On behalf of our more than 75,000 members, AARP Alaska is working to pass legislation in the current state legislative session that empowers all Alaskans to choose how they live as they age, and the vast majority of us want to age at home in our Alaskan communities. Alaska has the fastest growing senior population in the nation for the tenth year in a row. As the senior percentage of our population grows, more workers retire and the available workforce shrinks. We’ve seen this trend accelerated in the last few years, when many older Alaskans retired early to keep themselves safe from COVID.
We’ve focused our 2023 legislative priorities on workforce solutions to stabilize the flagging workforce in the healthcare field and public sector that is threatening older Alaskans’ access to care and benefits. None of our priorities offer a silver bullet solution, but they can all help to diminish barriers to healthcare and state services that are impacting seniors. We are also partnering with other organizations to promote these workforce solutions, which amplifies the impact of our advocacy and increases the chance of successful passage.
The Nurse Licensure Compact
This year, we have collaborated with Alaska Hospital and Healthcare Association, Mat-Su Health Foundation, U.S. Dept. of Defense, Alaska Native Tribal Health Consortium, Alaska Board of Nursing, UAA School of Nursing, and more than 70 other healthcare partners to advocate for Alaska to join the Nurse Licensure Compact (NLC). The NLC creates Registered Nurse (RN) license reciprocity with the majority of other states, allowing Alaska to put nurses to work faster in hospitals, nursing homes and clinics statewide.
Alaska’s local nursing program has capacity for just 324 graduates each year – a far cry from filling the 1,500 nurse openings annually. This demand is expected to grow to more than 5,000 by 2030 as our population and healthcare workforce ages. Maintaining a qualified and robust workforce is the single biggest healthcare challenge in Alaska, with nursing topping the list, and already we have seen closures and restrictions on patient care due to workforce crisis. Alaska nurses overwhelmingly support the NLC with 92% of the responding nurses stating they are in favor of joining the NLC, including 87% of nurses who are members of a labor union.
Home- and community-based services and participant-directed care
More than 80 percent of adults express a desire to remain in their homes and communities as they age and prefer a home setting over a nursing home or other institutional setting. Medicaid Home- and Community-Based Services (HCBS) includes a wide range of services and supports provided at home, but that system is threatened by workforce crisis. Much of the work of HCBS is performed by direct care workers, including personal care aides, home health aides and direct support professionals. Alaska is experiencing a severe workforce shortage in these areas, impacting the ability for people with disabilities and the elderly to receive home services and avoid costly institutional care.
Our state needs more home- and community-based direct care staff. AARP is partnering with the Statewide Independent Living Centers, SEIU caregivers union, Peer Power, and the Governor’s Council on Disabilities and Special Education to advocate for a Participant (or Self) Directed Care program option, modeled after the VA’s successful Veteran Directed Care Program in Alaska.
Participant-Directed Care is a HCBS option in which the individual who receives services decides how, when and from whom their services will be delivered. Self-direction is a flexible alternative to “traditional” HCBS, in which a person receives services from a worker employed by a home care agency and the person generally has less control over how his or her services are delivered.
Participants in self-directed programs often choose to hire family, close friends, or neighbors as paid caregivers. Paid family caregiving through participant-direction addresses multiple needs: the person who needs care can age in place among friends and family; the family caregiver can earn modest income for the difficult work he or she performs, which lessens the impact of the lost job hours for the caregiver and the larger economy; the homecare workforce is expanded; it prolongs the use of lower-cost HCBS while delaying or avoiding costly institutionalization.
Defined benefits for public employees
The State of Alaska has an average 17% vacancy rate across departments, with the Dept. of Health topping the list at over 20% vacancy. Public workers earn up to 14% less than private-sector workers. Providing a defined benefit pension would help to bridge that wage gap in the long-term and would make the state more attractive and competitive in employee recruitment and retention. Without such a program, state services are suffering and public access to benefits and services is threatened by short staffing.
In Alaska, where public employees do not participate in Social Security, the average pension benefit is between $2,133 and $3,176 per month, providing a retirement income floor to public retirees. As public employee retirement benefits have declined, Alaska is consistently short of the qualified workforce needed to create strong state services and public education systems. AARP is part of the State Pension Coalition organized by AFL-CIO to reinstate a pension option for all public employees.
To add your voice to our advocacy priorities and stay informed, visit https://action.aarp.org/secure/aarp-2023-priorities-older-alaskans.
Marge Stoneking is the AARP Alaska Associate State Director for Advocacy.
