San Francisco-based John Tellez recalls taking BART to the end of the line for only 60 cents, a bygone era when he could more easily afford to live in The City and as a caregiver for his grandmother in Daly City to work .
But after the death of his grandmother, Tellez had to find a new job in addition to the loss of a family member. Construction jobs helped him make ends meet, but the rising cost of living eventually left him homeless for nearly four years.
Today, Tellez is back on his feet doing what he loves: helping others live safely and comfortably at home. In addition, the 57-year-old is going back to school in order to take his practical know-how as a home care worker to the next level with the training to become a state-certified nursing assistant.
“I like helping people. You know, it’s like karma. I might need help myself someday,” said Tellez, who now works with clients at San Francisco’s shelter-in-place hotels, many of which are due common experiences with homelessness wish to work with him.
Tellez is one of the first five cohort members for a pilot program between the City College of San Francisco, UCSF and Homebridge, a San Francisco-based home care provider serving older adults and people with complex health and behavioral needs.
On a typical day, Tellez meets with clients like a stroke survivor who lives in a shelter-in-place hotel in Japantown, where he helps out with everything from running errands to changing sheets to administering medication and the Helping the customer move safely.
It is the same type of job Tellez did while helping his grandmother and most recently as a trained housekeeper at Homebridge, where he has now been working for two years. But now these hours are helping him to gain a new qualification and higher earning potential in the next job he hopes to find in a nursing home or hospital.
The program, funded by the San Francisco Office of Economic and Workforce Development and the Metta Fund, offers free on-the-job training for supportive service workers at home at Homebridge and clinical training at UCSF that culminates in a Certified Nursing Assistant certification through CCSF.
Fifteen weeks of fully accredited classes began in September. It includes 10 hours of weekly tuition from CCSF as well as a clinical practice requirement of 100 hours from UCSF Health.
Home health care is a key cog in the San Francisco health network that helps keep extremely low-income residents within their own four walls.
However, the training initiative comes at a time when San Francisco is facing a serious shortage of home service providers coupled with an aging population, creating the perfect storm for unfulfilled hospital beds and rising homelessness.
“If you can’t survive at home, you could lose your home,” said Mark Burns, Homebridge’s executive director. “You cannot keep the place clean and can be evacuated. You could have too many emergency health experiences, end up in the emergency room more, and not be able to help yourself at home. You could end up in a nursing home, but there aren’t even enough beds. “
Older adults are the fastest growing age group in San Francisco. By 2030, the city’s Human Services Agency estimates that 30% of the population will be 60 and older.
According to the San Francisco Human Services Agency, there are currently approximately 25,000 people receiving home care and 23,000 caregivers. The demand for home care recipients has increased about 5% annually over the past two years, a trend that is expected to continue unless workforce patterns change.
“There is a big need and a big gap. As you can imagine, this is a really tough job, ”said Kelly Dearman, Executive Director, Disability and Aging Services, SF Human Services Agency. “It’s not just about recruiting anyone, we need people who speak different languages and can meet different needs.”
Compared to other medical practices, home care is a homework. In many cases, these caregivers are family members who are paid to care for a loved one full-time.
Customers who cannot afford to manage their own services or who don’t have a family member to support can find home care workers through the San Francisco Caregiver Register or Homebridge. (To ask questions or request home support services, San Francisco residents can call (415) 355-6700 or learn more here.)
A classroom in Homebridge’s mid-market offices. (Kevin N. Hume / The Examiner)
However, home support services typically pay minimum wage salaries, making it difficult for caregivers to live in San Francisco and do a physically and emotionally demanding job.
According to the Human Services Agency across the city, 65% of in-home service providers are women and 34% are men. Black and Latinx women make up the vast majority of home care workers in San Francisco and beyond.
“People who work in this industry are mostly immigrants and women of color, people who are often exploited to work long hours on low wages,” said Burns. “Our goal is to get them to a place like Laguna Honda, where the entry (salary) is closer to $ 25-26 and (they can) see more growth in the salary scale there.”
Veronica Diaz-Gracida, another participant in the program, has been a home carer for four years. She chose the program when she saw an opportunity to advance in the medical field, an opportunity she hadn’t considered when fees and regular job duties got in the way.
“I don’t want to worry about whether I can pay my rent or how I can take care of my children and do a job that suits me,” says Diaz-Gracida, 32, who lives in the mission district.
Throughout the pandemic, home and community caregivers have been first responders to older adults and people with disabilities living in isolation at home. Burns and Dearman believe that more people will be interested in these jobs by providing more opportunities for advancement in the field and training to move into other medical professions.
“That’s how we get people in the door,” Dearman said.
Diaz-Gracida has goals beyond a bigger paycheck. She hopes her children will see her study and discover opportunities to pursue.
“I tell my kids, ‘I’ve had to learn new things every day,'” said Diaz-Gracida, adding that she plans to show them around campus as soon as she starts her clinical training at UCSF. “I want to show them that if you want something, you have to work for it.”