1. Tell me about your experience with the Health and Aging Fellowship program.  How did this influence your current work?

The Health and Aging Policy Program was a life changing experience for me.  Not only was I immersed in a new (to me) world of policy that opened so many doors and possibilities, but I was able to focus on one of my passions, the eldercare workforce.  Through the experience we learned about policy, governmental agencies and processes, and connected with government officials and field leaders.  We also collaborated on projects across disciplines and formed life-long relationships with other fellows.
The Fellowship experience has influenced my current work in many ways.  My home organization, Charles House Association, is growing some of our programs based upon connections and ideas gathered during the fellowship.  While we have always been involved in collaborations locally, we are now much more involved at the state level.  We’ve been participating in state coalitions and collaborating with local researchers on new projects.  The fellowship has helped to open these doors by broadening my perspective and giving me the confidence to try new things.

The Fellowship gave me a working understanding of how the different branches of the government work and affect policy.  It also gave me access to field leaders as well as agencies and organizations which then further connected me to those working in the field locally.  The Fellowship also provided an opportunity to see how federal policy trickles down through the state and then affects organizational behavior. Also, having the understanding and even the “practice” of advocating at the federal level prepared me to do the same at a state and local level.  Overall, I am much more knowledgeable and even “involved” in the legislative process than I had been prior to my experience as a Fellow.

2. How did the coalition in North Carolina get started?

I wanted to stay in North Carolina while participating in the Health and Aging Policy Fellowship but also work with the Eldercare Workforce Alliance (EWA) in DC to learn about policy and how to improve the eldercare workforce.  Luckily, EWA had been discussing their role in state advocacy work at the same time.  These two variables provided an opportunity for the formation of the North Carolina Eldercare Workforce Coalition.

When starting at the end of 2016, I began trying to learn and understand the issues.  I read through Retooling for an Aging America, as well as any information I could find on eldercare workforce issues at both the federal and state level.  Because I have worked in eldercare for nearly a decade, I was very familiar with most of the concerns, but less so on what had already been attempted to address the problems.  I then started reaching out to other organizations and state agencies in North Carolina to hear what their biggest eldercare workforce concerns were and let them know about the effort to build a Coalition. Since starting, the Coalition has had over 100 individuals or organizations participate in meetings and formed a steering committee as well as a strategy for regional work in the year(s) ahead.

3. What are some of the major issues you are focused on in the state?

While the Coalition has identified some broad focus areas such as family caregivers, the rural eldercare workforce, and economic development, we have found that many of our issues surround the direct care workforce.  Like many states, there is a shortage of qualified direct care workers in North Carolina.  Our Coalition has been working to address this issue by raising awareness, reviewing training and education requirements, identifying best practices for organizational policy and procedures, and advocating for state policy change.

4. Do you see state coalitions as an important part of the future in advocating for the eldercare workforce?

I believe that state coalitions will serve as a significant mechanism for eldercare workforce improvement.  Our state coalition in North Carolina includes associations, individuals, and organizations that are all very close to the issues making the members subject experts and effective advocates for change.  Finding the solutions to statewide and regional concerns involves knowing the issues at an individual and organizational level which we are more able to do at the state level.

The state coalitions are also able to directly affect the implementation of policy at multiple levels.  They can do this by collaborating to bring awareness to local and state representatives, advocating for change in state regulations, financing state or local projects, and even influencing how the state interprets federal policy.  State coalitions are also able to serve as a resource and sounding board for local and individual organizations, providing guidance for best practices affecting organizational policy.

While the advocacy work at the federal level is paramount, particularly for funding, the state coalition work may have a more direct ability to provide practice change for eldercare workforce improvements. This could become more imperative as we are all trying to “do more, with less.”