Policy Update

Workforce development for aging care professionals gains momentum in California

A recent analysis conducted by SWLI, utilizing data from the Bureau for Labor Statistics and a study by California State University, found that California currently needs between 800 and 1600 social workers who specialize in working with older adults. This number will continue to increase as the population ages. However, California schools of social work graduate fewer that 150 students each year who have specialized in aging. SWLI has partnered with the California Social Work Education Center (CalSWEC) to explore ways to address this issue. SWLI and CalSWEC— the nation's largest state coalition of social work educators and practitioners— are working with staff in California state assembly member Patricia Berg's office to schedule a legislative hearing on the aging workforce crisis, especially as it pertains to the need for more social workers.

SWLI and CalSWEC have also been working with representatives from the California Council on Gerontology and Geriatrics and the California Senior Legislature - a group that annually makes recommendations to the state legislature around issues that affect older adults - to draft legislation aimed at attracting students to geriatric social work. Legislation that aims to reduce the amount of student loan debt held by those who work with older adults has been drafted and is expected to be brought before the state legislature early in 2008. The student loan forgiveness, or repayment, program would provide funds to be used to reduce the student loan debt of social workers, doctors, and nurses who have specialized geriatrics training and work with older adults.

While this legislation is an important first step toward addressing the need for social workers trained to work with older adults, it may not be the best way to attract new practitioners to the field because funds would only be available to those who have already been trained and are working with older adults. Therefore, SWLI and CalSWEC are also exploring ways to attract new social work students to the field of aging, such as scholarships, stipends, or a service payback program that would provide funds to students in exchange for working with older adults upon graduation.

Forty health organizations support the Positive Aging Act of 2007

An estimated 20 percent of older adults living at home have a mental health problem. Depression, a treatable illness, causes many older people to become despondent and attempt suicide. SWLI is among a group of health, mental health, and aging organizations who are petitioning Congress to support the inclusion of the Positive Aging Act of 2007 (S.982) in the bill to reauthorize the Substance Abuse and Mental Health Services Administration. This will improve access to quality mental health care for older adults by supporting the integration of mental health services into primary care and community settings where older adults reside and receive services.

New York State engages key constituencies on care coordination

Care coordination takes many forms in every state across the country, but New York is the first state to engage in a nationwide assessment of successful program elements and a statewide consensus-building process on standards of care coordination. SWLI, in partnership with the New York State Department of Health and the Aging Office, is working to develop standards for comprehensive care coordination to serve as the critical bridge between clients and the multiplicity of available service systems, and as an important tool to help family members think about their future long term care needs. To this end, SWLI is engaging social workers, nurses, doctors, and other service providers in a roundtable discussion about care coordination and its potential role in the New York State long-term care system. The group will review and provide input on a comprehensive report, being prepared by SWLI, and analysis of care coordination models currently in use in New York State and elsewhere, with the aim of building consensus on the key elements of a successful care coordination blueprint for New York State.

Aging Care in the News

Informal caregivers bear heavy financial burden

The nation's first in-depth survey of expenses related to caring for an aging relative found that the average cost per household is $5,500 per year— double previous estimates and more than the average household spends on health care and entertainment combined. As reported by The New York Times on November 19, 2007, in "Study Finds Higher Costs for Caregivers of Elderly," the strain of caring for an aging parent or spouse is much more than emotional and physical— it can average 10 percent of a household's income, forcing caregivers to give up saving for retirement, going on vacation, or even taking care of their own health issues.

Within the next three decades, an unprecedented one in five American will be 65 or older. Thanks to modern medicine and healthier lifestyle habits, more Americans are able to live at home longer, often with help from family and community support networks. But our nation's outdated approach to long-term care, with its narrow focus on institutional care, has yet to catch up with the times. Under the current Medicaid system, funding is mandatory for institutional care for qualifying older adults, but community-based care— including the support provided by family members— is not eligible for compensation.

States that have taken advantage of a federal waiver system that gives them flexibility to funnel public dollars to community-based care are finding that this strategy has public popularity-and saves money. Vermont, for example, has successfully leveraged its waiver authority to reduce the number of older adults in nursing homes by serving them in their homes and communities, which is saving the state a third of what nursing home care would have cost. Last year New York State launched a referral and assistance program that connects older New Yorkers with services in their communities-and that may relieve family caregivers of some of their psychological and financial burdens.

With enough consumer pressure, compensation for community-based care should make policymakers, including presidential hopefuls in the 2008 elections, take notice.

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