PHInational.org

Iowa direct-care workers with State Senator Jack Hatch (D, Des Moines)

Forty-five direct-care workers and their supporters participated in the Iowa Caregivers Association‘s (ICA) annual Direct-Care Worker Day at the State Capitol. Read the full story

On May 26, after months of debate among state lawmakers, Iowa Gov. Chet Culver signed into law a bill that will impose a quality assurance fee on all for-profit and nonprofit nursing homes in order to leverage matching federal money. The state’s direct-care workers are among those who are expected to benefit. Read the full story

As reported by The Des Moines Register (“Winners, losers seen in ‘granny tax’ plan,” March 17, 2009), Iowa lawmakers are debating a bill that would impose a new tax on the state’s nursing homes. The tax would equal roughly 3 percent of residents’ cost of care and generate approximately $33 million per year.

Read the full story

An extensive Health Care Reform bill, House File 2539 (pdf), passed by the Iowa Legislature in 2008 included a provision calling for the improvement of wages and benefits for direct-care workers. The legislation directed that the first phase of this effort be focused on direct-care workers employed by Iowa nursing facilities.

The legislation created a Direct Care Worker Compensation Advisory Committee that includes members of the Iowa General Assembly, representatives from the nursing home industry, directors of state agencies, AARP, and the Iowa CareGivers Association.

John Hale, policy director for the Iowa CareGivers Association and a member of the Advisory Committee, said that “the first meeting of the Compensation Advisory Committee occurred on September 10th. I was pleased that every person in attendance recognized the extent of the problem and the need to do something. I’m hopeful that the effort will produce recommendations that can be adopted by the Iowa General Assembly in 2009.”

A report from the Advisory Committee will be shared with the Iowa Governor and the General Assembly in December of this year.

Aaron Toleos, Online Communications Director
atoleos@phinational.org

Recommendations for Establishing a Credentialing System for Iowa’s Direct Care Workforce, (pdf) a recent publication from the Iowa Direct Care Worker Task Force, is a useful tool for advocates in any state who want to create “an accessible, comprehensible, flexible, quality system of education and training for all direct care workers.”

The report documents work to be done to implement recommendations published by the task force in December 2006.  Work began on the project last month.

Iowa’s proposed three-tiered credentialing system is intended to ensure that all direct-care workers are adequately prepared for the job. It also aims to make workers’ duties and qualifications clear to the consumers and family members who hire them, to acknowledge their special skills, and to correct the inequities of the current system, which requires training in some settings but not in others even when the same set of services is delivered in both.

Read the full story

The July issue of The Gerontologist is devoted to findings from the Better Jobs Better Care research and demonstration project. BJBC, which began in 2002 and ended in 2006, was the largest initiative in the nation ever created to address the high vacancy and turnover rates of direct-care workers by improving the quality of direct-care jobs. The initiative involved changing both public policy and employer practice. Demonstration grants were made to groups in Iowa, North Carolina, Oregon, Pennsylvania, and Vermont.

A nine-page overview lays out how and why the project came into being, the problems affecting the direct-care workforce, and how awareness of and responsiveness to those problems is changing. The essay is by Robyn Stone (pictured), executive director of the Institute for the Future of Aging Services, and PHI President Steven Dawson. FAS and PHI conceived of BJBC and provided technical assistance to the grantees. Funding was supplied by the Robert Wood Johnson Foundation and The Atlantic Philanthropies.

Among the findings detailed in the issue:

• Direct-care workers across long-term settings identified more pay, improved communication, better supervision, and being treated with respect as the most important things employers could do to improve jobs.
• After accounting for satisfaction with wages, benefits, and advancement opportunities — good basic supervision was most important in affecting CNAs to stay in their jobs.
• There is a positive correlation between CNA job commitment and resident satisfaction.
• After accounting for satisfaction with wages, benefits, and advancement opportunities, good basic supervision was the most important factor behind commitment to the job. Read the full story