State legislators need to work across committee lines to strengthen the LTSS workforce.
A few months ago, I walked into a regional meeting of state lawmakers expecting to talk about the need to strengthen the workforce that provides long-term services and supports (LTSS) to a growing number of older Americans.
Within minutes after my introduction, I came to a conclusion that all public speakers fear.
The presentation I had prepared was quickly falling flat on its face.
I was addressing lawmakers serving on the education committees of their respective state legislatures. Many of my listeners were retired teachers. All were fully committed to providing the best education possible to the young people living in their states.
So why weren’t they connecting with me and my message about the pressing need to encourage and train young people to join the LTSS workforce?
I decided to stop my presentation in its tracks and find out what my audience was thinking.
TROUBLE CONNECTING THE DOTS
It turns out that the legislators in the room couldn’t quite understand how their work intersected with my message about workforce development. They had trouble connecting the dots between what they were doing in public education and the stark realities that I was sharing about the future, namely that:
- The population of every one of their states is aging.
- The growing older population will soon create an unprecedented demand for high-quality long-term services and supports.
- Meeting that demand will require a large cadre of well-trained individuals, including direct caregivers, clinicians, managers, and C-suite executives. Right now, all of these individuals are in desperately short supply.
- States have a critical role to play in helping us meet the coming demand for services and avert a workforce crisis.
After a refreshingly honest interchange with my audience, I came to understand that legislators are very excited about the STEM approach to public education, which focuses on training students to enter the fields of science, technology, engineering, and mathematics.
Legislators are less convinced that their education committees should be launching initiatives to train young people for caregiving jobs that they perceive to be less valuable.
I fully support STEM as a way to ensure that students interested in math and science have every opportunity to excel. But I urged the state legislators to make room on their education agendas for initiatives that give students who aren’t interested in pursuing STEM studies the opportunity to train for and succeed at other jobs that will soon be in high demand nationwide.
I put LTSS jobs at the top of that list.
THE BENEFITS OF PROMOTING LTSS JOBS
I tried to convince the legislators that their states would accrue many benefits if they took steps to create new jobs and career paths in the LTSS field, if they strengthened that field by making sure the LTSS workforce is well trained and well compensated, and if they worked hard to get young people to view our field as a respected career opportunity.
I told them that creating a robust LTSS workforce would position their states to serve the needs of their older citizens and to produce higher quality outcomes.
I suggested that they could also use workforce development initiatives to ensure that Medicaid dollars, which make up a growing percentage of state budgets, were wisely spent.
Finally, I urged them to consider the possibility that a statewide LTSS workforce initiative would create new jobs and new opportunities for young people living in at-risk communities characterized by high rates of unemployment or underemployment. All those new jobs would strengthen local economies in need of a boost.
I think I won over a few converts.
NO COMMITTEE IS AN ISLAND
To be fair, my workforce agenda is far too ambitious for education committees to tackle alone. And that’s the most important lesson I learned from the legislators with whom I met.
In order to move our workforce agenda forward at the state level, we need support and creative ideas from legislators who are responsible for a wide variety of committees and who can bring their unique perspectives, and a distinct set of tools, to the task of managing our coming demographic shift. For example:
- Aging committees should be focusing on designing innovative ways for states to meet the growing need for services and supports among older people.
- Education committees could tackle the challenge of attracting young people to the LTSS field, providing the robust training programs they will need to succeed, and supporting higher education to produce the faculty needed to develop curricula and to teach.
- Appropriations committees need to ensure that their Medicaid budgets are used to pay a living wage to a highly trained workforce.
- Economic development committees can surely find ways to turn the high demand for services and supports into an economic engine for local communities.
Health committees must ensure that any initiative to reform the care delivery system is accompanied by proposals to build a robust LTSS workforce to carry out those initiatives.
SEEING THE BIG PICTURE
We need to get away from the tendency to assume, as we have wrongfully assumed in Washington for many years, that legislative committees are only responsible for the issues that are listed in their names.
On the contrary, the chief job of committee members should be to ask themselves and each other, on a regular basis, how the issues before them are connected to other issues in other sectors of our society. Because, more often than not, those issues are connected.
In short, legislators have to start seeing the big picture when it comes to big issues like the aging of our society. That may require more work, and it may take more time, but it’s the only way to make policy.
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.