It’s autumn. National, state and local elections are looming, and Congress has a brief period to consider and enact priority spending and policy measures before the 118th legislative session wraps. Eldercare operators, policy experts and advocacy organizations like ours are closely monitoring legislation that aims to block the Biden Administration’s final rule on nursing home workforce standards.

We support the implementation of national safe staffing standards and are pleased to see that the first phase of the final rule, which calls for improvements in Facility Assessments, is proceeding.

Looking to 2025, we call on the next administration to make further investments in staffing — by taking steps to facilitate widespread initial training and to accelerate the deployment of a larger, better-compensated workforce of CNAs and other types of direct care professionals working in residential facilities and providing services in private homes and a range of community settings.

Why is this important, and why now? The answer is that, along with most other developed nations (and many developing countries), we are living in a longevity era when most people can look forward to reaching age 65 and beyond. Older adults can be invited and encouraged to continue contributing to their local community and to society more broadly — which means pushing back on ageism. 

And just as when the large cohort of baby boomers was young and the country invested in hospitals and schools, libraries, playgrounds and sports, living longer lives now means engineering easy access to a workforce that specializes in delivering high-quality supports and services. These are among the necessary shifts we’ll be making collectively to create a high-functioning, productive longevity economy. Nursing home operators have a role — and a stake — in this. 

Now is the time to put aside shortsighted arguments that “no one wants direct care jobs” and the pretense that nurse aides have no more skills than individuals stacking boxes or flipping burgers. Rather than promoting (or passively acquiescing to) widespread perceptions that working as a nurse aide is a “dead-end job,” it’s time to flip that script by redefining the profession as offering a clear upward career trajectory that empowers individuals providing the services. 

In the next administration, let’s work together to green-light rapid expansion of the direct care workforce by:

  • Defining those core competencies that are common to direct care professionals, regardless of location, payment source or setting.
  • Developing and making core competency-based training free and available online, featuring subject matter experts and accessible 24/7 to all interested learners across all states.
  • Encouraging states and employers to recognize this training as being valid for direct care professionals moving from one setting to another and across state lines.                            
  • Organizing and utilizing specially trained direct care professionals who can provide in-person demonstrations of core skills, thereby helping to ease a chronic shortage of nurses who are available to do this training, while offering career advancement opportunities for motivated nurses’ aides.

This work, together with a national recruitment campaign, should be high on the next administration’s list of economic development priorities.

Taking care of older adults is deeply honorable work. Positioning the direct care workforce to be a public policy priority is indeed essential for all of us who already are older adults — and for younger people who are counting on living long, rewarding lives.

Anne Montgomery is a leading health services analyst and researcher, specializing in issues affecting older Americans and people with disabilities. She serves as the senior expert on health care policy at the National Committee to Preserve Social Security and Medicare.

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.

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