The LeadingAge Center for Applied Research prepared The Long-Term Care Workforce Crisis briefing paper for the National Commission for Quality Long-Term Care to address long-term care workforce problems affecting frail and disabled older adults in nursing homes, assisted living, other residential facilities and home and community-based settings.
A new training program in North Carolina will help personal and home care aides (PHCA) move more easily between care settings during their careers.
This edition highlights research underway in conjunction with LeadingAge's Center on Applied Research, and models of achieving aging in place in non-subsidized settings as well.
The LeadingAge Workforce Cabinet has spent a year defining the skills sets for personal care attendants, care coordinators and middle managers to deliver effective supports and services.
Now, the Cabinet wants to make sure that nursing homes, home health agencies and housing properties will use those competencies to strengthen their workforces.
The Workforce Cabinet -- a group of educators, state association executives and LeadingAge provider members -- discussed in March strategies and resources that could help LeadingAge provider members create healthy workplaces and improve the workforce.
Creating Healthy Workplaces
During their March meeting, members of the Workforce Cabinet worried that the current economic downturn could make LeadingAge members too complacent about the need to address persistent workforce challenges facing the aging field. The current economic climate has helped to stabilize turnover rates.
But those rates are likely to rise sharply again as soon as the economy recovers.
An Organizational Readiness Assessment could help a LeadingAge member objectively examine its workplace, identify that workplace’s strengths, and assess how it might be improved. Staff members at all levels could use the tool to record their perceptions of the benefits and challenges of working for the organization.
Those responses could then be used to assign a score to the organization’s work environment and culture.
The Cabinet discussed a package of supplementary materials that could be targeted to an organization’s specific score on an Organizational Readiness Assessment. Those resources could help the organization address and resolve any workplace issues that surfaced during the assessment.
“It’s difficult to attract and retain qualified workers unless your organization supports those workers after they arrive,” says Natasha Bryant, managing director and senior research associate at the Center for Applied Research. “A readiness assessment is really the first step in this process. An organization that carries out this type of assessment will be in a much better position to make full use of the competencies that the Workforce Cabinet will release next fall.”
Improving Staff Training
The Workforce Cabinet plans to help nursing homes, home health agencies and housing providers incorporate its workforce competencies into their hiring and training practices. The Cabinet believes that these providers might benefit from:
- A checklist that would outline specific knowledge and skills that workers would need to meet each competency.
- A package of resources that would guide the organization in helping workers achieve the competencies they lack.
“The Cabinet’s primary goal is to make the competencies easy to use so that providers will use them,” says Bryant. “We would like to offer providers an all-in-one package that takes them from the readiness assessment right through to actually using the competencies to hire, orient, evaluate and train personal care attendants, care coordinators and middle managers.”
About the Workforce Cabinet
The Workforce Cabinet held its first meeting in April 2012 and will serve until April 2014.
The cabinet is co-chaired by Barry Berman, chief executive officer (CEO) of Chelsea Jewish Home Foundation in Chelsea, MA, and Frances Roebuck Kuhns, president and CEO of WRC Senior Services in Brookville, PA.
An informal conference call on a recent Friday afternoon convinced representatives of 4 LeadingAge member organizations just how much they had in common.
The LeadingAge Workforce Cabinet will spend the next 18 months identifying competencies for 3 staff positions in nursing homes, home health agencies and housing properties.
The Center for Applied Research is partnering as a subcontractor to the Lewin Group to provide technical assistance to states and other organizations seeking to improve the recruitment and retention of individuals who provide support services for people with disabilities.
The National Direct Service Workforce Resource Center was created to respond to the large and growing shortage of direct service workers. The resource center offers:
- An on-line searchable database.
- Access to information from a team of direct service workforce policy professionals.
- Technical assistance for selected State Medicaid Agencies awarded through an annual application process.
The project was funded by the Center for Medicare and Medicaid Services.
It seemed particularly fitting to mark the 50th birthday of the Senate Special Committee on Aging at the end of 2011, a year in which economic and social upheaval dramatically impacted our legislative agendas and the lives of our most vulnerable citizens. The Committee has been an important voice for aging Americans during many other times of economic and social upheaval. Older adults need its strong voice now more than ever.
The Aging Committee celebrated its anniversary on Dec. 14 during a Capitol Hill forum hosted by Committee Chair Sen. Herbert Kohl (D-WI) and former Chair Sen. Chuck Grassley (R-IA). I was invited to participate in the forum and to provide my perspective on the past, present and future of long-term care and housing policy.
During my testimony, I commended the Committee for its ongoing attention to nursing home quality, its promotion of home and community-based services, its support for the paid long-term workforce, and its commitment to service integration and care coordination. I also recommended that, over the next year, the Committee explore:
- How new models of service delivery might evolve in response to consumer preferences, the ability of consumers to purchase care, and changes in public policy.
- Whether and how a quality, competent paid workforce will be developed to meet changing demands for services and supports.
- How these services and supports can be made affordable for the vast majority of older adults who will need to use them. That affordability is critical, especially in our current economic environment.
Affordable Housing and Integrated Services
Five decades ago, one third of the elderly lived in poverty. That percentage decreased precipitously with the advent of Medicare and Medicaid, but the latest recession has dramatically expanded the gap between the “haves” and the “have nots.”
And who suffers the most? Moderate-income older adults do, because they don’t have the wherewithal to purchase services and supports, and they don’t qualify for government help unless they spend down their assets and move to a nursing home. Only then will Medicaid pay both their housing and their service bills.
This scenario doesn’t make economic sense. And it’s not what consumers want. That is why I recommended that the Senate Special Committee on Aging host a national conversation that explores innovative ways to deploy our long-term care and housing resources more effectively.
Specifically, I challenged the Aging Committee to explore a model that could deliver integrated services and supports to large groups of seniors living in affordable housing properties. Several states, including Vermont and Oregon, are already pursuing this housing-plus-services model in the belief that it will produce service-related savings that can then be used to support housing affordability.
Affordable shelter and services are essential elements of any viable community-based long-term care option. As a bipartisan, investigative body, the Senate Special Committee on Aging is uniquely positioned to begin its 6th decade with a ground-breaking exploration of innovative models that link shelter and services as a way to keep older people healthy while reducing costs and honoring consumer preferences to age in place.
The 2007 National Home Health Aide Survey is the first national probability survey of home health aides.
LeadingAge Center for Applied Research, in partnership with Social and Scientific Systems, Inc. (SSS), will be conducting analyses using this survey to provide technical assistance and policy analysis to the Office of the Assistant Secretary for Planning and Evaluation (ASPE).
The goals of the analyses are to describe workforce characteristics and to evaluate the interrelationships among workforce characteristics, job quality, and other worker and facility characteristics and quality of care.
The goal of analyses underpinning the "Workforce Characteristics" report is to understand the supply of workers by demand, geographic location, policy variation, agency characteristics, and recruitment strategies.
The team will prepare reports and manuscripts with results from these analyses.
This project is funded by ASPE and the Center is a subcontractor to SSS.