Spilka backs ‘moonshot’ to address caregiving crisis

What follows is an excerpt of Senate President Karen Spilka’s speech on Tuesday to the Greater Boston Chamber of Commerce.

I have been particularly struck by the statistics on the devastating effects COVID-19 has had on women in the workplace. Before the pandemic, women in Massachusetts were participating in the workforce at increasing rates, surpassing the national rate by 2019 – but the pandemic has brought women back to where they were after the 2009 recession. In fact, the percentage of women participating in the U.S. labor market in October 2020 was the lowest since 1988.

It is clear to me that if we wish to have a full and equitable recovery, we must take a close look at the factors that affect women’s employment, at every level and in every sector, and one clear factor that we must address is caregiving. In the same way that we learned to diversify our sectors after the last recession, we are now learning that we must support and strengthen the caregiving sector in Massachusetts so that we can support working families across the Commonwealth.

Almost exactly one year ago today, I appeared before this chamber, in what was your first ever virtual forum, if you can believe it, and declared that childcare was as important to our infrastructure as roads and bridges in getting people back to work. The struggles of the past year have borne this out, which is why I have pushed the Legislature to begin to address the need for childcare, including providing for emergency childcare for essential workers, increasing rates for early education providers, and dedicating $40 million for a new reserve to cover parent fees for those receiving subsidized childcare. We also established the Early Education and Care Economic Review Commission to review childcare funding and make recommendations on policy changes to expand access.

With the promise of over $500 million in federal funding through the American Rescue Plan, we are well-poised to make more strides in making childcare more accessible and affordable, and I look forward to working with all of you to dedicate our best thinking towards tackling this problem, both in the public and private sectors.

But childcare is just one piece of what many are calling a “caregiving crisis”–a storm that has been brewing on our horizon for a few years, but which COVID-19 has turned into a full-blown tsunami. Many people, mostly women, who work in non-caregiving professions, but are sandwiched between aging parents and growing children, have dropped out of the workforce in alarming numbers to care for those who rely on them, while too many black and brown women who work in caregiving professions have been crushed by the job losses of the economic downturn, with devastating results for their families and communities. As we all feel the squeeze of this caregiving crisis, is it any surprise that we are facing a mental health crisis as well?

But this is Massachusetts, my friends, and I know we can do better.

President Biden has identified the caregiving economy as a top priority, most recently in his infrastructure plan. With luck, there will be significant investment in caregiving, from early education and childcare to elder care and care for people with varying abilities, from the federal government in the coming months and years.

This is our shot to be a national leader in transforming the way we support caregivers–and careworkers–and build a thriving economy that works for everyone.

That’s why I am proposing here today that we steward federal and state dollars to create a system of intergenerational care that provides a way to support, connect, and integrate community-based care across all ages, with the goal of making intergenerational care accessible and affordable to all, while supporting the workforce to make it possible.

What does this look like? I’m not entirely sure yet, but I do know that we have a problem to solve, and we’ve tackled difficult challenges similar to this before.

In the Economic Development Reform bill we passed after the Great Recession, I helped to create Regional Economic Development Organizations, or REDOs, that, for the first time, provided a “front door” for businesses to access the many programs and services offered by the Commonwealth. Similarly, to keep children out of the juvenile justice system, in 2015 I created Family Resource Centers, or FRCs, which also created a single point of entry where children and families could access basic services, such as behavioral and mental health or housing support.

Both REDOs and FRCs have proven that this type of “one-stop shop” for services can be very successful, with FRCs proving to be especially vital during the COVID crisis, but they currently only support families with children under the age of 18.

I would like to see us expand and build upon the successful FRC model to create intergenerational care centers where everyone, no matter what age, can access information about childcare, elder care, and before and after school programs, as well as services for residents at all stages of life or level of ability, including, of course, mental and behavioral health support.

At the very least, these intergenerational care centers can act as a “front door” to help overburdened family members access information about, and referrals to, everything from childcare to elder care, with perhaps more ambitious goals, such as the co-location of childcare, elder care and care for those with disabilities in one community-based center, or caregivers credentialed to work in more than one area, or other innovative ideas to be implemented sometime in the future.

Now is the time to be bold and think creatively, because, as I’ve said, we have the opportunity, as well as the responsibility, to not only invest in our recovery, but to rethink and rebuild our communities with connection in mind, which I believe will lead to better physical, emotional and public health outcomes over time.

Too often, government tends to only do short-term planning, and not long-term. But I’d like to take this opportunity to propose our moonshot: long-term planning for Intergenerational Care Centers, which may not be realized until years in the future. But there are steps we can take now to lay the foundation for this future vision of caregiving, starting with shining a bright light on the needs of the caregiving workforce.

According to the US Bureau of Labor Statistics, women make up at least 80 percent of workers in the health and social assistance industry, with women of color making up a growing percentage of this workforce. Despite the truly essential nature of these jobs–after all, you can’t outsource a home health aide position, or the work of the person caring for your family member with disabilities–these jobs continue to be undervalued and underpaid.

We can change this, and build the kind of intergenerational care infrastructure we all deserve. But we have to fully understand the problem first. That’s why I’m asking Adam Hinds, the chair of the Senate Committee on Reimagining Massachusetts: Post Pandemic Resiliency, to hold a listening session on the caregiving workforce, with a special emphasis on the economic impact of COVID-19 on women of color in this workforce, so that we can collect more data on this crucial sector and center black and brown women in our economic recovery plan.

Centering women of color in our economic recovery means that we can tackle some of the most persistent and damaging inequities facing Massachusetts today, while putting us on a path towards stronger communities, better quality of caregiving for all those who need it, and a much stronger economic recovery overall.

Karen Spilka is the president of the Massachusetts Senate.