With California’s population aging rapidly—and the number of seniors over age 65 expected to rise to 8.6 million people in the next ten years—the Newsom Administration is poised to unveil a new, comprehensive Master Plan for Aging in January. The plan will outline a long-term strategy for helping the state’s growing numbers of older adults age with dignity in engaged communities, while also receiving appropriate and timely care.
The Master Plan stakeholder recommendations and the California Future Health Workforce Commission’s final 2019 report emphasized the need to strengthen the health workforce in order to support the state’s aging population—from addressing staffing shortfalls in skilled nursing facilities to closing gaps of at least 600,000 homecare workers. In a December 17 webinar, the Commission brought together leading experts who participated in both of these efforts to discuss key next steps for building the health workforce older Californians need.
“There is critical work to be done, and it’s not going to be accomplished simply by growing the number of workers, even if we could do that,” said Heather Young, professor and founding dean emerita of the Betty Irene Moore School of Nursing at the University of California Davis, who moderated the discussion. “It’s going to require system redesign as well as a shift in our values to support this vital workforce.”
Among the critical next steps discussed were investing in a broader workforce pipeline that includes a diversity of specialists who can provide the team-based care older Californians need—from doctors, nurses, and NPs to community health workers, health promotores, social workers, gerontologists, and many others. To get this workforce in place, panelists noted the need to take immediate steps to improve workforce training, update regulations to allow existing workers to do their jobs more effectively, and create new incentives to ensure the workforce can provide the care millions of older Californians will depend on.
Several additional high-priority ideas included:
- Skilled nursing facilities: COVID-19 has exposed the need for significant new training requirements for nursing home directors, as well as living wage pay and benefits for direct-care workers—many of whom take on multiple jobs to earn a livable wage, increasing the risk of infection for themselves and residents. “It’s going to cost some money, but we need to do it to save lives,” said Christopher Langston, president and CEO of the Archstone Foundation. (The panel also discussed a recent CHCF report highlighting key factors behind COVID-19 outbreaks in skilled nursing facilities, as well as detailed recommendations for addressing staffing and other issues.)
- Telehealth: “I think the state has to say ‘telehealth is with us,’ and it’s an important way for older people to get primary care,” said Marty Lynch, CEO emeritus of the Lifelong Medical Care and the Over 60 Health Center: “The flexibilities we’ve seen [during COVID-19] are going to need to exist into the future”—especially when it comes to Medicaid and Medicare financing.
- Home-based, long-term care: Three out of four seniors say they would prefer to age in place, but the state is facing huge shortfalls of homecare workers—highlighting the need to revisit once again the Commission’s proposal to create a “universal home care worker” family of jobs, career ladders, and associated training. “I think this needs to happen for people who are living in their home and want to have support,” said Joanne Spetz, associate director for research at the UCSF Healthforce Center: “We need to think about the training workers need and the delegation authority…That report is now more than a year old, and we still have an opportunity to move those ideas forward.”
- Recording: A recording of the session can be found here.
- Master Plan for Aging – Stakeholder Advisory Committee report: The final 2020 policy recommendations from stakeholders advising the Newsom Administration on the Master Plan are here.
- CHCF report – Skilled nursing facilities: The new report by CHCF, Factors Driving COVID-19 Cases and Deaths in California Nursing Homes, is available here.
- Full Commission Report: The 2019 Future Health Workforce Commission report is here.
- Heather M. Young, PhD, RN, FAAN, Professor and Founding Dean Emerita, Betty Irene Moore School of Nursing, University of California Davis; former California Future Health Workforce Commissioner; Member, California Master Plan for Aging Stakeholder Advisory Committee (Moderator)
- Christopher A. Langston, Ph.D., President and CEO, Archstone Foundation
- Marty Lynch, Ph.D., MPA, CEO Emeritus, Lifelong Medical Care and the Over 60 Health Center; Member, California Master Plan for Aging Stakeholder Advisory Committee
- Joanne Spetz, Ph.D., Director, Philip R. Lee Institute for Health Policy Studies; Associate Director for Research, Healthforce Center at UC San Francisco; Advisor, California Future Health Workforce Commission