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January 27, 2006 |
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Staff Understand the Concept of Conflict Resolution but Need Training on Specifics |
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Staff in nursing homes and assisted living facilities are aware of
the importance of using cooperative, non-confrontational means of
resolving conflict with residents, but further training in effective
conflict resolution strategies is probably needed, according to a
study published in the January 2006 of the
Journal of Gerontological Nursing.
Click here
for the rest of the story.
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Older Direct-Care Workers: Perception vs. Reality |
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Older Workers in Direct Care: A Labor Force Expansion Study,
a new research report from the Better Jobs Better Care (BJBC)
project, looks at people aged 55 and older as one potential solution
to the direct-care worker shortage.
Researchers Karen Kosniewski of Operation ABLE of Michigan and
Melanie Hwalek of the research firm SPEC Associates conducted
telephone interviews with 615 nursing home representatives, 410 home
health agencies and 696 lower-income job seekers 55 years and older
in seven states. They found many mature workers interested in the
profession, with 43 percent reporting an interest and 60 percent
wanting to work at least 30 hours a week. More than half said they
would attend a 75-hour certification training program.
Click here
for the rest of the story.
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Health Insurance Helps Stabilize Direct-Care Workforce in California |
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Offering health insurance helps with retention, according to the
latest in a series of studies of home care workers in the Los Angeles
In-Home Support Services (IHSS) program. According to
Impact of Health Benefits on Retention of Homecare Workers: Analysis of the IHSS health benefits program in Los Angeles County, 2005,
workers who take advantage of the health insurance offered are
"largely satisfied" with their medical coverage, with 75 percent
describing themselves as somewhat or very satisfied. The study also
found a relationship between enrollment in the plan and length of
service. Thirty-six percent of the enrolled home care workers having
been in the IHSS workforce for more than five years, while only 27
percent of those not enrolled had been there as long. This suggests
that offering health insurance may aid retention in a profession with
notoriously high turnover rates.
Click here
to read the rest of the article.
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Brief Outlines the Health Care Insurance Crisis in Direct Care |
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Caregivers without Coverage, a new four-page issue brief
published by the Paraprofessional Healthcare Institute's Health Care
for Health Care Workers (HCHCW) campaign, provides basic facts about
the health care crisis for direct-care workers.
The brief touches on the number of direct-care workers who are
without health insurance and describes how that lack of insurance
contributes to the instability of the workforce, undermining the
quality of services delivered to consumers. It also explains why
direct-care workers lack access to health insurance and outlines
options for expanding coverage, along with examples of each.
To download the brief,
click here
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New Assisted Living Consumer Group Forms
A new education and advocacy group first convened last October at the
annual meeting of the National Citizens' Coalition for Nursing Reform
will represent people who live in assisted living communities. The
mission of the Assisted Living Consumer Alliance (ALCA), a national
collaboration of groups and individuals, is "to advocate for assisted
living care that truly meets consumers' needs as individuals." Eric
Carlson of the National Senior Citizens Law Center, a member of the
group's steering committee, describes its goals as "joining together
to promote and preserve choice, safety, and legal rights for assisted
living consumers." The group, which is developing a website, has
already created a list of priorities, ten principles for assisted
living reform, and a listserv. Those interested in joining or in
learning more should contact Toby Edelman at the Center for Medicare
Advocacy (202-216-0028;
email Toby) or
Richard Mollot at the Long Term Care Community Coalition
(212-385-0355; email Richard).
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Dear Friend
If you've been wondering where we are, we've been working on
switching e-mail providers, a process that started before the
holidays. It's taken a little longer than we'd hoped -- and resulted
in a double issue that's a lot longer than usual -- but that's
because we took the opportunity to give
Quality Jobs/Quality Care a facelift while we were at it. We
also added a few new features: New in the Clearinghouse, Events, and
a quick poll. If your e-mail program doesn't allow you to see the
graphics, click on the "View this message in a browser" link at the
top of this message. And if that doesn't work either, please drop me
a line at
elise@paraprofessional.org.
Our other big news is that Allison Slaughter, our Clearinghouse
associate, has moved on to another position at the Paraprofessional
Healthcare Institute, so we're looking for a web content editor to
work on the National Clearinghouse on the Direct Care Workforce,
which publishes this newsletter. If you or someone you know might be
interested, please
click here
for a description of the job and information on how to apply.
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Iowa Registry Amends Employment Requirement for "Active" Nursing Assistants
As of January 1, Iowa has updated its requirements for remaining on
its Direct-Care Worker Registry. CNAs who have worked at residential
care facilities, residential care facilities for the mentally
retarded or for people with mental illness, health care staffing
agencies, assisted living programs, elder group homes, adult day care
centers, or rural health clinics within the past two years will now
be eligible to maintain active status. In addition, the Department of
Inspections and Appeals (DIA) will consider employment in other
healthcare settings on a case-by-case basis.
Federal regulations require that CNAs who have not performed any
paid nursing or nursing-related duties for the past 24 months be
removed from the nurse aide registry. Previously, only those who had
worked in licensed and certified long-term care facilities, home
health agencies, hospice, intermediate care facilities for the
mentally retarded, private duty, hospitals, or non-licensed religious
homes were considered by the DIA to have met the employment
requirement.
The change was made in response to requests from stakeholders,
including the Better Jobs Better Care Coalition and Education
Workgroup, the Iowa CareGivers Association Direct Care Worker
Advisory Council, and the Iowa Health Care Association.
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Online CNA Dementia Care Training Makes Learning "Interesting and Alive"
The Alzheimer's Association's dementia care training for CNAs in
nursing homes and assisted living facilities, which could formerly be
downloaded but not conducted online, can now be accessed through six
interactive online modules.
Module titles are Meet Clara Jones and Her Care Team,
Introduction to Dementia, Understanding Resident Behavior as
Communication, Making a Connection with the Resident, Eating Well,
and Recognizing Pain. Facilities can purchase use of the modules for
a month. They are available both as a package and one at a time,
since "we thought that probably a facility would want to do the
training one module at a time, the same way you would do an
in-service," says Katie Maslow, assistant for quality care advocacy,
Alzheimer's Association.
"This is very interactive, and probably more interesting for
staff than reading something," Maslow adds. "It focuses very much on
people. One of the people is a CNA, who is somewhat the star of this
web-based training program, and then there are nurses, family
members, and many residents with dementia. I think it's very
interesting and alive."
Click here for a demo
and ordering information.
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Supreme Court Weighs in on Home Care Wage Case
This Monday, the U.S. Supreme Court weighed in on an important case
involving home care workers. Although it did not agree to hear the
case of
Long Island Care at Home, LTD., et al v. Evelyn Coke, the
court vacated the decision that had been made by U.S Second Circuit
Court of Appeals, sending the case back to the lower court for
reconsideration.
Click here
to read the rest of the story.
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Coalition Files Amicus Brief in Appeal of "Feeding Assistant" Case
The Long Term Care Community Coalition (LTCCC), a consumer advocacy
group based in New York state, has weighed in on the "feeding
assistant" controversy. On January 10, LTCCC filed a friend of the
court (amicus) brief in support of a lawsuit aimed at preventing
"feeding assistants" with as little as eight hours of training and
minimal supervision to work in nursing homes.
The case, titled
Resident Councils of Washington v. Thompson, is currently on
appeal. It argues that the October 2003 federal regulation
establishing the use of so-called feeding assistants is in violation
of the Nursing Home Reform Act, which stipulates that direct care may
be provided only by a registered nurse, licensed nurse, or nursing
assistant. A district court upheld the regulations on September 8,
2005. According to LTCCC Director of Special Projects Cynthia Rudder,
"This reduction in minimum standards flies in the face of everything
we know and have learned over the years. Our organization's own
studies and reports, which have been widely corroborated, all point
to the need for improving training, to improve conditions for both
residents and workers."
LTCCC's amicus brief was joined by the National Citizens'
Coalition for Nursing Home Reform, the Coalition for
Institutionalized Aged and Disabled, the New York State Nurses
Association, and the Alzheimer's Association of New York City.
Click here to download the
amicus brief or read more about feeding assistants.
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UN to Hear Testimony on the Global Direct-Care Recruitment Crisis
A February 10 session at the United Nations Commission on Social
Development's annual meeting will focus on the supply and quality of
the long-term care workforce, with an emphasis on the looming crisis
in many developed countries that find it increasingly difficult to
recruit and retain direct-care workers.
The Long Term Care Workforce: Quality of Care, Economic
Development and International Migration will address the demographic,
social and political factors driving the increased international
migration of long-term care workers to developed countries. It will
also look at the impact of migration on the developing nations that
generally supply these workers and describe how policy decisions
regarding long-term care financing, immigration, credentialing and
recruitment affect long-term care labor markets.
Representatives of the International Association of Homes and
Services for the Aging, the AARP Global Aging Program, and the
Institute for the Future of Ageing Services will speak at the
session, which will take place at UN Headquarters in New York City.
Click here
for a preliminary program.
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... and Massachusetts
As of last November, homemakers and personal care homemakers working
for state-funded home care providers in Massachusetts got an
additional 75 cents in compensation (including base wages,
health/life insurance, travel stipends, and training wages), raising
average hourly wages from $9.79 to $10.54. The increase came from a
bump in reimbursement to providers of 85 cents an hour that was
enacted in the FY2006 state budget, which allocated $3.9 million to
the initiative. The increase is retroactive to July 1, 2005.
According to Lisa Gurgone, executive director of the
Massachusetts Council for Home Care Aide Services, which helped
create awareness of the need for the increase, one of the bill's
sponsors emphasized at a press conference on the budget that the goal
of the bill was to raise the average compensation earned by these
essential workers above $10 an hour. "It was a huge victory," says
Gurgone. "When we initially decided to ask for some funding, we were
under the impression that we would get half of what we asked for, if
anything, and that it would take years. But the legislature really
responded to our argument and said, 'You're right; these workers
should be getting more.'
"We just tried to explain that most home care aides are not
working 40 hours a week - they're lucky if they get 20 hours of paid
work. If you look at their earnings, it's $19,000 a year or less, and
in Massachusetts that's nothing. And we talked about the agencies
that are in a really dire situation with recruitment and retention.
It's surprising, but we're really happy that they supported us like
that."
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Wages Increase in Washington, D.C. ...
In the fiscal year 2006 budget that went into effect on January 17,
Washington, D.C., allocated an additional $6 million to fund payment
of "a living wage" to home health care workers and personal care
assistants in the District's Medicaid program. According to a January
13 Department of Health (DOH Notice of Emergency and Proposed
Rulemaking, the increase was "necessary for the immediate
preservation of the health, safety and welfare of Medicaid recipients
who are in need of services provided by personal care and home health
aides." The measure raises wages from a range of $7 to $9 to a
minimum of $10.50 an hour.
Providers had argued that the previous wages were too low to
attract enough workers to provide the care needed by Medicaid waiver
clients. Noting that "Federal rules require that the state Medicaid
rates be sufficient to enlist enough providers to make certain that
access to services is, at a minimum, comparable between program
recipients and the general population," the DOH notice said the
increase make the District's wages competitive with those paid in
surrounding jurisdictions.
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Direct-Care Workers Convene in Rhode Island
Certified nursing assistants met in Warwick, Rhode Island, last month
to explore the power of their influence on creating a collegial
workplace and its influence on the quality of life of nursing home
residents.
Click here
for the rest of the story.
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Annual Survey Reports CNA and Home Health Aide Salaries
Certified nurse aides in hospitals average $11.15 an hour, with those
who work evenings, weekends, or night shift earning shift
differentials that average $2.25 an hour. CNAs in nursing homes
average $10.91 an hour, and home care aides between $9.26 and $10.60
depending on job duties, according to this year's edition of the
Hospital & Healthcare Compensation Service's
Nursing Department Compensation Report 2005-2006. The report
also finds that per diem CNAs in hospitals average $12.41 an hour.
The data was compiled from three salary surveys, one of 368
hospitals, one of 2,336 nursing homes, and one of 1,530 home care and
hospice agencies. Two of the surveys were published in July 2005 and
one in October 2005.
To order the $295 report, which breaks down salaries by region,
facility size, and other factors, go to the company's
website and click on Order
Form.
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Culture Change Documentary Set to Air on PBS
E-mailed appeals to lobby PBS stations to air a documentary about
culture change piled up like the early winter snow in the in-boxes of
long-term care stakeholders earlier this month. The appeals
apparently worked: Almost Home, a 90-minute feature that chronicles a
year in the life of Saint John's on the Lake, a Milwaukee retirement
community engaged in a culture change effort, will air on Tuesday,
February 21 at 10 p.m. in most markets. The program was preempted
from its original air date by President Bush's planned State of the
Union address.
The documentary follows several of the home's residents and their
family members as well as the administrator and other staff,
including several CNAs.
A website builds on
issues raised in the movie - including the inadequacy of the CNA pay
rates. The filmmakers are using the film as a teaching tool, offering
DVDs and discussion materials to people interested in hosting
educational events.
"The good news is that we have conducted nearly 100 outreach
events already, and we've distributed nearly 2,000 DVDs to educators,
care providers and others in the field of aging," wrote director Brad
Lichtenstein in a January 4 e-mail. "We have conference screenings
and panels scheduled through 2006. And the U.S. Senate Committee on
Aging is sponsoring a screening on the Hill in February. We've had
quite an impact."
Click here
to check your local PBS station for an air date.
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Family Caregiving Continues to Outpace Paid Care
An AARP Public Policy issue paper published in November finds that
family caregivers are still providing the vast majority of the
long-term care received by Americans 65 and older with disabilities,
with the amount of care they provide increasing as compared to the
amount provided by paid caregivers. Staying the Course: Trends in
Family Caregiving analyzes data from the National Long-Term Care
Surveys from 1984 through 1999 to find that the number of spouses and
children providing care to older persons increased between 1994 and
1999. The use of formal (paid) care by the same population declined
during that period.
Authors Brenda C. Spillman and Kirsten J. Black of the Urban
Institute also found that the proportion of elders relying solely on
family care increased dramatically over the same period. Family
members were caring for people with higher levels of disability in
1999 than in 1994, and both the family caregivers and the care
recipients were older on average.
Click here
to download the 40-page paper.
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WHCOA Recommendations Make Direct-Care Workers a Priority
The top 10 resolutions agreed on by delegates to the 2005 White House
Conference on Aging include three involving direct-care workers in
long-term care. The conference, which takes place about every ten
years, is a highly anticipated event among professionals in the field
of aging. Delegates are charged with identifying policies and
priorities for the next decade, and important programs, including
Medicare and Medicaid, grew out of the recommendations of past
conferences. The 2005 group's top 50 resolutions, along with
strategies for implementation, will be presented to the President and
Congress this June.
Click here
for the rest of the story.
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February 25, 2006
FORUM 2006 - Think Local, Act Global. Renaissance Hotel, Washington,
D.C.
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March 5, 2006
Association of Jewish Aging Services. The Rio, Las Vegas, Nevada
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