Wages Adjusted for Inflation: Over the past decade, inflation-adjusted median hourly wages for Nursing Aides, Orderlies, and Attendants in Iowa increased by 13 percent, from $8.13 to $9.19. Real wages for Home Health Aides increased by 7 percent while those for Personal Care Aides were stagnant.
Employer-Sponsored Insurance: Compared to the national civilian workforce, fewer of Iowa’s direct-care workers have access to and use employer-sponsored insurance. Some work for employers that do not offer health insurance. Others work for employers that limit eligibility for health insurance to full-time employees. This creates a barrier for many direct-care workers, especially those in home and community-based settings, who often work only part-time due to the episodic nature of direct-care work. Even workers who do have access to insurance from their employer may find the co-pays and premiums unaffordable.
HF 2526: This bill appropriates dollars for the Iowa Caregivers Association (ICA) to help direct care workers participate in conferences, meetings, and training opportunities. In addition, the bill stated its intent to have a Board of Direct Care Workers established within the Iowa Department of Public Health by July 1, 2014. (Adopted April 29, 2010)
SF 476: In 2009, Iowa’s governor signed a law imposing a quality assurance fee on all for-profit and nonprofit nursing homes in order to leverage matching federal money. Proposed by the Iowa Health Care Association, the tax would set aside 60% of the money for use in covering salaries, wages, and benefits, half of which would be for direct care workers. (Signed May 26, 2009)
Come Care With Me (video): The CCWM program aims to increase awareness about the important role that direct care workers play in access to quality care and supportive services, by providing local legislators with the opportunity to experience firsthand what direct care workers do in a typical day. Iowa’s CCWM project features state Rep. Lisa K. Heddens as she job-shadows two direct-care workers at a nursing home and learns about their work.
Iowa Direct Care Workforce Initiative: This initiative, led by the Iowa Department of Public Health, aims to improve direct care professional education and ensure a qualified and stable direct care workforce in Iowa. The Department is currently conducting a pilot project of the training and credentialing recommendations of the legislatively-directed Direct Care Worker Advisory Council.
PHCAST Grant: Iowa is one of 6 states awarded a 3-year grant by the federal government to develop a training and credentialing program for PCAs, as part of the Patient Protection and Affordable Care Act of 2010.
Better Jobs Better Care (BJBC): Beginning in 2002, the Robert Wood Johnson Foundation and Atlantic Philanthropies funded a 4-year demonstration and research project that aimed to improve the direct-care workforce in five states: Iowa, North Carolina, Pennsylvania, Oregon, and Vermont. A variety of studies and publications are available.
Hope Haven: Hope Haven, a nonprofit organization, serves adults and children with developmental disabilities and gives its direct-care workers the opportunity to advance through a career ladder. Direct support professionals who take part in the program acquire new skills and earn wage increases along the way.
Iowa Caregivers Association: The Iowa Caregivers Association (ICA) is a nonprofit organization that advocates for policies and practices that address the needs of direct care workers. The Robert Wood Johnson Foundation describes the work and accomplishments of the Association under the Better Jobs Better Care grant, here.
The Future of Iowa’s Health and Long-Term Care Workforce (pdf): This December 2007 report to the Iowa legislation, written by the Iowa Department of Public Health and health care professionals, proposes an increase in Medicare and Medicaid payments for the purpose of increasing pay to long-term care workers. It also recommends raising public awareness of worker shortages and their impact, creating mentoring programs to prevent turnover, and other strategies to strengthen the health and long-term care workforce.
Iowa Direct Care Worker Task Force: Recommendations for Establishing a Credentialing System for Iowa’s Direct Care Workforce (pdf): These 2008 recommendations by the Iowa Direct Care Worker Task Force include improved education and training for direct care workers. The report also documents strategies for designing and implementing a training and credentialing program for this workforce.
Report to the Governor and General Assembly on Voluntary Employer-Sponsored Health Care Coverage Demonstration Project – Non-Licensed Direct Care Workers (pdf): This December 2008 report by the Iowa Department of Health and Human Services and the Division of Insurance presents a model demonstration project for providing health insurance for up to 250 direct care workers through a voluntary employer-sponsored plan. The purpose of the project was to assess the impact of providing health insurance on turnover and quality of care.
PHI State Facts: Iowa’s Direct-Care Workforce (pdf): This fact sheet, issued by PHI in September 2009, gives an overview of the direct-care workforce in Iowa.
Iowa Direct Care Worker Wage and Benefit Report (pdf): In 2010, the Child and Family Policy Center conducted a survey of certified nursing assistants and home care workers and found that direct care workers are among the lowest paid workers in Iowa and are twice as likely to be uninsured than the average Iowan.
Ready to serve? PFund Foundation Report of the Aging Network and LGBT Older Adults (pdf): This report issued by the University of Minnesota and the PFund Foundation in December 2010 includes results from a survey of 15 aging agency directors from Iowa, Minnesota, Wisconsin, and North Dakota on LGBT-training for their workers. The report makes recommendations on how to address the needs of LGBT elders.
Cost of Turnover in the Direct Care Workforce (pdf): This 2011 report from the Iowa Direct Care Workforce Initiative estimates that the cost of direct care worker turnover in 2010 was a staggering $117,000,000 in Illinois. These costs are projected to increase to almost $150 million by 2014, assuming a steady turnover rate of 64 percent.