By Sean Slone, CSG Senior Policy Analyst

The unveiling of a 10-year strategic plan was just the beginning of recent actions taken by Pennsylvania to meet the needs of its more than 3 million older residents. Bucks County, located approximately 40 miles north of Philadelphia, hosted a long-term care summit June 21 to further highlight the needs of the state’s long-term care workforce and caregivers, as well as strategies to support them.

The summit, held both virtually and at Bucks County Community College in Newtown, Pennsylvania, included participation from The Council of State Governments, state and local government officials, national experts, innovators from other states, stakeholder groups and long-term care services providers.

Aging Our Way, PA: A Plan for Lifelong Independence,” a 10-year roadmap, is the result of a year of work jumpstarted by a 2023 executive order signed by Pennsylvania Gov. Josh Shapiro.

“One of our five priorities in Aging Our Way PA is completely focused on caregiver supports. Caregivers across the commonwealth play a life-sustaining and necessary role in the health and well-being of older adults. The priority of caregiver supports focuses on strengthening the direct care workforce and supporting these essential workers by creating a better system of supports, education and assistance.”

— Jason Kavulich, Pennsylvania secretary of aging

Strategies discussed during the summit supporting the long-term care workforce included those identified as part of a two-year partnership between CSG and The Commonwealth Fund. That partnership yielded a “Long-Term Care Policy Guide,” a website showcasing seven state strategies to revitalize the long-term care workforce, and a series of webinars in 2023 and 2024.     

In developing the summit, organizers made the decision to emphasize four of the seven strategies where organizers felt significant programs were already in place in Pennsylvania or where changes could be made at the county level, regardless of whether state legislation would be achievable or necessary. Those strategies included:

  • Enhancing Training and Education: Initiatives around the country are looking at ways to create a workforce that is better equipped to handle the challenges of long-term care settings. There are numerous efforts to:
    • Provide training for workers to deal with dementia patients.
    • Create programs that allow workers to earn college credit or get student loans repaid.
    • Develop career pathways so that long-term care jobs aren’t a dead end.
    • Develop opportunities to be trained as “universal workers” to provide workers with greater access to more health care career options.
  • Employment Supports: Experts believe it is not enough to say those in long-term care need to be paid more. They also need other supports to allow them to stay on the job despite difficult work, long hours and better jobs in other sectors. From housing and transportation to lessen long-distance commutes to work and to child care, meals and various types of wraparound supports, states and localities and facilities are enacting these kinds of solutions.
  • Supporting Family Caregivers: Taking care of a loved one, especially when one works full-time, is one of the most challenging roles to take on. Many say it’s important to make sure those family caregivers have access to services like respite care. But in many cases, it’s also important to learn what these caregivers need most. Surveying them, providing resource guides and making navigators available are all key strategies.
  • Expanding the Pipeline: It is often important to think outside the box of who can fill jobs in long-term care. Many states have had to get creative in developing and promoting recruitment and retention strategies, creating programs in high schools to introduce students to these careers at an early age, and building new websites to connect employers and job seekers.

Kavulich told attendees that developing more supports for paid and unpaid caregivers is a key focus for Aging Our Way PA, which includes a caregiver toolkit. He said the commonwealth is also working with Area Agencies on Aging to develop a new navigation system to allow caregivers to negotiate available resources in their area.

The secretary also outlined major challenges facing direct care professionals in long-term care.

“Emotionally and physically demanding work coupled with low wages, minimum training, lack of advancement opportunities and respect, and a state with a rapidly growing aging population,” Kavulich said. “Pennsylvania continues to face a growing paid caregiver crisis due to shortages of direct care workers and high turnover. This volatility impacts consumers’ access to and the quality of long-term care services.”

Among the recommendations included in Aging Our Way PA that state officials plan to implement quickly, Kavulich said, are enhanced wages and benefits, trainings for the direct care workforce, and the development of a career ladder.

“Establishing a standardized core training and credentialing system for direct care workers will provide clear pathways throughout the continuum of long-term services and supports,” Kavulich said.

Kavulich added that his department recognizes the need for innovative solutions to direct care workforce shortages. Those include advocating for changes to scope of practice laws to allow direct care workers to fully perform functions of their qualifications as well as federal and state laws to allow legal immigrants and refugees who qualify to be hired to fill these jobs.


This is the first of two articles highlighting efforts in Pennsylvania to support the long-term care workforce. The second article, “Pennsylvania Summit Outlines 4 Strategies to Support Long-Term Care Workforce,” is available at https://csgovts.info/4e3yDyn.

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