Wages Adjusted for Inflation: Over the past decade, inflation-adjusted median hourly wages for Nursing Aides, Orderlies, and Attendants in Louisiana increased by 18 percent, from $6.17 to $7.28. Real wages for Personal Care Aides increased by 6 percent while those for Home Health Aides remained virtually unchanged.
Employer-Sponsored Insurance: Compared to the national civilian workforce, significantly fewer of Louisiana’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.
Direct Support Professionals Wage Enhancement and Wage Floor: In 2007, the Louisiana Department of Health and Hospitals implemented a $2-an-hour wage pass-through for the state’s Medicaid-funded direct-care workers, of which $1.50 must go to wages, and up to $0.50 could be used for benefits and employment taxes. Additionally, beginning in 2007, all direct-care workers were required to be paid the federal minimum wage in effect at the time plus 75% of the wage enhancement, i.e., a minimum of $6.65 per hour. The purpose of this enhancement was to address workforce shortages and turnover in a state where direct-care wages were among the lowest in the nation and where a state study found a wage disparity of nearly $3 an hour between private and public institutions in long-term care.
HB 642: Among other things, this bill provides standards for the training of direct service workers across all home- and community-based settings, and requires the Department of Health and Hospitals to develop a comprehensive plan regarding the quality of services provided to individuals receiving home and community-based services by January 2012. (Adopted June 28, 2011)
Volunteers of America DSP Training: In 2003, Volunteers of America implemented an in-person training initiative for Direct Support Professionals in New Orleans with support from a 2003 CMS Direct Service Community Workforce Demonstration Grant. The demonstration was almost complete when Hurricane Katrina hit in 2005. In response to the experiences of being dislocated by the storm, VOA developed an online training program that is available to all VOA chapters and the general public. An award-winning video called Higher Ground was made about the experience of DSPs after the storm, with additional support from CMS and NIDRR.
Direct Service Workforce Resource Center- Intensive Technical Assistance: In 2006, the Louisiana Department of Health and Hospitals (DHH) Office of Aging and Adult Services and Office for Citizens with Developmental Disabilities received CMS-funded technical assistance to help achieve four major goals: 1) examine opportunities for improving wages and benefits for DSWs in Louisiana, 2) develop recruitment programs to meet demand for DSWs, 3) expand utilization of “Career Pathways” for DSWs, and 4) implement a wage study to identify short-term interventions for addressing immediate shortages of DSWs in areas impacted by Hurricane Katrina.
Louisiana Plan for Choice in Long-Term Care: Comprehensive Long-Term Care Reform Plan (pdf): Louisiana’s 2007 plan for long-term care includes a section on workforce development, aimed at setting goals and objectives for recruitment and retention, among others.
You Know That It’s Got to be Dedication That I am Still Here: The Experiences of Direct Support Professionals During Hurricanes Katrina and Rita and the Aftermath (pdf): This 2007 study by LaLiberte and colleagues details the experiences of 41 direct-care workers employed by New Orleans Volunteers of America (VOA) who continued providing care during and after Hurricanes Katrina and Rita.