Home-Based Care Stakeholders Echo US Surgeon General’s Health Care Workforce Shortage Concerns

Home-based care stakeholders agree with the U.S. Surgeon General Dr. Vivek Murthy that burnout among the nation’s health care staff could lead to an even more severe worker shortage.

The ongoing staffing crisis in home-based care and other health care sectors was the topic of discussion this week as Vice President Kamala Harris visited the Children’s National Hospital in Washington with Murthy on Monday.

Murthy issued a report that projected a shortage of 3 million “essential low-wage health workers” in the next five years and nearly 140,000 doctors by 2033, according to the Associated Press.

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On Thursday, the same shortage was the topic of the home-focused virtual panel hosted by the advocacy organization LeadingAge.

“LeadingAge members see the reality of that burnout every day,” Katie Smith Sloan, president and CEO of LeadingAge, said during the panel discussion Thursday. “We agree with Dr. Murthy that far more than gratitude is needed. This isn’t just on the shoulders of CMS or HHS. We need an all-government approach. There’s a tremendous need for more — not less — investment in the aging services sector with a specific focus on our critical workforce, because without staff, there is no care.”

When considering the access barriers older Americans face when wanting to age in place, the current workforce shortage is one of the main contributors.

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“We can only provide the services and the care that we focus on in our field to older Americans if we have the workforce to support it,” Jenna Kellerman, director of workforce strategy and development for LeadingAge, also said. “If people aren’t even aware of jobs in our field or the type of work that we do, then it’s really hard to recruit people to become professionals in our field.”

Kellerman said exposure to the home-based care field is a first step in improving the labor landscape. One of the newer programs LeadingAge has implemented in the past six months is its “Opening Doors to Aging Services” initiative, which introduces home-based care careers to communities at an earlier stage.

“When you ask kids what they want to be when they grow up, they don’t say they want to work in nursing homes or work with grandmas and grandpas,” Kellerman said. “Campaigns like Opening Doors are so important because it brings awareness to our field. If people don’t see us in the community, they’re not going to think of us as a career option.”

Kellerman said the industry has been missing the mark on letting people know there are also jobs in accounting, environmental services, housekeeping, administration and culinary work all under the home-based care umbrella.

Other than awareness, policy is an obvious hurdle to climb when it comes to staffing, though the two can go hand in hand.

“We’ve always struggled with paying a living wage in our field,” Kellerman said. “That’s a systemic issue we’ve had and we’ll continue to have a transient workforce if we can’t get reimbursement rates that keep our caregivers from living in poverty.”

LeadingAge’s leaders have continued to fight for policy that would enhance the lives of a home-based care employees. Mollie Gurian, vice president of home- and community-based services policy, said the organization has continued to advocate for more Medicaid funding through the Better Care Better Jobs act, some of which made it into the Build Back Better bill.

That bill, however, did not come to fruition as intended.

“That bill included money to increase access to Medicaid for home- and community-based services, which would include access for the Medicaid portion of the PACE program, adult day and other home- and community-based services that our members need,” Gurian said.

Funding, Sloan said, is critical.

“It is absolutely fundamental,” she said. “It’s a big part of the solution. We also just need more people working in our sector. We’ve got to find new ways to expand the pipeline of potential caregiving professionals.”

At the hospital visit in Washington, the Biden administration reiterated the calls for more investment into the workforce.

“Unfortunately, there isn’t a silver bullet of any kind,” Kellerman said. “There’s no one solution. Recruitment, retention, training, organizational culture, diversity, equity and inclusion. These are all things that need focus. There’s not one thing that’s honestly more important than the other. They all need to be addressed in parallel. Many hands make light work.”

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