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Essential Jobs, Essential Care: A Conversation with North Carolina

October 6, 2020

Last week, PHI announced the launch of a multi-year advocacy initiative, Essential Jobs, Essential Care, which aims to improve jobs for direct care workers in three states: Michigan, New Mexico, and North Carolina. As part of this launch, we are speaking with the three participating coalitions’ leads to understand what this initiative means for them and what they would like to see change for direct care workers in their states.

Heather Burkhardt became the Executive Director of the North Carolina Coalition on Aging in August of this year. She has over 25 years of experience working with or on behalf of older adults, people with disabilities, and their caregivers. I spoke with Heather recently about the critical work of the coalition and what she envisions could change on the policy front for the direct care workforce.

Amy Robins: You are new in the Executive Director role for the North Carolina Coalition on Aging. What drew you to this position?

Heather Burkhart: I have a 25-year background working in aging in NC. What attracted me to the Coalition was the diverse membership—all of whom are dedicated to collaboratively working together to enact policies impacting older adults. Their passion spans from protecting the most vulnerable to living well in older age—it is not a singular definition of what impacts elders. Issues of the direct care workforce fit in very well within our scope and mission.

AR: Tell us about NCCOA. How did this coalition get started?

HB: The history goes back to the early 1980s. It began as an open invitation to advocates interested in aging issues. They would come together on Friday afternoons once a month to network. Over the years, the group became more formalized, brought in speakers, and established legislative agendas. In 2018, the organization established itself as a 501(c)3. Today, we have 75 organizational members, and we still extend the same open invitation to our meetings on Fridays.

AR: What are one or two recent coalition successes?

HB: In April, the Coalition was invited to present to the North Carolina General Assembly’s Working Group on Health Care of the House Select Committee on COVID-19. (Read the testimony here.) We provided information on the impact of the pandemic on older North Carolinians as well as recommendations on how to allocate federal and state funding. Some of those recommendations relate specifically to direct care workers. We have continued to have a strong voice at the table. Being able to hire a full-time executive director is a big step, too, in the organization’s evolution.

AR: What are some of the challenges facing direct care workers?

HB: There is a long list of challenges that these essential and dedicated workers confront daily. Poverty, racial and gender disparities, transportation, and job quality concerns. The fact that 53 percent of our state’s direct care workers live at or near poverty speaks to the wage issues and lack of benefits that impact this workforce nationally, as well.  This is largely a women’s workforce, so there is a real need for adequate and affordable childcare. Transportation can be difficult, particularly in our rural communities. And because so many workers hold multiple jobs, that just got more complicated given COVID-19.

AR: Can you say more about the impact of COVID-19 on this job sector?

HB: COVID-19 has shed a bright light on the multiple issues that direct care workers face and has elevated this workforce to policymakers in new ways. Hopefully, the increased awareness will bring some opportunity for change. We still struggle with the lack of adequate PPE in certain locations across a variety of care settings. Being able to retain direct care workers in this environment is challenging. On a good day, we had trouble with adequate staffing in this industry. Now it is even harder.

AR: Is there one policy opportunity you are anticipating in the next few months?

HB: Policies pertaining to healthcare access, sick leave benefits, and other issues will need to be examined to ensure that there is an adequate workforce in place to provide high-quality care to individuals across all long-term care settings. As North Carolina examines concerns about health equity across the state, the interests and needs of direct care workers will fall in line with that conversation.

AR: On a lighter note, what is a misconception people outside of North Carolina have about your state?

HB: The state is deeply divided over BBQ.  We have two styles. The western part of the state is tomato-based (aka Lexington style); in the east it is vinegar-based. You can draw a line down the state which defines what kind of BBQ you will get. I am a big fan of eastern North Carolina BBQ. There is nothing better than a plate of eastern North Carolina BBQ and a glass of Sweet Tea.

To learn more about this initiative, which is made possible through generous support from the W. K. Kellogg Foundation, click here.

Contributing Authors
Amy Robbins
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