Health Reform: the View from the Frontline

WorkforceThe Health Workforce Dream Team:

Who Will Provide the Care?

Alliance for Health Reform Policy BriefingSenate Office Building

December 2, 2010

Bob Konrad, PhD. Senior Fellow, Cecil G. Sheps Center for Health

Services Research, UNC-CH

Who are Frontline Workers?Who are Frontline Workers?

32 unique occupations* with these characteristics:

•High level of direct care/service, •Median annual wage under $40,000•Required educational training: BA or less•Minimal training, unclear career paths•(Bottom) half of all health care workers

*RWJF definition

Who are Frontline Workers?Who are Frontline Workers?

Key demographics:• 80% female• 33% minority • Aging rapidly

Will require 10-12 million new & replacement workers in 10 yrs.

Health Care Employment Growth

2008-2018

Expected Demand forDirect Care Workers

Key Provisions in ACA: Key Provisions in ACA: Direct Care Workers

• PHCAST grants (6 states awards)• Enhanced training through

college/employer partnerships.• Demonstrations to engage TANF

recipients in careers• Personal Care Workforce

Advisory Panel: already appointed

Key Provisions in ACA: Key Provisions in ACA: Public Health Workers

• Loan Repayment Program– 3 yr service obligations

• Scholarships and Mid Career awards public and allied health– State/Local Health Departments– Perhaps an expanded definition of

“allied health”

• Community Health Workers– Fed guidelines for training and

supervision

Key Provisions in ACA: Key Provisions in ACA: Mental/Behavioral Hlth

• Training Grants– Focus on underserved

populations/ youth and adolescents

– Special focus on HBCUs– Specific authorization for

paraprofessionals

Key Provisions in ACAKey Provisions in ACA

The promise of health insurance for nearly a million low income health care workers who currently are uninsured or underinsured!

The States’ RoleThe States’ Role

It is up to states to :• Watch closely and comment during the

rulemaking process• Use available federal resources for better

data about their local needs• Partner with local and national

foundations to leverage resources, e.g. RWJF Jobs to Careers

• Capitalize on the grant and demonstration funds to shape their workforces to fit their needs

• Thanks to– PHI– Robert Wood Johnson Foundation