The July issue of The Gerontologist featured the results of the Better Jobs Better Care initiative, the four-year $15.5 million research and demonstration project that was the largest initiative in the nation ever created to address the high vacancy and turnover rates of direct-care workers by improving the quality of direct-care jobs. Continue Reading

When we first heard of direct-care workers in the South Bronx, New York, being tracked by GPS, we thought of George Orwell’s “Big Brother.”

But when we spoke to workers and to a manager at Cooperative Home Care Associates, an affiliate of PHI that recently ran a successful pilot test of the system, we decided this was a good use of cell phone technology.

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For consumers of paid long-term care services, eight out of every ten hours of service are provided not by a nurse or a doctor, but by a direct-care worker—a home health aide, certified nurse aide, or personal care worker.

Therefore, for consumers who rely upon services and support from direct-care staff, PHI has identified the Nine Essential Elements of Quality Care —whether that care is received in the consumer’s home or in a residential setting.

This builds off of PHI’s Nine Essential Elements of a Quality Job, which is a guide to help ensure direct-care workers are able to provide the highest-quality care to all long-term care consumers.

We are interested in hearing your thoughts on the elements of quality care. Does this vision resonate for you? Let us know by commenting below. Continue Reading

PHI has released a comprehensive evaluation (pdf 604k) of its Northern New England LEADS Institute, a three-year demonstration project to improve the quality of direct-care jobs at 12 participating nursing homes and home care agencies in Vermont, New Hampshire, and Maine. The results showed decreased turnover at sites with strong implementation of coaching supervision and peer mentoring. All sites received training, technical assistance, and cross-learning opportunities.

Specific results include:

• Turnover for direct-care workers decreased from 2006 to 2007 for five of the ten sites (for which there are complete data).
• Two of the three organizations with very strong and sustainable coaching supervision and peer mentoring programs achieved reductions in both turnover and call outs.
• Five of the nine organizations with strong implementation of one or more LEADS interventions improved on turnover and/or calls outs.

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Following our story last week on Washington State’s ballot initiative, we were contacted about a ballot initiative in Missouri that also deals with long-term care workers.

The ballot question called Proposition B would create a Quality Home Care Council that would run a statewide registry, coordinate backup services, offer trainings, and negotiate with workers over wages and benefits–if they choose to form a union. Similar councils exist in Oregon, Washington, Massachusetts, Michigan, Wisconsin, and California.

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“We need a little more money for those who have worked for so long. You get fussed at, hit at, bitten, kicked, scratched, slapped, ” said Ronnie Fisher, Sr., a CNA in Wisconsin for the last 23 years.

The Kenosha County Long Term Care Project is working to help people like Fisher, in a state where the average caregiver earns just over $9 an hour.

The organization is working alongside others to launch a state-wide public awareness campaign, said the Kenosha County LTC Project’s Barb Wisnefski.

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