The Older Adult Services Workforce

LeadingAge Advocacy Goals

  • Ensure older adult services organizations’ ability to hire and retain a sufficient number of high-performing staff.
  • Enable older adult services organizations to hire foreign-born workers through a range of programs.
  • Promote training of direct care workers in older adult services.
  • Increase grant funding for training and hiring older adult services workers at all levels.
  • Expand funding to train geriatric nurses and physicians.
  • Support the retraining of older workers.
  • Replicate programs and models that hold promise.
  • Support federal and state efforts to increase Medicaid reimbursement for older adult services.

The Issue

Recruitment and retention of older adult services workers is the critical issue for nearly every provider member of LeadingAge. Demographic trends – a rapidly aging population and fewer people of working age – portend fewer informal caregivers and insufficient numbers of American-born workers. Half of all people turning 65 today will need paid LTSS before they die. LeadingAge members feel the staffing pinch in front line jobs – certified nurse aides, home care and home health aides, with dietary, housekeeping, and maintenance a close second. There are huge gaps in the supply of geriatric nurses and physicians.

U.S. Bureau of Labor Statistics (BLS), Employment Projections Program (EPP). 2017. Employment Projections: 2016–26

Frogner, B, & Spetz, J. (2015) Entry and exit of workers in long-term care. University of California San Francisco Health Workforce Research Center on Long-Term Care; San Francisco, CA

Advocacy Action 2020

116th Congress

  • Older Adults Services Guest Worker Program: We support the introduction and enactment of a temporary guest worker program for CNA and home care aides.
  • J-1 Cultural Exchange Visa Changes: We support the introduction and enactment of Cultural Exchange Visa changes to include older adult services workers in addition to child care workers.
  • Modify EB-3 Visas for Nurses: We support expanding and modifying visas to support improvements to increase the quotas for foreign-born LTSS nurses.
  • Expand “Religious Occupation” to Include Older Adult Services: We support modifying the R-1 program to cover temporary workers so it includes older adults services settings.
  • Increase Geriatric Academic Professionals and Clinician Educators: We support the enactment of the EMPOWER for Health Act of 2019 (H.R. 2781). The act reauthorizes the Geriatrics Workforce Enhancement Program (GWEP) and Geriatrics Academic Career Awards (GACA) program to provide training to students, faculty, providers, direct service workers, patients, and families to address gaps in health care for older adults.
  • Older Americans Act Reauthorization: We support the reauthorization of the Older Americans Act to include provisions focused on the direct care workforce and allows the SCSEP program to train older workers in LTSS. H.R. 4334 – Dignity in Aging Act – has passed the house.
  • Award Grants to Recruit and Retain Direct Care Workers: We support the Direct CARE Opportunity Act (S. 2521; H.R. 4397) that directs the Department of Labor to award grants to recruit and provide advancement opportunities to direct care workers.
  • Support finalizing Department of Labor proposed regulation allowing individuals under age 18 to operate lifts.
  • Reinstate CNA Training Programs within SNF: We support Nursing Home Workforce Quality Act (H.R. 4468) and Ensuring Seniors’ Access to Quality Care Act (S. 2993) that would allow reinstatement of a nurse aide training program once a nursing home has been determined by CMS to be in substantial compliance.

Action You Can Take Now

Additional Resources