Despite a budget crisis, Oregon made significant  strides this year in reforming health care. Legislators passed two major reform bills and renewed funding for Oregon Project Independence, a state-run home-care program. Read the full story

Official seal of ARRA

As states struggle to balance their budgets in the face of a deep recession, there has been little good news for long-term care.

At least three states, however — North Dakota, Montana, and Oregon — are using funds from the American Recovery and Reinvestment Act (ARRA) to stabilize and enhance their direct-care workforces. Read the full story

Oregon State Capitol

State leaders in Oregon have announced that they will be combining their state’s tax revenue with federal stimulus funds to create hundreds of new nursing home jobs.

The Associated Press reported (“Federal aid will create nursing home jobs,” March 28) that lawmakers are talking about using a combination of state and federal dollars to help pay for more than 300 new nursing assistants in long-term care facilities in all 36 Oregon counties. Read the full story

When direct-care workers and their clients can’t get the support they need through government agencies, they can always try the courts. That’s what Oregon resident Clay Freeman is doing in a federal civil-rights lawsuit, which would require the state to increase the base pay for some home care aides in the Oregon Home Care Commission (OHCC).

Only by guaranteeing workers a sufficient wage, says Freeman v. Goldberg et al., (pdf) can Freeman hire the help he needs to exercise his federally granted right, under Title II of the Americans with Disabilities Act, to live at home and remain a functioning member of his community. And the wages paid to his workers, the suit says, must reflect the complex levels of care they deliver.

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“My passion for working with people with dementia, for making life better for them, has been my major motivating factor. But over time, I keep saying to myself: ‘It’s the direct-care worker, stupid,’” says Joanne Rader. “The only way to make the lives of people with dementia better is to improve the working lives of the direct-care workers. We need to put the things in place that let them provide relationship-based care.”

Now a consultant, Rader has helped pioneer key advances in reducing the use of restraints and finding conflict-free ways of bathing in long-term care. The co-author of Individualized Dementia Care: Creative, Compassionate Approaches and Bathing Without a Battle, which won Book of the Year awards from the American Journal of Nursing in 1996 and 2002, she is one of the founders of the Pioneer Network.

She learned to appreciate the contributions made by direct-care workers early in her career. “I’ve always had a tremendous amount of respect for the work they do, and also for the informal power they have. I might have had the best solution in the world, but if I didn’t have their buy-in, it wasn’t going to get anywhere.” Read the full story