Recommendations to build Ohio's direct service workforce
Developing educational and training opportunities across settings
Ohio is facing a growing challenge: How best to provide needed long-term services and supports to a growing population of Ohioans. The number of Ohioans of all ages who will need long-term services and supports will increase by 14 percent between now and 2020 - an increase of 43,600 consumers, according to a report from the Scripps Gerontology Center at Miami University.
The Unified Long-Term Care System (ULTCS) Workgroup submitted 26 recommendations to state officials on how Ohio's long-term services and supports system can best meet the needs of its growing population of elders and adults living with disabilities. The Workforce Subcommittee generated several recommendations to address the increased demand for a highly skilled direct service workforce.
The direct services occupations are among the fastest growing jobs in Ohio and currently require little or no classroom training. Direct service workers form the foundation of Ohio's long-term services and supports system. They are the primary providers of paid hands-on assistance with activities of daily living, supervision and emotional support. There are multiple occupational titles, including nurse aides, home health aides, direct support professionals and others, across sectors such as developmental disabilities, aging, physical disabilities and behavioral health. Duties and training vary by setting.
The subcommittee recommended a two-pronged approach to address direct service workforce issues. One focuses on the quality of care and life for individuals of all ages with disabilities, and the other focuses on the economic necessity for the workers and our state.
Policymakers are paying close attention to the training of direct service workers, given the anticipated increase in demand for services and the complex needs of consumers as Ohioans live longer with multiple chronic diseases and recurring conditions. Because of this increasingly diverse and complex work, one of the subcommittee's recommendations focused on creating a flexible education and training system for the workforce.
"Our team realizes the need to address not only the current workforce, but also future workers," said Tiffany Dixon, workforce policy and program administrator at the Ohio Department of Aging, and co-chair of the Workforce Subcommittee. "Technological advancements, like telehealth, are already impacting the nature of direct services jobs."
The subcommittee took a modular approach to the education of workers by identifying core skills across workforce subgroups and acknowledging their differences through specialization. The group proposed identifying courses within Ohio's university system that match these core and specialized skills and creating an infrastructure where workers can easily find courses related to their jobs. Many of these courses will be for credit, and workers will be able to apply their direct service coursework to health and human service degree programs, helping them move into other occupations.
The full text of the report is available on the Ohio Department of Aging website.
Connect to More
Programs & Benefits
A large proportion of Medicaid spending is for dual eligibles
Nearly 8.9 million older Americans and younger persons with disabilities participated in both the Medicare and Medicaid programs in Federal Fiscal Year 2007, says a report by the Kaiser Commission on Medicare and the Uninsured. Although these "dual eligibles" accounted for only 15 percent of Medicaid enrollment in 2007, 39 percent of all Medicaid expenditures for medical services were made on their behalf. These same individuals also account for more than 25 percent of Medicare spending. Nearly one-quarter of Medicaid spending for dual eligibles went toward Medicare premiums, cost-sharing and other Medicare services. Roughly five percent was for acute care services (e.g., dental, vision and hearing services) and another one percent was for prescription drugs. The remaining 70 percent was for long-term care services that are mostly not covered by Medicare or private insurance.
Long-term care financing recommendations provide insights for state governments
Minnesota's non-partisan Citizens League introduced recommendations for financing long-term care for the elderly. The recommendations, while Minnesota-focused, provide insights for all 50 states in how to create new ways to pay for long-term care while preserving a safety net for those who cannot escape poverty. Long-term care is both expensive and likely, yet few people prepare for the cost, leaving government, through Medicaid, as the default funding source. The report, Moving Beyond Medicaid: Long-Term Care for the Elderly as a Life Quality and Fiscal Imperative, includes recommendations such as redesigning Medicaid to provide co-insurance options; promoting a mix of financial products; and making information about long-term care planning and financial options readily available to the general public.