Over the next month, the PHI Expert Interview series will bring you insights from four senior PHI staff. They’re an impressive group – among the nation’s leading experts on long-term care’s direct-care workforce – and collectively they’ve spent decades studying the challenges facing the workforce and how to address them. We think you’ll be interested in what they’ve learned.

The One Thing You Need to Make Culture Change Work

Sue Misiorski, PHI’s Director of Organizational Culture Change, has been making nursing homes better places to live and work for more than 20 years. A registered nurse, she started her career as a CNA and later became a director of nursing and vice president of nursing for an innovative nursing home chain.

Sue is also one of the pioneers of the Pioneer Network, the people behind the concept of culture change. She was president of the Pioneer Network for three years, and she wrote its handbook on how to implement culture change: Getting Started: A pioneering approach to culture change in long-term care organizations.

The Pioneers have worked hard to keep the concept of “culture change” flexible. They say that it’s a journey, not a destination, and that it can start almost anywhere. In keeping with that philosophy, Sue and her PHI colleagues start with an organizational assessment when they work with an employer, learning about that particular organization’s needs and goals rather than trying to impose a cookie-cutter solution.

But Sue has learned that one thing must be in place before an organization can embark on its culture change journey. Continue Reading

The Direct Care Alliance (DCA), a national advocacy organization for direct-care workers, is inaugurating its new midtown Manhattan headquarters on September 11.

After a half-hour reception, the program will begin at 6 p.m. with a welcome from DCA Board Chair John Booker. Executive Director Leonila Vega, Stacey Easterling of The Atlantic Philanthropies, and direct-care worker Bridget Siljander will also speak, followed by video highlights from the 2007 DCA convention.

See the invitation (pdf) for details and RSVP information.

Elise Nakhnikian, Senior Online Editor
enakhnikian@phinational.org

In response to a recent solicitation for comments from the federal government, PHI recommended changes to the three main categories used to track direct-care workers at the U.S. Department of Labor’s Bureau of Labor Statistics (BLS). The government considers revisions to its Standard Occupational Classification (SOC) categories every ten years.

PHI also asked the government to address the exclusion of direct-care workers who are “independent providers” from federal/state employer surveys, which PHI believes results in a serious undercount of workers counted as Personal and Home Care Aides. Independent providers refer to direct-care workers who are either self-employed or who are directly employed by consumer households.  

Workforce data can play a critical role in assessing things like the effectiveness of state initiatives to attract and retain greater numbers of direct-care workers, or the impact of policies designed to improve direct-care worker wages.

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It’s just one sentence out of 52 pages – not including introductions and appendixes – but direct-care workers got a mention in the 2008 Democratic National Convention platform.

In a section titled Renewing the American Community, under the subtitle “Seniors,” the platform (pdf) reads:

“We will take steps to ensure that our seniors have meaningful long-term care options that are consistent with their individual needs, including the option of home care. We believe that we must pay caregivers a fair wage and train more nurses and health care workers so as to improve the availability and quality of long-term care.”

Could this be a sign that a political will is stirring to improve home care jobs?

Elise Nakhnikian, Senior Online Editor
enakhnikian@phinational.org

Whether you call it person-centered, person-directed, or just plain quality care, the goal is the same for everyone receiving or regulating long-term care services as it is for all conscientious care providers: Everyone wants care to be tailored to individual preferences and needs. Yet that common-sense goal can be surprisingly hard to achieve in our complex, technology- and medication-oriented, often understaffed health care system.

Many of the barriers that stand in the way are systemic – boulders that no one person can shoulder aside on his or her own. But a self-published, spiral-bound booklet created by an aging services specialist gets long-term care consumers closer to that goal by giving them a way to keep track of their vital information — and share it with direct-care workers and other health care professionals.

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Download Release as PDF

PRESS RELEASE
For Immediate Release

Elders Vulnerable as Caregivers’ Real Wages Fall

Gas prices depressing workers’ already low wages to near minimum wage

Bronx, NY, August 11, 2008— Contradicting the law of supply and demand, America’s personal and home care aides are seeing their real wages (adjusted for inflation) decline as demand for their services rise. In its most recent publication, State Chart Book on Wages for Personal and Home Care Aides, 1999-2006, PHI documents wage trends for all 50 states.

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