Blog April 13, 2018

Ten Years Later

Ten years ago, the National Academy of Medicine (formerly the Institute for Medicine) released Retooling for an Aging America – Building the Health Care Workforce. This seminal report laid out the tremendous challenges inherent in preparing the health care workforce to meet the needs of older Americans. While we still have a lot of work to do, the last decade has seen some important strides forward in improving the workforce.

This blog launches a yearlong series of posts about the work of the Eldercare Workforce Alliance (EWA) focused on advancing innovative solutions to preparing the healthcare workforce to care for older Americans. The EWA team has lined up an outstanding group of member contributors who will focus on specific ways we have moved this agenda forward. We invite you to join our discussion as we look to revisit past successes and celebrate the future. We are so pleased with the progress that EWA has made in improving care for us all as we age — #TogetherWeCare.

Formation of the Eldercare Workforce Alliance
To address the recommendations in the Retooling report, the John A. Hartford Foundation (JAHF) and Atlantic Philanthropies (AP) provided funding to support development of a diverse coalition of stakeholders, which resulted in the founding of the Eldercare Workforce Alliance (EWA) in 2008. As conceived by the groups that would go on to become members, EWA would serve as a voice for the eldercare workforce. EWA members identified the need to bring diverse stakeholders to the table and, to this day, organizations representing consumers, caregivers, health care professionals, providers and direct care workers have been members of EWA. EWA is the singular voice speaking on behalf of the entire workforce that cares for older people. Members are focused on how to improve the capacity of the healthcare workforce to support quality of life and independence for older Americans.

Over the next year, EWA will be celebrating the progress that we have made in achieving the recommendations set forth by NAM in 2008. As co-conveners, we want to highlight a few of our achievements in this post.

FLSA Protection for Home Care Workers
As EWA was in its formative stages, the Department of Labor was focused on revising regulations under the Fair Labor and Standards Act (FLSA) that defined home care workers as companions, which meant that they were not protected by FLSA standards regarding minimum wage and overtime protection. EWA members, many of whom had not focused on these policies, quickly came to consensus that EWA should support extension of minimum wage and overtime protection to homecare workers. We joined others in advocating for this protection and also in submitting comments to the Department of Labor on the importance of this workforce to the care of older Americans. We were delighted when the revised rule was implemented by the Department of Labor in 2015 (after a protracted legal battle).

Title VII and VIII Geriatrics Health Professions Programs
Since its inception, EWA has been the leading voice advocating for the importance of the Title VII and Title VIII geriatrics health professions programs overseen by the Health Resources and Services Administration (HRSA). Through our advocacy, we have ensured that Geriatrics Health Professions Programs funded under Title VII and VIII—programs like the Geriatrics Workforce Enhancement Program—support the development of geriatrics competence across the healthcare professions workforce.

Currently, there are 44 Geriatrics Workforce Enhancement Programs (GWEP) in 29 states. The GWEPs provide critical geriatrics training to primary care providers as well as specific education in Alzheimer’s disease and related dementia care for families, caregivers, direct care workers and health professions students, faculty and providers. This innovative program also develops and works with existing community-based services to provide patients, families and their caregivers with the knowledge and skills needed to provide quality care and support.

In 2017, EWA worked with Reps. Schakowsky (D- IL) and McKinley (R-WV) to introduce bipartisan legislation in the House to authorize and expand the GWEP program as well as reestablish the Geriatric Academic Career Awards (GACA) program. GACAs support the development of academic clinician educators in geriatrics. We are currently working with members of the Senate on introduction of a parallel bill. In addition, we worked with appropriators to secure a $2 million increase in funding for Fiscal Year 2018. We know that, without the support of our broad coalition and coordinated advocacy, geriatrics workforce training could face elimination.

Family Caregivers are Key Members of Care Team
As recommended in Retooling for an Aging America, EWA recognizes the critical role family caregivers play in the care team of older adults. In fact, national caregiver organizations participate alongside workforce associations as member of EWA to provide critical input on family caregiving. A family-centered health care delivery system that addresses the needs of family caregivers and integrates their role in the health care team is vital to supporting family caregivers. We support caregiver training, respite and recognition as part of the care team. EWA worked with its members to successfully advocate for the RAISE Family Caregiving Act to develop and sustain a national plan to support family caregivers. We will continue to provide input as the national plan is developed over the next three years.

EWA Issue Brief- Family Caregivers: The Backbone of Our Eldercare System


Looking Ahead
As we look forward to the next decade, we know that we will need to continue our focus on developing a healthcare workforce that is prepared to care for older adults. We are excited about the work that our fearless EWA staff, Amy York and Brett McReynolds, are spearheading and the connections they are building with the Health in Aging Policy Fellowship Program. That connection, through the work of Amanda Borer, is leading to the development of state-based coalitions that are focused on building the eldercare workforce. One early product that we want to highlight here is our State Coalition Building Toolkit, which offers a resource for state-based and local champions who seek to build similar collaborations in their communities.

Our Thanks
As EWA co-conveners, we are extraordinarily grateful for the opportunity to work with EWA members on advancing programs and policies that will improve quality of life for us all as we age. We are also grateful to the John A. Hartford Foundation for its continued support of this work, and to Atlantic Philanthropies for its early investments in the Alliance. Without this diverse group of stakeholders and funders, we would not be where we are today. Our thanks to all of you for believing in this work.