US human services agencies struggle to recruit and retain human services staff amid intense competition and due to administrative burdens, low pay, and lack of collaboration.
Published by Deloitte Center for Government Insights
Smoke rises from a burning building—the blare of sirens approaches. Red firetrucks arrive. Firefighters jump out to combat the flames to save precious lives. The community applauds them, and rightly so. They respond bravely to crises every day. Their work is visible, and their contribution obvious to all.
Every day, first responders of another kind work on the frontlines to provide essential support to communities across America. They, too, are brave, but their contribution is far less visible. They include school counselors supporting at-risk youth, parole officers rehabilitating inmates for a return to society, social workers ensuring homes for children without families, home-care workers keeping our aging loved ones independent in their homes, and psychologists treating people who have mental illness or are suffering from substance abuse. These responders comprise a community’s human services workforce, ensuring the health, well-being, and survival of the most vulnerable in society.
“Human services workers are as essential to a strong community as emergency responders, but their contribution is under-recognized,” says Dr. Bill Hazel, senior deputy executive director of the Claude Moore Charitable Foundation and former Virginia Secretary of Health and Human Resources. “They need the equivalent of their own red firetruck as an emblem of their importance to our communities,” observes Lesley Abashian, human services director for the City of Fairfax and president of the Virginia Association of Local Human Services Officers.1
Human services workers in state and local governments encompass a range of functions and expertise, varying from state to state. But they share important commonalities. Often, they are the ones who provide crucial care in the most acute moments of crisis in an individual’s or a family’s life. They can make the difference between a positive trajectory and a negative spiral. Their involvement can provide the missing element that turns a situation around in a child’s life or spurs a drug user’s recovery.
Demand for human services workers continues to grow. National employment of behavioral health professionals by governmental and nongovernmental entities is projected to rise by 18%, from 388,200 in 2022 to 459,600 in 2032.2 Meanwhile, ongoing needs of other populations served by human services workers continue apace, including care for individuals with disabilities, justice-involved, and the financially vulnerable.
Yet, this vital workforce that responds to others’ crises is itself in crisis. The average national caregiver turnover rate is 65%, and the staffing shortages of government human services workers are reaching emergency levels in many communities.3
Why has this essential workforce reached such a critical juncture? In short, workers in the field are historically overworked and underpaid, and recent developments have made their livelihoods much less tenable.4 Although many enter the field with a strong sense of mission, it becomes difficult for them to withstand the obstacles that come their way. Their salaries tend not to keep up with the rising cost of living. The pressure of working with populations under stress has grown in recent years, along with an uptick in violence against human services workers.5 As their colleagues leave, the remaining workers are often tasked with taking on even heavier loads. Meanwhile, competing job opportunities at private organizations or other fields tend to offer higher pay, better work conditions, or both. Jobs in the retail sector, for example, pay on par with many human services jobs but entail fewer psychological and physical demands and a lower risk of burnout.
The Claude Moore Charitable Foundation studied the challenges affecting the human services workforce (see nearby inset) and identified solutions to elevate their improvement and development in the Commonwealth of Virginia.6 With Virginia as a prime case study, the findings of “Virginia’s human services workforce strategic investment initiatives report, August 19, 2022” provide a road map for other communities nationwide to build a stronger, more sustainable human services workforce to meet growing needs.
The study’s findings contain strategic options and recommendations across six key stakeholder groups that can affect change in the human services workforce. They include a state’s executive office, state legislators, state agencies, employers, regulators, and philanthropists. The recommendations identify the strategies needed to strengthen the resources, recruitment, retention, and regulation affecting human services.
The human services workforce in state and local governments may not have a red firetruck as a visible reminder of its importance, but its role in strengthening the social fabric cannot be understated. The growing crisis among these essential workers is a siren call to the communities that depend on them. At this critical juncture, communities across the country have an opportunity to initiate long-needed reforms to put the human services workforce on a more solid footing so that it, in turn, can continue to serve those in the greatest need in the years to come.
The path to addressing the crisis: Four key areas for action
Given the challenges facing the sector, combating the crisis in the human services workforce requires action on four fronts: resources, recruitment, retention, and regulation. Working in concert, they bolster the human services workforce, which can improve the quality of and access to care for the community. For example, today, inadequate resources and regulatory requirements hamper the recruitment and retention of talent. Conversely, adequate resource allocations across sectors, regions, and jobs, working hand in hand with improvements in regulatory practices, can spur a reversal in this dynamic.
To start a virtuous cycle, communities can take the following steps to strengthen resources, recruitment, retention, and regulation in the human services sector.
- Invest in comprehensive studies to assess where funding can be blended, braided, or adjusted to serve communities and providers better. State and federal guidelinesset the reimbursement and shared funding models that contribute to the disparity in regional services availability.
- Consider creative regional funding models that include philanthropic and other community employers and organizations to increase funding. Examine ways to blend and braid funding when emergency medical technicians or police officers lean in for social services work, particularly in rural areas where resources are limited.
- Reassess a more appropriate compensation structure to address pay inequities and determine levels for workers according to market value with cost-of-living adjustments, especially in less-resourced jurisdictions where the current funding formula with low match rates causes a struggle to provide adequate pay and resources.
- Invest in resources needed to carry out care responsibilities, including sufficient mobile technology for field workers, modern technology systems in institutions, and data analysis capabilities by providers and government agencies.
- Stakeholders can increase the pool of available workers by reaching out to diverse candidates and by educating the public about the importance of human services work. A public education campaign similar to the Army Strong campaign can help to promote understanding and respect for the field.19
- Increase outreach by human services agenciesto elementary and middle school students to help inspire candidates earlier when they are starting to form ideas about future careers. Include guidance about certification programs students can attain after secondary school, community college, or other education levels.
- Provide adequate compensation, prioritize job quality and experience, and establish clear career pathways. Offer professional licensing programs and creative regional funding modelsto help improve pay and benefits for human services workers.
- Create onboarding and leadership development programstoimprove the job experience. Allow for innovative pathways and early career mappingto elevate career progression in clearly established routes.
- Reduce regulatory burdens by having state leadership, regulatory bodies, and service delivery agencies identify the regulations that hinder entry into this profession. Engage state and local agencies and providersthat manage federal regulatory standards and reporting (in addition to state requirements) to help make decisions with state boards, regulators, and legislators regarding licensing standards for the health services profession.
- Encourage the review of existing rules and consider innovative solutions to ensure that regulations do not arbitrarily exclude or limit qualified workers, such as instituting licensing reciprocity agreements with neighboring states to ensure adequate staffing.
A road map for each change agent
Measures to improve resources, recruitment, retention, and regulation entail efforts by champions across the human services ecosystem. These include the state executive office, regulators, human services employers, legislators and funding agencies, state agencies, and philanthropic and community organizations. Each can contribute according to its unique purview with initiatives that range from the near term to the long term. The following are actions that each of the six key champions can consider taking.
The executive office
In its leadership capacity, the governor’s office is well-positioned to promote as priorities issues of public awareness, funding, interagency collaboration, public awareness, and the technology needs of human services workers. The executive office can help promote a broader understanding of the value of human services workers by launching a public marketing campaign. Elevating the general importance of the sector can also help all other champions accomplish their goals.
To strengthen funding, the executive office can undertake a variety of measures. The governor’s office can find ways to combine disparate sources of funding from philanthropic organizations, grants, insurance, and elsewhere. Additionally, it can bring together business leaders to identify opportunities for mutually beneficial investments in community wellness.
To encourage collaboration between sister agencies, the executive office can incentivize local police to work with human services by ensuring they are reimbursed directly for their contribution and enabling police and human services agencies to share data. The governor’s office can also take the lead in modernizing social agencies’ technology systems to reduce paperwork burdens on workers, support field workers with mobile devices, and improve connectivity for rural staff.
Regulators play a significant role in making human services recruitment and retention more viable. With worker shortages across the economy, the human services sector is losing candidates to other fields due to long regulatory approval times.20 To alleviate current challenges in recruitment, regulators may consider lowering barriers to obtaining licensing where appropriate. Measures can include interstate licensure compacts, where a state recognizes the licensing decisions of other neighboring states. Military spouses licensed in prior posts could receive similar reciprocity. To help students enter the field, clinically qualifying and billable college-level internships or state-approved provisional licensure may also be beneficial.
An overhaul of overly restrictive licensing requirements can widen the applicant pool. For example, the qualifying mental health professional designation could be open to graduates even if they have not majored in the field, provided they complete a training course. Candidates could be allowed to fulfill requirements for more senior qualifying mental health professional designations through training. Meanwhile, to overcome another bottleneck, current employees could be paid for the time they take to supervise the licensure process for recruits. The process should allow virtual supervision, and if no personnel from the relevant department is available, supervisors from other departments can be considered.
Employers can make more immediate changes to attract and retain qualified personnel than other stakeholders, such as legislators and regulators, whose initiatives may take longer to bear results. Employers, including government employers, can make a difference by modernizing their workplaces to prioritize a more supportive, employee-centric culture. Measures include trust-based leadership and more inclusivity with regular staff meetings to develop solutions for workplace challenges. Staff can even work with peers in other agencies to address common issues. Instead of competing for talent, agencies could collaborate on enhancements to improve retention, such as establishing new daycare centers.
Career development with adequate supervision and training is also crucial, starting with an intentional onboarding program. Then, each employee can have a career development plan, including options that allow for progression in direct care rather than into administrative work if they prefer. In addition, employers can reevaluate pay scales to reward employees based on performance and length of service.
Employers can support self-care to mitigate burnout, including offering flexible schedules and accommodating leave requests. Staff and management can identify and implement solutions to safety risks with the help of sister agencies, such as the police, when needed. Internal peer and clinical resources, modeled after public safety, can also provide essential support for stress, trauma, and burnout. Many employers in other fields are dropping degree requirements to attract more candidates to their open positions. Similarly, human services employers may reconsider what degree requirements are necessary for the human services workforce.
Legislators and funding agencies
Legislators can ensure adequate funding for local human services departments. They can also take additional measures to boost the recruitment and retention of human services workers by expanding educational stipend programs beyond foster care and prevention to broader human services careers to expand the pool of candidates. Additionally, they could pass legislation incentivizing local governments to develop student loan repayment programs. State funding supporting supervision for licensing and development would also lower barriers to entry into the profession.
To boost retention, funding to implement differential pay for less desirable shifts would help compensate for some of the hardships undertaken by human services workers. Expanding laws deeming threats of death or bodily injury to health care providers a class 1 misdemeanor—representing more severe crimes, including assault—to cover human services workers would provide needed protections.
State agencies control many essential levers that play a crucial role in affecting the well-being of the human services workforce, including pay structure, pipeline development, and improvements in the hiring process. To establish a more rational pay structure, agencies can undertake comprehensive funding and compensation studies to benchmark compensation for state and local human services workers against that of other healthcare professionals and related fields, such as teachers and police in urban and rural areas, both in and out of state. In addition, a study of job classifications can assess the alignment between job duties and skills and the education and experience required. With workforce shortages across the economy, many employers are considering relevant experience instead of degree requirements.
To broaden the pipeline of candidates, agencies can expose middle and high schoolers to opportunities in the field and address obstacles preventing them from participating in paid internships. Collaboration between philanthropic, educational, and other partners can help elevate the human services sector within the education system. In addition, engagement with local workforce development boards can help recruitment through partnerships with local businesses and organizations that also provide skills training for this workforce.
To reduce bottlenecks in recruitment, agencies can assess requirements, such as fingerprint analyses, often cited for delays in the hiring process. Similarly, they can reduce the paperwork required for barrier crimes, such as long outdated driving under the influence citations, which might eliminate otherwise qualified candidates. More generally, fostering a culture of collaboration between licensing boards and providers can help align licensing requirements more realistically to current hiring needs in the profession.
Philanthropic and community organizations
The contributions of philanthropic and community organizations can pay big dividends when employed strategically in the areas of greatest need. Projects can include assessments of the resource needs of regional and local human services providers and the development of databases and tools to support data analysis of the workforce. These organizations are also well-positioned to invest in public awareness and marketing campaigns to elevate the general understanding of the value of human services work. In addition, they can optimize funding for universities to train these workers.
Building a stronger future for human services workers: A call for community support and recognition
Human services workers play a critical role in addressing the many social challenges facing communities today, ranging from assisting families in crisis, to helping older adults and people with disabilities live independently, to providing mental health services. However, they often lack the recognition and support to continue their crucial work. By undertaking reforms to make human services work more viable in the future, they can build the equivalent of a red firetruck for these local heroes to continue serving the most vulnerable in our society.
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