4 Ways to Prepare for Aging Populations.

AuthorScotti, Samantha

The aging of America will cause a societal metamorphosis. The "oldest old"--those in their 80s and 90s--number 6.4 million today but are projected to surge to nearly 15 million by 2040. Here are four ways state lawmakers can prepare.

1 | Strengthen the Direct Care Workforce

States use various titles for "direct care" workers and often define them in statute. They include personal care aides, home health aides, home care workers, long-term care aides and nursing assistants.

Each profession has a slightly different scope of practice depending on the number of training hours required and varying state regulations. Personal care aides generally assist with social supports and daily activities, while home health aides and nursing assistants may perform certain clinical tasks under the supervision of a licensed professional. Together, these health care professionals play a critical role in helping older adults and people with disabilities remain in their homes and communities; however, they are hard to find and even harder to keep.

Generally, direct care jobs don't pay well and provide few benefits. The turnover rate is high--between 45% and 60%.

Some efforts may also boost the perceived value of direct care jobs, which could improve recruitment and retention rates. Examples of recent state actions:

* Arizona established a state-funded training system following recommendations from the Direct Care Workforce Committee.

* Colorado increased its hourly minimum wage for direct care employees.

* Illinois and Oregon both created training requirements for employees who serve people with Alzheimer's and other dementias.

* Maine and New Mexico created task forces to consider ways to strengthen the direct care workforce.

* Maryland increased the rate of reimbursement for community service providers, including direct care staff.

* Minnesota created a statewide job board that helps consumers and direct care workers find the right fit.

* Oregon, Illinois and Nevada passed "Domestic Workers Bill of Rights" laws, which extend protections against workplace harassment and required overtime.

* Texas' Health and Human Services Commission issued a report required by the legislature to improve recruitment and retention rates among state Medicaid-funded personal care aides.

* Washington expanded learning objectives, increased training hours and introduced certification requirements for personal care aides.

* Wisconsin increased funding for direct care workers' wages...

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