PHInational.org

The new issue of Generations, the quarterly journal of the American Society on Aging, is devoted entirely to the eldercare workforce, including articles by PHI that highlight the direct-care workforce.

The Winter 2010-11 issue of Generations, “Developing a Workforce to Care for an Aging Society: Challenges and Opportunities,” covers

• the current state of the nation’s eldercare workforce;
• the eldercare workforce’s makeup, deficiencies, and strengths; and
• strategies for much-needed workforce recruitment, training and management, policy development, and fostering of cultural competencies.

Guest Editor Robyn Stone, executive director of the LeadingAge Center for Applied Research, said that numerous recent developments “underscore my belief that eldercare workforce development is now on the policy radar screen,” such as “the Affordable Care Act‘s implementation, the creation of the national Eldercare Workforce Alliance, the Institute of Medicine‘s focus on these issues in many of their recent reports, the Department of Labor‘s recognition of health and aging services as an emerging sector, and state activities in this area.”

“Also, the aging of the society helps to ensure that this issue will become an even higher priority over time,” Stone added.

The article “Federal and State Policy Strategies for Developing a Quality Eldercare Workforce” discusses

• how the workforce elements in the Affordable Care Act (ACA) were shaped;
• the future and its challenges as new elements of the ACA impact the eldercare workforce over time;
• implementing the ACA, including the Centers for Medicare and Medicaid Services’ need to insure workforce preparedness;
• how Congress can support the eldercare workforce; and
• the ongoing role for eldercare workforce advocates.

The article’s authors — PHI President Steven Dawson and American Geriatrics Society Deputy Executive Vice President and CEO Nancy Lundebjerg, who are co-conveners of the Eldercare Workforce Alliance (EWA), and Caitlin Connolly, EWA project manager — write that “eldercare workforce policy will find its true test at the state level where care is received and where staffs actually work.”

“Caregivers on the Front Line: Building a Better Direct-Care Workforce,” contributed by Dorie Seavey, PHI policy research director, provides an accessible, challenging picture of  ”what is probably the largest workforce ever produced by our economy, and currently the fastest growing one,” including information on:

• employment levels — past, present, and future;
• demographics; and
• job quality.

Seavey argues that “changing fundamentals are reconfiguring the value proposition of direct-care jobs—to the health care system, to communities, and to workers.” The article highlights key policy opportunities at both the state and federal levels that leverage the potential of this workforce to both improve our eldercare and disability systems and to improve jobs for low-income workers.

“It is great to have this special issue that addresses the entire workforce with some specific articles devoted to the pivotal role that direct-care workers play and the challenges they face,” Stone said.

The online version of “Developing a Workforce to Care for an Aging Society: Challenges and Opportunities” will be available for purchase on the Generations website in March.

– by Deane Beebe

Steve Edelstein

– by Steve Edelstein, PHI National Policy Director

On October 23, The New York Times columnist Thomas Friedman highlighted direct-care workers who provide daily assistance for elders and people with disabilities as one of our economy’s fastest-growing jobs (pdf).

By 2018, this workforce will exceed 4 million — more than the number of teachers we will need to educate America’s children in grades K-12.

In “The Election That Wasn’t,” Friedman notes that these jobs can go to low-paid, under-trained workers or to workers with the knowledge and skills to provide “the elderly a better physical and psychological quality of life.”

And with better training and real advancement opportunities, today’s highly committed direct-care workers could provide even greater value, making our healthcare system more effective and efficient.

These workers could assist with transitions between care settings, participate in team approaches to managing chronic conditions and coordinating care, and provide support and information to family caregivers.

The Affordable Care Act promotes developing new models of care. Ensuring that direct-care workers are part of those models, however, will require public investments in training, job redesign, and a commitment to better wages commensurate with their expanded role.

Unlocking the potential of this workforce will offer millions of Americans better jobs and better care.

Allison Lee, PHI’s federal policy and campaign manager, testified at the February 25 listening session on the reauthorization of the Older Americans Act. Read the full story

(L-R) Mark McClellan of the Brookings Institution, Carol Raphael of the Visiting Nurse Service of New York, Steven Dawson of PHI

Nearly two dozen eldercare experts convened in Washington, DC, on January 28 for a long-term care forum held at the Brookings Institution, a public-policy think tank. Read the full story

Hilda Solis

A July 9 New York Times editorial calls for home care aides to receive minimum wage and overtime protections under the Fair Labor Standards Act. As the Times notes, in 2007, the Supreme Court upheld a 1975 labor regulation that defined home care aides as “companions,” but that regulation can be reversed anytime by Secretary of Labor Hilda Solis. This is the second editorial the Times has published on the issue; the first appeared in January 2009. Read the full story

The Center for Personal Assistance Services (PASC) has issued a report titled Home and Community-Based Services: Public Policies to Improve Access, Cost, and Quality that offers suggestions for improving policy at both the state and federal levels.

Read the full story