CHICAGO — The staffing challenges affecting senior living and other long-term care providers has reached “epic proportions,” according to one expert speaking at this week’s 2023 LeadingAge Annual Meeting.
During a workforce policy update, the association’s director of workforce policy, Nicole Howell, laid out several short-term, mid-term and long-term proposals and initiatives the group is targeting to address the challenges.
After surveying existing policy and gathering feedback from stakeholders, Howell said, LeadingAge has created a plan to plant seeds, build relationships and promote ideas addressing people, process and payments.
Supporting staff
The proposed staffing mandate for skilled nursing facilities — which LeadingAge President and CEO Katie Smith Sloan, among others, maintains will affect senior living and other providers along the long-term care continuum — disregarded the contribution and expertise of licensed practical nurses, proving that it is time for the federal government to look at the various levels of care and who is providing it, Howell said.
When it comes to staff, LeadingAge is advocating for a study by the Office of Government Accountability about the scope of practice and role of LPNs and direct care professionals in skilled nursing and home- and community-based services, which often are provided in assisted living communities to Medicaid beneficiaries. Howell said the report would get to the issue of equity.
“I think that this is about acknowledging who in our country is receiving that care, who is giving that care, and the true depth and breadth of their knowledge,” Howell said.
In the midterm, Howell said, the association would like to see the Department of Health and Human Services work with the Department of Education to develop a certification program for direct care workers; it could provide credit for time worked in HCBS and skilled nursing settings. The goal, according to the association, is a national online training platform for direct care professionals.
“We need our federal government to lead in this space and not wait for all of you to take ‘different bites of the apple’ in your respective states,” Howell said, adding that the initiatives would focus on “helping people along the way.”
Another mid-term initiative with LeadingAge’s backing includes career-technical education programs to allow high school students to earn credit for working in HCBS and skilled nursing settings.
Long-term, the association is advocating for requiring accredited nursing programs to highlight HCBS and skilled nursing settings in their curricula and maintain clinical placement agreements with providers in those settings.
“We’re acting as clinical sites. We’re acting as their first way these emerging nurses are learning their skill and their craft, and I think that is an ideal way to retain those folks,” Howell said. “We believe that long-term care and HCBS are prime areas to work. Our career opportunities where you cannot only flourish as a professional but you can engage in deep relationships.”
Shaping the future
Under the payment heading, LeadingAge is promoting an initiative to create tuition and stipend programs for Master of Social Work degree students completing internships with HCBS and skilled nursing programs.
Long term, LeadingAge supports incentive payments to providers offering clinical placements for nursing students.
“If we are really the opening of the funnel to so much of the medical industry, then we are really shaping the future of what’s delivered not only in long-term care and HCBS, but more broadly,” Howell said.
For senior living providers, LeadingAge supports access to low-cost loan programs and other support services for those that want to offer housing to their staff members. Providing staff housing not only improves staff engagement, but also reduces stress, Howell said.
Another workforce initiative LeadingAge is pressing for includes an expedited visa review process by the US Department of State. Howell said that the federal government should prioritize the review process for immigrants who have secured employment in long-term care and HCBS settings.
