Wages Adjusted for Inflation: Over the past decade, inflation-adjusted median hourly wages for Nursing Aides, Orderlies, and Attendants in Washington increased by 13 percent, from $8.85 to $10.00. Real wages for Personal Care Aides also increased by 13 percent and those for Home Health Aides increased by 9 percent.
Employer-Sponsored Insurance: Compared to the national civilian workforce, significantly fewer of Washington’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.
HB 1086: This legislation appropriated funds to the Department of Social and Health Services, Aging and Adult Services Program for the purposes of increasing wages, benefits, or staffing levels for CNAs and any other category of worker in the department whose statewide average wage was less than $15/hour in 2008. (Enrolled February 18, 2011)
HB 2073: This bill would direct the Department of Social and Health Services to pay the contribution rate for health care benefits for participating agency home care workers who work for state-funded personal care or respite clients at least 86 hours per month. (Introduced April 9, 2011)
SB 5197/HB 1278: Under these bills, a registered nurse may delegate nursing care tasks to registered or certified nursing assistants or home care aides. (Introduced January 18, 2011)
SB 6582: This bill creates a “career ladder” training initiative, whereby Home Care Aide (HCA) training is recognized as comparable to a portion of CNA training. It also allows HCAs to complete additional requirements to become certified nursing assistants. (Adopted March 23, 2010)
Washington Administrative Code 246-980: Home Care Aides: These regulations, based on a 2008 ballot initiative (Initiative 1029), require home care aides in the state of Washington to complete 75 hours of long-term care basic training, including training related to core competencies and population specific competencies. Approved training curricula must be developed with input from consumers and workers and aides must pass a certification exam. In June 2011, ESHB 1548 passed, delaying certification of all home care aides until January 1, 2014.
HB 2333: This legislation provides for parity funding of wages and benefits for publicly-funded home care workers who are agency-employed so that these workers receive compensation increases that correspond to those received by individual home care providers working directly for consumers in the state’s public in-home services programs. (Effective July 2006)
Demonstration to Improve Direct Service Community Workforce: The Washington State Home Care Quality Authority received a 2003 CMS Direct Service Workforce Demonstration Grant to 1) operate worker referral registry that matches worker skills, training and abilities with consumer needs and preferences and increases worker knowledge of in-home care job opportunities, 2) assist the Individual Provider workforce by providing information about health insurance enrollment, and 3) offer training and peer mentorship for workers and training for consumer-supervisors.
Washington State Home Care Referral Registry (HCRR): Operated by the Department of Social and Health Services, Aging and Disability Administration, this matching service registry connects qualified independent providers with consumers who receive long-term in-home care services, free of charge. HCRR uses a web-based interface in tandem with support located in offices across the state. Consumers can also access a number of support materials to assist them in finding and keeping a home care worker.
Chesterfield Services, Inc.: Chesterfield Health Services, a home health care provider in Seattle, has invested in its workforce of home care aides by providing them with abundant training and advancement opportunities. The investment has paid off in the form of high satisfaction rates for both clients and home care aides, as well as turnover rates considerably lower than the national average.
Providence Mount St. Vincent: This skilled nursing and assisted living facility transformed its traditional model of long-term care to a resident-directed model that strives to maintain the independence, privacy, and dignity of residents in a home-like atmosphere. This approach to care allows the direct-care staff to act with greater autonomy, leading to more natural interactions with residents, higher job satisfaction, and lower turnover.
A Longitudinal Study of Workforce Stability: Individual Providers in Washington State (pdf): This study examines the stability of the individual provider (IP) workforce over a 5-year span, from January 2004 through January 2009. The analysis covers topics such as turnover, exits from the profession, and outside employment held concurrently with IP work. This study finds marked improvements in the stability of the workforce, both from the standpoints of the consumers and individual providers.
Comprehensive Health Coverage for Consumer-Directed Home Care Workers (pdf): This 2007 case study describes the establishment of a Washington State multi-employer trust, which provides health benefits to home care workers. The report outlines eligibility requirements, benefits and costs of coverage, and then explores the lower than predicted enrollment rates.
The SEIU 775 Long-Term Care Training, Support & Career Development Network (pdf): This 2007 report establishes the need for a network to improve training for in-home care workers in Washington and provides a blue print to guide its development. The state’s home care workforce is described and the limitations to the state’s prior approach to caregiver training is analyzed.