Agency Staffing Survey Reveals Acute Labor Shortage

MITC recently conducted a staffing survey of 137 agencies employing nearly 40 thousand people across the United States. The results showed a severe shortage of direct service professionals (DSPs). As they struggle to deliver vital services to a vulnerable population, agencies are looking for ways to hire more employees and retain the ones they have.

Across the board, from smaller agencies with less than 50 employees to the largest providers with over 2,800 employees, agencies reported an excessive number of open positions, primarily for DSPs. The average agency employed 320 people when fully staffed and had 25 open positions (nearly 8 percent). The total number of open positions was over 3 thousand.

The Hidden Costs of a Labor Shortage

An employee shortage is not just inconvenient; it is costly. For example, agencies have responded to the shortage by authorizing more overtime. Of the agencies who participated in the survey, 65 percent reported overtime was higher than they wanted.

Overtime is not the only cost of the labor shortage. Turnover costs money, both directly and indirectly. Direct costs include overtime, lost billing if services cannot be delivered, recruitment activities, and fill-in staffing. Indirect costs include lost productivity while managers are busy interviewing and training new employees. Less obvious, but no less costly, are the negative impacts to staff morale and performance, which can lead to diminished quality of client care. Among the survey respondents, turnover rates varied quite a bit. For example, agencies in Maryland, New York, and Pennsylvania reported turnover rates under 10 percent, while some agencies the Carolinas, Indiana, and Illinois reported DSP turnover rates as high as 80 percent. This is not surprising, since the states with the lower turnover rates are able pay about 20 percent more for DSPs.

As if the shortage isn’t difficult enough, agencies also reported problems with the quality of applicants among those who are available. Common problems were applicants who failed drug or background checks, had no relevant skill sets, failed to complete training, had poor concepts of attendance responsibilities, or did not show up for interviews/training.

Ways to Improve Retention and Hiring Rates

Almost all agencies participating in the survey have already taken steps to improve their hiring and retention rates. These steps include:

  • Better applicant screening to concentrate resources on those most likely to stay
  • Annual review of retention and on-boarding process
  • Improved, more organized on-board training
  • Working with local colleges, such as nursing schools
  • Emphasizing total compensation value, rather than hourly rate
  • Developing career ladders
  • Referral bonuses and new hire bonuses
  • Graduated pay scales
  • Early access to benefits
  • Mentoring/buddy programs
  • Contests and awards
  • Employee appreciation days and events
  • Monthly staff newsletter
  • Shift differentials
  • Profit sharing

In addition to these things, agencies can focus on several areas to increase retention and attract workers.

Follow Good Scheduling Practices

One of the biggest complaints employees have is lack of advance notification for schedules. Poor scheduling or last minute changes can cause conflicts with your employees’ home lives. A DSP will be much less motivated to show up if they are constantly being rescheduled, especially at short notice. Frequent rescheduling leads to a culture of frustration and uncertainty in your workforce, and it encourages absenteeism and turnover.

When scheduling employees, it is important to track their preferences and restrictions. This will help you avoid calling them in to cover shifts they can’t take. Capture these preferences during the new hire process. Also, allow enough time between shifts for employees to rest, and avoid calling employees who have just finished a shift back in. Also, planning for holidays well in advance can avoid disruption and lead to better attendance.

Good scheduling practices, together with an accurate time & attendance system, help your agency track frequent offenders who regularly show up late, leave early, or call in sick. These employees set a bad example to others, causing lower productivity and more overtime.

Of all the agencies that participated in the staffing survey, 42 percent are considering new scheduling systems. Additionally, agencies reported that they had already changed some of their scheduling practices by:

  • Investing in new scheduling software
  • Allowing flexibility in how different sites schedule staff
  • Introducing rotating weekend shifts (one on, one off)
  • Creating more full-time positions
  • Increasing the number of part-time staff
  • Creating scheduler position(s)
  • Monitoring hours to ensure employees get breaks
  • Scheduling longer shifts on fewer days
  • Using salaried staff to cover open shifts

Empower Employees Through Self-Service

Employee self-service refers to a system that gives employees a certain amount of autonomy. For example, an online self-service system allows employees to see their schedules, who they are working with, which shifts are open, their PTO balances, and more. This saves time for you and your staff. It also reduces the amount of phone calls and emails between you.

Another popular self-service feature is an automated text or email alert system to remind employees about licenses, training deadlines, upcoming reviews, and more. An alert system can also send birthday and anniversary greetings or HR updates. It can improve communication between employees and managers, too, by sending notices when PTO is requested or approved. Using text/email reminders to notify employees of their next shifts can also reduce absenteeism and helps motivate employees. On the same token, including a digital checklist to assign duties helps employees know what they are meant to do; this is especially helpful if an employee is covering a shift for someone else.

Recognize Excellent Employees

Employees like to feel like their hard work is being rewarded. To do this, make sure your agency provides clear career paths for DSPs. Give them written guidelines on what factors will help them advance, such as good attendance records. Reward hard-working DSPs by gradually increasing their responsibilities. A DSP who has advanced from an entry-level position to a manager role is more likely to be loyal than one who has done the same job for years. For this reason, try to promote from within your agency workforce, rather than recruiting outsiders.

Also, employees want to know where they could be headed and how they can get there. Annual reviews or mid-year check-ins are one obvious venue for these discussions, but also encourage workers to come to HR with career questions and wishes throughout the year.

When excellent employees leave your organization, conduct exit interviews. You may even consider asking longer-tenured employees why they stay. Ask questions such as: Why did you come to work here? Why have you stayed? What would make you leave? What are your non-negotiable issues? How about your managers? What would you change or improve?

While there are no quick fixes for overtime or turnover, making a few key changes can increase caregiver retention and help alleviate the challenges agencies face by caregiver shortages.

Agencies Speak Out on Scheduling

With restricted funding, labor shortages, and state and federal mandates continuing to pressure providers, human service agencies need to use their limited human and financial resources as efficiently as possible.

Ineffective employee scheduling directly impacts labor costs, productivity, and an agency’s ability to operate within budget. Effective scheduling solutions improve manager productivity and enable managers to make more informed scheduling solutions, while eliminating the inefficiencies inherent to a paper scheduling system.

In this article, agencies across the United States share their experiences using an automated time & attendance solution, how they implement optimal scheduling practices, and the benefits of effective scheduling.

An effective automated scheduling solution can improve efficiency and organization at an agency. Community Living Connections is a non-profit agency founded in 2004. With 300 staff providing community supported living services to approximately 200 individuals in Wisconsin, CLC supports individuals to live in their own homes and participate in community life, providing in-home staff to help with planning, personal cares, medical support, finances, relationship building, and more.

The Senior Scheduling Manager at Community Living Connections, Stephanie Stringer, has seen improvements since automating scheduling practices, “It is liberating to have schedules accessible, accurate, and up-to-date. Employees can check schedules from anywhere, which makes it easy.”

The benefits have been numerous, “I know how important it is for our systems to run well and be up-to-date. CLC can really have flawless transitions between shifts. This helps the employee be less anxious. Employees have said it’s a huge relief to know that they aren’t going to have to work late. Those comments usually come from people who previously worked at another agency or remember how it used to be here prior to MITC with unreliable schedules. Even my boss thinks that MITC and centralized scheduling have given so much consistency and reliability to the function of the agency.”

Developmental Services of Dickinson County is another agency that uses MITC. Developmental Services supports over 300 adults and children in a variety of home and community-based service settings in central Tennessee. The agency employs over 280 staff working in eight counties with an annual operating budget in excess of $9.0 million. The agency manages 3 day programs, 30 smaller group homes with 2 beds, and a home and community-based service program.

Barbara Brandon, Team Manager, and Amber Donegan, Payroll & Benefits Coordinator, have improved scheduling practices at Developmental Services. Prior to using MITC, “Managers maintained schedules in excel. Whoever was on call had to flip through pages and pages of schedules and employee information that may or may not have been updated to find people to cover shifts. MITC gives managers more opportunity to see what’s actually going on. We have a weekend supervisor who covers on call shifts. Working with accurate schedules saves a lot of time. We have cut down on wasting time with phone calls and avoid calling people to cover a shift who are already working.”

Centralized Scheduling

Some agencies perform scheduling in a centralized manner, with a dedicated individual or department put in charge of all scheduling concerns. For example, Community Living Connections has a scheduling department overseen by Stephanie Stringer. “In our scheduling department, we have 3 people. I supervise and direct a Scheduling Manager and a Scheduler under me. We roll out schedules 2 months in advance for all employees. Supervisors are each in charge of a certain number of locations, and are ultimately responsible for shifts that aren’t filled at their locations. We meet twice a week with the three teams of supervisors to discuss scheduling and open shifts. I talk with teams monthly at their individual team meetings as well.”

“Overall, centralized scheduling is really a relief and tool that frees people up to do other aspects of their job. We ask employees and other staff not to do certain functions in MITC to allow the scheduling department to be responsible for most updates. This works better for us because too many hands being involved increases the chances of mistakes. I find our department needs to micromanage to a certain extent just to make sure no one makes a mistake that we are unable to track. Some might see it as obstructionist, but it prevents mistakes that would be even more cumbersome to correct,” according to Stephanie with Community Living Connections.


Gateway Services started in 1970 in an abandoned schoolhouse in Malden, Illinois, with a crew of three, one program, and $34,000. Today, Gateway has grown to support 10 programs, 2 main locations with day programs, 6 group homes, home-based supports, and a transportation program. During its long history, Gateway Services has had to implement many changes. One of the latest was to implement a new workforce management, payroll, and financial system.

“Our accounting assistant maintains the staff schedules. The schedules are used to ensure everyone has only 40 hours scheduled. This allows us to produce the early overtime warning report. This report gives us the opportunity to minimize overtime. The benefit of putting in the schedules is we can cut staff hours to reduce overtime where we can,” according to Mandi Johnson, CFO with Gateway Services.

Mandi believes Gateway is still working toward the ideal scheduling system. “We didn’t force management to do things,” she says. “In my opinion, schedules should be set up 4-6 weeks in advance with adjustments made as needed. We have one program that won’t do that. They start from scratch every 2 weeks. If we’d have said, “you’re going to do it this way and that’s it” things would have been smoother.”

Time Savings

Developmental Services of Dickson County gained time to focus on other tasks after implementing a scheduling solution. “Using scheduling with MITC makes your life a whole lot easier, especially when you have a lot of employees on the payroll side. I’ve been able to do a lot more accounting work that I didn’t get to do before. I can’t imagine the headache without MITC. MITC is a huge timesaver overall to everyone in administration.”

According to Stephanie Stringer, “When I first joined CLC, 50-60% of calls to the eCell manager were scheduling questions from employees! We found that our paper copies of schedules posted in the houses were inaccurate or not up-to-date. Once we started training and getting staff used to looking online for themselves, calls to the on-call phone were greatly reduced. Keeping schedules accurate and verifying assigned shifts has been much easier. The number of calls pertaining to scheduling are rarely an issue. On-call scheduling questions are seldom brought up as a problem in our bi-weekly meetings.”

“Developmental Services has definitely saved time on the approving of payroll. We have better control of what employees are actually doing as compared to schedules.”

MITC scheduling offers additional features to improve agencies’ operations.

“We use MITC availability selection criteria to help fill open positions. MITC allows CLC to screen or filter for available employees. All of our managers have access. We use MITC scheduling daily,” says Stephanie Stringer.

Self Service

With MITC, agencies have the option to give employees access to schedules. Stephanie Stringer shared that, “Community Living Connections allows employees to view their timesheets and make edit requests. Employees can view and request PTO through their calendar. Employees cannot edit their own information or restrictions.”

Most employees are able to benefit from self-service. “There are a handful of folks who struggle with self-service. It is largely because they are in a certain age range or lacking tech savvy. A good 90% of staff understands how to use MITC and use self-service,” according to Stephanie Stringer with CLC.

Developmental Services also gives employees access to self-service. “Employees use self-service, and the employees that I’ve talked to like having the access to it. Since we’ve started doing scheduling on the web as well, they can see schedules.” Additionally, the agency has 10 clients working for it, and they use client timesheets.

Overtime Reductions

Gateway Services has experienced reductions in overtime since implementing a time & attendance and scheduling solution from MITC. Mandi Johnson, CFO shared that, “Three years ago, overall overtime was 23%. Now it’s down to 5.77%. In the CILA program it is now 11.23%, down from 36% due to using scheduling and early overtime reports. At first, I ran reports and would give mangers notes about which employees were in danger of going over. They would look at schedules and adjust them as necessary to prevent overtime. Now, managers are on the web checking daily reports themselves.”

Scheduling can definitely help agencies reduce overtime. However, the nationwide staffing shortage has made many agencies reconsider their ability to focus on overtime reductions.

According to Stephanie Stringer, “In certain households, when there is a good pool of staff, CLC would be able to control the flow of overtime. It’s a great idea, but with our staffing shortage, reducing overtime isn’t a priority. We are happy to contain it! We’ve weighed whether it’s ok to go with the overtime, decided it is, and we build a percent into the budget to pay for it.”

Barbara and Amber with Developmental Services are in the same position. The agency is down about 30 people, so it has not seen any overtime reductions yet. However, they say: “Overtime might have been higher than what it is today without scheduling. It is helpful to see at a glance how many hours employees are scheduled for to make sure the agency isn’t giving any one employee more overtime than anyone else.”

Ease of Use

There are benefits of an MITC Solution that Stephanie at Community Living Connections had not experienced previously. “I was in a similar role at a different agency doing the same type of work prior to coming to CLC. In that job, all schedules were Excel spreadsheets. I was responsible for having 25 schedules up-to-date and ensuring they were understandable. After starting this job at CLC, I thought “if I’d have had MITC, I never would have left the other job, and it would have been so much better. I have worked with other scheduling systems. We get some mixed reviews from managers. Scheduling can be the scapegoat, and be blamed as the reason people are frustrated.”

She continues, “I prefer just a few people working with schedules as opposed to every single manager. Their real function as a manager is the advocacy and care of clients and the supervision of staff. Managers take these jobs because they want to work with people, certainly not to spend their time on scheduling.”