Susan Hildebrandt
Susan Hildebrandt

Last week’s announcement of The Geriatrics Workforce Improvement Act (S.2888) introduced by Sen. Susan Collins (R-ME) and aimed at tackling workforce training, clinical staffing, and support services for older adults across the US, is welcome news.

I felt heartened to hear Sen. Collins and other lawmakers speak of the eldercare issues faced by their constituencies at the May 22 Senate Committee on Health, Education, Labor & Pensions bipartisan hearing on the healthcare workforce. Their words confirmed what providers, and many others, know all too well: America faces a crisis.

Our population is aging, and the number of workers required to meet the needs of older adults now and in the future simply does not exist. As Sen. Lamar Alexander (R-TN) chairman of the HELP Committee, said at the hearing, “By 2030, our total population is expected to increase more than 10 percent and the percentage of people over 65 is expected to increase 50 percent compared to today.”

In some areas of the country, such as in Maine, the demographic shift is happening more rapidly. According to Sen. Collins, “within the next two years, our seniors will outnumber our children, 15 years ahead of the national projections.”

That’s why LeadingAge, in conjunction with the Eldercare Workforce Alliance (EWA), supports Sen. Collins and her bill’s cosponsor, Bob Casey (D-PA). Still, we in the trenches know that S.2888 touches only the tip of the very large iceberg concerning the current and projected needs of the aging services workforce.

And, while we are pleased by other recent proposals focused on the aging services healthcare workforce (HR 3713; HR3461; HR3778; HR3351), which suggest an awareness of the vast need for new policy approaches, we also know that the legislative process moves slowly. Years as a healthcare lobbyist have taught me that policymaking takes time.

For our members — and for everyone working in the aging services field — action is needed now.

The legislative approach cannot be our only strategy.

Since the launch last year of LeadingAge’s Center for Workforce Solutions, we’ve taken a collaborative approach, pursuing partners in sectors from education and local government groups, to workforce development boards and chambers of commerce both federally and locally.

We — like other associations in aging services and healthcare, including Argentum and EWA — are looking to establish coalitions, at the local and state levels, that will enable us to identify shared opportunities and build greater awareness of the aging services field.

Ours is a diverse and growing field with career options extending beyond clinical care. There are big needs and career path opportunities in finance, technology, architecture, management, operations and more.  

At the same time, LeadingAge is cataloguing and sharing promising practices — workforce-focused innovations and experiments culled from our members, as well as partners in academia and elsewhere — that address areas of greatest need for recruitment and retention strategies. We’ve found a variety of creative approaches, often crafted on limited budgets that provide field-tested solutions. The three examples below are a mix of evidence-based initiatives from researchers and home grown programs from our members:

NurseLEAD Online Training Program

Designed to help charge nurses and team leaders build competency as coaches, leaders and supervisors of frontline staff, NurseLEAD is a development tool created by LeadingAge with sponsorship from the California HealthCare Foundation and the National Institutes of Health. Participants complete seven separate online modules, including topic content (leadership, critical thinking, etc.), case studies and homework, at their own pace, followed by an end of program multiple choice test.

Peer mentoring

LeadingAge member Christian Living Communities took action after internal research revealed that unclear job expectations and lack of an onsite person to answer questions were the source of rising turnover. Leadership developed a mentor program for nurses, nursing assistants and personal care attendants, whereby each starting employee is assigned a mentor, who works alongside the new hire  from Day 1 and creates an assessment based on a defined set of competencies within their first 30 days. Mentors, who receive eight hours of paid training, can earn $500 in additional pay for their participation, provided their mentee remains with the organization for 12 months. Results: Skilled nursing centers at Christian Living Communities now report a 90% retention rate among CNAs, up from 49% in 2012. Recruitment costs have declined. Christian Living has incorporated the program into other settings, including assisted living, home care and dining.

Home health aide

Created in 2014 by the New Jewish Home in New York City, this three-month program trains older youth to become home health aides. Prospects are recruited through job fairs organized by high schools and community groups; enrollees learn over three months of training that includes a five-week paid internship. Since the program’s start, The New Jewish Home has trained about 150 students, offering enrollees support services including professional development, training in conflict resolution, and psycho-social support and counseling services. About 70% of those enrolled complete the program, and 80% of the graduates have been hired by the New Jewish Home as home health aides.

Solutions won’t happen overnight. But we are committed to join forces with policymakers, civic leaders throughout the country, academics, and our partners across aging services. With consistent focus, resources, and commitment, positive change is possible. And necessary.

Susan Hildebrandt is VP, Workforce Initiatives at LeadingAge, the Washington D.C.-based association for nonprofit providers of aging services.