Staffing challenges need attention from federal policymakers, industry advocates

Healthcare workforce shortages are at crisis levels and need attention from policymakers, according to senior living advocates.

The US House of Representatives’ 21st Century Long-Term Care Caucus and LeadingAge co-hosted a congressional briefing Wednesday to highlight the long-term care sector’s challenges in recruiting staff, as well as legislative proposals to address workforce issues.

The briefing provided a glimpse into what workforce shortages mean for providers, who discussed their experiences from the affordable senior housing, home health and hospice, and skilled nursing perspectives, LeadingAge Director of Health Legislative Affairs Todd Adams said during the association’s member policy briefing on Wednesday.

Critical workforce issues within long-term care, according to LeadingAge, include offering a living wage, establishing a pipeline of foreign-born workers, expanding direct care workforce training and advancement opportunities through existing federal programs, and enacting “meaningful and equitable” financing.

In a congressional handout, LeadingAge listed several key workforce bills and policies that it supports to address those workforce challenges, including:

• The Supporting Our Direct Care Workforce Act, which would authorize $1 billion in federal funding to support increasing direct care workforce positions and recruit, train and retain workers.
• The Workforce for an Expanding Economy Act, which would establish a new nonimmigrant visa for temporary nonagricultural workers.
• The Better Care Better Jobs Act, which would establish programs and funding for state Medicaid programs to improve home- and community-based services, as well as additional funding for the direct care workforce and an enhanced federal medical assistance percentage to states to achieve certain benchmarks.
• The Expanding Service Coordinators Act, which would provide $100 million each year for five years for multifamily service coordinators at Housing and Urban Development-funded properties.

Tuesday, members of the House Committee on Education and the Workforce also reintroduced the Direct Creation, Advancement and Retention of Employment (CARE) Opportunity Act of 2023. The legislation would invest more than $1.8 billion over five years in training and increasing opportunities for the direct care workforce.

“Our investments in this critical workforce have lagged far behind the rapidly growing need for their services,” Ranking Member Robert “Bobby” Scott (D-VA) said in a statement. “It’s time to address the shortage of care workers and provide them with the resources and support they deserve.”

A policy adviser for Rep. Ann Kuster (D-NH) told McKnight’s Senior Living that the long-term care caucus plans to host another workforce briefing this year to focus on a different perspective. 

Meanwhile, Argentum shared its perspective on the workforce challenges facing the industry in a letter to caucus members, sharing the association’s latest workforce report and pledging to work with the caucus to identify and pass bipartisan legislative solutions.

Policymakers have focused almost exclusively on nurse and physician shortages, ignoring the staffing challenges in long-term care, which have “eclipsed” all other healthcare sectors, Argentum President and CEO James Balda said.

Argentum is leading several efforts to address those issues, including the Healthcare Apprenticeship Expansion Program, a four-year US Department of Labor Employment and Training Administration Closing the Skills Gap grant program. Argentum and its partners plan to enroll and support more than 7,200 apprentices by February.

Last year, Congress included report language in the fiscal year 2023 omnibus bill, calling on the Labor Department and Health and Human Services Department to develop the aging services workforce through education, training grant programs and apprenticeship programs. Congress must now better target existing programs by building on that report language, Balda said.

Specifically, Argentum is calling on Congress to fund and re-direct federal workforce training programs, including Job Corps and American Job Centers within the Labor Department’s Employment & Training Administration, to offer specializations in senior living and care. Balda also called for an expansion of apprenticeship opportunities specifically for long-term care, and for the prevention of the expiration of the Closing the Skills Gap apprenticeship program next year.

“Given the scope of the workforce shortage in every segment of our healthcare system, it is my hope that the caucus will continue to further examine the crisis and policies to expand and…