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February 01, 2008
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In This Issue:
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Recent additions
Click here to see what's new in the Clearinghouse.
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Make Direct-Care Workers a Face of Uninsured Women, Says Bridges
Direct-care workers can "serve as a face of uninsured women," Tameshia Bridges of the PHI Health Care for Health Care Workers campaign told a roomful of health care reform advocates at a Families USA conference.
Bridges and Lisa Codispoti of the National Women's Law Center paired up to present their January 26 workshop, Putting Women in the Picture: The Face of Women in the Health Care Crisis. (pdf) "This was a good opportunity to partner with a national women's organization to highlight how direct-care issues are really women's issues," says Bridges.
Attendees included "people from all over, from Oregon to Florida, most of them from state-based health care reform advocacy campaigns," says Bridges. "They asked really good questions. I think we gave them a framework to look at how women are impacted by health care reforms."
Bridges and Codispoti will make the same presentation at the Raising Women's Voices, a conference to be held this April by the Avery Institute for Social Change, MergerWatch, and the National Women's Health Network.
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Direct-Care Workers Call on Politicians to Improve Health Care Coverage
Two recent letters to the editor from direct-care workers call on political leaders to increase health care coverage for workers.
"I want to thank Gov. Ed Rendell for playing hardball with the Legislature to get something done on health care," says Pat Downing, a member of the board of the Pennsylvania Direct Care Workers Association, in a letter to the editor of the January 27 Pittsburgh Post-Gazette. Downing says the problem of caregivers without adequate health coverage "cannot be ignored. Too many elders and disabled depend on us to be there for them, and without affordable health care we can't come to work."
In a letter to the January 25 Des Moines Register, Iowa CNA Lin Salasberry and 10 of her colleagues refer to the letter they wrote in late December to presidential candidate Mike Huckabee, expressing "frustration and concern" about a comment he made on Larry King Live that seemed to disparage direct-care work. They reiterate the points made in that letter, including "how low pay, lack of affordable health benefits and lack of respect contribute to a high level of turnover, and how that revolving door of workers leads to less care and less quality of care for Iowans," and note that their letter has received no reply from the Huckabee campaign. "We hope that Huckabee and other candidates understand that there are more than 3 million professional caregivers in America who are concerned about his words and failure to respond," Salasberry writes.
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Create Your Own Medicaid Fact Sheet
A new online tool from the Kaiser Family Foundation lets you create your own fact sheet listing Medicaid rates in your state - and comparing them to others and/or to the national average, if desired. The two-page color fact sheets can be easily converted into downloadable, print-quality pdfs.
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If you're reading this in a web browser, return to your e-mail to vote. Votes cast from the browser are not counted.
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What is the minimum total caregiving hours (RN, LPN and CNA combined) per resident per day needed in nursing homes, according to a CMS study?
The answer (which 33 percent of you got right): 4.1
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Dear Friend,
When most people think of dangerous jobs, they think of things like construction. And that's dangerous, all right, but we need to spread the word that direct-care work is, in some ways, even more perilous. Nursing aides, orderlies and attendants have the highest rate in the nation of job-related injuries and illnesses. They're far more likely than other workers to get musculoskeletal disorders that keep them from working -- and all this when they're also far more likely than the average American to be uninsured.
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Impact Special Issue Focuses on Direct Support Professionals
A special issue of Impact, titled Feature Issue on Direct Support Workforce Development, examines the forces contributing to a growing shortage of quality direct support workers and describes strategies being used to address that shortage.
The nine main articles include |
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Direct-Care Work Still Tops List of Dangerous Jobs
Direct-care work remains one of the most dangerous jobs in the nation, according to the 2006 Survey of Occupational Injuries and Illnesses (pdf) from the U.S. Bureau of Labor Statistics (BLS).
The BLS job category of "nursing aides, orderlies, and attendants" had the highest rate of injuries and illnesses requiring days away from work - 526 per 10,000 workers - of any job category, making them more than four times as likely to be injured on the job as the average American worker. They also had a far higher rate of work-related musculoskeletal disorders requiring days away from work than any other category - 293 per 10,000 workers, or 27,590 incidents.
Relevant tables and charts include:
Summary Estimates Charts Package (pdf -- see page 14)
Number and Incidence Rate of Injuries and Illnesses for Occupations with the Highest Incidence Rate, 2006 (pdf -- see Chart 6)
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The How and Why of Worker Registries
A detailed outline and handout from a January presentation on direct-care worker registries are now available on HCBS.org.
Expanding the "Registry" Concept: Creating Access to Care for Consumers & Employment for Care Workers includes a power point outline of the presentation by Dorie Seavey and Hollis Turnham of PHI, which explains what registries are and how they can meet the needs of both consumers and direct-care workers and gives examples of several online registries. It also includes a handout consisting of two comprehensive lists: one of resources about registries and another of registries in Arkansas, California, Connecticut, Illinois, Iowa, Kansas, Massachusetts, Michigan, Missouri, New Jersey, Oregon, Rhode Island, South Carolina, Texas, Washington, and Wisconsin.
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Guide to FLSA Eligibility for Home Care Workers, Employers
The Home Health Care Industry Under the Fair Labor Standards Act (FLSA) (pdf), a two-page fact sheet from the U.S. Department of Labor, outlines which types of home care workers are and are not covered by overtime and/or minimum wage laws.
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Recent Reports
The 2007 Nurse Employer Survey (pdf) surveyed all of Florida's hospitals, skilled nursing facilities, home health agencies, public health departments, and hospices, gathering data to back up what had previously been only anecdotal claims of staffing shortages. While the report focuses mainly on licensed nursing staff, it includes some information on CNAs. The highest job vacancy rate in the five settings was in home health agencies, where 15 percent of the budgeted CNA jobs were vacant. The report includes recommendations on how to better understand or ease the impact of the shortage.
Caring for the Caregivers: Improving Resources for Elder Caregivers In Massachusetts recommends ways of better supporting the state's family caregivers. Recommendation number 8, "Improve conditions of employment for paid caregivers," calls for health insurance, a living wage, and appropriate training for caregivers in programs such as the Personal Care Attendant Program and the Adult Foster Care Program, who are generally being paid to assist family members or friends.
"Grief Experiences of CNAs: Relationships with Burnout and Turnover" indicates several areas where interventions may help CNAs grieve for nursing home residents who have died. The report notes that these interventions may enhance workers' well-being and job stability. It was published in the January issue (Vol. 34 No. 1) of the Journal of Gerontological Nursing. Free to subscribers only.
Home health aide (HHA) and nursing aide, orderly, and attendant (NA) continue to be two of the fastest-growing job categories in New York state, according to The Health Care Workforce in New York, 2006: Trends in the Supply and Demand for Health Workers. Between 2001 and 2006, the fastest growth in jobs statewide was among HHAs, NAs, medical managers, and social workers, with the number of HHAs increasing by nearly 20 percent (21,630) and the number of NAs by 12 percent (10,930). Between 2004 and 2014, the most substantial job growth is expected to be among HHAs, NAs, and registered nurses.
Medicaid Payment Rates, Case-Mix Reimbursement, and Nursing Home Staffing-1996-2004 finds that CNA and LPN staffing levels increase with higher Medicaid payment rates, but RN staffing is often reduced. However, staffing has not increased under the case-mix reimbursement system, after adjusting for reimbursement levels and resident acuity. "In fact," says the report, "under case-mix reimbursement, there actually was a decreased likelihood of nursing homes achieving higher recommended staffing thresholds that CMS deems preferable or optimum for quality, despite an increased likelihood of just reaching the CMS reported minimum threshold to avoid harm to residents." Free to subscribers only.
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February 23, 2008
National Association of Workforce Boards (NAWB) Annual Forum
March 4, 2008
Direct Care Workforce Conference: Tackling the Revolving Door: Recruit, Recognize, Retain
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