Labor Force Challenges in Social Work

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Labor Force Challenges in Social Work

• 2008 NY-SAAN Northeast Area Aging Network
  Conference
• September 18, 2008

Patricia J. Volland, MSW, MBA SVP for Strategy
and Business Development Director, Social Work
Leadership Institute
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Demographic Overview

• We are in the midst of a demographic revolution
  as the older population grows to represent nearly
  20 of the total population by 2030
• Per capita, older adults use more healthcare
  services and have more complex needs, better
  served by interdisciplinary care models that
  integrate service delivery across settings
• As the older population swells, there will be a
  concomitant growth in the health and social
  service needs of older adults

He et al., US Census Bureau, 2005
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Health and LTC Needs of Older Adults

• About 80 percent of seniors have at least one
  chronic health condition and 50 percent have at
  least two, with hypertension, arthritis and heart
  disease as the most common illnesses
• It is estimated that 6 out of 10 people will need
  long term care sometime during their lifetime
• Home and community based long term care needs may
  include transportation, housing, financial
  management, and functional assistance in addition
  to health needs
• The combined needs of older adults often extend
  beyond institutional care to many types of health
  and social service providers

He et al., US Census Bureau, 2005
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Social Work and The Aging Population

• The Center for Workforce Studies at NASW notes
  that 75 of social workers report that they have
  older adults (55 years and older) in their
  caseloads.  24 of social workers report that
  older adults comprise at least 50 of their
  caseloads.
• 93 of social workers with practice area in aging
  report that clients always or almost always
  present with multiple problems
• Most common presenting problems are psychosocial
  issues, mental illness, chronic disease, physical
  disability, and grief/bereavement issues

NASW Center for Workforce Studies, 2006
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Social Work Settings

• Social workers provide services to older adults
  in
• Hospitals
• Area Agencies on Aging and ADRCs
• Skilled nursing and assisted living facilities
• Adult day centers and senior centers
• Home health agencies
• Adult protective services
• Geriatric care management and case management
  agencies
• Mental health agencies
• Hospice and palliative care

NASW Center for Workforce Studies, 2006
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Skills of Aging-Expert Social Workers
Client-centered assessment intervention
Program development, implementation evaluation
Interdisciplinary and interagency collaboration
Culturally competent, strengths-based practice
Support protection of client self-determination
Support before, during after transitions of care
Social Workers with Aging Expertise Are Uniquely
Prepared to Serve Older Adults and Their
Caregivers
Counseling psychotherapy
Expertise in navigating the continuum of care
Case management care coordination
Enhancement of medication treatment adherence
Mediation crisis intervention
Prevention, assessment treatment of elder abuse
Advocacy for clients and caregivers
Advance Care Planning
NASW, 2008
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Social Work Trends

• Employment of social workers is expected to
  increase by 22 percent during the 2006-16 decade,
  which is much faster than the average for all
  occupations. The growing elderly population and
  the aging baby boom generation will create
  greater demand for health and social services,
  resulting in rapid job growth among gerontology
  social workers.
• Complexity of negotiating multiple service
  systems medical, mental health, home and
  community based services suggests need for
  social workers will continue to increase
  significantly in the future

Bureau of Labor Statistics, 2006
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Bureau of Labor Statistics, 2006
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Social Work Barriers to Training and Education

• Schools often do not always have faculty engaged
  in aging research
• 40 of schools lack faculty in aging
• 80 of BSW programs have no coursework in aging
• 29 of MSW programs offer aging focus
• Programs have limited resources to strengthen
  curriculum with aging content
• Lack of financial incentives such as scholarships
  and loan forgiveness
• Limited institutional resources to sustain
  programmatic efforts once funding streams end

IOM, 2008
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Social Work Barriers to Recruitment and Retention

• Poor financial compensation
• Median salaries for geriatric social workers
  slightly lower than those of all social workers
• Workload and practice environment
• Increased workload but fewer supports in
  providing services
• Limited interaction with other geriatric social
  workers
• Negative stereotypes about aging

NASW Center for Workforce Studies, 2006
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Social Work Workforce Projections

• NIA projected need of 60,000 to 70,000 geriatric
  social workers by 2020
• Estimated number of social workers in long term
  care settings projected to increase from 36,000
  in 2002 to 109,000 by 2050
• Currently less than 4 of social workers
  specialize in aging

NIA, 1987 BLS 2004 IOM 2008
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Social Work Gap between Need and Supply

• According to the Center for Workforce Studies
  research on the social work labor force, the
  supply of professional social workers may not be
  sufficient to meet the demands of aging baby
  boomers.
• NASW Workforce Centers findings revealed that
  the social work labor force is expected to
  decrease in the next two years, with 13 of the
  survey respondents planning to leave their
  current positions.
• The social work labor force is older than most
  professions and occupations. Nearly 30 of social
  workers are over 55 years of age, compared with
  14 of the U.S. civilian labor force.

NASW Center for Workforce Studies, 2006
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An Urgent Need for Growing the Workforce

• Workforce shortages are projected as the older
  population doubles in size, and geriatric
  specialization remains static or is in decline
• Current recruitment and training initiatives have
  been judged inadequate to meet future need,
  although numerous initiatives are underway across
  disciplines and have shown positive results
• Capacity building must target both strength in
  numbers and strength in knowledge, including the
  preparation of geriatric specialists and
  generalists with aging expertise

IOM, 2008
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A Three Pronged Strategy to Build Capacity

• A recent IOM report Retooling for an Aging
  America suggests three areas to address
• Enhance the competence of all individuals in the
  delivery of geriatric care
• Increase the recruitment and retention of
  geriatric specialists and caregivers
• Redesign models of care and broaden provider and
  patient roles to achieve greater flexibility

IOM, 2008
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SWLI and Enhancing Geriatric Competence

• SWLI promotes competency based education for the
  training of aging-expert social workers
• Competency based training and evaluation is a
  foundation of the Hartford Partnership Program
  for Aging Education (HPPAE) model, a nationwide
  initiative that trains social workers to work
  with older adults
• Developed online training course based on
  competencies in partnership with NASW
• Working with AARP/FCA/CSWE to develop
  competencies for social workers and nurses to
  work with informal caregivers
• Developing geriatric competencies to incorporate
  into CSWE EPAS
• Partnering with AGS to develop competencies for
  all health and social service professions as well
  as direct care workforce

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SWLI Initiatives for Recruitment and Retention

• SWLI conducts programs and policies to support
  workforce development
• Hartford Partnership Program for Aging Education
  (HPPAE) recruits and trains next generation of
  social workers specialized in the field of aging
• Addressing lack of data on geriatric workforce
  through its work w/ University at Albany
• Supporting the Boxer Bill supporting
  reimbursement for care coordination under
  Medicare and advocating for legislation on loan
  forgiveness
• Partnering with CalSWEC to support loan
  forgiveness bill in CA

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SWLI and Care Coordination

• SWLI is working to improve models of care on
  state and national level
• Partnering with NYS Department of Health and
  State Office on Aging on blueprint for care
  coordination in NYS
• Convening national group of key experts and
  stakeholders to work together as allies, thought
  partners and policy advocates for care
  coordination
• Pilot program with Stony Brook University to
  place social workers in primary care offices
• Evaluation of Transitions of Care program with
  Rush University Medical Center in Chicago

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Conclusion

• In alignment with IOM recommendations the work of
  SWLI is focused on
• Raising awareness around social work and aging
• Building social work workforce data and
  evidence-based practice
• Recruiting students/future professionals to
  geriatric social work
• Enhancing geriatric competence in education and
  training
• Advocating for policies and programs in support
  of older adults
• Developing new models of care with emphasis on
  care coordination