I agree wholeheartedly with you that programs like OPEN are not the whole picture to linking quality jobs to quality care. OPEN is not a substitute for good wages and benefits. And, it seems true to me that the low wages and lack of benefits that are the norm for many caregivers generate a good deal of the need for such initiatives.

Yet, I wouldn’t want to undervalue efforts like OPEN because of that reality. It represents a positive response that acknowledges the challenges that many direct care workers face and that alleviates some of their difficulties and is doing good, even though it’s occurring in a broader context we also wish we could change now. As long as employers cannot see a way to pay higher salaries and benefits, but can envision some steps that support many workers, it seems good to encourage those steps and offer models to spread them.

Another issue that you raised highlighted the frustration many hardworking, independent workers feel who are able to live up to management requirements and provide great care without the kinds of assistance offered by OPEN – and often without much appreciation or recognition. When managers focuses their intention only on those employees who are challenged and need supports, and ignore the contributions of workers who do not call attention to themselves because of their steady reliability, it undermines the entire culture and success of the workplace, and has to be challenged as poor management. Highly performing workers need recognition and to be appreciated.

Supporting workers who need interventions when they are going through challenging times, though, doesn’t take anything away from the independently successful ones, particularly when programs like OPEN move that help off of in-house supervisors to others outside the LTC organization. It can actually help make their work lives easier too – as they work over less often to cover fewer absences, and work short-staffed less often, and share workloads with co-workers who are less stressed and strained.

It’s also really important to stress that the people helped in the OPEN program aren’t necessarily, or even usually “chronically troubled” employees. They’re like the great employee who is the Mom of an autistic son whose car is unreliable and who doesn’t know of all the community supports available to help her with her child. The reliable worker who is going through a horrific divorce and trying to hold her life together. Many of us who are usually valued employees go through tough times and it would be such a much more better world if we all had somewhere to turn. What we saw in OPEN was an investment to keep reliable employees who have a rough patch not an attempt to hold on to employees who cannot make it.

Finally, OPEN is occurring within a context of broader programs being sponsored by the Health Field Collaborative (HFC) that includes opportunities for education and career development for all employees, and training for supervisors and staff in communications and culture change. If the OPEN retention program was the only positive initiative of the HFC, it would fail for the reasons you cite, as well as because the OPEN program would get a reputation as being only for “problem employees,” and no one would want to take advantage of its services.”

I believe these programs drive down wages and expectations of good care. They may help some..but others see it as a slap in the face.
Aides who are not “disadvantaged” are indeed held to higher standard; they are expected to shoulder more burdens and take on more workload. Yet they get no credit or better wage for being able to do all this.

In a way, these programs are driving out those aides who want to do this work, who work for their own solutions to their own problems, and who stick with the profession for years..whereas these people who seem to always need help tend to come and go. I don’t know.

The other thing I see with these programs is the lack of attention to the true issues affecting aides: Poor pay (that could help with paying the babysitter); no insurance; no real empowerment. And, finally these programs create dependence upon others to solve one’s own issues. And they become an excuse for poor performance…which really irks many of us.