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How #60CaregiverIssues Aims to Transform Home Care

By Robert Espinoza (he/him) | December 27, 2017

This commentary was originally published in The Huffington Post on December 27, 2017. 

I wrote my first story at age 10. It was an illustrated, five-page tale about a woman haunted by nightmares, inspired by the popular horror novels of the 1980s. My family found it puzzling in both form and content. My 4th-grade teacher said it showed imagination but lacked coherence. In the years that followed—first as a journalism student in college, and then as a policy strategist and writer—I heeded that critique. Strong writing requires intelligibility, as well as an overarching idea that the reader can relate to and feel. However, in the context of social change, the conceptual frames attached to social issues are often like balloons—without strings that the public can pull down to understand, many of them float away from the popular imagination.

As agents of social change, our success rests on our ability to frame stories with strings. When PHI—the organization where I work, and a national thought leader on direct care—launched #60CaregiverIssues, we recognized that a smart education campaign needed to speak directly to a current concern, in this case the growing workforce shortage in home care. Families around the country were struggling to care for their loved ones, yet leaders across sectors seemed perplexed about how to effectively respond. We knew this challenge needed focus, concrete proposals, and a narrative rooted in hope that would compel leaders in the long-term care industry to avoid falling into despair. We had problems and solutions, said our campaign. And together we could solve this caregiving shortage, “one idea at a time.”

Throughout the year, we tackled a multitude of topics. When the debate over the future of the Affordable Care Act heated up in Congress early in the year, we published a study on the impact of this legislation on the health coverage of direct care workers. If workers couldn’t afford to take care of their health—we posited—then who would be there to take care of us? A few months later, as the Trump administration heightened its attacks on immigrants, we released a research brief on the prevalence of immigrants in direct care. One in four home care workers was an immigrant, our research showed, totaling one million. But if we punished immigrants, would we threaten not just their livelihood but the strained labor supply for home care?

And it didn’t stop there. Our research addressed the dearth in training standards for personal care aides, the largest-growing segment of the direct care workforce. We issued road maps for state and federal reform, an analytical tool for states to measure “quality jobs” in home care, a range of city and state landscapes on direct care, and studies that explored topics ranging from racial and gender disparities to the impact of public benefit eligibility on the incomes of direct care workers, and much more. Direct care workers nationwide need higher wages, improved benefits and training, advancement opportunities, significant government funding, and a transformation that elevates their value in both the healthcare industry and the overall economy. But getting there will take leadership and imagination to pinpoint the specific reforms required for this overhaul.

And it will take a strategic investment in public education campaigns like #60CaregiverIssues, the success of which is best exemplified in the increased media coverage on these topics in 2017. Throughout the year, PHI worked with journalists around the country, in both local and national outlets, to frame the workforce shortage in home care and its impact on families. These stories brought a much-needed human dimension to this issue, detailed through our research, and brought to life by the perspectives of workers, long-term care providers, older people, people with disabilities, and advocates nationwide. In 2018, as we take on the final 30 issues of this campaign, we’ll place the spotlight on even more solutions. We need more balloons with strings, more news stories, and more hope for our caregiving future. We need a whole new storyline.

Read the first 30 issues of our #60CaregiverIssues campaign here. And follow our campaign online at #60CaregiverIssues.

Private: Robert Espinoza (he/him)
About The Author

Robert Espinoza (he/him)

Former Executive Vice President of Policy
Robert Espinoza oversees PHI's national advocacy and public education division on the direct care workforce, and contributes vision and leadership to the organization's strategies.

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