(360) 709-4600 workforce@wtb.wa.gov

Long-Term Care Workforce

Developing a Strategy for a Stable, Sustainable Workforce

Long-Term Population Trends 

Long-term care is a form of care for young and old alike. Typically, this form of care comes into play when acute care is no longer appropriate. When considering long-term care, attention often turns to care for the elderly. As the number of older persons continues to grow along with their longevity, the need for long-term care (LTC) in this vulnerable population will increase significantly for those aged 80 and over, and particularly for older women who tend to live longer. The number of older persons aged 80 and above is estimated to grow from 125 million in 2015 to 434 million in 2050, according to a recent United Nations report.

Executive Director Eleni Papadakis, center, addresses the Health Workforce Council about Washington’s long-term care needs on June 22 in Port Angeles.

Coincidental with the rise in life expectancy and the growth in the number of older persons, the incidence of mental health diseases such as dementia and Alzheimer’s continues to grow. These conditions further increase the demand for LTC, be it in the home or a formal care setting. Around the world, the incidence of dementia is projected to grow from 47 million in 2015 to 75 million in 2030. In the United States, nearly 40 percent of the population aged 85 years and older suffer from Alzheimer’s and dementia.

Statewide Efforts to Staff Long Term Care Services

In 2022, the state Legislature tasked the Workforce Board to lead an effort to address the staffing concerns of LTC employers; specifically, the recruitment and retention of staff needed to provide quality long-term care for Washington residents. Two components were key to these efforts.  1) the development of an apprenticeship that moves Nursing Assistant-Certified (NA-C) and Home Care Aides (HCAs) along a pathway to becoming Licensed Practical Nurses (LPNs). This pilot program will be the first registered apprenticeship in Washington specifically designed to target front-line LTC providers and create supported pathways to help them progress in the nursing field. 2) an establishment of a broad coalition of stakeholders to examine the challenges of staffing long-term care services in rural and urban settings, challenges that include training and education, recruitment and retention, salary/compensation, public perception, regulatory oversight, and policy mandates.

Long-Term Care Initiative participants explore challenges.

Licensed Practical Nurse Registered Apprenticeship Program

Planning for the LPN Registered Apprenticeship Program began in 2021. The program – a collaborative effort between the Workforce Board, the Washington State Board of Nursing (WABON), and the Department of Labor and Industries (LNI) – has made significant progress in the last year, and we aim to launch the apprenticeship program in Fall 2024. In addition to the three state agencies, three employers (Pennant, Hyatt Family Facilities – Landmark Care & Rehabilitation, and Brookdale) and two community colleges (Edmonds College and Yakima Valley College) have committed significant time and resources to this project.

Program accomplishments include:

  1. A total of 40 NACs/HCAs are currently enrolled in prerequisite coursework for the LPN program.
  2. Edmonds College has successfully led a group of nursing educators in the development of a hybrid LPN certificate program. This hybrid program will serve as the foundation for the apprenticeship coursework in 2024.
  3. The Workforce Board has hired and trained two Apprenticeship Navigators to advise apprentices.
  4. The Workforce Board has contracted with the Merit Group to develop a digital wallet to track apprentices’ progress.
  5. The Workforce board has identified an organization to establish the apprenticeship sponsor: the Washington Health Care Association.

Department of Veteran Affairs Apprenticeship

Conversations are ongoing between the Washington Department of Veterans Affairs (DVA) and the Workforce Board regarding the development of an LPN Registered Apprenticeship Program within DVA’s four nursing home facilities. In January 2023, the Workforce Board entered discussions with DVA leadership to explore a pilot apprenticeship program in one of their facilities.

DVA has hired a program navigator to to examine the potential for establishing an independent, yet parallel, LPN Registered Apprenticeship Program. The DVA program will be distinct from the Workforce Board, WABON, and LNI’s efforts with private employers but will draw from the experiences of that effort. DVA is also working to develop a new job classification for their facilities – a nursing technician. This classification is a key step in the transition to LPN and in ensuring wage growth for apprentices. DVA’s exploratory effort is strongly supported by the Workforce Board.

Long-Term Care Workforce Initiative

The Workforce Board is also working on broader issues related to long-term care industry challenges – from public perception about LTC work, relatively low salary and benefits for workers, and safety and work-life issues that surfaced during the COVID-19 pandemic. Workforce Board staff are focused on the bigger picture of the industry and have worked to bring education and training organizations, the business community, healthcare providers, state agencies, frontline workers, and others to the table to guide this work. This effort – the Long-Term Care Initiative – convenes professionals from various disciplines to hold open discussions, share ideas, and develop collaborations that can efficiently and effectively utilize limited resources.

Annual Report

The Workforce Board is demonstrating its commitment to transparency by drafting annual reports to the Governor’s Office and the Legislature. These reports will detail our ongoing efforts, accomplishments, and next steps for our multiple projects.

Contact the Workforce Board

The importance of holding comprehensive discussions on the provision, quality, and funding of long-term care for disabled persons and older persons concerns not only the well-being of care recipients, but also of informal caregivers and families, and ultimately, the sustainability of government healthcare and social service systems. If you are interested in contributing to these efforts or would like more information, contact LTC Workforce Policy Manager Dr. Donald Smith at donald.smith@wtb.wa.gov.

New! 2023 Long-Term Care Workforce Legislative Report

Long-Term Care Policy Recommendations 

Upcoming Long-Term Care Initiative meetings:

  • LTC Rural & Underserved Communities Subcommittee – March 26 @ 1 p.m.
  • Education & Career Pathways Subcommittee – March 29 @ 10 a.m. Invited Speaker: Emily Ishado & Gina Werdel UW School of Nursing
  • HR & Worker Support Subcommittee April 9 @ 11 a.m.
  •  LTC Ecosystem Subcommittee April 10 @ 10 a.m.
  • LTC General Meeting – April 16 @ 10 a.m.
  •  Education & Career Pathways Subcommittee April 17 @ 10 a.m.
  • Rural & Underserved Communities Subcommittee. April 23 @ 1 p.m.

Please contact Michelle Pierce for more information.

    Long-term care covers a wide range of services and situations from in-home help with basic activities of daily life such as bathing, dressing, meals and/or more complex healthcare related services, attendance at day care centers, to care within an institutional setting.