Comments on: Kohl Bill Aims to Bolster Direct-Care Workforce Training

By: Karen Kahn

Karen Kahn — Fri, 23 Jan 2009 17:06:25 +0000

Lance, we agree. That’s why PHI has recommended a wage floor of $12 per hour to the Obama administration. Check out our recommendations at:

http://otrans.3cdn.net/e61823cf345a79af9b_8fm6i60fc.pdf

We are also very concerned about health care coverage for this workforce. If you haven’t visited our health care campaign website, go to: http://www.coverageiscritical.org.

By: Lance Lindeman

Lance Lindeman — Wed, 21 Jan 2009 19:54:35 +0000

None of this will have any effect on improving care for our most vulnerable adults, if workers can’t afford to work in these occupations because of the poverty wages that most direct care workers receive.

By: verna gilbert

verna gilbert — Mon, 29 Dec 2008 19:55:57 +0000

are there any standards for direct workers in place? who will do the training ?

By: Cara Goldstein

Cara Goldstein — Mon, 22 Dec 2008 22:21:51 +0000

Thank you for your comments Harry and Margaret- as one of the staff members who worked on developing this bill, I’d like to respond on behalf of Sen. Kohl.

You are both correct that a number of different state training programs for direct care workers have been developed. However, there is no national initiative underway that will develop and evaluate both competencies and a curricula for personal and home care aides – who today are not covered by any federal standards. While the competencies and curricula associated with many of the state training programs have been well-received, it would be a stretch to say there is a generally agreed upon consensus in the field regarding a standardized approach to training for direct care workers.

At the same time, there is a clear need for the health care workforce to adapt to the coming challenge of serving millions of additional older adults in their own homes or other community-based settings. Sen. Kohl believes this requires that we try to rapidly develop a larger workforce of direct care workers who are well-trained to provide services in a variety of post-acute and long-term care settings – and whose skill levels are well-defined, well-understood, and widely appreciated. That is why the “Retooling the Health Care Workforce for an Aging America Act” proposes a national demonstration that would encompass a variety of providers participating in Medicare and Medicaid.

In addition, existing CNA and home health aide requirements, which are based on federal standards, have not been reviewed or updated in over 20 years. The IOM report recommends expanding the requirements to at least 120 hours and adding additional geriatric competencies. This is another issue Sen. Kohl’s legislation seeks to address through a national demonstration.

So while there may be good examples out there of direct care worker training and other examples of more current CNA training, the standards themselves have not kept pace, and it is now time to raise the bar overall on direct care worker training. This legislation begins the process for doing that.

By: Margaret Baran

Margaret Baran — Fri, 19 Dec 2008 20:08:25 +0000

I have the same question as Harry – why establish 4 demonstration projects when there seems to be already training programs around the country with extensive training programs that probably are already doing the training, etc. required by federal law. My agency, for example the IHSS Consortium in SF has an extensive basic training and specialized trainining program. PHI has a wonderful training program with an extensive compentency testing program. So I am unclear why this is Kohl’s bill.

By: Harry Dispensa

Harry Dispensa — Fri, 19 Dec 2008 18:07:57 +0000

The part I don’t understand about the Kohl bill is that a demonstration program is already in place as the competency and supplemental training are already inherant parts of Registered Apprenticeship programs in the Home Health Aide and numerous other occupations that directly deal with our aging population on a day to day basis. This would be a duplication of what is already in place from what I have read about it. (Establish a national demonstration program in four states to develop, test and evaluate personal and home care aide competency and supplement training required by federal law) Check out Registered Apprenticeship for this training opportunity available to all employers to offer to their staff.

By: Nursepod

Nursepod — Thu, 18 Dec 2008 23:35:57 +0000

It is essential to note that this is one of the core issues at this present time.

By: Linda Flowers

Linda Flowers — Thu, 18 Dec 2008 20:30:55 +0000

Training for direct care workers is vitally important. Older people present unique challenges in the care environment and workers need a solid background in geriatrics to understand the health needs as well as the social needs of elders. Providing direct care to a frail elder requires a broad understanding of the health challenges, social challenges and mental health challenges faced by the person being cared for in order to provide quality care. I think a national certification and licensing process is long overdue.