rate! What we’ve found works best is to focus on developing a replacement staffing strategy first, before making any changes. We teach them how to create a pool of relief staff first — which is what they need most. That’s a very helpful way to do it when they’re working so hard to just make their boat float.
Companies like Amazon are now offering benefits like flexible schedules and on-demand pay. What does that mean for disability service agencies when it comes to attracting and recruiting staff?
Dr. Strouse: It’s very different when you’re Amazon and you have a window of time to deliver a product. We need to deliver care exactly at the moment of need.
We’re also competing with the virtualization of jobs. Virtualization has hurt our industry because if you’re working a five day work week in this field, you’re at a disadvantage compared to what everybody else is doing. So right now our effort is on, how do we change the game a little bit?
That’s why we focus on three day work weeks. Three day work weeks are very attractive for people because you have more days off, your childcare is less, and your transportation is less. And any schedule that’s not attractive, we pay more.
At GoodLife, we pay weekly and we’re also rolling out pay-on-demand. If you pay bi-weekly, that’s two months a year people get an extra paycheck. That means 10 months out of year, you’re paying people less money. Hourly people need as much money as possible, so we’re moving to pay on demand, which means they have the option to be paid whenever they want. We’ve done everything we can to get the edge on it.
What would be your #1 piece of advice for someone who is interested in making these kinds of changes?
Dr. Strouse: Don’t piecemeal it. People hear an interesting concept like premium pay, and they say, “We’re thinking about doing premium pay now.” But it’s a system; it’s not little parts. All these strategies are like an inch that you do to get a yard. So my best advice is to get some really good help, put together a comprehensive plan, and then implement it methodically. Don’t just hear a good idea and do a part of it. It’s not going to be what you had hoped.
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