Long Term CareLong Term CareBetween March and November 2023, CSG convened nine meetings of the National Long-Term Care Workforce Network to address a variety of topics related to various segments of the long-term care workforce. Recordings of eight of the meetings and presentation slides are available here.
This webinar considered how state and local policies can complement each other in providing support to family caregivers. In 2022, the RAISE Act Family Caregiving Advisory Council developed the National Strategy to Support Family Caregivers and an action guide for states. More recently, the National Academy for State Health Policy (NASHP) and the National Association of Counties partnered on the publication of an Action Guide for Counties. Among the webinar presenters discussing the national strategy and the actions states and localities can take: Jennifer Wolff, PhD, a professor at the Johns Hopkins University Bloomberg School of Public Health who served on the Advisory Council that developed the state actions report. She was joined by two colleagues, Katherine Miller, PhD, who has led analyses of state policies on family caregivers, and Chanee Fabius, PhD, MA, who works on the interconnection between paid and unpaid caregivers. Plus, NASHP Senior Director Wendy Fox-Grage discussed the action guide for counties and other resources. The meeting also included a report on a June 21 long-term care summit in Bucks County, PA.
This meeting highlighted resources and initiatives from ADvancing States, the organization that represents the nation’s 56 state and territorial agencies on aging and disabilities and long-term services and supports directors. The organization recently published a report on lessons learned from the state implementation of American Rescue Plan Act (ARPA) spending plans for Home and Community-Based Services (HCBS) programs. Under Section 9817 of the ARPA, states were able to access $37 billion in funds to invest in Medicaid HCBS. States had to act within a short timeframe to identify and implement projects that would expand, enhance and strengthen HCBS, and combine them into spending plans subject to approval by the Centers for Medicare & Medicaid Services (CMS). Included in these spending plans were more than 900 projects, many of which focused on workforce needs. ADvancing States Deputy Executive Director Camille Dobson provided an overview of the lessons learned report and a companion resource on the future sustainability of HCBS. In addition, Senior Director of Strategic Initiatives April Young provided an update on the intensive technical assistance ADvancing States and its partners are providing to states to address the workforce crisis through the Direct Care Workforce Strategies Center. The meeting also included a preview of a forthcoming long-term care summit in Bucks County, Pennsylvania.
This meeting of the Network featured an update on the workforce-related action plans of the Moving Forward Nursing Home Quality Coalition. The Coalition is making progress on a number of fronts, including helping to create apprenticeships for Certified Nursing Assistants (CNAs) and encouraging states to develop Medicaid Incentive Payment Programs. Presenters included Coalition Chair Alice Bonner, Betsy White from Brown University’s School of Public Health, Jasmine Travers from the New York University College of Nursing, Jenna Kellerman from LeadingAge, and Kezia Scales from PHI. The webinar also included a report from Caroline Cadirao, director of the Hawaii Executive Office on Aging, who outlined legislative successes in the Aloha State during the 2024 session in the wake of a long-term care summit in February that CSG participated in.
This meeting of the Network looks at multisector plans for aging (MPA), which many states have explored in recent years to engage in cross-sector strategic planning to help them better coordinate long-term services and supports. Presenters included Carrie Graham, Ph.D., director of aging and disability policy at the Center for Health Care Strategies, which has offered guidance to states as part of MPA learning collaboratives. Also joining the conversation are Kevin Hancock, who has led the MPA process in Pennsylvania, and Rob Ence, who has led the process in Utah. A recent long-term care summit in Honolulu is also highlighted.
During this Network meeting, attendees heard about the work of the Moving Forward Nursing Home Quality Coalition, which focuses on advancing seven goals outlined in a 2022 report from the National Academies of Sciences, Engineering and Medicine (NASEM). Joining the conversation were Coalition Chair Alice Bonner, Jasmine Travers of the New York University College of Nursing, who co-chairs the Coalition’s workforce-focused committee, and Jenna Kellerman, director of workforce strategy and development at LeadingAge.
During this meeting of the Network, the dementia care workforce was the focus. Featured experts included Diane Ty, Senior Director of the Center for the Future of Aging at the Milken Institute, which has issued recent reports on building the dementia workforce and system capacity, the projected prevalence and cost of dementia, and the roadmap for investment in dementia care. Also, Andrew Ross, Director for State Affairs at the Alzheimer’s Association, discussed the association’s policy agenda and how states have addressed dementia care in recent years.
During this meeting of the Network, the nursing home clinician workforce shortage was the focus. Presenters included leaders of AMDA, the Society for Post-Acute and Long-Term Care Medicine, the medical specialty society that represents over 50,000 medical directors, physicians, nurse practitioners, physician assistants and other practitioners working in various post-acute and long-term care settings.
During this meeting of the Network, shortages in the home care workforce were the focus. Presenters included Dr. Rachel Werner, MD, PhD, Executive Director of the Leonard Davis Institute of Health Economics and a professor of health care management and economics and medicine at the University of Pennsylvania. She co-authored a recent article in the journal Health Affairs entitled “The Home Care Workforce Has Not Kept Pace With Growth in Home and Community-Based Services.” The Home Care Association of America is among the organizations working on policy solutions to address “The Home Care Workforce Crisis,” as a recent report describes the challenge. CEO Vicki Hoak joined the conversation as did April Young, senior director of strategic affairs at ADvancing States, the organization that represents the nation’s 56 state and territorial agencies on aging and disabilities and long-term services and supports directors.
During this meeting of the Network, building career pathways in long-term care was the focus. Among the presenters were Amy Robins, Director of Advocacy at PHI, the nation’s leading authority on the direct care workforce, which works to promote quality direct care jobs as the foundation for quality care. This meeting also highlighted the progress being made in Hawaii to support the development of career pathways.
This meeting of the Network was a follow up to the August discussion on building career pathways. Among the presenters were Natasha Bryant, Senior Director of Workforce Research & Development in the Washington, DC office of the LeadingAge LTSS Center @UMass Boston and Kevin Coughlin, Policy Initiative Advisor – Executive at the Wisconsin Division of Medicaid Services. Also, Elizabeth (Betsy) White, APRN, PhD, Assistant Professor of Health Services, Policy, and Practice at the Brown University School of Public Health and a member of the Moving Forward Coalition’s Workforce-Focused Committee discussed the Coalition’s action plan to expand career pathways for certified nursing assistants.
This meeting of the Network highlighted workforce development initiatives in three states: Arizona, Indiana and Tennessee. Among the presenters were Bill Kennard, administrator of the Office of Health Care Workforce Development at the Arizona Health Care Cost Containment System, Peggy Welch, chief advocacy officer at the Indiana Family and Social Services Administration, and Anna Lea Cothron, system transformation director at the Division of TennCare (Tennessee’s Medicaid program).
This meeting of the Network highlighted the workforce needs of long-term and post-acute care facilities and initiatives they have in the works to address them, including career pathways for certified nursing assistants, efforts to bolster the ranks of nursing home administrators, and strategies to incentivize youth to go into long-term care professions. Presenters included officials from three state affiliates of the American Health Care Association and National Center for Assisted Living (AHCA/NCAL); Claire Enright of the California Association of Health Facilities, Kristen Knapp of the Florida Health Care Association, and Nicole Mattson of Care Providers of Minnesota. Plus, NCAL Executive Director LaShuan Bethea and AHCA/NCAL Associate VP for Member Services and Government Relations Dana Ritchie joined the conversation to talk about the national policy agenda and other state workforce initiatives among their members.
