Health Reform: the View from the Frontline Workforce The Health Workforce Dream Team: Who Will Provide the Care? Alliance for Health Reform Policy Briefing Senate Office Building December 2, 2010 Bob Konrad, PhD. Senior Fellow, Cecil G. Sheps Center for Health Services Research, UNC-CH

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 def inition

Who are Frontline Workers? Key demographics: 80% female 33% minority Aging rapidly Will require million new & replacement workers in 10 yrs.

Health Care Employment Growth

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

The 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