“Time waits for no man. The issues of the aging are the issues of us all.”
On Thursday morning, March 9, Dr. Hannah Maxey, associate professor of family medicine and director of the Bowen Center for Health Workforce Research and Policy at the IU School of Medicine, opened with those words during her expert testimony before a U.S. Senate Special Committee on Aging hearing.
Maxey, a nationally recognized expert in health workforce policy with more than two decades of experience in health care and public health, appeared on Capitol Hill to share with committee members how several proactive U.S. states, including Indiana, are strategically working to build a reliable and sustainable home- and community-based services (HCBS) workforce and ensure their aging citizens and those with disabilities are able to receive quality care in their homes or other community settings.
In his opening remarks, U.S. Sen. Bob Casey (D-PA), chairman of the U.S. Senate Special Committee on Aging, underscored the nation’s “caregiving crisis.” He cited statistics indicating that nearly two-thirds of home-care providers have discontinued programs and services because of staffing shortages and that 92% of service providers struggle to meet quality-of-care standards. Casey added that the average salary of an in-home caregiver is just $19,000 a year, making it extremely difficult for those workers to provide for their own families.
After being introduced by Mike Braun, Indiana’s junior U.S. senator and newly ranking special committee member, Maxey, who serves as an expert consultant to the National Governor’s Association, outlined some of the targeted policies and programming that Indiana and other states are developing and implementing to support its HCBS workforce now and into the future. These strategies include actions to catalyze standardized workforce development and training and enhance worker wages and benefits without adding to states’ economic challenges.
As Maxey explained, a large segment of HCBS workers qualify for and receive some form of public assistance, such as Medicaid or the Supplemental Nutrition Assistance Program (SNAP). Strategies which increase wages to just over the qualification levels for public assistance can suddenly and negatively impact overall income—this is commonly referred to as the “benefits cliff.”
Maxey also discussed how some states are working to create registries of credentialed employees that enable workers to demonstrate their skills to new employers and identify and pursue professional growth opportunities.
“Portable credentials empower workers by demonstrating their performance achievements and facilitating their pursuit of economic opportunity among new employers, in new settings or through additional academic training and staffable credentials,” Maxey said, adding that “empowered workers power our economy.”
These same registries, when coupled with effective patient safety incident reporting, can also be used to protect aging members of the public from hiring “bad actors,” Maxey said.
As she explained to committee members, Maxey provided research support to the Indiana Direct Service Workforce Plan, which is guiding Indiana’s leading efforts to enhance access to HCBS services and improve the recruitment, training, support and retention of direct service workers in home- and community-based settings. That research was conducted at the Bowen Center for Health Workforce Research and Policy, which aims to improve population health by analyzing complex health workforce issues and informing related policy and programming.
“I’m humbled and honored to be able to represent Indiana University and represent the research we’re doing in this space,” Maxey said on the eve of her testimony as she took her son, Sebastian, on a quick tour of the National Mall. “I’m especially grateful that members of the U.S. Senate are prioritizing understanding what’s going on here in Indiana and within our states and the programs they’re designing and implementing. It’s critically important for federal legislators to keep a finger on the pulse of what’s going on in our states and ensure that the federal policies that they’re supporting align with state-based solutions.”
Click below to watch the hearing.