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SUMMARY: Dr. Dorie Seavey, director of policy research at PHI, is interviewed by Margaret Prescod for the “Sojourner Truth” radio show. The topic is the Department of Labor’s proposed rule to end the companionship exemption.
The PHCAST Program was created as part of the Affordable Care Act. It is a three-year demonstration program to develop core competencies, pilot training curricula, and establish certification programs for personal and home care aides.
A total of $4.2 million was awarded to California, Iowa, Maine, Massachusetts, Michigan, and North Carolina for the project. The six states that are participating in the three-year PHCAST Program are expected to train over 5,100 personal home care aides by 2013.
The PHCAST Program grants are part of a larger $253 million HHS funding package to improve and expand the primary care workforce under the Prevention and Public Health Fund of the Affordable Care Act. The programs will be administered by the HSS’ Health Resources and Services Administration (HRSA).
Vital to the Future Healthcare Workforce
“PHI commends HRSA for their expeditious action in awarding the PCHAST grants,” said PHI National Policy Director Steve Edelstein.
“It is heartening to see that the states selected include many that have been leaders on direct-care initiatives for years. This bodes well both for the success of their efforts to develop competency-based training programs for personal and home care aides, and for the impact these programs will have in their own states and the entire nation.”
Referring to all of the state health profession grants under the Prevention and Public Health Fund, HRSA Administrator Mary K. Wakefield, Ph.D., R.N. said, “These grants are the most comprehensive yet in addressing our nation’s shortage of key health professionals.”
“They will provide much-needed support for increasing primary care capacity by expanding training programs for primary care providers, increasing access to patient care clinics, strengthening state-level workforce planning, and providing training for personal home health care aides. All are vital to our future healthcare workforce,” Wakefield said.
An HHS chart details the workforce categories and the amount of each state’s award.
PHI a Resource for Curriculum Development
PHI’s Curriculum and Workforce Development team will be working with several of the grantees on developing adult-learner centered training curricula. One of PHI’s top policy priorities is improving training and certification for personal care aides.
MA State Representative Kate Hogan assists home care client Shekhar Mehta with a pressure regulation device for his legs.
PHI Massachusetts recently sponsored two Come Care With Me events in which Massachusetts State Senator Pat Jehlen, Senate Chair of the Committee on Elder Affairs, and State Representative Kate Hogan, co-chair of the Elder Caucus, shadowed home care workers on the job.
First, on September 22, Representative Hogan worked alongside Cam King, a home health aide for New Century Homecare Services, who provides critical support services three times a day to Shekhar Mehta.
Representative Hogan helped Ms. King as she provided a wide range of supports to Mr. Mehta, who has a disabling condition which impairs his mobility.
“This was an excellent opportunity to learn more about the important work that home health aides do in supporting seniors and people with disabilities,” Representative Hogan said. “Their work is essential to the quality of life of families throughout the Commonwealth, but to do a good job they need support: decent wages, health coverage, better training, and opportunities for career advancement.”
Aides Work is Essential
Next, on September 29, Senator Pat Jehlen joined Philomena Ahern, a homemaker and personal care attendant with Homemaker Services, on her weekly visit at the home of 102-year-old Stella Murphy. The senator pitched in to help Ms. Ahern, who prepares food, does laundry, and light housekeeping, by washing Ms. Murphy’s floor.
State Senator Pat Jehlen and direct-care worker Philomena Ahern.
“This was an unforgettable experience where I learned more about the essential work of homemakers and personal care attendants – the direct-care workers who make it possible for older adults and people with disabilities to live independently in their homes,” said Senator Jehlen. “Families depend on these workers to care for their loved ones – often so that they can work themselves.”
Like Representative Hogan, Senator Jehlen said these jobs need to be quality jobs if “Massachusetts is going to meet the rapidly-growing demand for this workforce.”
Challenges Ahead
“There are nearly 60,000 home care workers in Massachusetts (pdf), and these occupations are growing rapidly as our population ages,” said PHI Massachusetts State Policy Director Amy Robins, who organized these Come Care With Me events and a Massachusetts legislative briefing earlier this spring.
“To prepare to care, Massachusetts needs to examine future needs in this area and develop a feasible plan for recruiting, training, and supporting a qualified, compassionate caregiving workforce. Among the hurdles going forward will be ensuring that these workers have affordable health coverage. Massachusetts has made big strides on the access front, but the challenge of national health reform will be to provide quality coverage that these caregivers can afford.” Robins said.
Rhode Island State Senator Charles J. Levesque, who co-sponsored the Nursing Home Culture Change legislation (pdf) that passed last June, has posted an eight-part Capitol TV video on YouTube that captures the legislative process that made the bill law.
The law was the result of a compromise concerning adding nursing home bed capacity in order to promote culture change. Only when nursing facilities close, or reduce their bed capacity, will new nursing facility beds that are dedicated to culture change be permitted by the state.
The Nursing Home Culture Change law “maintains the statewide cap on nursing facility beds but provides that, as beds become available due to the closure or reduction of facilities, the majority of those beds will be transferred to home-like facilities that reflect the culture change values,” said RI Lieutenant Governor Elizabeth H. Roberts, who is also the chair of the state’s Long Term Care Coordinating Council, in a press release.
“Patients and their families are increasingly seeking more comfortable, personal, home-like atmospheres in nursing facilities,” said Senator Levesque in the release.
“This is a plan that will help transform and improve the care of the elderly in Rhode Island without harming the industry. It will help Rhode Island’s nursing homes move toward the cutting edge and provide the kind of setting that the patients and families of today want,” the senator added.
“I hope that other states will follow the excellent example that Rhode Island has set with the passage of this culture change legislation,” said PHI Director of Training and Organizational Development ServicesSusan Misiorski. “Elders and individuals with disabilities who live in America’s nursing homes deserve to live in settings that reflect all aspects of “home,” including privacy and self determination.”
Home care worker Evelyn Coke brought her fight for fair pay all the way to the Supreme Court. PHI has released this video on the first anniversary of her passing.
The Centers for Medicare & Medicaid Services (CMS) partnered with the Pioneer Network on May 14 to sponsor an online symposium to address dining initiatives that promote culture change in nursing homes and explore the potential and perceived regulatory barriers to making such transformations. Continue Reading
The Centers for Medicare & Medicaid Services (CMS) partnered with the 
