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March 28, 2006 |
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Overcoming Obstacles to Expanding Health Care Coverage for Direct-Care Workers
Health Insurance Coverage for the Home Care Sector: Experience from Early DirigoChoice Enrollment in Maine
reviews the findings of an outreach project conducted during the
first six months of 2005. The aim of the project was to help connect
direct-care employers and employees in Maine with
DirigoChoice,
an innovative state program aimed at expanding health care coverage.
The researchers found circumstances unique to home care work,
including fee-for-service funding, part-time schedules, and
fluctuating work hours, affect whether employers and their employees
"are eligible and have the resources to participate in health
insurance plans." They conclude: "other states experimenting with
innovative health coverage plans will need to address major
challenges-such as the part-time nature of direct-care work, low
wages, and low reimbursement rates-to ensure coverage for these
critical health care workers."
The report was conducted by the Paraprofessional Healthcare
Institute's Health Care for Health Care Workers initiative in
collaboration with Consumers for Affordable Health Care Foundation
and the Institute for Health Policy at the University of Southern
Maine's Edmund S. Muskie School of Public Service.
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Reports Urge Use of CMP Funds to Improve Care Quality |
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A series of reports on civil monetary penalties (CMPs), the fines
levied against nursing homes for violations of federal care
standards, looks at how those funds are spent and how they might
better be used to improve care quality for residents. Produced by the
National Citizens' Coalition for Nursing Home Reform (NCCNHR) and the
Long Term Care Community Coalition (LTCCC), the documents include:
- An overall report detailing projects in six states
- A resource brief describing the recommendations of a group of
ombudsmen and advocates for changes in policies and practices
- An action plan for stakeholders on how to use the information
in their states to advocate using CMP monies to improve resident
quality of life.
The researchers found wide variation among states in how CMP
fines are both issued and collected. Some states use the money
collected for things unrelated to long-term care, while others use it
to help with recruitment and retention of CNAs. According to Charlene
Harrington, co-director of the project and a professor at the
University of California, "[T]here is a large amount of money that
could be used to improve nursing home care. Forty-six states reported
having $60 million available in accounts from CMPs/fines in 2005."
Click here
to view the reports.
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CMP funds should be used to improve CNA recruitment, retention, and
job quality
Agree
Disagree
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Do CNAs in your state pay to be in the nurse aide registry?
Yes:
23%
No:
50%
I don't know:
27%
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Dear Friend
If you've already filled out our user survey on
Quality Jobs/Quality Care and the National Clearinghouse on
the Direct Care Workforce, we thank you. We'll be looking closely at
your responses to see if there are ways that we can better serve your
needs.
For those who have not, we'll be sending out a reminder soon that
includes the survey's web address. We hope you can find time to fill
it out.
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CMS Launches Direct Service Workforce Resource Center
A new resource center from the Centers for Medicare and Medicaid
Services (CMS) offers information and assistance to "support efforts
to improve the quality of the workforce and to enhance recruitment
and retention of direct support professionals."
The National Direct Service Workforce Resource Center is aimed at
state and local governments, policy makers, researchers, employers,
workers, and consumers with an interest in recruitment, retention,
and support of direct-care workers who assist elders and people with
disabilities. It includes:
- A searchable
online database of
resources, current research, best practices and policy briefs,
including worker and supervisor training curricula, guidance on
measuring workforce outcomes, recruitment materials, and peer
mentorship program designs.
- Access to information, resources, and advice from a diverse
and experienced team of direct-service workforce policy professionals
through a national toll-free telephone number (1-877-822-2647).
- Individualized, in-depth technical assistance for state
Medicaid agencies with initiatives aimed at improving the home- and
community-based direct-service workforce.
The Resource Center's online database includes numerous links to
the National Clearinghouse on the Direct Care Workforce,
Quality Jobs/Quality Care's publisher, and the
Paraprofessional Healthcare Institute, QJ/QC's parent
organization, is one of the Resource Center's team of experts. The
other experts on the team are The Lewin Group, the Institute for the
Future of Aging Services, and the Research and Training Center on
Community Living, University of Minnesota.
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Iowa Group Issues Action Plan for Expanding Health Care Coverage
Providing Health Care for Direct Care Workers-A Case Statement/Action Plan,
a report from Iowa's Better Jobs Better Care program, identifies
"affordable and meaningful health coverage" as "part of the basic
definition of a 'good job'" and a necessary step in stemming the
turnover tide.
The report, which also outlines the costs of turnover among
Iowa's direct-care workers, outlines a strategy for expanding
coverage for direct-care workers. It recommends that the state:
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Help direct-care workers maximize their knowledge and usage of available programs.
This includes informing them about types of benefits, eligibility
rules, application processes, and alternative routes of health care
access such as rural and free clinics and community health centers.
It also includes enlisting the help of direct-care workers in
"assessing and meeting the needs for coverage and access."
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Work to secure expanded health care coverage options for both direct-care workers and other uninsured populations.
Working for broader coverage involves forming a coalition of
organizations and leaders to obtain consensus and craft legislation
for consideration by the 2007 Iowa legislature. Working to expand
coverage for direct-care workers in particular, the report suggests,
means identifying coverage options specifically tailored to that
group and then crafting proposals for legislative action and a
"legislative strategy." The report also suggests using direct-care
workers as a "face" of the broader coalition's efforts.
Click
here
for the full version and
here
for the abbreviated version of the report.
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Tapping Into What CNAs Already Know
"Empowering the CNA,"
an article in the March issue of Nursing Homes magazine,
describes a Newark nursing home's in-service program where certified
nursing assistants are often taught by their peers.
"Nursing assistants can take on this new challenge and do a
fantastic job," writes author Lois Beatty, the facility's director of
nursing. "Why not? They know everything that goes on in the facility
regarding residents and families because they spend more time with
them than any other team member. Residents and family members often
are more comfortable telling them things that they might not tell
other staff members."
In addition, as Beatty points out, "Outside the workplace, direct
caregivers take on various roles. They run households, maintain
budgets, hold positions in civic organizations, participate in church
activities, and serve on school PTAs. They have a multitude of skills
that we have not accessed."
The article includes tips on how to support CNAs who may not have
experience in public speaking but who have valuable information to
share.
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Converting Leavers to Stayers
As the care gap grows, one possible new source of qualified and
motivated direct-care workers is in the pool of caregivers recruited
by Medicaid-funded programs that pay for consumer-directed care, such
as California's In-Home Supportive Services (IHSS) program. IHSS
supports home care clients who recruit, hire, and supervise their own
personal assistance workers. Most of the people they hire are friends
or relatives who might not have considered direct-care work if their
loved one had not needed them.
Two new studies from the Better Jobs Better Care research
program, one by Ted Benjamin and the other by Candace Howes, look at
what makes some of those caregivers stay in the profession and others
leave once their loved one no longer needs their assistance. They
also recommend things states and employers can do - including
offering health insurance and wages of at least $10 an hour - to
encourage more of these caregivers to remain in the direct-care
workforce.
Click here
for the rest of the story.
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April 29 - May 3, 2006
American College of Health Care Administrators 40th Annual Conference
and Exposition, Neville Grange Resort, New York
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May 1-3, 2006
National Association of Area Agencies on Aging's n4a Aging Policy
Briefing and Capitol Hill Day, Washington, D.C.
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