By Robyn Stone
We must reform our system of long-term services and supports to ensure equal access and equal opportunity for all.
Hugo Pizarro, senior vice president at ArchCare in New York, could not have chosen a better way to start off last week’s Virtual Summit on Mitigating Racial Inequities in Post-Acute & Long-Term Care.
The 3-day summit, sponsored by the Advancing Excellence in Long-Term Care Collaborative, brought together a variety of stakeholders—including residents, families, and staff—to shed light on the persistent racial inequalities that exist in the field of long-term services and supports (LTSS).
Pizarro made 3 points that are worth remembering:
- Any action to address racial disparities in the LTSS field starts with the daily actions of organizational leaders.
- Those leaders must address the racial disparities that exist both inside and outside their organizations.
- Barriers to racial justice exist within ourselves and within our teams. It’s our job as leaders to identify those barriers and take action to eliminate them.
Notice the focus on action. It’s not enough to play lip service to the Black Lives Matter movement, to bemoan the racial and ethnic inequities in our nation, or to simply wish our organizations were more diverse and inclusive than they are.
LOOKING IN THE MIRROR
Only deliberate action will help us erase the inequalities that people of color in this nation have lived with for too long. And that action must start with an acknowledgement that our LTSS sector is a microcosm of the systemic racism that plagues our nation.
It’s a painful admission—but an essential one, according to Dr. Freeman A. Hrabowski, president of the University of Maryland, Baltimore County. During his summit keynote, Hrabowski insisted that empowered organizations must always be looking in the mirror to understand what they have done well, and where problems exist.
His conclusion: every organization that is honest with itself will recognize it has problems with discrimination and prejudice based on race and ethnicity.
We need look no further than the LTSS frontline workforce to see the problems Hrabowski is talking about. Consider these painful truths:
Half of our professional caregivers are nonwhite. And yet, as Kendal Corporation Chief Operating Officer Marvell Adams pointed out during the summit, the leaders of our organizations are predominately white.
Our diverse workforce of certified nursing assistants and home health aides provides 80% of all the care our residents and clients receive, and each year we ask them to perform increasingly complex care tasks. Yet, many of these caregivers live on very low incomes, and an alarming percentage rely on government assistance to make ends meet.
This situation keeps our frontline caregivers in a subservient position in our organizations, leading many workers to tell me over the years that they feel as if they are working “on the plantation.”
HOW DO WE CHANGE THINGS?
How can we ensure equal access and equal opportunity in the LTSS sector? The first step entails following the advice of Pizarro and Hrabowski: Look in the mirror and acknowledge the presence of racial disparities in our organizations, recognize our own biases, and understand how those biases influence who we hire, support, mentor, and nurture.
With this new self-awareness, we can then take deliberate action to:
- Change the racial imbalances that exist in our organizations by making our upper-level and mid-level management teams, and our boards of directors, as diverse as our frontline teams.
- Recognize, nurture, and reward talented professionals of color who are already working at all levels of our organizations, and offer them pathways to meaningful careers.
- Work closely with community colleges and professional schools to identify, attract, and prepare people of color for management positions in our field.
- Offer meaningful internships and build a community of mentors that can introduce people of color to our field and offer them an equal opportunity to succeed. LeadingAge is working on several initiatives, including our Summer Enrichment Program, to advance these goals.
- Empower our frontline care professionals by allowing them to participate more fully in directing the work we do, and monetizing their valued work with good wages and benefits.
We cannot view this work as a burden. Instead, we must see it as an incredible opportunity to be leaders in a historic effort to turn systemic racism on its head. Our organizations must embrace the opportunity to become shining examples of diversity and inclusion that our colleagues will notice and imitate.
By seizing these opportunities, we will improve our society and our field, create healthier workplaces, and achieve better quality outcomes. Make no mistake about it. When LTSS organizations take on systemic racism, everyone wins—residents, families, team members at all levels, our organizations, and the communities in which they operate.
Robyn I. Stone, DrPH, is senior vice president of research at LeadingAge, and co-director of the LeadingAge LTSS Center @UMass Boston. Her widely published work addresses long-term care policy and quality, chronic care for people with disabilities, the aging services workforce, affordable senior housing, and family caregiving.