Comments on: Better LTC jobs will boost economy, says Kuttner

By: Lee Goldberg

Lee Goldberg — Wed, 19 Nov 2008 23:24:09 +0000

Robert Kuttner’s article makes an important point that is often overlooked by progressive policy leaders seeking to expand consumer choice. Kuttner rightly describes the problems associated with the “trend toward casualization of labor”, which can be a problem with consumer-directed care if programs are not carefully constructed.

No doubt, consumer-directed care is an important means of improving the quality of life for people who need home care and similar services; it is also an important way to expand the workforce. But an orthodox version of consumer-direction ends up leaving workers without the supports that a traditional employer relationship provides. No way to raise wages without cutting back services; no way health insurance or worker’s comp.

One option is giving independent providers an entity that can bargain with the state on their behalf over wages and other traditional components of a regular employment relationship. After all, it is really the state that controls the resources available to the program or to the individual beneficiary. There are probably other options but in most cases, it is clear that “casaulizing” home care makes the workers may worse off than if they worked for an agency. The last thing most of us want to do is create a long-term care system that advances the well-being of one group of low income individuals at the expense of another.

By: Maureen Drouin

Maureen Drouin — Mon, 17 Nov 2008 16:01:32 +0000

As someone who has worked in the nonprofit disability field for more than 20 years, I could not agree more about the need to increase the training, support and mosdt of all, the salaries of my colleagues who provide essential services through direct care. howeve, it needs to be pointed out that many direct care workers are employed by nonprofits (like mine) whose reimbursement/salary rates are set by the state – not the nonprofit employer (we continually advocate for higher salaries for our staff). Unions like SEIU cannot effectively secure higher salaries from the employer through negotiation/pressure – because we can only pay the rates established in the state contracts.

By: Larry Wenger

Larry Wenger — Mon, 17 Nov 2008 15:47:00 +0000

I also want to support Mr. Kuttner’s thoughts on professionalizing the human service workforce. We would do well to take his choice of words seriously…that is, the entire human service community must advocate for these issues AS ONE! It makes no sense for the senior care industry to act like the mental health, child welfare and developmental disability communities do not exist. They do exist and in significant numbers. And if my experience in all four areas of service is at all valid, the experience of the direct care workforce is practically identical regardless of whether they are working with seniors, children or adults. Besides, from a political perspective, most of the public does not differentiate.

Larry Wenger, MSW
Workforce Performance Group

By: Cheryl L. Neal

Cheryl L. Neal — Mon, 17 Nov 2008 14:53:15 +0000

I agree with Mr. Kuttner I’ve worked in the LTC for 3 years and I see what goes on the Nursing Homes the workers are under tremendous stress as well as being underpaid for the work that they do, I decided to remain in LTC but work as a Private Duty
Caregiver for an agency I also think they need pay raises in this sector also. I believe if you give people the respect, and the tools to work with it would be a better outcome for both the workers and the patients.