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Expanding intergenerational care is on the horizon for Nebraska child care, nursing homes


Expanding intergenerational care is on the horizon for Nebraska child care, nursing homes

May 29, 2024 | 6:45 am ET
By Zach Wendling
Expanding intergenerational care is on the horizon for Nebraska child care, nursing homes
A new incentive grant program seeks to expand intergenerational care programs, combining care for children and older adults under one roof. Pictured are North Platte long-term care residents and a child from the neighboring Trucks N Tiaras Intergenerational Academy that already offers such combination. (Courtesy of Holly Hill)

LINCOLN — As a number of long-term care and child care facilities continue to face challenges, even closures, in Nebraska, a new intergenerational care grant program seeks to turn the tide.

Legislative Bill 1178, introduced by State Sen. Anna Wishart of Lincoln, was amended into a different child care proposal, LB 904, in this year’s legislative session and passed 45-0. Under the incentive grant program, qualified nursing homes or assisted-living facilities that were certified for Medicare or Medicaid could apply for one-time startup costs to build out child care in the same unit.

“The concept is simple: providing child care in a nursing facility and creating opportunities for shared activities between senior citizens and children,” Wishart told the Nebraska Examiner.

The $300,000 program begins with up to $100,000 per facility through the Nebraska Department of Health and Human Services. Priority will be given to rural communities.

Meeting workforce needs

Wishart said she first read about the concept of intergenerational care in 2019 and was “instantly inspired,” introducing a proposal the next year that stalled, in part, due to the COVID-19 pandemic.

Long-term care is struggling in the state, she said, with seemingly a new closing or nursing home on the brink of bankruptcy each week. Additionally, young families struggle to find child care.

With Wishart’s new program, she and advocates for both older adults and children see an initial investment that they hope will have a positive return on investment and encourage future lawmakers to provide additional support.

“Ultimately, the bill will have a twofold effect, first supporting children and elders to connect and second to address a critical workforce issue,” Wishart said.

North Platte success

Holly Hill is the owner and director of one such facility in North Platte: Trucks N Tiaras Intergenerational Academy. She testified in February that Trucks N Tiaras gives children positive role models through daily interactions with older Nebraskans and builds their communication skills and sense of community.

“Learning alongside seniors will help children see beyond their years and their own small worlds,” Hill told the Health and Human Services Committee on Feb. 7. “They understand more about life and discover many similarities between themselves and their grandfriends.”

Hill said visits children make from the academy to neighboring Linden senior care properties bring children face-to-face with residents for a variety of activities, such as making cards, enjoying arts and crafts or having costume parties.

“You see the light shine in the residents’ eyes the moment these children walk into the room,” Hill said in an email.

Many residents don’t have grandchildren who live close, Hill added, and the interaction allows residents to create bonds with the children, who are each making memories.

Additional funding would help create more of those lasting relationships, Hill said.

At least eight other Nebraska communities have intergenerational facilities, according to Sara Howard, policy adviser for First Five Nebraska. These are: Grant, Kearney, Imperial, Hastings, Fairmont, Hebron, Adams and Syracuse.

‘Innovative solution’

Howard noted that the number of child care providers has not returned to pre-pandemic levels, running up against state demographics where parents of three of every four children under 6 both remain in the workforce.

Jalene Carpenter, president and CEO of the Nebraska Health Care Association, which represents more than 400 nursing and assisted-living facilities, said nursing home staffing also has not recovered after the pandemic.

Carpenter said child care and workforce issues are “inherently interwoven,” although the state has a low unemployment rate, so the grants could support prospective workers and residents.

“It gives those residents that endorphin boost and makes them excited and also puts them into, hopefully, a better mood for the rest of the day,” Carpenter said.

Howard said the “exact areas” where nursing homes are closing is where more child care is needed to meet such workforce needs.

“It really is an innovative solution to a very, I think, tricky challenge on the child care side,” she said.

Wishart said from her work on the Appropriations Committee, she’s learned that some nursing facilities may have building wings that are unoccupied or underutilized, where child care could be added.

Under the bill, nursing facilities do not have to jointly operate the child care facilities. At Trucks N Tiaras, for example, Hill’s facility works in conjunction with Linden properties.

Under the program, by Oct. 1, DHHS staff must meet with statewide associations for nursing homes and other stakeholders to review laws, rules, regulations or other barriers that could impede creating intergenerational care environments and develop recommendations if so.

Hill testified that facilities already have infectious disease protocols, for example, and Carpenter said safety and compliance will remain in two fields that are already heavily regulated.

‘Nowhere to go but up’

Kierstin Reed, president and CEO of the nonprofit LeadingAge Nebraska, said the country is reaching a “tipping point” where younger families are not having as many children, and the workforce is transitioning to replace retiring workers.

The COVID-19 pandemic also highlighted the need for care and interaction — Wishart noted that social isolation can lead to increased risk of premature death and dementia, for example.

Reed said she’s seen firsthand how older adults and young children interact. She said her aging father has difficulty holding a conversation but can engage with a child at a restaurant or other venues “in a way that they have this unspoken language.”

“I’ll find him peeking over the booth and making faces at the kids and doing things like that to interact with them, and it just lifts his spirits,” Reed said. “It brings him a lot of joy to be around kids and to interact with them.”

Howard said meaningful interactions for a child with an adult “exponentially” improves their development and said care facilities could support infants in teaching them social cues and toddlers who desire individualized attention that might be more difficult to obtain. 

These moments might also reduce behavioral health challenges, Howard said, which could lead a parent to call a hotline for support or feel inadequate about their care.

“I would love to see a world where every assisted living and nursing home facility that wants to co-locate a child care facility onsite has the support to do it in this state,” Howard said. “I think there’s nowhere to go but up.”

Program supports all ages

Reed and Jina Ragland, AARP Nebraska’s associate state director for advocacy and outreach, said more and more adults are wanting to age in place, which requires investing in the future and addressing ageism.

Workforce shortages correlate to child care availability, Ragland noted, rippling into short-staffed nursing home facilities and reduced quality of care that can lead to falls or other risks.

She described the grant program as a “big win-win” that will help older adults at all stages of life.

“They’re stimulating a young child’s developing brain while also enhancing their own well-being and cognitive functions as an older adult, which in turn provides a sense of purpose and fulfillment,” Ragland said.

Reed said she got into human services through volunteering at a nursing facility when she was young, so she understands that providing those lessons to children and families — whose facilities might be nonprofits and require community support — is critical.

Ragland added that realizing people are people, no matter their age, will lead to a better society, community and state.

“When you look at what the end result is and the benefit to the entire spectrum — from young children clear up to older adults and, in between, our workforce — I think this is something that makes total sense,” Ragland said. “We’re really excited to see it launch.”