Listening to caregivers

June 30, 2014
By Adrienne Smith, President and CEO


Adrienne Smith, president of the New Mexico Direct Caregivers Coalition, discusses challenges and opportunities for direct caregivers.

Adrienne Smith, president and CEO of the New Mexico Direct Caregivers Coalition, discusses challenges and opportunities for improving outcomes for direct caregivers, their patients and their employers.

What is the New Mexico Direct Caregivers Coalition and how did it come about?

The New Mexico Direct Caregivers Coalition (NMDCC) is a statewide 501(c)(6) organization created to promote the voice of family and professional caregivers and those they serve. We advocate for direct care workers’ education, training, benefits, wages and professional development. The organization was formed in 2009 following a series of statewide “Listening Sessions” funded by the Developmental Disabilities Planning Council.  We seek to develop and stand behind well-trained, adequately paid workers who are working in jobs they love and who have opportunities for advancement if they want to advance.

What do you see as the unique role of NMDCC in New Mexico?

We conduct statewide “Listening to Caregivers” sessions in which we hear from caregivers about what’s important to them. As a result of those sessions, our mission and other data, we deliver training and education programs for caregivers seeking additional skills; we offer and administer a nationally-recognized Credential that measures eight core competency areas that all direct care workers should know to perform their jobs at the highest levels; and we advance public policy to support caregivers and their role as leaders.

Healthcare is changing rapidly due to issues such as demographic changes, technology developments and the Affordable Care Act. How are the changes affecting caregivers and their opportunities?

The changing demographics are already rapidly affecting this low-wage workforce.  Technological advances further affect those with less education, skills and training.

The direct caregiver workforce—some 2.5 million strong—is a labor force that provides the day-to-day care for our state’s elderly and people with disabilities. In New Mexico, the paid labor force of direct caregivers will grow from 50,000 in 2010 to more than 60,000 in 2016.1

According to our state Department of Aging and Long-Term Services, the number of informal or unpaid family caregivers in New Mexico number 210,000, almost four times the number of paid caregivers. Family caregivers also are important to the economy—not only because they are performing unpaid labor as a caregiver, but also because these are people often forced to reduce their hours at work or leave the workforce altogether to care for a loved one.

Between the years of 2010 and 2050, the number of U.S. adults aged 65 and older is projected to increase to 88.5 million individuals, more than double the number of those over the age of 65 in 2010. The U.S. Census predicts that New Mexico will move from 16th in the nation to 4th in the percentage of people over the age of 65 by 2030.2

The demographics of an aging state—and nation—point to the imperative of investing in skills, education and opportunities for advancement of a low-wage workforce, so they can fully participate in the economy.


1The figure only includes workers who indicate that direct caregiving is their primary or only occupation. The figure does not include workers in the informal labor force.

2Con Alma Health Foundation and New Mexico Association of Grantmakers: “EngAGE New Mexico: Promoting and Strengthening Grantmaking in New Mexico to Support an Aging Population” (October 2012).

What are some promising policies and practices at the state or federal level that are making a difference for caregivers? What key issues need to be addressed?

Key strategies for this sector include raising the floor for low-wage workers’ in health care, and building the ladder of opportunity for people to advance in the sector. At the state and Federal levels, this means working on policies and issues to stabilize workers’ present economic security while simultaneously supporting efforts for them to move up that economic ladder. Key issues may be training and education for caregivers, but it also means fair opportunities for workers to grow and advance on the job or as leaders of their own small businesses.

NMDCC is one of only two such state level organizations. How do you suggest other states increase their focus on the needs of caregivers and their employers? How do NMDCC's efforts support broader workforce and economic development goals?

I find from traveling and talking to people who have supported our work that even the smallest communities have the brightest examples of caregiver-focused initiatives. Most often, these are community-focused efforts that start very small as a result of a shared vision.

In New Mexico’s case, the “good idea” started with a state council of persons concerned about people with developmental disabilities asking the question: Is there a “voice” of a caregiver in New Mexico? The Iowa Caregivers Coalition recommended we focus on developing leadership qualities of caregivers as a first step in organizational development. That decision validated the data and helped clarify our mission.

Fortunately for all of us, the council that provided seed funding recommended that “all” caregivers working in the wide variety of settings (home health, nursing home, group home) participate. Today, we reach 7,500 caregivers, agencies, advocates and even care recipients. I think if we had closed the door to serve only wage-earning caregivers, we could not have learned from family caregivers about the value of their contributions to caring for loved ones, but also the consequences to their own labor force participation and future earnings.

Congratulations on being named an Aspen Institute Sector Fellow. How do you expect that will support your work with caregivers?

Thank you! The fellowship has already had a tremendous impact. We are benefitting organizationally from leaders working to improve their own states’ workforce and employment policies. Learning from recognized experts at the national level—and having the opportunity to do so in a reflective setting, away from the day-to-day constraints of work—is invaluable.

About Adrienne Smith

Adrienne R. Smith, President and CEO, has 20 years experience in program development, program implementation and management. Ms. Smith designed and implemented one of the nation’s first training programs to prepare mid-level staff for future roles as executive directors, agency leaders and elected officials.  Ms. Smith has delivered training to Federal workforce and youth employment grantees through the U.S. Department of Labor (DOL)-Employment and Training Administration, the U.S. DOL Women’s Bureau, and on US Agency for International Development contracts for employment and workforce development. Ms. Smith has a Master of Public Policy and Administration from University of Texas and nonprofit management certificate from Georgetown University in Washington, D.C.