Innovations in Workforce Development: A Critical Component of a Public Health Ecology

Innovative efforts in paraprofessional workforce training are fragmented leaving gaps in the public health ecological system between aging individuals and their health care environment. Although individuals are living longer, they are doing so with chronic conditions that increasingly reduce their autonomy in taking care of themselves in their homes. Families provide the most social support in maintaining their continuing to live in their homes, but they are overburdened leaving elders at risk for even poorer health and possible institutionalization. The paraprofessional workforce, or the unlicensed, direct care workers, represent a critical link between unmet social needs of elders and their families through temporary or ongoing assistance with activities of daily living in the community and in institutional long-term care settings. They buttress elders’ increasingly limited autonomy as they cope with their acute and/or chronic medical needs by providing the complementary social care. The Affordable Care Act of 2010 offers provisions for training this paraprofessional workforce that is oft overlooked but a critical part of the integrated health care workforce. The presentation will present and discuss the ACA-related provisions for paraprofessional workforce training and their implementation through innovation grants and demonstration projects in government agencies as well as in community- and institution-based long-term care settings. Despite these innovative efforts, training the paraprofessional workforce needs more systematic co-ordination between integrated health care system efforts and co-operation from licensed health care professionals. Modification of existing health care policies or the development of new policies have the potential to stabilize those aspects of the public health ecological system serving vulnerable elders and their families’ long-term medical and social needs.