SGS Aging Services Workforce
SGS Aging Services Workforce
Addressing Challenges in the Aging Services Workforce
In 2021, the Southern Gerontological Society conducted the second SGS Priorities Survey regarding aging in the South. Five priority focus areas were identified including the Aging Services Workforce.
If you would like to read more about the SGS Priorities Survey results, please click here.
To further bridge the gap between research and practice, this webpage spotlights best practices in our region that provide real life examples addressing the Aging Services Workforce challenges. If you have a best practice you would like to see highlighted here, please complete our Best Practices/Legislation Submission Form.
Aging Services Workforce Case Studies
The following case studies were submitted from Dr. Jennifer Craft Morgan as part of her extensive work in workforce development. You can contact her for more information at jmorgan39@gsu.edu.
Investing in Frontline Workers
Improving Direct Care Jobs Best Practices
Compassionate Crisis Care for Certified Nursing Assistants
According to the 2022 report of the National Academies, American nursing homes are in crisis and require immediate action. This crisis includes a critical nursing home workforce shortage. This is especially true for certified nursing assistants (CNAs), who provide the vast majority of hands-on care for nursing home residents and are overworked, underpaid and underappreciated during normal circumstances and during pandemics and disasters. This has important implications for resident care, including challenging behaviors due to behavioral and neurological disorders, which are a major cause of staff burnout and a risk factor for abuse and neglect. Among other things, recent data show that staff shortages during COVID-19 contributed to the increased use of pharmacological restraints for challenging behaviors, which is in opposition to the national effort to reduce these restraints in favor of behavioral management techniques. By way of major CDC funding through the Virginia Department of Health, the Eastern Virginia Medical School has developed a program called Compassionate Crisis Care (CCC). Among other things it is designed to empower CNAs during pandemics and disasters, to promote CNA mental wellness, and to reduce CNA burnout and facility abuse and neglect complaints.
Contact Paul Aravich (aravicpf@evms.edu) for more information.
Culture Change Matters
CULTURE CHANGE Matters is a fun and interactive series presenting a clear pathway to develop a deep and pervasive understanding of Person-Centered Care and Culture Change. This is required to deliver and enable quality of life and well-being for the people you serve and for all the staff that care for and about them. These modules were developed by the Culture Change Network of Georgia in collaboration with Georgia State University Gerontology Institute. There are three courses. Onboarding with CULTURE CHANGE Matters is for all new staff who join an organization and need to become familiar with this content “on day one.” CULTURE CHANGE Matters for Direct Care & Support Associates is designed for everyone who comes into contact with residents and interacts with them. This is literally ALL STAFF. CULTURE CHANGE Matters for Supervisory Staff is designed for Senior Management, Supervisors, Managers, and Facilitators from every department and service area.
Contact info@culturechangega.org for more information.
Direct Care Workforce Innovation Program
In 2021, the Maryland General Assembly passed “Labor and Employment – Direct Care Workforce Innovation Program,” which established the Direct Care Workforce Innovation Program. The purpose of the program is to provide matching grants to eligible entities that create and expand upon successful recruitment and retention strategies in an effort to increase the number and availability of direct care workers across Maryland.
Paid Sick Leave
In 2021, Virginia enacted Paid Sick Leave for Home Health Workers, which provides up to 40 hours of paid sick leave per year for direct care workers who provide personal care, respite, or companion services to self-directing consumers under Virginia’s Medicaid state plan.16 Workers may use sick leave to obtain preventative care or to seek a diagnosis or treatment for their own or a family member’s mental or physical illness, injury, or health condition.
Improving the Social Significance of the Workforce Best Practices
The Hearts of Gold Collective
The Hearts of Gold Collective is a photo-narrative art exhibit and website that uplifts the stories and work of home care providers. The result of a yearlong health equity and the arts project, the Hearts of Gold Collective is a poetry group of home care providers. The exhibit has traveled to the Virginia Museum of History and Culture, City Hall in Richmond, Virginia, and the Richmond Memorial Health Foundation, in addition to its online presence. This work has been instrumental in elevating conversations and action regarding living wage, quality training, and supports for the workforce. Additionally, the project addresses the intersection of trauma, racism, and caregiving; provider experiences of death and dying, and peer supports. Hearts of Gold members also serve as trainer-mentors in workforce training programs throughout the state and region. This project was funded in part by the Richmond Memorial Health Foundation and is a partnership between Family Lifeline, a nonprofit home care agency and artists Gigi Amateau and Penelope Carrington.
Contact Gigi Amateau (amateaugg@vcu.edu) for more information.
Increased Compensation Best Practices
In the SGS region, some states have begun increasing the minimum wage for direct care workers. Advocates can use this information to help influence bills in their states. If you know of pending or passed legislation in your state, please complete our Best Practices/Legislation Submission Form.
North Carolina
North Carolina increased the hourly wages for direct care workers to $15 as of March 1, 2022.
Florida
Florida increased the hourly wages of direct care workers in the Florida Medicaid program as of October 1, 2022.
Training/Workforce Development Best Practices
CNA Advancement Initiative
The Jobs to Careers project led by Capital Workforce Partners is called the CNA Advancement Initiative. Through this initiative, frontline workers in the partnering long-term care facilities complete a series of seven clinical courses designed to increase the skills and knowledge necessary to be successful as a CNA in the long-term care sector. Four of the courses, Issues in Aging, Dementia and Alzheimer’s, Rehabilitation, and Hospice and Palliative Care were existing courses that project team members enhanced to be delivered in the work-based learning format. Two additional courses, Mental Health and Substance Abuse, were new courses community college team members worked together to develop. The final course offered by the initiative is Medical Terminology. This report is the culmination of the work of the UNC Evaluation of the Jobs to Careers Initiative at the level of the Capital Workforce Partners grantee partnership.
DSP Apprenticeship Program
The Direct Support Professionals (DSP) Apprenticeship Program is a work-based learning model where individuals are compensated for on-the-job training. Wages increase by $3.50 or more per hour upon completion of this one-year program. Individuals wishing to enter the DSP workforce or those already associated with an employer are eligible to participate. The curriculum for this program is managed by the QuILTSS Institute. This body also manages the credentialing registry and acts as a liaison for community colleges and four-year institutions wishing to train students in direct care work. This public-private partnership includes QuILTSS Institute, Tennessee state government, and UnitedHealthcare Community Plan (Medicaid managed care organization). In this model, trainees may earn up to 18 college credits and a post-secondary long-term care certificate. Offering opportunities to earn additional credits and/or certificates on top of standard training requirements may further entice individuals to enter the field.
Portland Community College Jobs to Careers Training Initiative
The purpose of the training program for this partnership is to train frontline workers using a standardized curriculum and develop a new, industry-recognized, portable credential for workers who successfully complete the curriculum. The curriculum utilized in the training program is based on previous efforts by Portland Community College (PCC) and two of its employer partners to develop skill standards for frontline workers and design a work-based training curriculum through the Assisted Living Facility Training Consortium (ALFC) project in 2003-2005. The Jobs to Careers training program builds on these efforts by implementing standardized training in the five employer facilities and developing certificates for workers through the gerontology department that state they have successfully completed the curriculum. The training is designed primarily for caregiving staff, typically resident assistants and medication aides, though it can be offered to other frontline staff as well. The curriculum focuses on caring for the elderly and comprises a total of 27 modules. These modules include topics such as roles and responsibilities, resident service plans, personal care, self-care, and diabetes care. The curriculum is tiered in that it includes modules for resident assistants as well as additional modules that focus on the training needs of medication aides. Completion of the modules results in either a Resident Assistant I or Resident Assistant II certificate, depending on the number and depth of the modules completed by the participant.
Radford University/Health and Aging Minor
The Health and Aging minor was recently re-envisioned to align with the new undergraduate curriculum (REAL) at Radford University and meet the degree requirements for students across different disciplines. There is an ongoing shortage of professionals who have specialized knowledge and skills to work with older adults. The minor is designed to meet the degree requirements for students in fields that the Virginia Governor's office has identified as in need of qualified professionals such as; nursing, social work, and information technology. The goal of these changes is to reach more students in different areas of study and ultimately meet the growing demand for qualified professionals in this region.
Contact Sarah Rakes (srakes3@radford.edu) for more information.
Trauma-Informed Approaches to Improving Dementia Care in Nursing Homes
Georgia State University’s Gerontology Institute, in partnership with Culture Change Network of Georgia, is working on a three-year project to provide resources and accessible high-quality education to nursing homes in Georgia. The training will emphasize using trauma-informed approaches to improve the quality of life for residents and reducing the use of antipsychotic medications, particularly for residents living with dementia. The free webinars are divided into three categories: Trauma-Informed Care, Person-Centered Dementia Care, and Quality Improvement.
Contact (info@culturechangega.org) for more information.
Additional Resources
There are a number of wonderful resources available that outline the issues facing the Aging Services Workforce and provide recommendations on addressing these challenges. Here are links to some that we recommend:
- A Practical Resource Guide for Direct Care Workforce State Advocacy (PHI)
- Addressing Wages of the Direct Care Workforce Through Medicaid Policies (National Governors Association)
- Caring for the Future: The Power and Potential of America’s Direct Care Workforce (PHI)
- Direct Care Workers in the United States: Key Facts (PHI)
- Direct Care Workforce Policy and Action Guide (Milbank Memorial Fund)
- Feeling Valued Because They Are Valued (LeadingAge)
- Guide to Investing in Frontline Health Care Workers (CareerSTAT)
- Jobs to Careers: Transforming the Front Lines of Health Care – Evaluation Brief: Preliminary Results for Educational Institutions (Jobs to Careers)
- RAISE Act State Policy Roadmap for Family Caregivers: The Direct Care Workforce (NASHP)
- State Policy Strategies for Strengthening the Direct Care Workforce (PHI)
- Workforce: Addressing Today’s Aging Services Challenges (LeadingAge)
What We’re Watching
On April 18, 2023, President Biden signed an Executive Order that included more than 50 directives to nearly every cabinet-level agency to expand access to affordable, high-quality care, and provide support for care workers and family caregivers. We will update this site as we learn more.
Congress ended 2022 by passing an omnibus bill with several key policy items important to older adults, including provisions that will help Americans save for retirement and access mental health care. The bipartisan measure—formally known as the Consolidated Appropriations Act of 2023—includes most of the priorities identified by the Leadership Council of Aging Organizations (LCAO), which NCOA chairs. This article includes some highlights as well as areas that the National Council on Aging will continue their advocacy efforts. Of particular interest to the aging service workforce, are the measures around retirement savings. Read More Here
Thank you to the SGS Priorities Survey Sub-Committee for their work in developing this resource page: Karen Appert, Dr. Kyle Bower, Yun-Zih Chen, Dr. Lee Ann Ferguson, Amanda James, Chanel Reid, Dr. Graham Rowles, and Dr. Abby Schwartz.
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