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We’re all aging. This Labor Day, let’s remember: without workers, there is no care.

Labor Day is a unique celebration, a holiday conceived nearly 130 years ago by the very people it is intended to celebrate: workers. The holiday’s history speaks to me this year, in particular, as Congress reconvenes after the August passage of the Inflation Reduction Act (IRA). While a landmark piece of legislation in many ways, the IRA sadly does not address the needs of a critical part of the country’s workforce: the direct caregiving professionals who serve America’s rapidly expanding older adult population. 

Two years ago, these caregivers were heralded as heroes who deserved protection. And the older adults in their care were the focus of well-deserved concern. Now? COVID-19 has ravaged the aging services workforce. According to the U.S. Bureau of Labor Statistics, 229,000 professional caregivers have left the aging services sector since February 2020. As a result, older adults and families are struggling to get the care they need as nursing homes close and reduce admissions and home health providers decline service requests. Though N-95s are no longer in short supply today, other resources are, including adequate funding for fair wages, support for workforce training and development, and policymakers’ attention on legislative fixes that will, for instance, help to build a pipeline of domestic and international workers. 

Congress’ failure to act on issues related to older adults is not new: ignoring and underfunding the critical services older adults need to age with dignity has been the norm since my first days on the Hill, working for Sen. Tom Eagleton (D-Mo.). We’ve seen some progress in fits and starts, to address the concerns of adults 65+ — with a lot of effort. The IRA, which gives Medicare the ability to negotiate prices on some prescription drugs, is a clear win for older adults by helping them save millions on out of pocket drug costs that represents, in the words of Johns Hopkins University professor Jeremy Greene, “20 years of work by advocates who have labored to close a loophole in the Medicare Modernization Act of 2003.” 

But here’s the thing: our country cannot wait another 20 years for Congress to provide the support for the workforce to help older adults with bathing, dressing, toileting, medication management, and feeding so they can live with dignity and independence. In fact we can’t wait another minute. America is aging rapidly: about 16.9 percent of the American population was 65 years old or over in 2020 and is expected to reach 22 percent by 2050. The nation will need to fill 8.2 million direct care jobs in the long-term care sector between 2018 and 2028 as existing workers leave the field or exit the labor force altogether, per researchers at PHI. Action is needed now. 

One leader of a nonprofit provider serving home health care to people in their 80s or 90s explains the situation well: “Demand for care has grown tremendously and continues to as we navigate the pandemic and as our population ages. Labor shortages make it more difficult to hire the people we need to provide the care that’s necessary. We are struggling to piece together care for home care cases because of fierce competition for staff. Wages for home care professionals — aides, physical therapists, social workers, nurses — are tied to reimbursement rates. … The outcome is simple: no staffing, no services — and that will surely lead to a crisis in caring for our nation’s aging population.” From another: “We’ve been making hard decisions for months; we turn away 250 admissions a week because we do not have enough staff.”

Some elected officials understand the urgency. The June debut of the bipartisan 21st Century Long-Term Care Caucus, created to focus on issues related to older adults and aging, is heartening. We urge their House colleagues to join caucus’ founders, Reps. Ann Kuster (D-N.H.) and Bryan Steil (R-Wis.), and lead on proposals that will support our long-term care workforce to make jobs serving older adults respected, sustainable, and desirable. 

This Labor Day, it’s time for all of us — Congress as well as the voting public — to consider how we want all of us to age in this country. Changes to prescription drug pricing are welcome, but not enough. Policymakers can help older adults and families access the care and services they need: just remember the people providing the services. Without them, there is no care. 

Katie Smith Sloan is president and CEO of Washington D.C.-based LeadingAge, the association of nonprofit providers of aging services.

Tags Tom Eagleton

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