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The Huffington Post has published a column about home health aides written by Marki Flannery, president of the New York-based home care agency Partners in Care.

In the column, Flannery writes about how critically important home health aides can be to elders who require regular caregiving.

“Trained home health aides are highly skilled, compassionate caregivers,” Flannery writes, adding that “the job of a home health aide cannot and should not be done by just anybody — contrary to all-too-popular belief.”

About 22,000 home health care workers in Washington State will be awarded $57 million in back pay, the result of a Thurston County jury decision delivered on December 20.

From 2003 to 2007, the Washington Department of Social and Health Services (DSHS) made across-the-board 15 percent pay cuts to people with Medicaid who received care from a home care aide who lived in the consumer’s home.

The reason the state gave for what was called “shared-living-expense cuts” was that tasks performed by the in-home health aides, such as cooking, shopping, and doing laundry, were considered household services that the aides would be doing anyway, according to the Seattle Times.

“The state knew that many of these people had family, relatives, and friends who would take care of them no matter what,” Greg McBroom, who represented the workers, said in the Times. “They knew they could take advantage of them.”

In 2007, however, the Washington Supreme Court ruled that the cuts violated federal Medicaid law, which requires that all people with Medicaid benefits be treated equally. The state did not first assess the individual needs of each client as required by law.

Large Sum for Minimum Wage Workers

The workers filed a class action suit against DSHS in 2007, seeking the amount of pay that had been withheld over the years. The award is reported to be the largest damage award against the state.

“The jury, after hearing from both the workers and Medicaid beneficiaries, and from DSHS personnel who implemented the pay reduction, found that DSHS breached its duty of good faith and fair dealing with the workers,” McBroom said. “This case has always been about whether DSHS should pay for work it required these folks to do.”

“While the total recovery is very large, the award to the workers amounts to about $2,500, on average,” said Darrell Cochran, another attorney who represented the workers. “That $2,500 is a very large sum to someone making the minimum wage.”

The state is deciding whether to appeal the jury’s decision, according to Bloomberg News. A statement (pdf) released by one of the law firms representing the plaintiffs says that the state will “probably” appeal the jury’s verdict.

– by Deane Beebe

The average private-pay hourly rate for a home health aide was $21 in 2010 — the same price as last year, according to a recently published survey of long-term care costs.

The daily average cost of care at adult day service centers — which employ direct-care workers — also remained constant, at $67.

Meanwhile, other types of long-term care increased in cost according to the survey (pdf), which was published in October by MetLife Mature Market Institute, the research wing of the insurance company.

For example:

• The average daily cost of renting a semi-private room in a nursing home increased by 3.5 percent (to $205 from $198);
• The average daily cost of renting a private nursing home room increased by 4.6 percent (to $229 from $219);
• And the average monthly rate of living in an assisted living community went up by 5.2 percent (to $3,293 from $3,131).

Home Health Aides See No Gain

Although private-pay home health aide services cost an average of $21 an hour, only about half of those dollars goes to the aide.

In 2009, the last year for which data are available, the median hourly wage for home health aides was just $9.85.

In terms of real dollars, however, home health aides’ wages have gone down over the last 10 years, from $8.21 in 1999 to an inflation-adjusted $7.85 in 2009.

“It is clear that consumer preference is shifting away from more institutional facilities such as nursing homes and to home and community-based care settings,” said Dorie Seavey, Ph.D., PHI director of policy research. “However, this report, combined with PHI’s own research on direct-care worker compensation, shows that home health aides and homemaker/companions are not reaping any benefits of that increased demand in terms earning more competitive wages for their work.”

– by Matthew Ozga

This year, home health organizations have a new tool to mark the National Council on Aging‘s (NCOA) third annual Falls Prevention Awareness Day on September 23, the first day of fall.

The Fall Prevention Awareness: Enhanced Training Curriculum for Home Health Aides now augments the list of NCOA Falls Prevention Resources.

The curriculum, a joint project of PHI and NCOA that was released this spring, is available at no charge.

Meets In-Service Requirements

Uniquely designed for adult learners, the training curriculum is designed to help home health aides across the country reduce falls and minimize injury to their clients by increasing their awareness of the risk factors for common falls and enhancing their communication skills.

Participants learn to build on their existing knowledge and skills by strengthening their “observe, record, report” skills and developing communication skills that help them address with their clients how to reduce the risk of falling.

“There is no better time than Falls Prevention Awareness Day for home care leaders and managers to commit to train home health care aides on how to help their clients to prevent falls in and outside the home,” said PHI National Director of Curriculum and Workforce Development Peggy Powell.

“As the home health aides enhance their ability to view clients through a fall-prevention lens, they also learn how to reduce their own risk of falling — unfortunately, too common an occurrence in home care work.

“When home care agencies offer falls prevention education, they address an important health and safety issue for clients and aide staff alike. The PHI/NCOA Falls Prevention Awareness curriculum contains all of the materials you need to conduct an in-service training for home health aides, and it’s just a click away,” Powell said.

The downloadable course includes two three-hour sessions that employers can use to meet in-service requirements.

Leading Cause of Death by Injury

Falls are the leading cause of death by injury for older Americans. They threaten the lives, safety, and independence of older adults and have an enormous impact on the cost of health care.

“When older adults fall, it often leads to a loss of independence, reduced mobility, and earlier admission to a nursing home,” said Lynn Beattie, vice president of Injury Prevention at NCOA, and national director of the Falls Free^TM Coalition. “But the good news is, through appropriate risk management, falls are largely preventable.”

PHI is among the 70 national organizations and 31 state coalitions from 35 states that have joined the Falls Free^TM Coalition.

– by Deane Beebe

A home health aide in training

A new study by Pennsylvania State University researchers found that home health aides who had training are less likely to be injured on the job, and aides who felt they did not have good support from their supervisors were also more likely to suffer injuries.

The researchers also concluded that home health aides who had not experienced on-the-job injuries had a higher rate of job satisfaction and lower turnover “intentions.”

Benefits of Training

The study found that how employees felt about their workplace and training affected the probability of injuries. Employees who felt that their training had not prepared them well enough for the job were three times more likely to be injured than employees who thought that their training prepared them well.

The aides who felt their training prepared them well, not only had lower workplace injury rates, but they were also more likely to rate their organization highly as a place to work and seek services from.

“What this suggests is that investing finances into soft resources can have tangible benefits to organizations,” Deirdre McCaughey, assistant professor of health policy and administration at Penn State and lead author on the study, said in a press release about the study.

“Organizations tend to cut back on spending on soft resources, especially during hard economic times, because there is usually no tangible benefit,” she continued.

Good Supervisor Support

How home health aides perceived the support they got from their supervisors also affected on-the-job injuries, reported the study’s authors. The aides who felt they had poor supervisor support were one-and-a-half times more likely to have one injury, and three times as more likely to have three injuries, than the aides who considered their supervisors to be supportive.

“The study confirms what PHI has found it its own work over 20 years — that well designed adult-learner centered training and good supervisory supports improve retention and job satisfaction,” said PHI National Director of Curriculum and Workforce Development Peggy Powell.

The Penn State researchers analyzed data from the nationally representative 2007 National Home Health Aide Survey, which was funded by the U.S. Department of Health and Human Services and conducted by the Centers for Disease Control and Prevention.

The research findings were reported at the 2010 Academy of Management (AOM) Annual Meeting on August 9.

“Who Needs Caring? We Do! Workplace Injury and Its Effect on Home Health Aides,” was selected as a “Best Paper” for the AOM’s Annual Meeting Proceedings. The conference proceeding article can be purchased for $20 by contacting the AOM Communications and Publishing Coordinator at mdavis@pace.edu.

Visit PHI’s Training and Organizational Development Services website for more information, including PHI Coaching Supervision^SM (pdf).

– by Deane Beebe

Direct-care workers in training

The House Committee on Financial Services passed the Public Housing Reinvestment and Tenant Protection Act of 2010 (H.R. 5814) on July 27, which includes provisions to fund training for public housing residents to become home health and personal care aides.

If enacted, a three-year, federal pilot grant program would be established to train public housing residents to provide home health and personal care services and supports to public housing and federally assisted rental housing residents who are elderly or living with a disability, including veterans.

Home care providers, community health centers, faith-based organizations, labor organizations, public housing agencies, and state and local government agencies that have established — or provide assurances that they will establish — an employment training program would be eligible to apply for a grant.

The funding is targeted to programs that primarily serve urban, rural, or Indian populations, as well as people in Puerto Rico or the U.S. Islands.

Under the act, the U.S. Department of Housing and Urban Development (HUD) would receive $2.5 million for distribution in each fiscal year: 2011, 2012, and 2013.

Recognizing Workers’ Needs

In addition to supporting home health and personal care aide training, the grant money could also be used to cover transportation and child care expenses for the public housing residents in the training programs.

“This model recognizes the needs that many home care aides have as they transition to work, particularly child care and transportation,” said PHI New York State Policy Director Carol Rodat. “Funding for these critical supports is seldom available, which is why the grants envisioned in this legislation are so important.”

Income earned from providing home care services will apply toward the public housing residents’ eligibility for federal housing on a graduated basis for the first three years, with no income applying in the first year.

These provisions of the Public Housing Reinvestment and Tenant Protection Act of 2010, sponsored by Rep. Maxine Waters (D-CA), were taken from the Together We Care Act of 2009, introduced by Rep. Nydia Velázquez (D-NY) in December 2009 and cosponsored by Rep. Barney Frank (D-MA), the Financial Services Committee Chair, and Waters.

“Home care is a profession that will be in high demand for years to come and this legislation will offer hard-working public housing residents the tools they need to enter this field,” said Velázquez when she introduced the Together We Care Act last December.

– by Deane Beebe