Aging in Our Community A Message from W. Mark Clark, President and CEO
Direct Care Workforce Shortage Grows One of the prevailing issues facing older adults, those who love them, and the sector that serves them is a severe and worsening direct care workforce shortage. Entry-level Direct Care Workers provide in-home assistance with activities of daily living such as bathing, dressing, mobility, light chores, and shopping. A step up the career ladder, Certified Caregivers and Certified Nursing Assistants offer some of these same services, with additional ability to provide support and monitoring of medical concerns with appropriate supervision in-home or a facility. They may also apply skills such as medication administration and management as their training allows. These highly-skilled, underpaid and often under-recognized workers offer capable, compassionate, and critical care and are key members of our frontline healthcare defense. During the pandemic, frontline healthcare workers provided the support that allowed vulnerable adults to remain safely in their homes and care settings, work that has been more critical than ever during the public health crisis. Collectively, there are currently 4.6 million of these workers in the US, according to PHI National, which projects that between 2019 and 2029, the direct care workforce will add an estimated 1.3 million new jobs to meet rising demand - more new jobs than any other single occupation. Factoring
in high rates of turnover for the field, it is estimated that long-term care employers will need to fill 7.4 million job openings in direct care from 2019 to 2029. There was already a shortage of skilled direct care providers in our community prior to the pandemic, and with the significant labor migration currently taking place, that shortage has become much worse. PCOA has been sounding the alarm about this issue for several years. Today, more than 280 older adults who have qualified for and were found to be in need of in-home help through PCOA's case managed services are waiting for a Direct Care Worker to become available. That number has steadily risen over the past three years. We are not alone in facing this challenge - nearly 820,000 older or disabled Americans were on state waitlists for Medicaid’s home and community-based services in 2018, according to a Kaiser Family Foundation study published last year. PCOA is continuing to tackle this critical challenge in a variety of ways, which you will hear more about in months to come. This has included work with local homecare agencies and our own non-medical homecare agency PimaCare at Home to implement a series of strategies to positively impact the issue. These include compensation and professional recognition challenges, potential career ladder opportunities, adequate training, and overall
employment challenges. In our most recent effort, PCOA is partnering with United Way of Tucson and Southern Arizona to expand their Direct Care Workforce Resource program, which provides free training and support to prepare people to enter the direct care workforce. PCOA has invested in this work and launched a marketing campaign to encourage interest in both the program and direct care work as a career. Beyond what PCOA and our community partners can accomplish, a series of broader policy changes are needed. A component of the American Rescue Plan Act includes a specific program to enhance Medicaid-funded home and community based services. These one-time funds afford the opportunity to transform the home and community based services system and expand a well-trained workforce, implement retention strategies and provide a series of benefits for workers. This plan is being put into effect as we speak, and we hope to see these efforts increase the recruitment and retention of a high-quality caregiver workforce, in part by continuing to help with enhancing career pathways in healthcare. These efforts are a step in the right direction, but in themselves are not sufficient to address the growing shortage. An extensive plan to expand Medicaid coverage for (continued on page 10)
April 2022, Never Too Late | Page 3
Pima Council on Aging
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