2021-05-05 00:00:00 - Senate Committee on Reimagining Massachusetts Post-Pandemic Resiliency
2021-05-05 00:00:00 - Senate Committee on Reimagining Massachusetts Post-Pandemic Resiliency
SEN HINDS - Good afternoon everybody. My name is Adam Heinz. I'm a state senator for the Berkshire Hampshire franklin hampden district and sharing the new committee for the state Senate reimagining massachusetts post covid resiliency and and today is our third hearing of the39 new committee and today we're focusing on a critical topic intergenerational care. Before I go there, I want to welcome my colleague Senator50 Joan lovely for for joining us and thank you for your presence and we'll have other senators have said57 that they will be coming in and out as our schedule allows and we have a full docket today, so we're ready to get started with three different panels um and to really pick up this, this issue of intergenerational care.
Um the starting point, I would say it's pretty well known and that covid exposed the centrality of the care economy for a robust, robust recovery, for increasing equity and equal opportunity in our society for bringing women back into the workforce and much more childcare is certainly a critical element, but It truly is an intergenerational care model that starts to get at the full scale of the issue. I saw recently in 2015 in Massachusetts alone, there were 844,000 reported informal caregivers out of a population of 6.7 million at the time. And this starts to get up this, this definition of what an informal caregiver is and there across the generations where we have millennials, gen, x, baby boomers are what many people are now calling the sandwich generation, caring for maybe a younger child, but also an older adult or maybe a family member with special needs.
And so it starts to give you a sense of How big this is beyond just childcare. When you look at things like the Massachusetts rate of Dementia is for those over 65 is 14 and 120,000 people who are 65 and older are living with Alzheimer's and we we know in Massachusetts that there are 332,000 people who are the informal caregiving givers of that population. So that's, that's kind of setting the stage of what we're trying to, to dig into. Um and I think what we'll be investigating today and throughout this process is something like the geography of care. Are we going to see um, patterns in the use of child care and other things?
Um, change if folks are not driving as much to an employer and then maybe we need180 therefore the care to be more approximate, maybe in the point of the neighborhood or community based care as a more robust portion of our models. And it speaks to the value of us napping our caregiving services as we embark on this and try to create an inclusive network. Um Today, we're also going to hear that employers in the business community have been a big part of this conversation to date. There is a study in 2017 that massachusetts employers have spent close to a billion dollars as a result of increased turnover, absenteeism connected with informal caregiving. And so the mass business roundtable supported the launch of the massachusetts Caregiving Coalition and we'll hear from them a little later, in particular mastec that's now running that initiative.
And then we'll also try to look at um as the Senate president has has dictated that we really wanted to understand the framework in which236 we have our our intergenerational care, whether it's family239 resource centers and we'll have a family resource center joining us on this panel, or is it our SAP structure? Are aging services, access points, which are not here today, but we'll be in future hearings. Uh Senior centers and beyond. There's just a network that we need to understand. It may overlap with the home care259 models and we have SEIU and others today joining us to dig into that as we try to explore our their financing issues um challenges around licensing workforce challenges in the light. SHOW NON-ESSENTIAL DIALOGUE
So with that, why don't we jump into our first panel and it's a distinguished panel. Indeed. Um I'm going to introduce all the panelists and then we'll have them speak in the order in which I introduced them um uh when I'm done and then we'll have time for question and answer after we hear from each of them. So we'll start with Sandra Harris, who's the AARP state president here in massachusetts. Um and so Harris has done, you were appointed in 2019, I believe, so that there's a couple of years. Um and so we're looking to hear the range of initiatives that that Sandra has been leading up, including with the city of boston and a strong commission and age friendly initiative and a range of other issues. So looking forward to that. Um that prayer, the chair of the H. M. A. S Autism Resource Center advisory Council. Um and so that will be an important conversation, Stephanie steed. I don't see yet, correct double check, I don't yet, but Stephanie will be joining us. Um and Stephanie joint interim executive director of a family resource center out here in Pittsfield called 18 degrees and Marianne Mulligan, the legislative consultant to the home care aide council. Um and Julia uh what fuckers with her as well. Um So Sandra, why don't you take it away?
SANDRA HARRIS - AARP MASSACHUSETTS - HB 3043 - SB 788 - HB 35 - SB 2084 - Good afternoon. Chairman Hinds Vice Chairman366 Lewis and members of the committee. My name is Sandra Harris and I'm the state president of the AARP Massachusetts. AARP Massachusetts would like to thank the Senate President Spilka for establishing this new committee and for holding this important hearing and for seeking to use this once in a lifetime pandemic to reframe the way we care for each other. AARP is a nonprofit, nonpartisan membership organizations for people 50 and older. We have nearly 38 million members nationwide 775398 members in the Commonwealth. America's population is aging and becoming more diverse. The age 65 plus population is projected to almost double from 48 million in 2015 to 88 million in 2050. Supporting our nation's family caregivers and ensuring a sufficient, competent and stable workforce to care for older adults and people with disabilities is of growing importance.
As our country continues to age the need to support caregivers as the cornerstone of society will become more and more important. Today, more than one in five Americans are caregivers having provided care to an adult or child with special needs at some times in the last 12 months. This totals an estimate 53 million adults in the United States, up from the estimated 43.5 million caregivers only five years ago. More than 844,000 bay state residents are caring for aging parents or loved one, helping them to live independently in their homes and communities where we know people want to stay and not go to nursing homes. Besides, on an average, for every one person residing in a nursing home, Medicare can fund three individuals receiving community based long term care.
Let me start by sharing some important data that is critical to understanding the current situation. Last year alone, nearly 39 million adults provided unpaid care to an adult family member or friend. Caregivers provide help with a wide variety of activities of daily living, such as bathing and dressing, instrumental activities such as paying bills, doing housework and laundry and managing medication. And sometimes complex medical and nursing tasks, such as to feeding interests, dressing wounds. The average duration of care is 4.5 years. For 29% of caregivers have provided care for five or more years. 61% of family givers529 are women. The average caregivers age is 49532 and one in four is a millennial. About three and four are unemployed outside the home, and family caregivers can incur540 high out of pocket costs for care, with three out of four spending an average of $7,000 a year, with long distance caregiving incurring as much as over $11,000 per year.
Suffice to say I could go on for a very long time sharing important data much of it is concluded in my written testimony. The important takeaway is the impact on real people, our neighbors, friends and families. I can personally share with you the emotional and financial burdens that my siblings and I are experiencing Caring for our 92 year old mother who's living at home with Dementia and we hear so much of the same from our members. What's most critical582 for us is how we make plans now to address shortcomings in the near and more distant future. Balancing caregiving responsibilities591 with work has never been easy and the pandemic has only highlighted these challenges. A particular concern is the impact on caregivers, health, wellbeing and finances.
I have already mentioned how caregivers assist with activities of daily living. These activities represent the exhausting reality of the family caregivers. The roles are ever changing. One day, you are the personal care attendant, or personal chef the next day you are the financial, legal and health advocates the next day an entertainment628 director.628 Yet 48 million unpaid family caregivers work to keep their older parents, spouses and loved ones at home facing these639 challenges daily, they need help and they642 deserve support. 61% of family caregivers work full or part time jobs. Too many caregivers have reported retiring early or giving652 up work entirely to devote more time to caring for a family member. My own sister left her profession at age 56 to care for our mother. When family caregivers are not available or are unable to offer their assistance to a loved one many face challenges finding affordable, competent and trained workers to do the job.
Long term workers are in short supply, wages are low and benefits are usually not provided, contributing to high staff turnover and low quality care. These shortages are cause for serious concerns. To help address these caregiving challenges AARP recommends respite care. At the federal level, AARP supports establishing701 a Medicare respite benefit that would provide important assistance to Medicare beneficiaries and their caregivers. At the state level AARP recommends expanding funding for respite care service in settings such as personal care in the home or adult day services. Allowing family caregivers with moderate incomes, and who would not otherwise qualify for publicly funded respite services to buy into or otherwise access these services. And establishing policies to pay relatives and friends who are caregivers as part of a service plan.
For home and community based care AARP recommends the federal government should eliminate Medicaid's bias for favoring nursing facilities. It should mandate the provision of home and community based services or HCPS for everyone who meets Medicaid eligibility criteria and choose to receive service in HCBS setting. Allow individuals to qualify for766 Medicaid to have a choice between an HCB or a nursing facility care and have a choice of providers. At the state level AARP urges funding services needed to meet individuals long term services and support or LTSS needs, allowing them to remain in the community.
To improve the long term care paid workforce AARP urges federal and state governments to793 ensure that Medicaid and other public programs reimbursements are sufficient to pay wages and benefits that will attract and retain long term care workers. Support programs to increase the supply of long term care workers with geriatric trainings to improve labor standards for the direct care work force to arrest such things as a minimum wages, overtime pay protections and times off. Both federal and state governments should support payment reform, adequate health and retirement benefits, educational opportunities, and career ladders that would encourage recruitment and retention of workers.
The responsibility of family caregivers take a toll on the caregiver's financial wellbeing. Almost three in four caregivers are employed in jobs outside the home while spending an average of 24 hours of caregiving each week. And on an average, they're spending nearly 20% of their incomes on caregiving activities. When a caregiver decides to decrease their hours or take time off from the workforce to devote more time to caregiving their pay and personal savings take a hit. Transitioning from full to part time work. can mean ineligibility for a workplace retirement plan, even if one was offered and lower earnings, making it difficult to send money aside. So to address these financial challenges, AARP supports a family caregiving tax credit.
At the federal level AARP supports enactment of a new family fund tax caregivers tax credit, such as the Credit for Caring Act. At the state level AARP Massachusetts supports House bill number 3043 and Senate bill number 788, an act to establish the family caregivers tax credit. Emergency paid family medical and sick leave at the federal level we urge an immediate extension of emergency paid family medical and sick leaves and an expansion of the individuals919 who are covered by it. Employer sponsored retirement savings in Massachusetts AARP supports expanding the core plan eligibility so more workers at nonprofit organizations can save for their own retirement. House bill number 35 Senate bill number 2084 act942 relative to the 401K Core plan would take needed steps to increase the financial security of this workforce.
AARP has tremendous resources in the area of family caregiving and these resources are cited in my written957 testimony. As the committee considers caring for aging Americans and possible solutions, we suggest you incorporate existing insights, learnings and promising practices from states and localities as well as other federal programs. Both private and public solutions are needed and there is no silver one silver bullet. Instead, there are multiple solutions of varying sizes that are needed, both in the short and long term. AARP has suggested some solutions in this testimony, but more are needed. Some will require thinking differently. Some will require sustained engagements, persistence and commitment. However, the driving force for solutions should be how they help individuals and families who are trying to get the care or service they need for themselves or their loved ones. AARP appreciates the committee's attention to this important issue and opportunity to testify today. We look forward to working with the committee to address this critical work. Thank you. SHOW NON-ESSENTIAL DIALOGUE
Thank you. That was incredibly comprehensive and really useful. So I think we can disclose the hearing now. That's a girl.1038 Yeah, thank you. That was really, really helpful. And as I said before we started, I I look forward to continuing the work beyond this this hearing because it's there's really so much to unpack there. Um I want to move to event Pure Prayer who is the chair of the H. M. E. A autism Resource Center advisory Council. So, event over to you.
YVETTE PRAYOR - HMEA - Good afternoon. My name is Yvette Prayor. I am a registered nurse by profession for almost 30 years. I do have a son who is on the spectrum who was diagnosed at the age of eight with an autism spectrum disorder. Uh, we moved from Ohio to here for a better education and life, which he has done very well with. Um he is a high school graduate and he is also a college graduate.1088 And currently he is um employed but not gainfully. Um I have set on the POW Board for the Worcester chapter as co director for 10 years and has have been involved with the HMEA Autism Resource1104 Center uh for about 20 plus years. Currently, we've been on the advisory board for myself and my son as a self advocate for the last1114 three years and I am chairperson for this current year. Um our, um, our biggest thing right now is that our kids are aging out since we've been together for so long and we're running into bigger challenges of employment.
A lot of our kids have gone to college and it's hard to find employment for them for what they've gone to school for. Um Also housing seems to be a big issue, transportation, um entertainment, socialization, it still is a big um still is a big concern for our group in general. So we're working with other um agencies that are out there and trying to give them the best quality of life that we can. Um thinking outside of the box, we do have a lot of parents and agency folks who are and very um very much motivated to get our kids or our young adults to where they need to be. So I'm very pleased to have been asked to be on this panel and see where we can go from there. Thank you. SHOW NON-ESSENTIAL DIALOGUE
Yeah, thank you. And your insights will be valuable for sure. Thanks all the work that you've been doing through the years. Um Good. And I've been told that Stephanie steve, you have been able to join us. We weren't sure if you joined us at the beginning. So welcome. Um and I explained earlier that Stephanie steve is the interim executive director of 18 degrees, which is uh has a whole range of programs, including as being actually as the family Resource center here in Pittsfield. Um, and she's been with 18 degrees for 15 years or so. So Stephanie over to you.1228
STEPHANIE STEED - 18 DEGREES - Thank you Senator Hinds. I appreciate the invitation to participate in the panel And to tell you a little bit you and the participants and listeners a1239 little bit about 18 Degrees. We are in Western Mass and our intention is to promote the well being of children and youth and to strengthen families in order to build a better community. Um We provide education, we provide parenting skills, we1257 provide various avenues of support. We address preventative measures, interventions and advocacies. We work hard to develop life skills um starting with very young children in our child care programs up through our young adults and even those in adulthood who are looking to um advance their uh their skill set, their place in their communities and their place in their families. We do that all along a spectrum of programs that serve Children, young people, individuals and families.
Um We focus on early education and care, foster care and adoption, child and family wellbeing and community development. So when talking about inter generational care and also talking about the resiliency of that care post a pandemic we certainly have1320 addressed that in our program services and our delivery. Um as Senator Hinds mentioned, we have our family resource1330 center in the Berkshires in Pittsfield specifically where we host a variety of groups in different platforms where folks in the community can seek supportive services, interventions, referrals and support. We have found that um in addition to the family work we do we see lots of families that are experiencing what you mentioned, um that sandwich generational approach where they are in homes with their parents or elders and they are then providing care and services to young people in their lives.
We find that being a program and being a agency that offers a blend of programs and intersection of different services, we are able to offer some support, especially for those who1386 are in such situations. For um grandparents who are acting as kinship providers to their grandchildren, um and by having our child care services on site and again, the connection between programs where we can make those kinds of referrals has really been helpful. We certainly have seen in addition to an increase of grandparents raising grandchildren or acting as kin. Um We've seen that not just in the services that we offer at our family resource center, we see that in our foster care and adoption services as well.
You know, during the pandemic, there was a huge shift of care provided and care needed through the foster care system. And of course, um the reach of kin to care for folks, especially during the pandemic was even more important and probably1449 stronger than it's ever been. So we worked really hard with the Department of Children and Families to explore those options to find the best situations when possible to help kids they connected to kin. And more often than not that is with their grandparents. So recognizing though that brings a variety of situations that aren't usually um explored when we're training and recruiting typical foster parents and some of them were mentioned by Sandra when we talk about economic resources. When we talk about availability, when we talk about folks who want to reach out and parent um, in a kinship way, but they still have to work. Um, they have the health issues that they have to continue with.
So when we evaluate kin particularly grandparents who are looking to1509 help to raise their children and mitigate time in the foster care system. We want to make sure that they have the supports they need in order to offer, the best supports that the young people in their lives need. We're glad to be able to be a voice in that realm, and we're glad to be able to provide some supports and services, but we do recognize that there's much more to the conversation, especially to again keep families intact the best way we can. And1542 improve1542 and increase the opportunities for this multi1545 generational approach, and also to bounce back from the from the woes of the pandemic. So I appreciate your time. Thank you. SHOW NON-ESSENTIAL DIALOGUE
It's great. And I have had a lot of questions, but we'll be holding on to the end of this panel before we do that. Um and I so selfishly mentioned that 18°1568 is based in Pittsfield, but1570 really it's all of Western mass. So you, yeah, a presence in the greater Springfield area as well. And so we appreciate all that. Okay, And so now to close out this first panel is Marianne Mulligan. Um I mentioned earlier is legislative consultant to the home care aide. Council Marianne,
MARYANN MULLIGAN - HOME CARE AIDE COUNCIL - Thank you so much, Senator. And um boy I'm telling you1594 the panelists that came before me made it a little easier I could scratch out about half of what I was going to say. And what it shows is there so much synergy between the things that we're talking about and the needs and the challenges presented. First off, I want to mention that I'm joined today by Julie Watt Faqir, the executive director of the council. And I just want to say I've had the privilege I'm speaking today because I have worked with the council for over 25 years. So I have seen a lot of the changes and challenges that they've lived through and1630 experienced. So who is the council? The council is a nonprofit organization. They're celebrating their 54th year this year and they're comprised of 85 member agencies, home care agencies.
They're the ones that employ the home care aides that provide the direct hands on services. Okay. They are statewide. And one of the biggest things the council did in its early years and that's carried through to today is established standards for the industry. In the early days, there were no standards and the council partnered with Elder Affairs to create standards for the workforce and to guide and inform the work. They also have really pioneered training and more recently have done advanced skill training. And again, some of the panelists before Sandra especially talked about the needs that are being presented now by elders and persons with disabilities are so much more intensive than you might have imagined in earlier years. Behavioral healthcare needs, substance use disorders, dementia.
It really is a large span. So being able to have a trained workforce that's trained in these specialties is critical,1709 and the council has been leading that effort with Elder Affairs. And they converted it to an online platform to respond to the COVID needs. So we just wanted to mention a few of those to kind of help you understand who's the council. Um And so again, I have to give thanks to Sandra for teeing up. I don't think I need to tell you what the home care aides do anymore. She did such a fantastic job. I will just tell you we're going to share with you. There is a career ladder and there are about six levels of home care workers um starting with a homemaker and going all the way up to a supportive role. Where and I'm just going to my ladder, we're going to provide that to the committee.
And basically what it is is each level provides a more intensive service than the next level. It requires more training, more expertise. And it creates a career ladder also for these professionals. So that's something that we'll share with you so you can see what's their training, um, what are they able to do and then what funding and state agencies support them. Okay, So we're hoping that will be valuable as the committee looks to, you know, who's the workforce, How can we support them? And again, in this intergenerational space and sense. I do want to share though a couple of demographics again, they will be in the written comments, so I will have to look at these, so I get them right.
But number one, we are an industry of women, 96% of home care workers are women. the average age and again some of this I want to just clarify some of the data that we're citing comes from a Tufts study that the Home Care Aide Council conducted. It is several years old now but The data hasn't really changed. You know these demographic data points have not changed much. So 96% are women. Um average age is 48. Nearly 50% of the home carried workforce was born outside of the US. Most have very little formal education and 40% of their households again, this may have changed slightly, but at the time of the survey, 40% of their households had an income of1848 under $20,000.
And this is to1852 Sandra's point, over 25% have caregiving responsibilities for family and friends. And 36% of our home care aides have children under 18 that they are responsible for. Here we go with presenting this intergenerational. You can see the challenges they face to meet all of those needs right for their job, for their own family, for their own children. So we're thrilled to be part1879 of this and hopefully trying to address those challenges that clearly the home1884 care aides are facing. Um now I want1888 to move on to the COVID impact just very briefly. There was a massive workforce shortage of home care aides before the pandemic hit. It's something the council has been working on in collaboration with Elder Affairs and our key stakeholders.
What COVID and the pandemic did has exacerbated that because think about the demographic I just mentioned to you, add on1912 the limited availability of childcare, transportation became a barrier, fear of infection, um aides or family members becoming infected. So I would just say to you the pandemic had1927 a significant impact on our home1930 care agencies and the workforce. What did we do? We worked with Elder Affairs and we want to recognize them here and our key stakeholders. The first thing they did was1941 to give home care aides and home care workers essential status. That was key. And the next thing was helping us prioritize them for PPE and testing. The home care aides needed these supports in order to be able to do their job during COVID. So again we want to applaud them for that.
Um what I want to tell you about now is pivot to, so what are the workforce challenges kind of as we're1968 recovering from the pandemic. Home care agencies we asked them, we um meet with them all the time the board, the executive committee etcetera are telling us this is the most severe recruitment and retention challenge they have ever faced in their time in this industry, period the end. What they're saying specifically is they can't recruit and retain enough. And then this piece I thought would be interesting for the committee they're seeing week to week fluctuation in service hours. So aides again, I think the threat is think about the challenges I talked about before, lack of childcare transportation, COVID and that's why they're seeing the hours that the aides can work and stay employed going up and down in ways that they didn't before COVID.
So we want to note that snapshot Indeed.com and this2024 is only for one area on, on any given day they show 700 home care workers positions posted and that's for the metro west area alone. So to tell you that there that we're in the most severe challenge ever that it's just2044 to give you a little glimpse. Um And then um wanted to share just a couple more. I know it's hard getting all these numbers they will be in the talking points we'll share with you so just hoping to round it out. But over 35% of home care agencies direct care workforce from the Tufts survey showed that the workforce changes every three months. Agencies will hire on average 18 new home care aides every three months. And then the turnover they will lose 15 home care aides over the same period.
As a result despite their best efforts to recruit and retain they're only adding three new home care aides each quarter. So again I'll stop there with those those data. I think that explains it well enough. Let's get on to some of the, one more thing I want to share on access because you're probably thinking so much on the work force because that's what our member agencies do. But let's talk about access. Mass Home Care, one of our key partners that we work with all the time. They are the represent the ASAPs the Aging Service Access Points. They did a survey in February of 2021 And they wanted to see what impact are consumers having during COVID. And they found that 2240 home care consumers were waiting for authorized services. This is known as pended referrals, meaning they're authorized to receive home care services but they're not getting them. And the primary reason for this is the lack of workforce. We cannot find workers to fill the hours. And this was a 66% increase when compared to July of 2019.
79% of the consumers on that wait list I just told you about our pending referral list were waiting for all of their home care hours. So I just want to share that. Let's get to some of the solutions. Um, our organization has partnered with what we call the NFP to Stay Coalition and that is ourselves, the Home Care Alliance of Massachusetts and Mass home care, which I just talked about. We've been partnering for the last several years to do just what the name says, try to provide enough pay so home care aides can stay in the profession that they love. And thanks to the Legislature, I want to just pause and give kudos and thanks to the legislators on this call and to your colleagues because you have responded to our plea if you'd call it for help and have funded what are rate add on specifically to go to the work force to try to support the level of wages and benefits that our agencies can pay for them. Because the rates that are set by the state are not enough and they do not provide enough.
So, um, we have some long term solutions for that. But the short term solution was, we have to do rate add-ons. And I want to tell you in FY 20 and again in FY 21 the Legislature responded doing enough pay to stay rate add-on. This boosted the rate and therefore the wages for the home care workforce and2248 we're2248 extremely grateful for your doing that. And now the FY 22 budget, you may think what's the immediate next step? We can't fall off the cliff. If those rates, the rate2260 add-ons are not continued in the FY 22 budget, those rates will go down and the difference is almost $3 per hour for home care and home health. So it's significant when we say cliff, it's a cliff. So that's our first requests. The House included a rate add-on enough pay to stay of $28 million in the FY 22 budget and we're hoping the Senate will support that as well.
Um besides that budget, um, the next thing up is ARPA, the American Rescue Plan. We want to just call your attention to the home and community-based services. Sandra mentioned this in her comments, so I'll only speak briefly, but Massachusetts,2302 there are differing estimates could receive as much as $400 million under the home and community services waiver. EOHHS has released an RFI and comments are due by this Friday. I can tell you that our group, the Home Care Aide Council, the Home Care Alliance and Mass Home Care are all responding to the RFI. This is an incredible opportunity. It is one time non recurring funding and all of our recommendations are about what the workforce. How short term strategies childcare voucher let provide some assistance2341 to2342 our aides they can use for childcare or transportation and one time bonuses. Help us with the recruitment piece to try to get more home care aides in the door.
Or for those who have had to go on un unemployment if we could offer that bonus so as they transition off unemployment, they can resume their hours. So that's we're2366 hoping again and we'll stay in touch. We're awaiting the guidance so we don't know how that will go, but the Legislature will have a role because this is subject to appropriation. Okay. So we'll pivot back and get back to you once we hit that. I want to just mention one other thing, a legislation um we have filed similar to Sandra. We're kind of again, we're following the same path here. There is an enough pay to stay bill. And that is because it's we want to get away from doing the every year rate add-ons. How do we do that? We need to make sure the rate process is transparent and the methodology takes into consideration things like the minimum wage, mandate, the paid family and medical leave. All of the things that I've talked about that we need to support the workforce.
So that bill filed by Senator Pat Jehlen um and Representative Carmen Gentile will be before um committee this session and we're hoping that it passes because that's what we need. That's the longer term, how can we really deal with the rates. Now I want to just look to the future because I know the committee is really focused on that. We turned to our council president and another member when we um kind of saw the Senate president's intergenerational, um Moonshot, which we love that idea we're all in and we'd love to hear more about that. But specifically they had some ideas and again, we'll go in writing as I want to try to be brief, but we need more of a direct employment model. Agencies need to be able to offer competitive benefits, incentivize the staff to pay and to demonstrate the loyalty, respect and investment that they deserve. Reimbursement rates like we talked about through the rate setting process are one way we do that.
And another idea that folks had, which I think hopefully Senate will play into some of the things you're looking at is more predictable hours. Right now some of the hours can be an hour or less. How do we bridge some of the transportation challenges and keep aides, keep them off the road if you will and our public transportation and in the homes? One of the ways is having longer service hours 2 to 3 hour blocks. As opposed if we can move in transition to that, that would be helpful. Especially in the Berkshires and rural areas where those aides are traveling big distances. To have an aide travel for an hour um, to provide an hour service is not cost effective for anyone for the state or for that aide.
A couple of other quick things because our folks are creative. One thing I thought you might be interested in a clustered model where you can cluster services, right? So it could be a neighborhood, it could be a multiple unit apartment building. If one ASAP kind of owned that neighborhood and unit because right now there are 26 and then either an agency or a couple of agencies provided all of the services that would really have maximum efficiency and address some of the geographical issues that you talked about. It could be a stepping stone to that intergenerational model that you were talking about senator and that2571 the Senate president is talking about. So pursuing and looking at a clustered model of care is another thing.
And having maybe a premium reimbursement rate for specific2582 cities, towns or geographic areas that are hard to serve. Um Again, I think we need to be willing to think outside of the box here and I know our members are happy to work with you this committee and others to try to come up with some of those ideas. Um, and then finally, because we want to just close here on the intergenerational um care centers. I think some of the things we've talked about, we hope you look at as a first step and then um we can transition some things to think about how do we transition to a really intergenerational care model. Um, one of the things I want to mention, our members do provide services 24/7. I know the Senate president said, how do we get away from the 9 to 5? We already, thankfully in our space, we are away from that. You have to serve the elders and persons with disabilities on weekends. Um, but those are the harder to serve hours. So we do need help with that on the things I talked about in order to realize we provide that, but it's harder during those off hours.
Um, and then finally we just want to close with something. Our members are very thoughtful and said, you know, some of them viewed it not just as a2661 someone running an agency, but from a kind of a sociological perspective in saying it's really about treating people with dignity. We have to help them remain at home or in the community and getting the care where they need it. And I think the one thing our home carers are the heart and soul of the home care system. The future success of everything2685 we do it rests entirely on our ability to recruit and retain a professional workforce. But this is the key we need them to be as prepared as they are valued. Thanks so much for the opportunity to present today. SHOW NON-ESSENTIAL DIALOGUE
powerful. There's a reason that we started with all of you because2706 you really laid out the, each of the issues that need to be both kind of drilled into and also reformed and improved upon and um,2716 so maybe before I jump into a couple2719 questions, Senator, lovely. Any, any questions on your side? Marine sites?
SEN LOVELY - Uh, thank you Mr. Chairman. Just a couple of comments. Thank you to all four presenters really, uh, really informative information and a lot of things that we already knew but I learned some of some new things as well. Uh, to MaryAnn who just, you know, just presented about the home care aides we hear this all the time. All the time. I will hear from, from seniors or family caregivers who are trying to get those hours and it's taking weeks, months to even get a few hours fulfilled. There was one particular woman who has left her job to care for her ailing mother and her mother recently passed away, but she had no source of income to help this mom. And she just, waiting, just waiting for hours. I think they2775 were offered maybe six hours a week, but still couldn't get the six hours a week.
Um, so so many layers here to talk about and how, you know, each kind of, each entity can, you know, I don't know if it's pool resources. Pool you know, so that there's a lot of, a lot of overlap support, but2795 how to make it efficient because, um, you know, talking about autism, um,2800 I have a couple of nephews who are on the spectrum. One is in, in a, in a group home one isn't. Um, and, but just, you know, seeing these boys grow up from babies, um the effects on on their on their parents, their aging parents. Um you know, and what does that look like for their future for their, you know, so and how this all again crosses over. Uh So thank you to everyone in the family resource center, we know how valuable the family resource centers are. There's the only one out in the western part of the state. That has to change because that's that that is such a valuable resource. And of course the AARP thank you for everything. Um Just that national model that supports us in each of our states. SHOW NON-ESSENTIAL DIALOGUE
So I don't have any questions, I just as soon as I was listening, you're hitting on different points that we're hearing already Pre pandemic, but the pandemic's made it even worse, so um thank you so much today for presenting. Thank you Mr. Chairman.
HINDS - Yeah, there are a few other family resource centers out here I should be clear. There's a micro just expanded recently in North County Northern, County. But your point is is still relevant. There's always need for more. Um And it kind of points to what we're trying to get at. I feel like uh rather than going through2880 the list of issues that I've written down and as Senator Lovely points out, there is there is consistency in terms of what we hear in our districts and amongst constituents. But you know, I've heard about the importance of um flexible work for folks who have given the number of folks who are working full time and are caregivers, unpaid caregivers often. And2902 the2902 importance of affordability and mental health for the workers and the family members um and a range of other things respite care. A lot of a lot of these issues um, we're definitely going to add to the list of things that we need to drill into.
I'm curious because it came up at the end and it's been a consistent part of the Senate president's vision, which is the kind of the, is there a model for the bricks and mortar centers um, that we should be looking into and how we change either existing centers or I like this idea of the cluster model where it goes beyond multiple agencies and to the intergenerational kind of posture? And I'm just curious what all of you or any of you who have reaction, um, might I might see as the potential for that or some of the obstacles and challenges that we should be aware of just right out of the gate.
MULLIGAN - Um, We definitely are going to be circling back to our members senator to give you more informed comments. But um I think we propose the pursuing more cluster models because we aren't even there yet, you know at that step in care right now. And you can imagine as Senator Lovely said it's a bit of a scramble to and I think there is such a desire to once someone is approved for hours the scramble is get them those hours however you can do it right. And so agencies and even different agencies are used if if one agency can't meet the full need, it's even divided among agencies to try to meet one family's need or one consumer's need maybe coming from several agencies. So one challenge we have is um for people that may, you know, I don't know if they can get to a care center.
I know just speaking, thinking of my mother in law, there were different periods of time in her trajectory where sometimes she could have and we were actually looking at, could she go to like a place like an intergenerational care center um for some things, right. But then as her diseases progressed and her mobility declined, it was clear it had to be home base. So, um, that would be my only thing is, is in trying to serve the span. There may be some that could go to a center for some of their care and that would be great. Especially it could help with those hours we just talked about and the efficiency. But for others, I think the reality is they may be home bound and, and so it may not be able to leave their house or their3075 immediate neighborhood. But I defer to others who may have thoughts on that.
HARRIS - I personally would just like to say that I think it's important to look at the individual needs of the um, the person, um, and their caregivers. I think it's very critical. I don't believe that there's3097 any silver bullet. And as you're asking the question chairman, I think the thing that comes to mind, because I thought in terms of when and if and when I began to need some type of service, I really like a paste like model, which I think is only the beginning. It could be a stepping stone to begin looking at. Um, I like the idea of having those kinds of models in the communities and so people can continue living in their communities, but the services are there and they, you know, can walk to, they're easy to get to. So I think I would encourage that. I think that maybe looking at a hybrid or at least beginning to look at the pace model and what would something like that look like in our community.
HINDS - Yeah. Um Stephanie Steed, the Senate president often refers to the family resource centers as an example and3155 so I'm curious in particular um, is there room to grow? And I guess the workforce and all these other issues continue to be the key3165 element. Um,3166 and what would be the obstacles? I mean, we keep hearing about, you know, licensing across workers for entire different responsibilities and age groups and the like. Are there other issues that come to mind if you were to suddenly expand beyond um, uh, children and their parents?
STEED - Where we are in the Berkshires in Pittsfield some of the barriers have been expressed here um, space and transportation are the biggest ones. Um, anything in the Berkshires specifically, um for where we are located requires a level of transportation to get to where we are. Um many things are not as walkable or in that limits access. So again, if the need is to, if the need is to provide that additional care, there are certainly are going to be opportunities where that care has to extend in the home to get someone to even participate in programming at our family resource center.
Um secondly, would be space. We are at a space now where we've made accommodations to be mindful of the needs that the pandemic has3246 presented. However, going forward in order to still continue to a level of comfort of participation, it's a concern of space. Where do we have groups? How do we have groups that we can maintain um social distancing at a level that's comfortable to participants? Um, in terms of our staffing and our skill set, we do have that seemingly in place, but what would come next, what would be needed next would be3281 an inclusion of licensure.
So, um where we stand now, the family resource is open to the community. It's open for whoever needs a referral. Um, we do address a lot lots of children and families and their parents who have behavioral health issues and concerns within their family units. So we have the staff available that can tend to those measures. However,3311 when it comes to licensing and programming and extending beyond back to a more caregiving role, we'd have to explore what um, grants, what contracts what quite honestly what the sources of the funding would come to to have the staffing that would be3330 uh, maybe beyond what we already do.
HINDS - That makes3336 sense. Yeah, Well this has been incredibly valuable and really such a great way to start off this conversation publicly. And I look forward to continue to work closely with all of you as we kind of crystallize how we can support your existing work, how we can um really improve upon our system so that these each of these these issues that we've talked about are addressed, because as I said in my opening remarks, we've really been um when when you kind of lift up the hood and realize all the flaws in our in our society and our communities and that the structure of our services and how um we really need to do better to support you all in the work that you do every single day. Um it's impossible to go back to the way things were and the status quo um in 2019. And so, um thanks for your work in identifying ways to3390 do that and thanks for taking the time out of your day today, appreciate it. SHOW NON-ESSENTIAL DIALOGUE
Um And now I guess with that we'll move on to our our second piano. Um and I believe we're all here and so it may mean turning cameras on and others turning cameras off and we'll pretend we just changed in our in our panel in the hearing room. Um I'll start down the list and as I said before a previous panel, I'll introduce everybody. Um and then if we could speak in that order and then we'll have kind of an exchange and a conversation and questions and answers. At3428 the end of everybody's presentations, we're going to start with Lawrence stunts, who's the director of the massachusetts Health Institute, it's a part of mastec. They've been doing quite a bit of research and so we're looking forward to hearing about the mass caregiving initiative, Mark Butler, who is the president of Signal New3448 England um and well we hear about the experience as health insurers and employers supporting caregivers. There are also a part of the massachusetts Caregiving coalition and the founding of that um Helen Adios and the Ceo of Care Academy. Um and we'll hear about the kind3467 of caregiving workforce and and kind of the training and other elements here, Alexandra Drane will3474 help us, who is the Ceo and co founder of Arc Angels to talk specifically about the unpaid caregivers. So this is another good balance kind of perspective of the range of issues and in perspective. So Lawrence, why don't you start it off? Sure, sounds sounds great,
LAURANCE STUNTZ - MASS TECH COLLABORATIVE - Thank you very much Chairman Hinds And the committee members and to Senate President Spilka for highlighting this issue and helping to raise its profile. Um My name is Laurance Stuntz. I'm the director of the Massachusetts Health Institute at the Mass Tech Collaborative. Uh as you heard from the first panel, uh caregiving is a super important public health issue that affects the quality of life for millions of individuals, but it's not just a healthcare, human services or paid workforce issue it's an economic issue. And caregiving and particularly family and unpaid caregiving is woven throughout our economy. It affects personal3537 employment and employers, it affects healthcare costs and the health care system. It affects the ability of our citizens to function and participate in society. And particularly as3548 we've seen through this pandemic uh caregiving affects the ability of women and people of color to participate in the broader workforce and the economy.
Um speakers uh in this part of the hearing uh will focus on three high impact areas of the economy, as you said in your introduction Impact on employment and employers and on healthcare and health costs and women and people of color. And our testimony is also going to highlight the psychological and physical and financial difficulties of caregiving, especially among women, minorities and low income caregivers. Um, as many folks have seen we're undergoing a demographic shift in the country. Population continues to age living longer with more complex and chronic conditions. By 2025 it's estimated that the number of people over 65 will surpass the number of Children age 133604 and under for the first time. And the number of adults over 65 are projected to nearly double from now to3610 2060.
Um, as baby boomers age, that also means that the supply of caregivers is unlikely to keep pace with demand. In 2010, uh, caregiver support ratio was more than 7 to 1 in terms of potential family caregivers for each person 80 plus, And this ratio is projected to decline 4 to 1 by 2030 And in less than 3 to 1 by 2050. So technology will be an increasingly important piece of making aging in place easier and active support for telehealth and remote care technologies will be key. So all this is combined with the overall impact of family caregivers on the economy. A 2020 report from the National Alliance on Caregiving highlighted that about 53 million Americans today Provide care for adults or children with significant special needs. And about 80% of those caregivers, about 42 million are looking after uh care recipients who are age 50 or older.
Um Our best estimate is that, you know, since the number you cited in your intro remarks were up to about a million caregivers here in Massachusetts, just as the population continues to age and continues to grow. So all of that, um you know, in terms of caregiving and its impact on the individual caregiver, a caregiver 50 plus3698 will on average lose3701 about $300,000 in lifetime earnings and that's due to just increased intensity,3707 having to scale back and drop out of the workforce. As they do that their skills get rusty and it can be harder to come back into the workforce, leading long term to lower economic conditions for that caregiver and a potential greater reliance on state services. So this is critical for all of us across the state to try to understand how we can uh support caregivers and make sure that they're able to continue to participate in the workforce.
So Mass Tech has, as you know senator, we've done a lot of work with you in different areas is an economic development agency, focused on the uh focused on the innovation economy. And so, you know, to highlight the importance of family caregiving and caregiving, family caregivers and caregiving in general to the economy we launched the initiative earlier this year to, you know, and the goals of the initiative are to bring together public and private partners to support critical supports for family caregivers in Massachusetts, support the Massachusetts economy and ensure a healthy and stable workforce and grow in the tech and innovation ecosystem in the commonwealth. And it buys on policy recommendations to better support family caregivers.
So there are three legs to the initiative. The first is employers working with employers and so along with the business roundtable uh and leading employers like Cigna New England. We launched the Massachusetts Caregiver Coalition to assess and address the needs of unpaid caregivers working in the commonwealth. And the coalition's mission is to encourage employers to acknowledge family caregiving as a critical workforce opportunity and to support uh individuals who are caregiving with the caregiving responsibilities, through providing education, webinars, providing resources like our employer toolkit. Um Mark Butler, president of Cigna New England, and one of the coalition's co founders will speak after me in just to talk about the specific examples of Cigna and highlighting the reasons they're moved to help launch the coalition.
Over 60% of caregivers are employed, but only half say their supervisor is aware of their caregiving responsibility. So this is a cultural thing that we think is critically important to help address. Uh one in 10 working caregivers have had to give up work entirely or retire early to fully handle their caregiving responsibility. Uh And as you mentioned in your opening remarks, we sponsored a study a couple of years ago that estimated about a billion dollars in sort of total cost to Massachusetts employers in terms of increased turnover and absenteeism and presenteeism. The second leg of the initiative is around community. Family caregivers are an essential component of our healthcare system, and states rely heavily on caregivers and the critical support they provide to millions of older adults and individuals with disabilities.
We work closely with the Executive Office of Elder Affairs actually, earlier today sponsored a webinar that directed to family caregivers and Partners with Elder Affairs like Mass Home Care came up a bunch in the first hour of this are critical to helping to support family caregivers. The family caregivers support program run by the executive office is a free program3925 for people caring for an older loved one programs old people adults living with disabilities including Alzheimer's and dementia. Uh And it's often seen as3936 the first line of defense for unpaid caregivers. So, programs like these out in the community providing direct support to caregivers are critical because during care transitions, um you know, they're really significant positive results of supporting and recognizing the needs and preferences of family caregivers. There's better patient outcomes, improved quality of life, even reduced hospital readmissions.
And then sort of the third leg of the initiative stool is around uh innovation. And, you know, as a innovation focused economic development agency we're particularly interested in that. But you know, it's critical, as we mentioned, the number of family caregivers available are the ratio at least is decreasing. The number of people in need of care in the US is expected to reach about 117 million uh this year according to AARP. Uh, An innovation that supports family caregivers can improve the quality of health and quality of life for both the caregiver and the care recipient. So at Mass Tech we've launched an innovations in caregiving webinar series to highlight both high tech and no tech ways that people across the country and across the world are using new solutions to support caregivers.
We're launching the family caregiver Family Caregiver focused COVID Recovery challenge funded by a $680,000 federal EDA Economic development Agency, Sprint Grant. Uh that challenge is kicking off this month and will be focused on finding innovative solutions that can help family caregivers and then accelerate getting those solutions to market. We're seeking to foster the development of equitable, inclusive and accessible innovation that supports family caregivers through that and through our other efforts supporting the4050 broader digital health ecosystem. Uh one of the things that we did as part of that is sponsor Cambridge Innovation Center to launch an aging focused4058 incubator agency at their location in Kendall Square. And they've created a vibrant community of entrepreneurs concentrating on this critical need.
So as we think broadly about the impact of caregiving on the economy, just have to keep in mind that caregiving takes a significant financial toll on many Americans, especially those with incomes under 50,000. And it takes a significant toll on women as a recent report by the National Institute on Retirement Security that showed that the median wealth of women who are caregivers is less than half of that of those who aren't caregivers. So, sort of in conclusion on my remarks, COVID-19 pandemic has heightened our awareness of the ways that family caregivers impact the health of our economy. As part of the broad recovery from this crisis, we're excited to work to support caregivers and the people that care for. And Massachusetts really has the opportunity to lead the country in developing policies and a culture that supports unpaid caregivers.
So, through the Caregiving Initiative, we've developed relationships with employers4124 across the state, and the coalition is an example of that. Uh There are more than 50 companies headquartered here in Massachusetts, like actually both ARCHANGELS and CareAcademy who are supporting caregivers in some way. Uh We've got one of the nation's leading entrepreneurial ecosystems, we've got nation leading research into ageing well with the UMass Gerontology Institute, MIT4148 Age Lab and many others. We've got great state programs and resources for caregivers. And we should be focusing on efforts and resources to create a broadly supportive culture for caregivers. Uh, And doing so, will have a huge economic impact on both the commonwealth, as well as on caregivers themselves. So I'll turn it over to uh, to Mark to talk a little bit about Cigna and the efforts that they've got going on there. SHOW NON-ESSENTIAL DIALOGUE
That's great. Thanks very much. Lawrence. Can you hear me?4180 Ok, folks, on the, on the previous session, I've had a little trouble hearing. Okay, great
MARK BUTLER - CIGNA NEW ENGLAND - Chairman Hinds, thank you for having us here today. First of all, thank you for listening. I do want to acknowledge, acknowledge the folks are on the segment with me, the great work that they do. And as I was listening to the prior segment, it's just unbelievable the passion that people bring to this and the good work that's already being done. I think when I think about it from the employer's perspective and the sort of, the essentialness of it, uh, it's so important and there's so many areas that overlap because of the significance of this as we look at our population aging and we look at the new folks, the gen z's coming in that are going to be in caregiving situations.
So what I want to do today is I just want to kind of break down into a couple of different areas from the employer's perspective, where we sit. Just by way of introduction I'm the President of Cigna Healthcare here in New England. So I have a responsibility really for all of the employer relationships and their employees across New England,4245 but also relationships that we have with all the hospitals and physicians that are involved in those critical issues. And then lastly, you know, and I don't want to say lastly, but all of the communities that are impacted by this issue that, you know, all of us are in someway or another are trying to solve. And I think one of the values that we see as we think about the overlap in the different discussions that we're having, we hear very common themes is this is more than just, you know, sort of a single shot strategy, you know, that employers have to do or community has to do or hospitals and physicians have to do, we all really have to come together4281 to solve this issue.
So from the employer perspective, just to back up a number, you know, there's a couple of areas I want to focus on. Number one is just really sort of the, the leadership that needs to take place and that's really a call to action by employers to understand this issue. It's a call to action as Laurance just referenced to bring government agencies and the tools and the support that they have to this issue. We're fortunate in Massachusetts, we have a lot of resources here. That's not necessarily the case when you look at other states across the US, but we're fortunate in that regard. The other issue there is in the communities, do they know what the resources are? Do they know where4323 to find them? Are they easy to access?
You know, think about the caregiver that's got 24-304329 hours of Unpaid caregiving time on top of a full time job. I used to say in the old days, on top of sitting on 93 in4339 a4339 Mass4339 Pike4339 for4339 two hours each day, get into work and getting out of work. It's tremendously difficult. So the resources not only have to be available, but they need to be very simple and they need to be easy to use as we think about these folks. So let's go back to, you know,4353 sort of the point of really kind of bringing everybody together a minute. Cigna ran a study as you might suspect with a healthcare company. And we really began to look at the impact of the pandemic. And we looked at the impact of the pandemic on people who are providing caregiving services as well as just people being affected by the pandemic.
But you know, one of the things that we found and this is a little bit of an alarming4376 statistic, 67% of those people in a caregiver role have got loneliness and isolation issues. So if you think about the difficulty of caring for another brings every day and then you're sort of retreating back into yourself, you're isolated, you're lonely. You begin to really create a cycle where you have individuals that are not going to reach out for the help that they need. they don't know where to go. It seems too big, they can't initiate. So this issue of loneliness and you know the impact on mental health, is beginning to affect many people inside of the pandemic but is amplified if you're a caregiver is very significant. Because what very quickly translates over into the employer market is in the study that4430 we looked at people4431 who are caregivers, they're lonely, isolated, they're also missing work two times more than those that aren't in that situation and their productivity is three times less.
You know, some obvious statements, but when you start really looking at two times and three times the impact that that can have on an employer and trying to compete in a global economy these days, it's pretty significant. Now, there's a reference made that Laurance made that many employers are not aware of caregiving situations. And I like to use the analogy that we've become a society that's become very conditioned to you have children, you have sporting events, you know, you've got a play or a musical at the school, you may have to miss work either to get them there or to go to that event that sometimes scheduled at 3:00 o'clock in the afternoon. But what we find is very few people in caregiving situations like to go to their employer and say, listen, I need to go get a prescription from my dad or my mom or someone else in my family. They're very fearful of what the implication of that, whether the employer may come back and very simply say, well, can't you have somebody else do that?
It doesn't have the same. I'm going to call a positive association that we have in society today, of helping and being involved in our children, working with elderly parents or those that maybe are just disabled. It doesn't have the same sort of cultural acceptance yet inside of employers. So when we think about the work that we're trying to do inside of the Massachusetts Caregiving Coalition, that Laurance referenced is we're trying to bring that whole issue up through the employers to say you need to acknowledge us, if you're not aware of it we can guarantee you it's there and we can guarantee4541 you that the4542 impact on productivity inside of your company is there. So I'd like to share a story, you know, Laurance and4550 Alex have heard this before.
But um chairman, I I know you're in Pittsfield, I grew up in Bennington Vermont, so you're just over the, over the line, as we used to like to say in the old days, right? But my dad is still,4563 he's 91 years old, he still lives independently up in Bennington4566 Vermont. The challenge I have, I'm the sole caregiver. My brother is on the west coast has been for 40 years and my challenge is distance. You know, how do you stay in contact? How do you make sure4578 he's okay? I'm very fortunate he is a Facetimer, he's a texter. Okay. So we bridge the distance gap with those types of technology tools, some of the things that Laurance alluded to. But I'm also fortunate enough, I have flexibility in my job, I have flexibility in my schedule. So if I need to be up there to help, I can get there, I can do that.
But the reality is you heard Laurance reference the different sort of pockets of people are affected by this. If you're in a job where you need to be in downtown Boston every day, you have a parent that may be living up Northern New Hampshire, okay, you4617 need to be in the office, people are very reluctant to come and say I need time off, I need time away to go4624 up and make these trips. So what happens is sort of the amplification of sort of hiding that or you know, I stepped out and I didn't tell anybody. It begins to create a tremendously stressful work environment. So the call we're really making is to employers to understand this exists,4642 begin to bring tools and4645 solutions that you as an employer have. You know, we hear about employee assistance programs, but there's a lot of good work being done through4652 resource group ERGs most of them refer to amount or just employee resource groups that sort of begin to bring people together to tell their stories.
Because one of the things that the data supports is that if we can open the issue up, if we as leaders and businesses can begin to empathetically speak about our own caregiving issues you begin to create an environment where everyone will be more comfortable talking about it. As you talk about it, you now realize that you're not alone. You now realize that I can talk freely. There may be suggestion. Again I referenced in the commonwealth, we have so many tools that people can access. But you begin to share that there's tremendous impact that that can have to open that issue up and not make it as sort of taboo as it may be feels to the individuals that are involved with it today. So, you know, if we kind of continue on and we sort of amplify that, break it into the buckets that we've heard a little bit about it's financial stress. It's physical time commitment4718 stress.
Okay, it's oftentimes supporting financially those individuals who need care. It's sort of a multiplied commitment that creates the exhaustion and then ultimately you have an employee who is either unproductive. Unfortunately, in the pandemic, we're seeing a lot of people, particularly minority women dropping out of the labor force. But there is a huge concern, particularly when we look at the sort4746 of the demographic make up of our labor forces of younger people and women. We cannot afford to have that happen. So as an employer to sort of bring that back home, I think the future of work as we like to refer to it today begins to become a platform of much more4764 aware of what's happening inside of your employee population. It's a platform of much more flexibility and schedules and how we let people work.
Um I talk a lot about, you know, I think we're moving from a very transactional-based measurement of employee success to more of an outcome-based measurement. And when you do that, you begin to create flexibility and schedule and you focus more on the results that you get rather than maybe the 9-5 time period that we historically, or certainly I've grown up in my business dealings here. So maybe just to conclude because I know there's a lot of other good folks, when we look at the demographics and the other group with and AARP talked about this, we have a tremendous amount of people, the boomers aging out. Okay, that's great for us. The bad news for disease coming in is they're going to have 20, 25 years potentially of taking care of us.4827
So the statistics just to sort of round that by 2025, about 27% of our labor force will be the gen z's And about 30% of them at least are going to be in some type of a4842 caregiving situation. So if you sort of multiply that out, um it lends it all to the way we work um will have to change. We know that's going to happen. I think when4854 we look at a lot of the survey results as a4856 result4856 of the pandemic. But the pandemic has amplified and I think open the issue of caregiving that was already there. It's amplified it and I think it's increased, particularly when we looked at the individuals who have that balance home schooling, taking care of elderly parents, disabled folks and then trying to maintain a full time job working inside of their house also.
So work will change. We encourage employers really to bring the support tools that are available inside their4888 own companies together. And then also that we continue to take the really good work that Elder Affairs does AARP Senior Length. There's all types of organizations that are trying to take this on inside of the work that we do inside of the Massachusetts Healthcare Coalition. So I really appreciate the time and your willingness to listen to this because I like to refer to this. This is a tsunami coming over the labor force. Uh, and I just don't think we know it yet, but it's going to come and it's going to come on very quickly in my opinion. SHOW NON-ESSENTIAL DIALOGUE
Thank you. It's a lot of follow ups on that too because I really appreciated that that you learned and others, the masses roundtable kind of jumped on this uh long before Covid really, and recognizing it as an issue that needs to be improved upon. And we keep hearing from the childcare perspective, in particular the important flexible workplace policies. And so maybe we can dive into that4947 at the end of this panel, what that might look like. Um Hello? Yeah, Helen, do you uh want to take the floor from here?
Absolutely.
HELEN ADEOSUN - CAREACADEMY - Thank you so much Senator Hinds really appreciate it. Chair Hinds and members of the committee Um I'm very grateful to be here and I'm looking forward to uh and have enjoyed all the remarks thus far. Thank you so much for the opportunity to take part in4975 today's discussion on how the commonwealth of Massachusetts builds a more equitable and and really just caregiving system. Um, My name is Helen Adeosun and I'm the CEO and founder of CareAcademy.com. We're based in downtown Boston and we're a company that's developed a really a leading edge platform in up skilling the direct your workforce. And also a proud member of the Massachusetts Home Care Aide Council and Alliance. We work with over 1100 home care agencies throughout the United States and Canada uh and have provided certification and training for over 200,000 direct care workers and growing.
Um My own background, like many Bay Staters, I'm a first generation American whose parents came from Nigeria, um5023 seeking a better life and opportunity. And uh they also mirrored the expectations that they had for their children. They worked hard in service jobs, um also as direct care workers while obtaining their own degrees, uh and successfully building up5039 their own credentials in their careers. And they impressed upon me and my siblings the value of education coupled with opportunity and support was really the key to success. Uh And the5051 question that I really sort of hold in the center of our discussion today are how do we replicate? Um The question is how do5059 we replicate um5060 the opportunities that my parents had uh not just for the few. Uh and how do we think about ways that we can impact the direct uh direct care workforce?
Um I want to thread a couple of things here. I'm going5075 to largely talk about the director workforce really as a5079 microcosm of the impact of COVID on opportunity and employment for black and brown folks as people of color more broadly and women because they're very interesting at parallels. And um really the the uh the opportunities that CareAcademy uh and and we envision and project for5101 the commonwealth and more broadly um moving forward beyond the pandemic. Um, so first I always want to orient uh into what are the demographics of the direct care workforce. according to the Paraprofessional Health Institute or PHI uh, the caregiver demographic largely includes 96% caregivers who are women, The median age of the workforce are 46-48. And 56% are immigrants, uh, 62% are people of color and identify as people of color both nationally as well as here in the Commonwealth.
And as you can imagine if we look deeper at those demographics, many of the direct care workforce are not only making a living caring for others, they are also as many other panelists and the panel also before us mentioned, are also family caregivers themselves. And so there are multiple linkages and parallels as you know, I've been hearing several folks echo across the panels. So unfortunately the macroeconomic picture for immigrants and specifically for women and people of color have been grim in this last year of the pandemic. After 2019, a decades long climb uphill for wage attainment in communities of color specifically um, we have seen just sort of a precipitous decline in terms of opportunities as well as wage gains.
Um, one of the, um, The research that I love to cite actually comes from the, from the Federal Reserve Bank of Boston that noted that, you know, we saw a median wealth that persists of roughly about 250,000 for white households. And while here in the Boston area Dominicans um, and blacks have seen a median wealth of close to zero. I think the number that's cited specifically is $8. Um and so as we think about those, um and we think about also what the National Community of Reinvestment5230 Coalition recently termed America's first female recession Uh The pandemic has really emerged as a perfect storm or an exacerbation as several folks pointed out um for the direct care workforce. Especially when we consider that the demographics of this workforce are largely people of color and um folks who represent uh immigrant backgrounds.
Um and that perfect storm lies between the health challenges disproportionately facing communities of color because of COVID and a pandemic of racial reckoning and systemic challenges of violence, access and systemic injustice. Uh and specifically, um as we think about the direct care workforce and how they're a microcosm of what is happening5278 within our country right now, all of those uh impacts are broadly felt. Um the pandemic has left the direct care workforce feeling the dual tub of being a necessity for families who now wanted to position the caring of loved ones um into home care and community based settings and also being caregivers for people in their own homes and communities. Um often multigenerational um uh are living within uh all throughout Boston and all throughout the commonwealth.
Um so emerging from this pandemic, the demand for the direct, care workforce will continue unabated. Um MaryAnn Mulligan spoke about this earlier but recently as have actually a week ago, an Axios poll recently published showed the emergence of coming out of this pandemic. The role of direct care workers and caregivers respectively, showed 156% fold increase and a 249% increase in demand for this critical and necessary workforce that we at CareAcademy have posited a really the future of work and the future of healthcare. Um and so one of our mantras this year at CareAcademy has to never waste a good crisis. That usually comes from political circle so maybe some of you may be aware of that. But we have taken that on, and I really firmly believe that the commonwealth as an opportunity to lead from the front and posit that in order to support a direct care workforce, uh we also have to support their communities to support our basic residents who are from immigrant backgrounds and who are people of color.
It is looking at what we offer in terms of support for the direct care workforce uh and communities at large.5393 So CareAcademy actually announced last year that we would be the Company that enabled one million new direct care workers to empower their communities and the millions of baby boomers and those who are aging and desire to age in place. Um and that we'll increasingly rely on them. Um and so there is much work to be done we realized that. We echo a lot of the sentiments across the panels that have acknowledged that this is not a one shot solution uh and everyone brings multitudes the table. So we think it's actually all of what everyone has mentioned today. Um and I specifically want to focus on looking and solutioning around three uh aspects of uplifting and elevating the direct care workforce and a workforce that is largely composed of immigrants and women of color.
Addressing first, uh compensation and reimbursement rates for our direct their5451 workers, we think is the first topical issues, second, really linking and uh several folks have spoken about this, but linking direct care5459 worker advancement as part of a necessary to healthcare outcomes. If we're seeing the transitioning of healthcare models, both5468 on the acute and post acute side in the home um linking the people who do that work through those healthcare outcomes will be absolutely key. And CareAcademy has begun to do that. And creating an opportunity building or career5480 laddering, as MaryAnn Mulligan mentioned earlier within the direct care workforce and community based care models is absolutely key. Um just to even cite some, I think everyone did tremendous work in terms of citing some of these opportunities. Um but we know that the wage gaps for direct care5499 workers specifically direct care workers of color are large. Um in Massachusetts, the median hourly wage is, roughly about $16.38.
Um and and uh that is based on the Bureau of Labor Statistics accounts in 2021 and that's across all care types. Um and further kudos uh that I will extend also to the legislative efforts of the alliance and uh several folks on this call. Um However, we know that broadly, you know, when index for cost of living in Massachusetts, particularly eastern Massachusetts, and we take into account disparities uh in communities of color in pay, uh this number remains relatively low. And uh we we want to seek ways in which we can improve this over the long term. Um and so one of the three points that we think are key in terms of bridging the gap is really strengthening the social safety net and improving access to workplace benefits for direct care workers. When we talk about benefits and benefits structures, we talked typically around um white collar work or sort of office based work.
Um We are starting to see a shift just based on the acuity of the demand for the direct care workers and how we think about who gets access to benefits. But we see opportunities in terms of providing affordable health insurance, free or low cost childcare, paid sick leave, paid family and medical leave and retirement savings options offered to uh traditionally non white collar or more oriented sort of a blue collar worker in the direct care workforce as really critical to some of the challenges that MaryAnn Mulligan mentioned earlier in terms of the recruitment and retention opportunities for direct care workers. Um and this directly impacts when we talk about economic impacts, we're talking about ripple effects. So not only5623 the families of direct care workers would be impacted by this, but also uh multi generationally as well as uh communities would be wholly impacted by uh the ability of direct care workers to access these benefits.
Um paying direct care workers um and considering a living wage. Um I think we think about this in terms of balancing both the ability to do so in terms of um looking at reimbursement rates as well as the value of direct care from a healthcare uh standpoint, which I'll talk about a little later in terms of some of our findings. And also evaluating um what that wage increase means. Um You know, I think this is a very nuanced conversation when we talk about providing for wage gains and MaryAnn as well as uh several others who have been on the call of mentioned their work around this. But we think this5679 is actually first and foremost when you're talking about economic uh impacts as well as the delta between communities of color uh and and um their white counterparts and white neighbors.
Um the second piece that I'd like to talk more about, and this is more of a new sort of paradigm um as well, and I mentioned this earlier, but it's linking direct care worker advancement as part of a necessary to achieving healthcare outcomes. Um and that comes from many ways. We specifically at CareAcademy look at that from the impact of education. Um We acknowledge that, and we measure among the hundreds of thousands of direct care workers, we've had the privilege of impacting uh training instills both ability and confidence to perform necessary and asked for skills. Um We know that coming out of this pandemic, uh there are not only a need for more direct care workers, but also the skills required uh they will be asked upon. Uh Direct care workers will be asked to do more in terms of those skills desired.
And so, providing for ongoing training or continuing education will be absolutely necessary. And that ensures that direct care workers are uh are gaining competencies in core areas over time, are gaining skills and acknowledging best practices in some of the comorbidities and the social determinants that most impact older adults. Um and really just uh you know, providing really updates in terms of provision of care that align with overall best practices and5781 best practices standards. Um and then uh and something that we'll also talk about a little later too, but Um offering further avenues for special specialization within direct care workforce or what we term as upskilling um will be key in terms of building opportunities specifically for direct care workers and more broadly within our healthcare system and capacity.
Um and then Knowledge um one of the one of the surveys that we one of the studies rather that we completed um and an abstract published in 2016 with the journal of the American Geriatric Society actually looked at the linkage between interventions through education. Specifically a class that we have available on5828 falls um and falls prevention, that is one of the leading causes of death and and readmissions within5835 our our aging population. Um we had caregivers complete a 45 minute intervention. Uh and we saw that caregivers coming out of that 45 minute intervention, um Pre and post saw a 20%5850 increase in terms of their knowledge about falls and falls reduction. 92% of the caregivers reported that they were confident in their knowledge about risk factors and assessing falls and risk factors and interventions uh coming out of that class.
And lastly, um in terms of creation of opportunity um for direct care workers, we also support career laddering. It's something that I've heard and I'm very happy that it has been echoed throughout the different panels today. Um, but we also acknowledge that there's a need for providing for an overarching federal mandated, um uh outlook on what it means to be a direct5899 care worker, what it means to be a community health worker. Um That work5903 has been piece by piece federally. Um, 22 states don't license home care uh, agencies and therefore don't have minimal training standards, um, including the commonwealth. And upskilling, um, is going to be key, I think, in terms of recruiting and retaining um, this workforce. So, as I mentioned before, specializing um enhanced training um, to advance the careers of direct care workers.
Um, so one of the, as we were researching just for the comments today, um one of the, one of the tidbits that we pulled out was actually from the Massachusetts Board of Higher Education and in their allied health workforce plan. And I quote, the current array of training and certificate degree programs that address direct care jobs are not well aligned to meet employer expectations regionally in statewide, nor these programs based on common core competencies to promote these programs, I'm sorry, uh common core competencies to promote seamless and accelerated career progression of workers. Further, these non credited training programs must also articulate a credit bearing certificate and degrees to ensure seamless academic progression for workers and students.
So one of the challenges that we've always surmised has been, you know, it's not only, it's multiple levels of, of training and training engagement. Um, it is to be able to do the work of now, it is to be able to upskill to provide care um as uh disease states progress. And it's also, and this is sort of a triple flip, making that uh that credential mean something um and have what we call an education portability. Um We at CareAcademy were proud to announce um last Tuesday, actually, um, that we launched uh a program a first of its kind in the country called the Career Path Program. Um and what it allows for is for direct care workers for the6038 training that they are already receiving with any of our customers here in the commonwealth or throughout the country or really uh the world. Um they are able to use that same credit um towards advancing their careers and can continue working with their employers while utilizing the training that they are receiving in lieu of providing services towards an associates degree, a Bachelor's degree or more.
Um, we linked arms with, uh, Southern New Hampshire University, which is a really a regional powerhouse and a multi nationally based powerhouse in providing6075 this opportunity.6077 And what we imagine this uh, in order to provide for6080 opportunities within the direct care workforce that happens to include um women of color and immigrants. Providing these opportunities that really remove the barriers of access towards greater educational attainment and opportunity. Um, and often what I'm asked um, by employers are you know, how do we know that by providing some level of skills attainment that will make a difference or, you know, how many folks want to obtain necessarily a college degree?
And I think that's a real, it's a new paradigm shift, but one we have to take, um, in lieu of attracting more folks into the direct care worker, um, population.6124 And um also imagining that for everything that we want our direct care workers to be to be talented, to be of quality, to take care of our family members, they also aspired to be. And in fact, before announcing this initiative last Tuesday, several years previous, we had completed a survey of nearly 800 direct care workers with Southern New Hampshire University and their College for America program. Roughly 52% of the respondents said yes, they were with or without CareAcademy or Southern New Hampshire University were considering obtaining more education in the future. And that percentage remained consistent when comparing across gender and even increased specifically in communities of color. In fact,6171 we saw a higher likelihood for direct care workers coming from communities of color.
When comparing the ethnicity of caregivers we found that6182 there's a higher likelihood to desire education among Latinos and among African Americans. And we look forward to expanding our Career Path Program and other initiatives uh to support the direct care workers who are in large part like my family um coming from communities of color. So I just wanted to complete as I'm getting a little bit of feedback out of great challenge comes really great opportunity. And we believe that emerging out of this pandemic, they're really great opportunities to engage creatively and more broadly. And imagine a healthcare future that meets the needs of direct care workers uh and their communities. So thank you so much. I really appreciate the time to speak today. SHOW NON-ESSENTIAL DIALOGUE
Okay, thanks6228 for taking the time to go through all the all your work and the kind of the different elements of the challenges and also the opportunities. I think it sounds like you and CareAcademy are truly are at the center of a lot of critical areas, including6244 you know, wage increases skills, increases creative ways to transfer that to education, elevation, um lifting workers lifting women lifting women of color, I really appreciate your6257 insights and participation and continue to work. Um since we have about 10 more minutes on this panel, I should move quickly to Alexandra, who's,6267 as I mentioned earlier, alexander drain is the Ceo and co founder of Arcangel. So over to you Alex, thank you,
ALEXANDRA DRANE - ARCHANGELS - Thank you so much chair, chairman, thank you. Vice chair members of the committee, thank you guys so much for caring6279 about this. This has been an extraordinary 40 50 minutes so far. I'm Alexandra Drane, I'm the CEO of ARCHANGELS. I'm a serial Massachusetts based entrepreneur. ARCHANGLES is my fifth company shout out to the commonwealth. Um I'm also on the board of Mass Tech, a big love in my heart for Mass Tech they're doing extraordinary things. So ARCHANGELS is a movement that is reframing how caregivers are seen honored and supported using a combination of data and stories because both matter right. You need the data to engage the brain, but you know the stories to engage the heart and that's where the behavior change happens.
I know there's been so much data coming at you. I want to reinforce this data and Helen did a beautiful job talking about it from the direct workforce, direct care workforce. I'm going to actually take a minute, I'm going to transfer over to some visuals because I want this day to imprint on your soul so these data stays really with you forever. So I'm going to share my screen quickly and just soak this in um and let's run through this quickly, Can you guys see that okay? Is that coming up? Okay, great. So we've been talking about caregivers, I'm going to talk about unpaid caregivers, okay. And these unpaid caregivers are everywhere. And a recent national survey that we did, when we ask, are you worrying about or a caring for the health of a family member, a neighbor, a friend? A full 66% of individuals say yes.
That's a lot more than what most people usually think about. And in fact, that's because most unpaid caregivers don't think of themselves in that way, right. In their mind, they're just a husband, I'm just a grandson, I'm just a nephew, I'm just a neighbor. And that's a missed opportunity to be providing these extraordinary humans with access to the incredible stuff that exists in Massachusetts, for example, to support them. So these unpaid caregivers are everywhere and they don't always look like what we'd expect. People have in their mind the vision of a 46 year old woman caring for her mom that's6390 true6390 she6390 is.6390 But 45% of caregivers before COVID were men, one in four millennials and one in five are gen z. Again, this is often surprising to people.
What I don't think it's surprising to anybody who's a parent or guardian of children right now is the extent to which the unpaid caregiver definition now has extended to include anybody who is caring for kids. That's Erin, she's a coworker at ARCHANGELS, that's Benjamin and Emelin they're also co6417 workers at ARCHANGELS. And I want to acknowledge how lucky we are that we get to work from home and we get to have an office workplace. So many unpaid caregivers are not, they are on the front line, there are essential workers. And quickly, just by way of reminder, if6430 that 66% number is true, then anybody who's listening, you are and everyone's alluded this so far, you are likely a caregiver yourself as well. You are in the work that you do supporting the state, but you're also an unpaid caregiver for your loved ones. So, as you listen to these statistics that I am going to fly through, please think about that.
We did a study that was published in collaboration with the Blue Cross Blue Shield Association that looked at the health of Caregivers before COVID. So even before any of this additional impact and stress happened, caregivers already had 26% poorer health. We were over utilizing the ER and hospitalizations twice as likely to develop chronic illness due to distress. We had twice the rate of depression. When you think about the workplace impact, 60% of caregivers reported needing to cut back at work. Of course they did. Caregivers are costing employers $3,200 more. This was before COVID and replacing the salaries, a caregiver's salary costs 1.5 times more. That matters to all of us, as you6485 know. But as of COVID, we were very lucky at ARCHANGELS.
We were able to be a part of a study published by the CDC that looked at the impact on mental6495 health, substance use and suicidal ideation as of COVID. And our role as ARCHANGELS was to bring to bare the6502 role of the unpaid caregiver specifically as it relates this mental health impact. And what we can tell you and many of you guys have experienced this firsthand is that for the unpaid caregiver as of COVID, a full 56% of us are experiencing clinically significant anxiety or depression, that's 2.5 times the rest of the population. And when you think about those double duty caregivers that Helen was talking about. So you're carrying at home and you're carrying at6527 work you can only imagine the impact. This study was picked up in an extraordinary way. I can tell you it's in the top 1% of publications in the CDC's Journal and the top 10 of CDC COVID articles in 2020.
Why did it strikes such a chord? Because the data that we were able to uncover as part of the Cope initiative um showed when we say caregivers are not all right, we mean really not all right. And again, listen for yourself and for the people that you care for. A full 31% of unpaid caregivers contemplated suicide, suicide ideation in the month of June before we published it. That's 10 times the rest of the population when one time of the population would be too much. What do you do when you're super stressed out? You self Medicate, a full 33% of unpaid caregivers using substances to cope. That's increasing at five times the rate of the rest of the population. We talked quickly about how unpaid caregivers in the old days were over utilizing the ER and the emergency and the urgent care, which we thought was bad because it's not an efficient way for them to get care. Now we're like, oh, those were the good old days because as of now, caregivers are delaying care to an alarming degree.
Delay or avoidance of medical care because of COVID-19 um, is five, has increased at five times the rate. Um five times the rate for unpaid caregivers as opposed to the rest of the population. So at ARCHANGELS, we have a tool we call the intensity index that looks at sort of the how all these things come together to impact the intensity of your caregiver experience. And I just want to run through really quickly. When you get your intensity measure, it takes 2.5 minutes to do, it translates into how well are you doing? Are you in the green? Are you in the yellow or are you in the red? Before COVID a full 28% of unpaid caregivers were in the green, 8% were in the red.
As of COVID we can tell you as you would imagine that6631 these6631 numbers are startling and they're really important to employers. Right? As6634 we're thinking about, how do we meet caregivers where they are to get them the support that they need that they often don't know about that exists, but they're not utilizing. Look at that. We've now got a 4.6 time decrease in um, intensity and those in the green and at 2.6 times increase for those who are in the red. This matters in particular because if you are in the red, you are 49% negative impact on productivity. So as we're looking at ways to impact top and bottom line of our employees, not to mention the heart line, which matters the most.
A couple of quick myths, the younger you are the better it is. Not so if you are a caregiver. If you look at loneliness and isolation, Mark, thank you for referencing this before. ARCHANGELS has similar data gen z 69% of that population is experiencing loneliness or isolation. Um, But that's not, the number doesn't exist for other populations as well. A6681 full 42% of boomers are as well, lonely or isolated because of their caregiving, due to the pandemic. And we made the terrible mistake of saying in a meeting that's only 42%, 42% right? That's close to one in two of any boomer is experiencing loneliness or anxiety or um isolation due to due to COVID as a caregiver. Another myth, money fixes everything. Not6704 so6704 if you are a caregiver. Um, high intensity caregivers are found at all income levels. Again, important as we're looking around us and thinking about who they are.
And then I'll just touch very quickly when you look at the impact of whether you're working or not working, we want all of our citizens of the commonwealth to be working right. What impact does work have on your caregiving responsibilities? If you are working and you are low intensity, you're in the green. You have a 30% greater chance of having depression, anxiety, or stress. But what if we look at as your intensity goes up what does that do to your experience as a caregiver in the workplace? And what we see is that if you're in the yellow, you actually see a reduction in that negative impact, which is extraordinary. And if you're in the red, that reduction holds too. So there's a different way of thinking about the opportunity to be supporting people staying at work. They want to stay at work, not only because they need to make the money, but because it actually is positive for them from an intensity perspective.
In fact, we can actually think in a way of work as respite, which is very different than how we often think about it. And what role can each of us play as employers or health plans or health systems or communities or the state overall? Workers in the red who feel strongly supported by their employer further reduced their likelihood of depression, anxiety or stress up to 19%. So these are extraordinary numbers when we're thinking about the impact that each of us can be having. So in closing, um, I went so fast because I want to leave time for conversation. Um, I just want to get a massive shout out to you, Senator Hinds to6795 the committee Overall and our Senate President Spilka. I love the moon shot. A long term effort to reimagine care systems in the state to um, to better support that people, particularly women caring for loved ones of all ages and help them stay in the workforce.6808 Big heart to that. And I'll be quiet. SHOW NON-ESSENTIAL DIALOGUE
Yes, next time with a little more energy.
Mm Thanks. Solider alexander, That was great and incredibly insightful. They appreciate it. We do as you pointed out, only6827 have a few minutes before we move to the next panel. But um I'm just6831 curious. Uh well maybe Senator, lovely, I thought you just turn on your screen. How about uh open it up to you first?
LOVELY - Thank you Mr. Chairman. Um I don't know where, where to begin. Um a tremendous amount of information. Thank you so much. Uh It isn't, that isn't a think set that I think of often or really at all to be honest with you. So thank you for educating me and and what this looks like, future of work. So many different layers, layers and levels and and I will tell you I took a minute to go say hello to my six month old granddaughter. So I popped out of my job for a minute and that gave me that really, that picked me up a little bit for this afternoon. This is6873 usually my lull time. So um when you're talking about that, it really makes so much sense to really have fulfilling um uh work lives um as we also help care for family members that six month old in my household, so um that, her husband and my daughter. So anyway that I'm going to stop there, amount to think about and just so much. Thank you so much.
HINDS - You know, really quickly, we6902 started this off with this panel with the kind of, how this impacts uh the workplace. And uh Helen brought in a conversation around it just could reduce the cost of health if we're actually paying attention to some of these preventive measures. I'm just curious if anyone has thoughts on this concept of the geography of care and how that influences. We've heard a little bit about the flexible workplace policies. We've heard a lot about the need for supporting workers' wages and certification and beyond. I'm just curious on this, this geography of access. Um, is it we'd be focused more on home care providers or where you all kind of view this as uh, kind of that hybrid mix of bricks and mortar and visiting at home.
BUTLER - Senator Mark Butler, I'll take the first shot out if you like, and certainly others. I think we're going to see a significant rotation in how care services are delivered. So if you think about that, you know, we've traditionally trained healthcare workers to work in you know, hospital settings, physician office settings. The set of requirements, education how you deal with particularly older individuals in more of a home care setting uh is going to require different training. We have a lot of college clients that are thinking about constructing different curriculum as they think about nursing and those types of things as you go forward. That's one point. And I think secondly, uh there probably will be a tremendous acceleration in digital monitoring tools usage um that will really rotate.
You know, we saw during the pandemic telehealth visits7013 increased significantly, you know what kind of routine urgent care type things, very significant increase in the behavioral health space, which even I'm going to say, as we move into maybe a post pandemic period that we're in now, or certainly a better pandemic period, interestingly, the telehealth visits have stayed at the pandemic levels. So I think what I would think about is a rotation7040 of where services are delivered and the types of people who have to support them, the technology influence that will make that easier uh and more accessible for folks,7051 particularly in rural locations, as we think about, you know, even western Massachusetts, up in Vermont where I grew up in New Hampshire Maine, you know, some of the less urban locations. And then I think the last piece is, is that we'll see data come into play and how we help physicians stand beside them. As a health service company we think there's a big role in telemedicine that we can create better, more efficient care experience for everybody. SHOW NON-ESSENTIAL DIALOGUE
Great, thanks for that. Um Anyone else? Lawrence, you want the last word, thank you. Mhm. Or Helen Helen, you just popped on your screen, did you want to say something?
ADEOSUN - I did, and I thought those remarks were fabulous. Um I would also add the ability to imagine a direct care worker is not only distributed but practicing the top of licensure. Um, One of the questions we often7104 ask are knowing that we don't have enough nurses or enough clinicians are there things that certain people within uh an acute setting should be doing that post acute worker or direct or direct care worker can be doing as well. So imagining someone working at the type of top of licensure, being unable to do things like provide for medication and other things I think will be part of this idea of distribution, which I think Mark excellently spoke about. SHOW NON-ESSENTIAL DIALOGUE
Great. Perfect.
Uh Lawrence. I see your your mouth moving, but I can't hear you. Yeah.
Still the case actually. My father's can hear him No.
Okay wave. Goodbye. Thanks for your help on this lords and thank you for your good work. We'll check in soon. And same goes for all of you. I really appreciate you taking the time today. Um, It's an important conversation and it's one that we clearly have to lock arms on for a while here as we try to rethink our systems.
DRANE - Um, Senator one last quick point, which I want to give a shout out to the Mass Broadband Initiative because whenever we talk about digital health and the unpaid caregiver, there are so many unpaid caregivers who don't actually have access. So not only the work through Mass Broadband Initiative to get unpaid caregivers jobs to get people access but this broader definition of what health is, who's doing it and where it happens. And really to acknowledge this invisible workforce, that is these unpaid caregivers. While they're not getting paid, they are. It is an enormous amount of value that I hope we can start recognizing and supporting across the commonwealth. Thank you so much for your time.
HINDS - That's a great point. And and the digital divide is one that keeps coming up. And so we're talking about all these things around telehealth and online training and on and on. And yet7214 we have a big, big problem in access just with the digital divide in our downtowns and in our rural areas. So um thanks to7222 Mass Tech and MassBI for that. SHOW NON-ESSENTIAL DIALOGUE
Great, thanks everyone. And we'll move to our final panel here, um which is uh we're gonna as we've said previously, what I'll do is I'll introduce everybody and then we'll come back through and speak in that order and we're going to hold questions and the conversations for the end. Um I really have to give my appreciation to tim Foley, who is the Executive Vice President, S C I S E I. U. 11 99 in there helping kind of organizing um this panel and organizing some of our thoughts and uh just really being a thought leader and this and many other issues.7259 Um so tim will be kicking us off and we'll have Rebecca Gutman,7264 who is the vice president S. A. U. 11 99 for home care and Candia think who is a personal care attendant, paul spooner, who is the executive director of the Metro West Center for Independent Living. Um and I'm looking forward to to hearing from um now use yuzu who's a worker7286 in Chiang law who's a client. Um and we're joined by Karen Chen who's a good friend and executive director of the chinese Progressive Association who will facilitate that participation. So tim why don't you start us off,
you're on mute. Still, it really helps to go off mute. Welcome.
Yeah, thank you. Uh interested to catch the last part of that last panel as well.
TIM FOLEY - 1199SEIU - So uh thank you uh Senator Hinds and Senator Lovely and members of the committee for and to the Senate president really for pulling this important and timely conversation together. Clearly uh this is an important one and we're grateful to be a part of it. As you said senator, just for folks listening in my name is Tim Foley. I am the executive vice president of 1199SEIU. We're the largest union of healthcare workers in Massachusetts, representing workers in hospitals and health centers, long term care facilities and throughout the home care sector. And really it's on behalf of the frontline healthcare workers of 1199 that I just wanted to again express our deep appreciation for the opportunity to address this committee today. And really we applaud the efforts um to think big about intergenerational care with a critical focus on the child care needs as well as the home care needs that we all know are critically important to the folks within the commonwealth. And we appreciate that opportunity.
I'll just start out senator just to reinforce that, I'm joined here today on this panel with frontline home care workers from both the Independent Provider PCA program as well as a number of home care agency workers, both union and non union By the vice president of 1199 Home Care Division, Becca Gutman and our leader in the disability community Paul Spooner. Each of whom are here to share their unique and important perspectives, experiences and thoughts about what we need to do to improve the home care sector to expand services and importantly support the workforce. Uh when we think about reimagining Massachusetts in a post pandemic era, and I know we're all very much looking forward to that post pandemic piece of that statement uh we believe strongly um that we have to center our efforts on7427 those who cared for us during this pandemic.
The essential workers who were on the front lines, uh the heroes that risked their lives and the caregivers who continued to provide care throughout the commonwealth to today. Um And this includes uh folks on this call who are often the invisible workforce, right? Um but also are an critically important workforce and those are our home care workers. In Massachusetts um there are over 100,000 caregivers who are caring for our family members, our friends, our colleagues, loved ones and neighbors, um but yet7460 their contributions are not always valued or acknowledged and that's something we need to work on. Um And the truth is, home care providers are an essential part of America's family infrastructure. Uh they're caring for older adults and people with disabilities so that they may live in dignity at home. Uh It's also those care jobs7479 to make all other work possible as family members can go to their own jobs, knowing their loved ones are at home, receiving care safely and that their care needs are being met.
We also know that home care is one of the fastest growing professions. Uh We have one million home care jobs will be needed in the next decade, and those jobs need to be family sustaining union jobs with a livable wage, benefits like retirement training opportunities. I heard the prior speaker talk about career development within the healthcare field, how do we establish that career pathway? Um However, we also know that this pandemic has exposed the lack of infrastructure7517 in home care that best supports workers, consumer clients and families. And uh at 1199, we believe, and clearly the Senate president has weighed on this too, that this is the moment uh to reimagine and to think big. Um not just7535 because of what we went through the pandemic, but because what's also happening at the federal level.
With the recent passing of the American Rescue Plan,7543 which7543 included uh 10% FMAP increase for home and community based services, as well as President Biden's America Jobs Plan, which we are working every single day to ensure that his statement is uh followed through into law to make an investment of $400 billion in home care services. We see this as our state's opportunity to lead the nation, like Massachusetts has led in so many other things in creating a comprehensive home care delivery infrastructure that supports workers and the consumers7576 and families that they serve. And so we see this as the time is now to make these changes, uh, to think big as the Senate president challenged this committee and all of us to think about. Uh, and to continue to push to make the investments we need to make, to improve the services that are being delivered and support the workers that are so that they can care for the residents and families that they do currently, uh, and across this commonwealth.
So, um, thank you for the opportunity Senator. As you said, I'll turn it over to our vice president, Home Care Becca Gutman who lives and breathes home care every single day, uh,7608 and to the other members of this panel that, um, we thank you for the opportunity to bringing their voices to this discussion about their ideas and thoughts about how we do just that. And we put together a plan moving forward that grows and supports both the care infrastructure of home care services, what we're speaking to today, but clearly the importance of childcare as well. So thank you for the opportunity. SHOW NON-ESSENTIAL DIALOGUE
Great, thank you over here, Rebecca
REBECCA GUTMAN - 1199SEIU - Thank you. Thanks Tim. Thanks Chairman Hinds and members of the committee and the Senate President for this opportunity. Um and of course, thank you to the home care workers um on the panel, the clients and consumers, the over 100,000 home care workers across Massachusetts who went to work day in and day out, especially during the pandemic. Um So our 1199SEIU members and home care workers live in some of the hardest hit communities, especially the hardest hit communities during COVID. Black white Latina, Asian7669 mostly women uh do the bulk of caregiving work. And these women, these caregivers need to be put at the center of reimagining Massachusetts what Massachusetts looks like post pandemic. Really they along with the people who receive the care are the experts.
So as our union imagines what is needed in this moment, we wanted to name just a few ideas and we7698 have many but we're gonna keep to a few today. There are about four to 500 different home care agencies in Massachusetts. They7707 range from agencies that employ hundreds of workers to mom and pop agencies that really come and go. And we need accountability and oversight for all of these home care agencies to ensure that elders and people with disabilities get the care they need and workers are treated fairly in the process. Home care workers need and deserve a safe work environment free7732 from discrimination and abuse so that they can protect themselves as caregivers and make sure that the people who receive the care are also protected.
So 1199SEIU our union recently surveyed personal care attendants and found that one of the major problems is that there's really no reporting mechanism to even track the issues right now and there's no standard protocol. And just on this point, I really wanted to thank Senator Lovely for for your for your leadership on this issue. And it will come no surprise to anybody here that home care workers need higher wages, including premium or pandemic pay and quality benefits to stay in these jobs. And that if we're going7779 to meet the growing demand for home care workers, we need to address this important issue. And then finally, this pandemic has taught us in many realms that we need better emergency preparedness. So both home care agencies and home care workers can be prepared as possible when the next new challenge comes our way, whether it's in the form of a natural disaster, or a pandemic or or something else7803 entirely.
We can't ignore the calls for action. 80% of voters say that ensuring high quality and home care for seniors and people with disabilities is a top priority. And it's just time I think we all know for a long overdue investment, um, and oversight of our state's home care system. So now I'm really looking forward to hearing the real life experiences of home care workers, consumer employers, and clients, those who are directly impacted by the system. Um, and really these are the voices we need to listen to and these are the stories that should shape future policy. So I wanted to start with Candejah Pink who is a personal care attendant in Springfield, Mass. Who was going to share her story. SHOW NON-ESSENTIAL DIALOGUE
Alright. Western Mass. 4 1 3. Exactly.
CANDEJAH PINK - CONCERNED CITIZEN - Thank you so much Becca I really appreciate this moment. My name is Candejah Pink. I live in Springfield Massachusetts. I've been working in the medical front line for years. I was a New York Fire Department emergency medical technician, volunteer for the elderly and a paid uh sorry, a paid personal care attendant and I am a proud member of 1199SEIU. I got into PCA work because a friend asked me for help. I wear my heart on my sleeve. If I was at, If you ask me for help, I will rearrange my schedule to accommodate yours. I'm an honest person you can trust. I have an elderly friend who would ask me to do errands for her. She would give me her cash and I will make the money orders to pay her bills mail them off with no problems or complaints.
My current client only asks for things we take granted for. She is partially blind and I7915 am mindful to keep her independence as much as possible yet I will never let her fall. She loves to cook and I'm there if things get overwhelming plus my regular duties. I see that consumers and clients have trouble finding flexible PCAs and PCAs have difficulties getting the hours they need to survive. My last client was only approved for 4.5 hours a week, but she required more time and flexibility. She kept changing the set schedules on me. As PCAs We need a constant schedule, consistent schedule and reliable, well earned income. We also need more training. Some consumers are hard to handle. We need more training to support people with complex behavior, especially people with dementia. Orientation is available, but we don't get paid for any training.
As an EMT I got trained. They used to say you need a little knowledge and a lot of common sense. I have the common sense but I need the knowledge. As a PCA I need to know the protocols to how best to assist the client and who to contact in case of an emergency or an incident. PCAs have continued to provide care for our elderly and most vulnerable population throughout this pandemic despite not having the proper PPE. We face unsafe situations, especially with the COVID. PCAs are worried because sometimes we work for consumers with the possibility of not knowing they have COVID or not. Some refuse to wear masks and we hear about workers being exposed at work. I received my mask and gloves from the union and when I put on my PPE I feel safer but we need more protection.
Someone should be responsible for giving us the tools we need, like disinfectant and know how to protect ourselves and the people we care about. PCAs also need better pay. A lot of these jobs are part time. It is hard to pay your rent, car notes insurance and insurances. These are essential to maintain a PCA position. We can't survive off these wages. if this is the only check you are that we are getting. We need to ensure that we are protected in our jobs and in our jobs have adequate housing and sustain ourselves. Unfortunately we are the workforce who are often overlooked and severely underpaid. We should have a career ladder as a PCA. When I worked as an EMT we had a starting wage and then you would go up with more experience and paid training. As a PCA we have no paid training at all. We do not get higher wages no matter how long we worked on how much training we have.
We don't even have a retirement plan. Why should a person have to work as hard as we do without a future plan? We need retirement security. What is our options? What is our option plan to live off when we are older and can no longer go to our client's house? DTA, SNAP. We can't live like that. How are we going to make our lives, How are we going to make, how are we going to make our living? We have our clients' back the state should have our back. I am pretty sure state employees have retirement plans and health insurance. We have to pay bills, some of us cannot afford health insurance. Who is going to take care of us, who is willing to take care of those who are doing this work. I'm a registered8177 voter and I need to be heard please. We do a lot as a public servant. It doesn't matter if I'm a doctor or a PCA. We are on the front line. We earn respect for what we do and we are worth it. Thank you for listening. SHOW NON-ESSENTIAL DIALOGUE
Oh
thank you. Thanks. That was powerful, appreciate it. Thank you. You do. Um, you're you're hitting on some something that we're hearing across panels in terms of pay and training and benefits and retirement. It's a uh all sounds a bit like a no brainer. And yet we still have a system that isn't providing it. So that's one of the things we'll be looking at. Rebecca. Did you want to introduce paul or or should we just handed off to paul either way, thank you. Can be I thank you. Senator paul spooner, exec executive director of Metro West Center for Independent Living. And I imagine somebody most folks in the room. No, already
PAUL SPOONER - MWCIL - Thank you Becca. Uh and thank you for the opportunity that you guys set up for me to speak. Um and thank you Mr. chairman and other members of the committee. This is such an important issue. And I've got to throw a marker out to my friend, Senate President Karen Spilka who knows I'm testifying today but couldn't be here. And she's been a strong friend and advocate to the Metro West Center for Independent Living where I work. Um, a little bit about myself and then I'll go into some of the issues that have been covered because I've been kind of listening in the background through a couple of the panels. And I think there's a, there's a clear message that's being presented by all of us. And we may have slightly different perspectives or views, but I think our intent is all very similar.
I have been, I am obviously a person with a disability. I use a power wheelchair to get around and I've been on the PCA program for 42 years. Since I was in college. That kind of dates me pretty old. But nevertheless, without the provision of community based consumer control personal assistance services, I would not be where I am today. And I've been working and been active as a disability advocate since the early 80s. The reality is as a person with a disability there are things I cannot do and those involve issues around personal care and other activities of daily living. But by providing a program that's flexible to my needs, not regimented by an agency model um and having control over who I hire, manage and fire. The PCA Program in Massachusetts is a shining example nationwide of how a community based program can work.
We're probably somewhere in the 4th or third state in the union that has one of the largest community based programs. We're talking about almost 39,000 people with disabilities and elders who use the PCA program. And that adds up to at least 50, 60 70,000 PCAs. We're well over 100,000 individuals in the community working together to provide community based services so that people can live in their own homes in the community and basically not being sheltered in facilities such as nursing homes. And a point to be taken, we all realized that the highest fatality during the pandemic was nursing homes. Those are people with disabilities and elders who feared unfair, very unfair burden on this pandemic.
But nevertheless, our community model works and I would say that it works fairly well for a number of reasons. Pre pandemic one is the institution of legislation that enabled SEIU1199 to form a union for PCAs. That foundation led to a consistent growth in wages and some benefits for PCAs. Before that creation of a union, we had to go to rate setting commission to try to get a, or 10% increase in PCA8518 rates. We now have one of the highest rates of pay for PCAs in the country. However, it's not enough and we knew this before the pandemic. What happened with the pandemic is really multifaceted. Clearly people were sent home and in some cases more people became involved in unpaid caregiving. But at the same time, a number of us, myself included by being isolated and for a better word, quarantined in our own homes lost PCAs. Even though the commonwealth considers PCAs essential workers, the whole issue of pandemic and whether people had the virus were positive or sick. The lack of PPEs. A whole number of things affected us both personally myself8588 as an employer of PCAs8594 and my PCAs. One of my PCAs who I lost for a while and she came back works in a facility where she actually caught COVID and I lost her again for three months.
Well ultimately, you know, she was able to return. But clearly the pandemic indicated8615 how vulnerable our current system of8622 home care workers, community based programs are. Now, what are the solutions? A number of people have spoken much more articulate about what are the long term solutions and what are the issues. So I'm going to talk about what it means from a consumer employer perspective. And mind you, I run a center for independent living. So I have a staff of about 15 people. So I think I have some sense of understanding what it means to have employees, what to provide for benefits. One of the tragedies in our society and I cannot be more blunt is that we totally undervalue caregivers. Whether they're paid or unpaid. It's considered a low class, uneducated menial job and it's not.
It's about taking care of people you know, your family, friends and a societal obligation to provide support and assistance to people with disabilities and elders who need help with their activities of daily living. We need to elevate the value of home care workers regardless of the model, whether it's home health aides, home care or PCAs. People who work for this job or this type of job first of all, they are a special group of people who actually care about other people and two,8745 we need to value them. We need to provide them with a living wage, we need to provide them with a comprehensive benefit package which should include issues around healthcare, family medical leave and the opportunity to invest in retirement because all of us are eventually going to get older and have to rely on Social Security or other means for retirement.
We are creating a class of employees which are predominantly women and women of color who have no future and that's inexcusable. We need to find a solution that values people for the work they do which is caring for other human beings. I'm sure that numerous people will come up with arguments about how costly that may be or it's too much or some other crazed idea that sounds like socialism. Well, it's not it's about providing assistance to people with disabilities and elders to live in the community of their choice. That's the foundation of the Independent living Movement, that's8842 the foundation of independent living centers. And we need to all embrace that in order to solve the systemic issues that exist for this workforce. It's very fragile, it's under appreciated, its underpaid and it's inadequately resourced to provide us with support, but the type of work this is.
I know that we live in an extremely early elitist society that rewards degrees and education. I don't think that that's a proper measurement for the quality of work that8892 people in the community provide to people with disabilities or elders. Again, you know, a lot of times as a disabled person, I've faced the stereotype or stigma of being special because I've been able to achieve a lot of goals in my life. You know who's special, special are the people who come to my house at seven o'clock every morning to get my ass out of bed. They're the special people because they enable me to be here on this panel telling you what I think. And that's a huge opportunity that is not rewarded to the people who assist me to do that.
You know, in closing, I've had a career of almost 40 plus years in the disability movement and as an advocate. and you know what, I wouldn't be here without the PCAs who have worked for me and helped me throughout my period. And that's a reality that I think about every day because I'm not sure how many people out there can say the same thing. That if it wasn't for the help I received I wouldn't be here and that's important to me and it should be important for all of us. And I also want8992 to close in thanking Senator Spilka too, having given us the vision and the9000 idea to approach this like a moon shot because we've got to fix this or else we are really in deep trouble. So thank you. SHOW NON-ESSENTIAL DIALOGUE
Thank you paul. Thanks so much. Um
if it's okay, um I'll we'll move it along to um Somalia yuzhou um is going to speak. Who is a worker at medical resources along with her client king law. And Karen Chen is going to help by doing the interpreting. So I'm gonna turn it over to Karen
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CHANG LAW - CONCERNED CITIZEN - Um so um my name is Chang Law, I'm 90 years old and that's why you can, you can barely hear me in speaking. Um but I have I started home care needed home care when I was like 75 years old. At the time I was a lot healthier. Um Home care has been very important to me. Um My my feet hurt when when I walk so I can't, you know, I can't walk and I need help getting grocery, I need help cleaning, I need help washing clothes. Um You know so um the home care workers help me take care of these day to day needs. And especially during the pandemic, you know, I'm really grateful to have home care workers to come visit me and then also take care of my everyday um need. Otherwise I would have felt very helpless and lonely. Um So to me, you know, it's really important if we care about elderly, um you know, we have to make sure that the workers are taken care of. Uh I think the home care workers deserve better pay. They should have better benefits and so therefore they can do their job even better. SHOW NON-ESSENTIAL DIALOGUE
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WINNIE - CONCERNED CITIZEN - So my name is, and my English name is Winnie, And I'm a home care worker at Medical Resources. I'm also a PCA and a member of 1199. Um I immigrated to the US in 2008. I worked in a restaurant for about 8 to 9 years before9320 I became a home care worker. SHOW NON-ESSENTIAL DIALOGUE
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WINNIE - So, um, so when I first got into this job, you know, I was told it's a lot. It's very flexible. It's more relaxing than working in a restaurant. But after the training when I started working it's not that easy. That's what I found. It actually there's a lot of pressure that's involved. SHOW NON-ESSENTIAL DIALOGUE
Mm. Uh You can totally go home to hold on to. Uh
huh.
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you see uh hey you laugh. No they told the whole whole like you get your bunker like nothing hang on call so you don't want to hang out like mhm.
WINNIE - Um So you know the job present a lot of challenges. I'm not really sure how to explain it. So we have good clients, we also have difficult clients. And then you know it's not necessarily9400 their fault but sometimes the way that we do things the clients may not like it and that can you know be very difficult for us to deal with. It could be you know other issues like mental health. SHOW NON-ESSENTIAL DIALOGUE
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WINNIE - Um and then, you know, and and we all have elderly parents, we all know that they can be easy or, or you know, they love you, but they can be very difficult. So a lot of times these, you know, our client is kind of like our family members. But we also know that, you know, they're very vulnerable. Um they need need us to care for them. So, you know, sometimes, you know, it could be very difficult. We do a certain things put their clothes the wrong way, they don't like it and which what we have to do, just kind of have to swallow the, you know, if they yell at you, you just have to swallow it and kind of like, you know, move on to the next thing. SHOW NON-ESSENTIAL DIALOGUE
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WINNIE - Um So and also in our culture respecting the elders is really important. So you know, so in some ways being able to kind of take care of the elder, It's a sense of fulfillment that we have. And I have about you know, a little bit more than 10 years before I retire, I plan to stay in this job, be in home care until I retire. SHOW NON-ESSENTIAL DIALOGUE
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WINNIE - Um and you know we work very hard to make sure that you know the clients are taking, their needs are met. But in terms of the workers, you know um because it's an industry that we have, pay is very low and many of us don't really not9578 like are, you know, don't have good health insurance. Um Only if you get the state insurance. And then I also have seen that you know my co workers a lot of them are struggling with rent because of rising you know housing costs. And then at the same time in the last period you know groceries it has gotten a lot more expensive. SHOW NON-ESSENTIAL DIALOGUE
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WINNIE - So a lot of things I talked about you know existed pre pandemic and then during the pandemic you know our work became even more difficult mainly because we have to get to work and there's T, the MBTA cut some services so it takes longer for us to get9684 to work. And um the supermarkets limit the number of people who can get in. So the lines are longer and buying stuff takes longer you know. So a lot of us actually do a lot more, but our pay didn't go up very much.
And um and also, you know, basically for some of the workers who have been continually working, you know, in the pandemic, you know, pretty much you have to wear a mask for like, you know, almost the entire day. And then because of the pandemic, a lot of elderly buildings, they locked the bathroom, they don't want to publicly to use the bathroom. Everybody don't want, you know, don't let you use the bathroom. So sometimes the workers couldn't even use the bathroom the entire day. No water, you can't use the bathroom, but you know, we have to work because you know, there's um you know, we have to make a living um and support our family. SHOW NON-ESSENTIAL DIALOGUE
Thank you. Thank you, Karen, thank you, Winnie. Oh we need you want to just wrap up. I want to make sure that we have an opportunity for Charlene to speak. Okay.
Uh gone like a machine gun. Okay. Uh huh. I can tell you. Uh,
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WINNIE - Uh so I just want to add that there's more and more people needed in home care. So it's really important, you know, we make this change now to have better benefits, better pay and training. And there's more younger people actually entering the industry as well so they will need training in career advancement. Thank you. SHOW NON-ESSENTIAL DIALOGUE
Thank you Wendy. Thank you Karen. Um and I think we're gonna move to Charlene Dickerson and I um and then hopefully there's a little bit of time for questions at the end.
9809 CHARLENE9809 DICKERSON9809 -9809 CONCERNED9809 CITIZEN9809 -9809 Hello?9809 Can everyone hear me? Oh, hi. Um, I listened to everybody's story and I love it because it's all so true. I live in Springfield Massachusetts. I'm from West Virginia with my little country voice, but I've been up here and I've been doing home care work for about 30 years and I'm good at what I do. Um, I'm an advocate for everybody. I love going on Zooms and fighting for everybody because we have the right and the dignity to get paid, the right pay that we deserve because we're hard workers I mean very hard. And if it wasn't for us, um that people wouldn't be able to live in their homes, they would have to go to nursing homes. And when you go into nursing homes they decline so fast.
When they're home, they got the advantage to live the way they want to9868 live in the area that they feel comfortable with. They can live longer. They love us coming in because they need us. They can't live in their homes without us. I love my job but it gets so difficult when you have to work two jobs and then you don't get any benefit of working CNA work or PCA work because there's no benefits, there's no moving up, there's no9895 pay raises. You have to put up with stuff that you shouldn't even have to put9899 up with because you don't have a union. We're losing valuable and good people, and especially the young people that's coming on, they want to join but then they look at how hard it9910 is. They don't have a union, they don't have anything to look forward to. Um they don't motivate themselves to be in it, because look at the way they treat us, they under treat us and they treat us wrong, and it's wrong.
We want a career in this. We want to advance up, we want some workshops. We want benefits that we deserve, what it look like we working 20 to 30 years like I have and I got nothing to look forward to in the aftermath. Um, they're not paying us enough, so I have to work a second job. So that means I'm leaving time from my kids from my family. So when my kids come in and ask me questions, I kind of snap sometimes. I don't mean to, I'm tired. You know, my kid is like, hey mom, I'm like, what? It shouldn't be like that. And then how do we take care of people, the elderly in their home if we're working two jobs and we're overworked? We're not giving them the full effect that they really need, but we're trying to.
I go to different places because I go to different nursing homes and do like a person and I actually walked in and seen color. Like I walk in to the cafeteria and I'm like, why is it just people of color? Why do we have to stay just right there? It made me think of slavery and I'm not trying to be funny. It brought it back. I'm like, why do we have to be stuck here why we can't advance up? Why we can't get to pay that we deserve? What about the legislators that we fight for and they're supposed to fight for us too and then some don't when they get in. Well, they're going10012 to need some of us10013 one day too. Just because they're10015 making $600,000 a year don't mean they're not going10018 to need somebody like10019 us. And they better hope they're paying us good so we'll come in and do their10023 family well because you10025 can't do it tired.
They're going to need us just like everybody else does. We're good people. We10032 work hard. We're good at what we10034 do. And the people, I ain't trying to say we10037 have compassion and we have it and we show it. and those elderly people10042 they know it. They depend on us more than their family.10045 Some have family members who don't come by and see them. They got us. They feel like we're part,10052 they10053 talked to us, They10054 tell us everything, wait on10056 us to10057 come. They depend on us so much we help them with everything. And I'm like, Khadija, we work hard. We don't take10065 people's things. We10066 go pay their bills, we bring their change back, they give us a check, we do what we're supposed10071 to do with it and we come back.
We work so10075 hard. I mean10077 like10077 hard and we ain't10079 working for what? You have no10082 advancement so10083 it's10083 like why I stay in10084 this? So why lose10086 good people now10087 when you can step up and do what they're10089 supposed to do and give us a union,10091 give us some workshops,10092 give us some retirement, give us some extra pay. Give us something where10096 we can move up to. Why do we have to just10098 stay as a CNA? Train us.10101 I mean we got a mind, we use10105 it every day. I want to move up. I want to advance up. I want to get an10112 apartment with a backyard not one I walk into and it's a bad area10116 because I10117 can't afford nothing good.10118 And then what about food and stuff on our table? I don't know if to pay the10123 daycare, pull my kids off, leave me in the house by themselves and just take a chance. What we got to do?
We already Uh some jobs you have to stay. Somebody don't show up now You're doing 16 hours. You got to cancel appointments. Now you're frustrated. Now you're mad because you already worked your other job now10143 you got to stay for this too. You're10144 overworked. For what? And then I got to call and find babysitters. You can't even10151 leave. You got an appointment, can't10153 go to it. You get home, you're too tired.10156 You don't do your housework cause you ain't got time.10159 And then your kids is doing things you don't even know what they're doing. They're trying to talk10164 to us. We tell them to go sit down and it's not right. In order for us to10170 function we need better benefits. We need a10174 union. We need people to stand up10176 and back us up.
I mean, we are on Zoom. We're fighting for something we should already have and it's not right. I bust10185 my butt every day and it seems10187 like you're not getting nowhere. So why10189 bother? And then10191 like she said, go on welfare for what? I don't want10194 that. A check what every month and food stamps what are they going to give10199 you? Because sometimes they'll tell you $100 over your pay so now you can't10203 even get food stamps. You can't get MassHealth sometimes, you can't get health benefits from a job that don't give10210 it to you. So what are we supposed to do? We stand up10214 and we fight. We continue to10216 fight. I'm not10217 sitting. I'm going to stand and I'm10219 going to fight until we10220 get it and I'm not sitting back.
And if I got a call legislators and if I got to go to10225 the mayor's office and set10226 up and if I got10227 to go with and do what I10228 got to do, well guess what I'm going10230 to do it. I'm going to stand and fight. You guys tell10233 me what you10234 need to do what we need to do as a10236 team to get this happening I'm there and I'm in it. And I'm in it until everybody gets it because we all deserve it.10244 We all10245 deserve a better life, a future. I want to look to for retirement but in CNA I don't have one.10252 So after I worked for10253 30 years, what am I going to do? I can't work no more10256 because about time I10258 get damn 75 they're going to wear me out doing the CNA work and then I'm not going to10264 be10264 able to get no money because10265 we don't have a retirement anything. So what10267 am I supposed to do at10268 that age, go out and try to find10270 something?10271 Who's going to hire me at that age? I'm just saying10274 we need to get somebody to stand behind us and give us10279 what we deserve. And this is it.10281 Thank you.
FOLEY - Thank you Charlene. Thank you everyone, I10290 know10290 there's limited time but appreciate everyone um sharing their story about their experiences as direct10295 care workers. Um you know to get10299 to the moon we need workers to build the the shot and um right now they're explaining an environment which they're trying, they're doing amazing10307 work under very difficult circumstances. We know the demand is growing and the need for workers and10313 the folks who want home care10314 but we can't10315 it's not sustainable under the current structures and systems and the working conditions that you just heard from10320 these frontline workers. SHOW NON-ESSENTIAL DIALOGUE
10323 I10323 really10323 appreciate every10324 single one of you10325 incredibly powerful and you just you just nailed it, each one of you in terms of saying, you know, everyone's asking, well, how do we grow our workforce?10333 Or everyone saying how10335 do we improve our care economy and all the flaws that we've seen in terms of pay and and treatment of women in the workforce, and women10343 of color in the workforce. And and you've10345 you've laid out beautifully10346 what10347 it means. It's not it's10348 not rocket science. Speaking of the moon analogies,10350 um, if for how we get10352 there and um, and each of you have kind of added the layers that look, you have your own caregiving roles at home, even10359 though your caregivers during the day, and and that's still inadequate piece of this equation. Um so I I just,10368 I want to10369 thank you all for your10370 kind of giving us kind of clarity on on what it means10373 on the10374 front lines and thank10375 you for doing that work10376 before we close out,10378 Senator lovely, wanted to give you an opportunity to say something. Thank you. MR Chairman, I want to thank all the presenters in this panel very, very much. The work you do is critical10389 and we need more of you and you need to be treated with respect10394 and dignity and get paid for what you do10397 because that work is hard, so thank you so very much, I really appreciate from hearing from all10403 of you and this is10405 a necessary piece of as we look at the10408 future of work um and what you do is10411 extremely, extremely important.10413 So, uh Chairman Heinz, thank you so much for assembling10417 this. Really great. These three great panels today look forward to continuing our work as we um10423 as we10424 figure out how to best support ourselves and our workers and our10430 new normal. So thank you. Thanks. And and10434 really it's 1199 help kind of organized this panel and will be continue10438 to be a kind of a thought leaders were working through this and we have a lot of, lot10443 more conversations ahead. So this is just kicking off the10446 conversation.10446 So thank you tim for that. And um, and10449 every everyone else10450 I also want10451 to thank Shamus, um,10452 in uh, with who, uh, honestly10456 without whom we wouldn't be here together. And so I really appreciate the hours that10461 he and10462 others spend making sure that10465 we can have this new normal reimagining government and and10469 advocacy and interactions across the Commonwealth. So,10472 um, thanks again to everyone for participating. Your voices matter10476 and appreciate you using them today. Thank you. Senator. Appreciate the opportunity. Yeah. Thank10484 you. Yes.
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