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April 13, 2007
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In This Issue:
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No More Okey Doke
Closing the growing care gap requires making some dramatic changes to
"business as usual," according to
The Long-Term Care Workforce: Can the Crisis be Fixed? Problems, Causes and Options.
Prepared by the Institute for the Future of Aging Services for
the National Commission for Quality Long-Term Care, the report
recommends reducing negative stereotyping of long-term care,
reforming working conditions, and introducing "more flexible and
relevant approaches to education, credentialing, and ongoing
training," among other things.
The report outlines the composition of the workforce, the
dimensions of the care gap, and likely future trends. It also lays
out options for ensuring a stable and adequate workforce and
identifies topics for future research and demonstration projects to
strengthen the evidence base for future improvements.
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Recent additions
Click here
for more news from the Clearinghouse.
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Working on Health Insurance Reform in Pennsylvania
The health care reform plan unveiled by Pennsylvania Governor Ed
Rendell in January is being considered by the Pennsylvania House
Insurance Committee. The plan would make health insurance available
to about a million Pennsylvanians who currently lack coverage.
Direct-care workers would benefit because many work for the small
employers targeted by the plan.
Under the proposed plan, health insurance would be subsidized for
workers who earn less than three times the federal poverty level. The
average wage for a direct-care worker in Pennsylvania is $9 an hour,
which falls within that window. The governor's plan also addresses
those in this income bracket who live with chronic conditions such as
diabetes and back injuries, which plague thousands of the state's
direct-care workers.
Health Care for Health Care Workers Pennsylvania is working to
ensure that the proposal meets the needs of direct-care workers and
their employers.
Click here
for the text of the bill.
Introducing Legislation to Improve Health Care Access for Direct-Care Workers
On March 26, Maine State Senate President Beth Edmonds introduced
legislation to increase access to health care for direct-care
workers. The bill,
LD 1687,
expands the definition of businesses eligible for Dirigo Choice, the
state's health care program, to include long-term care providers
funded by the state and MaineCare program that have more than 50
employees.
The bill makes DirigoChoice coverage available to home care
workers who work part-time and are not eligible for Medicaid or other
employer-sponsored health insurance. It also establishes a
demonstration program to increase health insurance coverage among
direct-care workers at agencies that get funding from Medicaid or
other state long-term care programs.
PHI's Health Care for Health Care Workers campaign is working
closely with the Maine Coalition to pass LD 1687 this session.
Click here
for talking points issued by the Maine Direct Care Worker Coalition.
Lessons Learned from CMS Grantees
"Providing coverage to the direct-care workforce is not a simple
endeavor," according to a comprehensive report describing recent
efforts made by several recipients of a Centers for Medicare and
Medicaid Services (CMS) grant.
Emerging Strategies for Providing Health Coverage to the Frontline Workforce in Long Term Care
looks at all the efforts by grantees to expand coverage, examining
four strategies in detail. It also examines the policy implications
of expanding coverage for direct-service workers and lists the
following characteristics of successful health coverage plans:
Accessible to all workers regardless of how many hours they
work
Affordable for workers and their employers
Comprehensive, with a full range of benefits to protect older
workers and those with chronic health conditions
Simple and easy to understand and enroll in
Sustainable over time
The report was written by Ingrid McDonald for the
Paraprofessional Healthcare Institute, with the help of Carol Regan,
the director of PHI's Health Care for Health Care Workers initiative.
Survey Finds High Uninsurance Rate among Home Help Workers
Nearly a third of Michigan's Home Help providers are uninsured,
according to When Michigan Caregivers Lack Coverage, a survey of the
Home Help workforce, which provides home care services to Medicaid
recipients.
The survey was conducted by HCHCW Michigan and funded by the
Michigan Quality Home Care Coalition. Among its findings:
The uninsurance rate among Home Help providers is almost
three times as high as that of the state's general population.
A third of the providers who have insurance are covered by
Medicaid and/or Medicare. Another third get it through a second job
or a spouse.
Home help providers pay significant out-of-pocket health care
expenses despite low household incomes. More than half (56 percent)
report household incomes of less than $30,000 a year.
Half of those without health insurance say they have chosen
not to seen a doctor when they needed one.
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More Information
Click here to read more from and
about the HCHCW campaign.
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Dear Friend
PHI, the organization behind the Clearinghouse, needs some help
you may be able to provide. First, we're looking for a policy
analyst. If you or someone you know may be interested, please check
out the
job description and application information.
And second, we're seeking contributions to a fund to help would-be
direct-care workers who face financial roadblocks. For details, see
"PHI's $10,000 Fundraising Challenge" below.
Meanwhile, if you're interested in the personal assistance
services workforce, you might want to check out a one-day conference
at the end of this month hosted by the Center for Personal Assistance
Services. The presenters will discuss current research, policy
implications, workforce trends and more. See Events below for
information on how to attend.
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Louisiana Boosts Direct-Care Wages in Katrina's Wake
Earlier this year, the Louisiana Department of Health and Hospitals
(DHH) received legislative and budgetary approval to implement a
$2-an-hour wage pass-through for the state's Medicaid-funded
direct-care workers. The wage increase, which awaits approval from
the federal Center for Medicaid Services, is intended to address
workforce shortages and turnover in a state that suffers acutely from
both.
Policymakers in Louisiana have long tried to raise wages for
frontline staff. Kathy Kliebert, Assistant Secretary for the Office
for Citizens with Developmental Disabilities, says a number of red
flags inspired her to develop the state's new pass-through. Among
them were a study indicating that Louisiana's direct-care worker
wages were the lowest in the nation and the state's own 2005 findings
of a wage disparity of nearly $3 an hour between private and public
institutions in long-term care.
Click here
for the rest of the story.
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Supporting and Stabilizing the Direct-Care Workforce: Who, How, and
Why
Long-term care providers and policymakers looking for ideas about how
to build a more stable and effective direct-care workforce can find
plenty to think about in the current issue of FutureAge, the
magazine of the American Association of Homes and Services for the
Aging.
The April issue, the first to be devoted to a single topic, looks
at the goals and accomplishments of the grantees who participated in
the four-year Better Jobs Better Care research and demonstration
project now winding to a close. Articles include "Respectful
Relationships: The Heart of Better Jobs Better Care," "The Business
Case for Investing in Staff Retention: Can You Afford Not to?" and
"Training That Really Works."
To order a copy, call 202-508-9480.
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PHI's $10,000 Fundraising Challenge: A Special Opportunity to Help
Direct-Care Workers
PHI, this newsletter's sponsor, has been challenged by a lead
supporter of our work to raise $10,000 to help aspiring direct-care
workers who face financial hardships. This support can be essential
as they work to secure employment and better their lives.
For example, with only a week of home health aide training to go,
Martha, a single 46-year-old mother of two, was struggling. Homeless
and relying on friends and family for temporary places to live, she
traveled several hours each day to attend our training program in the
South Bronx.
Through our Special Assistance Fund, we helped her to find
permanent housing in the city, paid her first two weeks of rent, and
provided her with money for groceries. After completing our training,
Martha now works as a home health aideĀand has regained her
independence.
To find out how you can contribute to help us to meet our
challenge—and expand the assistance that we provide for
direct-care workers—
click here.
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A Gift for a Giver
Personal care attendant Mary Campbell, a founding member of the
Pennsylvania Direct Care Worker Association, is one of four winners
of this year's
Mercy Courage Award for Compassionate Care
from Philadelphia's Mercy Health System, an integrated health care
system with more than 8,000 employees. Campbell works for Mercy's
adult day center.
"The thing that amazes me about Mary is that I don't know how she
does all she does," says Lisa Borowski, co-chair of the awards
program. "And she does it with a smile on her face. She puts her
whole self, her heart and her soul, into her work and into developing
relationships with people that last even when they're no longer part
of the program where she works."
The award, says Borowski, also recognizes the care Campbell
provides in her private life. "She's opened her home to nieces and
nephews who needed a place to stay, and to disabled adults who need a
home. And when her regular work is done, she goes and visits people
in their homes. She always puts the needs of others first, and she
does it with an amazing amount of enthusiasm."
Campbell and her fellow winners - a doctor, a nurse, and a
physical therapist - will be honored at an $250-a-head awards dinner
on April 18. About 600 people will attend the dinner, at which videos
depicting each of the winners will be shown.
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Maine Legislature Learns about Strategies to Strengthen the Workforce
A comprehensive report to the Maine legislature outlines some of the
things that can be done to improve recruitment and retention of
direct-care workers in the state.
Study of Maine's Direct Care Workforce: Wages, Health Coverage, and a Worker Registry
is a response to three pieces of legislation mandating studies of,
reports on, and changes to the state's direct-care workforce and the
services they deliver. Beginning by providing a demographic overview
of the workforce, it goes on to look at worker wages and health
insurance coverage, reimbursement for long-term care organizations,
and more.
Raising the wages of all direct-care workers in state-funded
programs to at least $8.50, the report says, would cost the state $3
million, while raising wages to a floor of $10 would cost $6 million.
It also outlines the benefits that could be gained by establishing a
state worker registry and issues to consider when setting one up.
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Funding Opportunity for Caregiver Training Programs
Up to 12 grants of $25,000 each will be awarded to community colleges
to establish new training programs or build on existing ones for
family and professional in-home caregivers. The grants are funded by
The Caregiving Project for Older Americans.
The
request for proposals
encourages innovation in the design, management, and implementation
of caregiver training programs. Program requirements include:
Care of Older Adults. The training must prepare students to
care for older people, either exclusively or in addition to other
groups.
Care in the Home. The training must prepare students to
provide care in home settings, either exclusively or in addition to
institutional care.
Family Caregivers. While the overall program may be for the
training of professional caregivers, some components must address
family caregivers.
The deadline for submissions is May 8.
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Care Gap is Costing Family Caregivers, Businesses in New Hampshire
A March 16 article in the
New Hampshire Business Review described that state's growing
"care gap" and its negative effects on both family caregivers and the
state economy, calling for new sources of direct care providers,
career ladders, better wages and supervisory support, and better
working conditions for direct-care workers.
According to
Numbers don't add up to meet direct care needs,
there are 131,000 family caregivers in New Hampshire, many of them
"dependent on the availability of qualified in-home care providers."
Those numbers are growing fast while workers are becoming harder to
find, due to factors such as "low wages, lack of benefits,
ineffective supervision, lack of a career ladder and sometimes poor
and isolated working conditions."
Citing a 2006 MetLife study, which said employee caregiving is
costing American businesses up to $34 billion a year in lost
productivity, the article says it is "clear that local economies will
suffer as well from a shortage of in-home care providers."
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April 27, 2007
Center for Personal Assistance Services conference, Washington D.C.
May 3, 2007
Delaware conference for direct-support professionals, Dover, DE
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