The July issue of The Gerontologist is devoted to findings from the Better Jobs Better Care research and demonstration project. BJBC, which began in 2002 and ended in 2006, 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. The initiative involved changing both public policy and employer practice. Demonstration grants were made to groups in Iowa, North Carolina, Oregon, Pennsylvania, and Vermont.
A nine-page overview lays out how and why the project came into being, the problems affecting the direct-care workforce, and how awareness of and responsiveness to those problems is changing. The essay is by Robyn Stone (pictured), executive director of the Institute for the Future of Aging Services, and PHI President Steven Dawson. FAS and PHI conceived of BJBC and provided technical assistance to the grantees. Funding was supplied by the Robert Wood Johnson Foundation and The Atlantic Philanthropies.
Among the findings detailed in the issue:
- Direct-care workers across long-term settings identified more pay, improved communication, better supervision, and being treated with respect as the most important things employers could do to improve jobs.
- After accounting for satisfaction with wages, benefits, and advancement opportunities — good basic supervision was most important in affecting CNAs to stay in their jobs.
- There is a positive correlation between CNA job commitment and resident satisfaction.
- After accounting for satisfaction with wages, benefits, and advancement opportunities, good basic supervision was the most important factor behind commitment to the job.
- To improve recruitment and retention of home care workers, jobs should be flexible and provide affordable health insurance for part-time workers.
- A great many of the people who provide paid consumer-directed care for friends and relatives are interested in caring for others as well, even people they don’t know.
There are also reports on the success of two workforce interventions: North Carolina’s WIN A STEP UP program, a multi-faceted program to reduce turnover through incentivized training and improved supervision; and, an experiment in New York and Connecticut proving the value of retention specialists in reducing turnover.
The articles are free to Gerontologist subscribers only. Others must pay $20 per article or $50 to download the entire issue.
Elise Nakhnikian, Senior Online Editor
enakhnikian@phinational.org
There’s nothing wrong with more money or better supervision. But I am coming to believe that direct care workers will benefit from the kind of mentoring and coaching that helps them develop their leadership skills. We all have them. Leadership is not something that some of us are born with. John Maxwell points out that everyone can be a leader regardless of their title or compensation. Studies indicate that some 70% of human service organizational leaders are baby-boomers and will retire within the next ten years…maybe half of them by 2010. This means that there will be lots of leadership opportunities in the 1 million or so service organizations in the U.S. At the risk of sounding self serving, preparing direct care workers to move up immproves the quality of their work NOW and puts them on a path to a liveable wage. They do not have to be the victims of a system that too often treats them with a lack of equity.
Larry Wenger, MSW
Workforce Performance Group
Here at OSU-OKC we offer a free C.N.A. training, one of the things we want to do is to provide Oklahoma with better C.N.A.’s. First thing we think is most important is the education part of it, even though Oklahoma’s minimum required hours for C.N.A. training is 75, we made ours 96 hours and next FY we are going to 120 hours. To get into our C.N.A. classes you MUST first pass a reading test; you have to pass it with at least a 9th grade reading level. This program has been going on now since 2005 and we are told all the time by Oklahoma Long Term Care Facilities, that our OSU-OKC C.N.A.’s are the ones that stay longer, some are still working in their first LTC facility, that they started in, much less turnover in the homes with multi. OSU-OKC grads. We also teach our C.N.A.s to be professional, Lori Porter R.N. Co-founder of NAHCA, says it best, “The attitude of C.N.A.s toward their peers has more influence than does administration. Change the attitude of the C.N.A.s from negative to positive and it will change the whole facility and eventually all of long term care” We feel if they are made to dress more professional, they will feel and act more professional too, not only do we teach them how to be a C.N.A., we also teach them what to wear and not to wear to an interview, how to fill out a resume ect. I have been teaching C.N.A.s since 2001 and I would have to say 95% of the ones I stay in touch with say, they would have stayed at the “home” if they had been treated with respect, not one C.N.A. said they got out of nursing because of the poor wages.