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February 16, 2007
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In This Issue:
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The Joy of Caregiving
In an interview conducted for
Frontline Care
magazine, personal care attendant Mary Campbell talks about the
fulfillment she gets from her work in an adult day center. "It's the
participants," she says. "It's just the reward and the joy that I get
when I know that I've made a difference in their day. Especially when
I take a day off and I come back and they know I was gone. It's the
joy."
Click here for the rest of the story.
Person-Centered Peer Mentoring
A new best practice profile in the Clearinghouse describes the
person-centered peer mentoring program at the Center for Nursing and
Rehabilitation (CNR) in Brooklyn, New York. Turnover rates and
resident and family satisfaction ratings, as well as staff
satisfaction levels, all improved after the program was implemented.
Click here
to read the profile. CNR's peer mentors are pictured below.
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Recent additions
Click here
for more news from the Clearinghouse.
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National Campaign Coordinator Appointed
PHI's Health Care for Health Care Workers initiative has appointed
Allison Wagner as its new national campaign coordinator, responsible
for developing national campaign strategy and helping with
implementation of state campaigns.
Allison has 15 years of experience in mobilizing constituencies
for issue and political campaigns. She has served as a coalition
campaign manager for anti-tobacco advocacy campaigns, as a consultant
to interest groups in areas of voter mobilization and grassroots
action, and as a candidate campaign manager. A graduate of Wake
Forest University, she is based in the HCHCW national campaign office
in Washington, D.C.
Power to the PEO
A provider employer organization (PEO) in Wisconsin that makes
affordable health insurance available to home care workers is "a
clear example of the kind of innovation that the state should support
to improve recruitment and retention of direct-care workers, reduce
administrative inefficiencies, and support quality care for
Wisconsin's elderly and disabled population," according to an HCHCW
report.
Subsidizing Health Insurance Coverage for the Home Care Workforce in Two Wisconsin Counties: An Analysis of Options
describes the PEO, and the home care workforce in the two counties
where the PEO operates. It also looks at the availability of health
insurance coverage for these workers and analyzes how funding can be
found to help subsidize premium costs for employers and employees.
Authors Tameshia Bridges and Carol Regan also recommend options for
employers to consider in making insurance affordable for direct-care
workers.
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More Information
Click here to read more from and
about the HCHCW campaign.
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Cover Me
See the Covered the Uninsured
website for ideas on how
to observe the week, which falls on April 23-29 this year.
Analyzing Medicaid Spending
Two recent reports from the Kaiser Commission on Medicaid and the
Uninsured shed light on Medicaid spending on long-term care.
Profiles of Medicaid's High Cost Populations
looks at the role Medicaid plays in covering the needs of people with
spinal cord and traumatic brain injuries, mental illness,
intellectual and developmental disabilities, Alzheimer's disease, and
more.
And
Medicaid's Long-Term Care Beneficiaries: An Analysis of Spending Patterns
shows, among other things, that long-term care users accounted for
just 7 percent of all Medicaid recipients but 52 percent of its
spending in 2002.
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Should all home care aides and personal attendants be eligible for
overtime?
Yes--86%
No--14%
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Dear Friend
When the editorial board of Frontline Care magazine picked
Mary Campbell as their profile subject a year or so ago, they
mentioned her irresistible smile and the positive spirit with which
she greeted everybody, every day. After just a few minutes with her
on the phone, I saw what they meant -- and if you read her profile
(see New in the Clearinghouse) I think you will too. Inspired and
inspiring, Mary Campbell is a vital reminder of why, for the right
person, direct-care work is not just a career: It's a calling.
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House Hears Testimony about the Need to Train and Empower Workers
Training and empowering direct-care workers is an essential part of
creating a truly person-centered health care system, Commonwealth
Fund Assistant Vice President Mary Jane Koren told lawmakers at a
House subcommittee hearing on health care access and aging.
Koren, who was one of the experts invited by the legislature to
provide
testimony,
spoke of the "urgent issue" of "a coming shortage of skilled and
trained workers who are empowered to make decisions on the
front-lines to ensure the kind of care we all want in our old
age-compassionate, competent, and kind." However, she noted, the
potential crisis can be averted, "as the results of such
demonstrations as the Better Jobs/ Better Care initiative, funded by
the Robert Wood Johnson Foundation and Atlantic Philanthropies, have
shown."
Click here
for a webcast of the hearing.
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Helping Residents Grow Their Minds
A recent
editorial
illustrates the importance of caregiving staff in the lives of people
with mental retardation. Writing about his developmentally disabled
brother in the January 28 edition of Newsday, Allan B.
Goldstein says: "When will it be routine that those paid to work with
people like him are professionals with the proper training to help
residents grow their minds?"
Goldstein's brother lived for years in Staten Island's infamous
Willowbrook State School for the Mentally Retarded. Many of the
institution's residents, Goldstein writes, "wallowed in their own
feces, served as guinea pigs for hepatitis experiments and fought for
attention from a staff outnumbered by a ratio of 50 to 1." While the
counselors who assisted the residents were "hard-working," he adds,
they received "minimal training and a state-dictated minimum wage.
They were not trained educators."
Two years ago, Goldstein moved his brother to another residence
"with a larger, more mature staff." As a result, he notes, his
brother has made tremendous strides and "improved his label from
'severe' to 'moderate' retardation."
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CNA Satisfaction Benefits Everyone, Says Study
"Nursing home administrators need to understand CNAs better, and
cultivate avenues for growth and development in their work,"
concludes the author of a Taiwanese research study. Otherwise,
"numbers of CNAs will likely show their dissatisfaction through poor
performance, burnout, work absences, and high rates of turnover."
"Job Satisfaction of Certified Nursing Assistants and Its Influence on the General Satisfaction of Nursing Home Residents: An Exploratory Study in Southern Taiwan"
examines the relationship between CNA job satisfaction and resident
and family satisfaction in nursing homes. The study finds that
married CNAs, part-timers, and those with longer tenures in their
current nursing home all tend to be less satisfied than their
colleagues. Otherwise, the most significant factors affecting
satisfaction were "fairness of work allocation and performance
rewards."
In general, the relationship between resident and staff
satisfaction is not found to be statistically significant, but more
positive reports from staff on interpersonal relationships correspond
to higher resident satisfaction with the content, duration, and skill
level of services provided. "This could be because the better the
interpersonal relationships the CNAs had with residents and families,
the more they would do for them," observes author Li-Fan Liu.
The article was published in the January-February 2007 issue of
Geriatric Nursing.
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Helping States Strengthen Their Home- and Community-Based Workforces
Five states have won technical assistance grants in a second round of
funding from the Centers for Medicare and Medicaid Services' National
Direct Service Workforce Resource Center. The technical assistance
will help the five -- Michigan, New Jersey, North Carolina,
Wisconsin, and Utah -- strengthen the direct-care workforce providing
their home- and community-based services.
The grants were awarded to Medicaid agencies because of the key
role they play in quality assurance, educating workers and their
supervisors, setting wage and benefit rates, and reimbursing
providers in their states.
Visit the Resource Center
website for
descriptions of last year's grantees. Descriptions of the 2007
grantees' ongoing and planned work will be posted soon.
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There Oughta Be a Law
State legislators have an important role to play in ensuring a
sufficient and stable direct-care workforce as states shift more
long-term care from institutions to home- and community-based
settings, according to a policy brief from the National Conference of
State Legislatures.
In
Long-Term Care Reform: Legislative efforts to shift care to the community,
authors Donna Folkemer and Barbara Coleman describe efforts made by
Delaware, Illinois, Iowa, and North Carolina to improve wages,
benefits, education, career ladder opportunities, and more.
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Workforce Measurements in P4P
Several state Medicaid agencies are developing pay for performance
(P4P) programs to increase reimbursement to nursing homes that meet
workforce and other quality criteria. According to the
lead article
of the January/February issue of States in Action, the
Oklahoma Health Care Authority is developing a tiered reimbursement
system in which facilities will be evaluated based on staff turnover
and other measures. Minnesota and Iowa are developing ways of
measuring staff turnover and retention, among other factors, for
systems that will award points to nursing facilities based on their
performance on seven measures.
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February 23, 2007
Pennsylvania's Direct Care Workforce: The Next Horizon
March 06, 2007
National Center on Caregiving at Family Caregiver Alliance (FCA) and
American Society on Aging (ASA) National Conference
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