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Michigan is a step closer to establishing a permanent statewide home care registry, and a law to create a registry in West Virginia was just passed.

Michigan Petition Approved

The Citizens for Affordable Quality Home Care, which advocates for elders and people with disabilities in Michigan, has cleared the first hurdle in its efforts to create the Michigan Quality Home Care Council, a statewide registry that would help connect home care consumers with independent home care providers — and vice versa.

On March 19, the Michigan Board of State Canvassers approved the format and language of an initiative petition to amend the state’s constitution to establish the Quality Home Care Council. The question could appear on the November 6 ballot.

The next step in order to get the initiative placed on the ballot is for supporters to gather at least 322,609 signatures and submit them to the Michigan Secretary of State by July 9, according to Ballotpedia.

“The permanent establishment of a home care council will help to assure that Michigan’s citizens who have disabilities and those who are aging can connect with and choose from providers who have been screened, are compatible, and are looking for work,” said Dohn Hoyle, executive director of The Arc Michigan and treasurer of Citizens for Affordable Quality Home Care.

“We also support the training available for providers to address their safety and acquisition of skills, as well as the training offered to those who need supports and assistance regarding the selection and direction of their workers,” Holye said.

Should the Michigan Quality Home Care Council be established through an amendment to the state constitution, home care workers who register would be required to undergo background checks and have access to training. The workers would also have limited collective bargaining rights, according to a Michigan Department of State Ballot Proposal Status document (pdf).

The new registry would permanently replace the existing Michigan Quality Community Care Council, a pilot matching services registry program designed to help people with Medicaid locate personal care home care workers.

“Our previous efforts demonstrated how well a quality registry benefits those who provide these critical services so they can find enough work to make a living and stay in this field, and allows those who need the supports in order to remain in their own homes to find the right person to support them,” Hoyle said. “And, the trainings have shown the efficacy and value for the person who needed services as well as the person who provided them.”

West Virginia to Establish Home Care Registry

In West Virginia, Governor Earl Ray Tomblin (R) signed a bill [HB4062] into law on March 22 to establish a statewide home care registry through the state’s Bureau of Senior Services.

The West Virginia home care registry would be responsible for creating and maintaining a list of certified home care workers who meet the eligibility criteria established by the Bureau and approved by the legislature. Eligibility requirements would include educational and certification requirements and the completion of a criminal background check, according to the bill.

To learn more about home care registries, visit the PHI Matching Services Project site.

– by Deane Beebe

The SCAN Foundation sponsored a webinar on the Community Living Assistance Services and Supports (CLASS) Plan.

The one-hour webinar, originally held on May 25, is the third in a series entitled Marketing CLASS: Key Issues and Supply Side Perspectives. It can be viewed free, without registration, on the SCAN website.

During the webinar, PHI Director of Policy Research Dorie Seavey presents slides (pdf) on the role that matching service registries will play in creating a viable infrastructure for the CLASS Plan.

Matching service registries are databases of independent home care workers. They provide information for consumers to help them find a caregiver who will best meet their needs — and for home care workers to find employers who are a compatible match.

According to a PHI analysis, statewide matching service registries exist in 16 states, while six other states have registries that serve a particular region within the state.

Lisa Shugarman, SCAN’s director of policy, and Eileen Tell of Univita, an organization that promotes the concept of “aging with independence,” also presented during the webinar.

Shugarman briefly introduced The SCAN Foundation and the CLASS Plan, while Tell presented long-term insurance best practices that could inform the U.S. Department of Health and Human Services‘ (HHS) efforts to develop the CLASS Plan.

CLASS Background

The CLASS Plan is a component of the Affordable Care Act, the health-reform bill signed into law by President Obama in March 2010.

It is a voluntary, publicly administered federal insurance program to help elders and people with disabilities pay for long-term home care.

HHS is scheduled to introduce the CLASS Plan in 2012.

SCAN Series Focuses on CLASS

In addition to its webinar series, The SCAN Foundation has published a series of technical assistance briefs examining the CLASS Plan from multiple perspectives.

One of the briefs, Building Infrastructure to Support CLASS: The Potential of Matching Service Registries (pdf), was written by PHI’s Seavey and Policy Research Associate Abby Marquand.

Seavey and Marquand’s research was recently cited in a post on The New York Times‘s “New Old Age” blog, written by Times reporter Paula Span.

– by Matthew Ozga

In a May 4 post, Paula Span, author of The New York Times‘s “New Old Age Blog,” describes a first-hand account of how matching service registries help connect consumers who want to direct their own home care with compatible independent care providers.

In “A Better Way to Find Home Care Aides,” Span tells the story of how a mother and her adult daughter living with physical disabilities searched for a compatible home care aide.

Having been “unhappy with the workers dispatched through an agency,” they sought help from the Oregon Home Care Commission Registry and Referral System, a state-wide matching service registry.

By using the registry, which conducted a search of available workers by location, home environment, and other factors, the mother and daughter found an independent home care aide with whom they felt an immediate connection and lived only five minutes away.

Three years later, this aide is still happily employed in the family’s home, a match that both parties attribute to using the Oregon matching service registry.

Span’s article draws on findings from PHI’s state-by-state analysis of matching service registries. These findings were recently published in Building Infrastructure to Support CLASS: The Potential of Matching Service Registries (pdf), an issue brief co-authored by Dorie Seavey, PHI director of policy research, and Abby Marquand, PHI policy research associate.

The report was made possible with support from The SCAN Foundation.

– by Deane Beebe

Matching service registries — which help connect consumers who want to self-direct their home care to compatible personal care aides — could prove to be a valuable building block under the CLASS Plan, according to a new PHI study, which is the first to focus on the workforce issues raised by CLASS.

The CLASS (Community Living Assistance Services and Supports) Plan, the new voluntary long-term care insurance program created under national health reform, requires states to ensure “adequate infrastructure for the provision of personal care attendant workers.”

“The legislative framers of CLASS were clearly concerned with creating a sufficient supply of home care workers and with adequate infrastructure to meet new demand,” says PHI Director of Policy Research Dorie Seavey, Ph.D., who co-authored the study with PHI Policy Research Associate Abby Marquand.

“Given that many elders and people with disabilities prefer to manage their in-home care themselves, this begs the question of how consumers and workers are literally going to find one another, with or without CLASS,” Seavey said.

Current state efforts to create matching service registries — dynamic search platforms that allow consumers in need of a worker to tap into an up-to-date bank of available workers — are reported in Building Infrastructure to Support CLASS: The Potential of Matching Service Registries (pdf).

Findings from State-by-State Study of Matching Service Registries

The 50-state study identified 16 publicly funded, state-based matching services registries and six additional ones that are regionally based [see map]. Two-thirds of states lack matching service registries.

While all of the state-based registries are designed to accommodate consumers who need personal care services under specific Medicaid programs, 13 states allow private pay consumers to access the registries, and nine of those give private pay consumers access to the registry at no charge.

The matching service registries described in the study allow consumers to search for workers by geographic location, and most allow consumers to search by availability of workers with respect to day and time.

The most robust services also offer search criteria, such as the experience, education, and training of workers, and their access to transportation.

A small number provide additional services, such as access to training opportunities for both consumers and workers, in an effort to address quality of care.

Mechanisms Needed for Deploying Aides

The study concludes that matching service registries in general are still in their infancy but that their role and potential is compelling.

“There’s a lot of room to bring matching services registries to scale and there is some exciting work going on around the country,” Seavey said.

“Creating a more adequate supply of personal care aides to meet demand and to alleviate burdens on family caregivers is extremely important, but that’s not enough,” said Seavey.

“We also need more effective and efficient mechanisms for deploying these aides in millions of consumer homes on a daily basis. And we need to create access to high-quality supportive resources like training and peer mentoring for both self-directing consumers and independent providers.”

Information on the supports and considerations for building more robust registries is available in the brief (pdf).

The issue brief was made possible with support from The SCAN Foundation and is part of a series of Technical Assistance Briefs addressing key issues for successful implementation of the CLASS Plan.

– by Deane Beebe

A national survey conducted by PHI found that only one-third of states have developed a public “matching services registry.” Read the full story