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The job quality and wages of home care workers are the focus of recently published articles in LeadingAge Magazine and BrainTrack.

“Ethical Workplaces” Needed

In LeadingAge, writer Dianne Molvig explains the need to create more “ethical workplaces” for home care employees.

“To me, an ethical home care organization is one that cultivates both quality care and quality jobs,” PHI Policy Research Director Dorie Seavey is quoted as saying in the article.

“High quality care is individualized and respectful,” Seavey continues. “High quality jobs provide a family-sustaining wage, affordable health insurance and respect for the worker, who gets excellent training and is allowed to participate in decision-making.”

Molvig uses PHI data to show that wages, retention, and overall working conditions for home care workers must improve if the U.S. hopes to keep pace with the increasing demand for such care.

She cites two organizations — Senior Independence in Columbus, Ohio, and Loretto’s PACE Central New York in upstate New York — as examples of ethical workplaces. Both organizations have invested in their workers in recent years, with positive results.

Revising FLSA Is “Win-Win”

The BrainTrack article, by Beth Panitz, focuses on the debate surrounding a proposed revision to the federal Fair Labor Standards Act (FLSA), which would extend minimum wage and overtime protections to home care workers.

“This revision would be an essential first step to stabilizing the home care workforce and positioning it to meet the demand we see coming,” Seavey is quoted as saying.

“We can raise the floor of these jobs in a way that’s win-win. We can attract more workers to these jobs so that we meet demand, and in so doing, it will improve the livelihood of workers,” Seavey adds.

Opponents of the proposed revision have argued that it will lower care quality by making it more expensive for home care companies to employ workers for 40 hours or more a week, which they say is necessary to establish care continuity. Seavey, however, told Panitz that “the notion that you get the best care when you have one aide working more than 40 hours a week is very questionable.

“We need a more modern approach to what continuity of care means,” Seavey added.

– by Matthew Ozga

Caring Across Generations logo

Caring Across Generations, a multi-stakeholder effort to promote quality care, is hosting a legislative town hall on Capitol Hill on May 21.

Two short panels will discuss:

• protecting current programs such as Medicaid, Medicare, and Social Security; and
• implementing future policies that will build a quality direct-care workforce to support America’s families in meeting care needs across generations.

PHI Government Relations Director Carol Regan will frame the panel discussions, which will include workers, consumers and employers.

Senator Tom Harkin (D-IA) and other members of Congress have been invited. Harkin recently introduced a Sense of the Senate Resolution that commits policymakers to addressing America’s caregiving needs, including quality direct-care jobs and accessible home- and community-based services.

Please join PHI for this important forum on creating a caring economy — and invite your member of Congress and their staff to attend.

The one-hour program takes place in Room 902 of the Hart Senate Office Building and starts at from 11 a.m.

– by Karen Kahn, PHI Director of Communications

Caring Across Generations (CAG) will hold a New York Care Congress on June 3 at New York City’s Pace University.

At the Care Congress, participants will be able to share caregiving stories and learn how to take action on state and local CAG campaigns.

The New York Care Congress is one of several taking place across the country this year. Upcoming Congresses will be held in Chicago, Los Angeles, Las Vegas, and Philadelphia.

CAG is a coalition of 200 organizations that promotes quality care and dignity for aging Americans and their caregivers. (PHI is a member of CAG’s leadership committee.)

For more information, visit CAG’s New York Care Congress website or contact Melanie Willingham-Jaggers at Melanie@ALIGNny.org or 212.701.9478.

– by Matthew Ozga

FHI 360 is hosting “Quality Work, Quality Care: A State-of-the-Art, National Conference for Home Care Stakeholders” on April 2, in Washington, DC.

The conference will take place from 8:30 a.m. to 5:30 p.m. at 1825 Connecticut Ave., N.W.

Conference highlights will include the relationship between quality work and quality care, with an emphasis on how the caregiver’s safety, health, and well-being impacts the quality of work, and therefore the delivery of quality care.

PHI Government Affairs Director Carol Regan will be a panelist at the all-day event, which is co-sponsored by PHI. Register and learn more online.

– by Deane Beebe

Sen. Robert Casey (D-PA)

Senator Robert Casey (D-PA) has introduced a bill that would expand the role of direct-care workers across the country.

The Improving Care for Vulnerable Older Citizens through Workforce Advancement Act (pdf) would establish demonstration projects focusing on care coordination and service delivery redesign for older adults with chronic illnesses, or those at risk of institutional placement.

“Direct-care workers are key to providing services that improve the health of older Americans and reduce re-hospitalizations, vastly improving the quality of life for our older citizens and reducing costs and strain on the entire healthcare industry,” Casey said.

“My legislation will help to better train and utilize direct-care workers to lower the cost and improve the quality of healthcare provided to older Americans,” he continued.

Demonstration Projects Detailed

The bill would create six three-year demonstration projects:

• Two would incorporate direct-care workers into interdisciplinary care coordination teams to promote smooth care transitions and prevent unnecessary re-hospitalizations;
• Two would have direct-care workers take on a greater role in monitoring, maintaining, and improving their consumers’ health status; and
• Two would train direct-care workers to care for specific diseases and afflictions, including dementia, diabetes, and congestive heart failure.

“With adequate training, compensation, and support, a newly created ‘advanced aide’ position could support health promotion, better chronic care management, and care transitions, resulting in less institutionalization and fewer re-hospitalizations,” PHI President Steven Dawson said.

Partnerships of health service providers, including at least one long-term care facility or home and personal care service provider, are encouraged to apply for demonstration funding if the bill passes into law.

PHI has published a one-page backgrounder (pdf) capturing the highlights of Casey’s bill.

– by Matthew Ozga

The newest additions to the PHI National Clearinghouse on the Direct Care Workforce:

No Time to Waste: Recommendations for an Integrated National Plan to Overcome Alzheimer’s Disease — This report offers a detailed strategy for how the U.S. should approach the fight against Alzheimer’s disease in the coming decades. One of the steps recommended in the report is an expansion of the eldercare workforce, including the direct-care workforce. The report argues that direct-care workers should be given competitive wages and benefits and career-advancement opportunities in order to attract more people to the job. Direct-care workers should also receive comprehensive geriatrics training to better serve people with Alzheimer’s. The report was published by the Alzheimer’s Foundation of America in October 2011.

Stayers, Leavers, and Switchers among Certified Nursing Assistants in Nursing Homes: A Longitudinal Investigation of Turnover Intent, Staff Retention, and Turnover — Published in the October 2011 issue of the Gerontologist, this study presents the results of a longitudinal survey of 620 full-time CNAs working in Pennsylvania nursing homes. The survey found that after one year, 85.8 percent of CNAs remained in their jobs (stayers), 8.4 percent switched to another facility (switchers), and 5.8 percent left the industry (leavers). Among switchers, the most-cited reason for leaving their jobs was to pursue other opportunities. Leavers, meanwhile, said they were motivated primarily by emotional distress, low job satisfaction, and a lack of respect from supervisors. The authors note that, even accounting for methodological differences, this turnover rate is lower than previous studies, which use alternative methods and include part-time workers.

Top Management Leadership Style and Quality of Care in Nursing Homes — This study, published in the October 2011 Gerontologist, documents the relationship between nursing home managers’ leadership styles and the quality of care provided in their facilities. The authors found that the “consensus management” style — in which managers solicit input from their employees — had the strongest correlation with a high care-quality standard.

Reassessing Nurse Aide Job Satisfaction in a Texas Nursing Home — This article presents the findings of a job-satisfaction survey administered to nursing aides at Carillon House, a Texas nursing facility. The survey found that the greatest source of nursing aide job satisfaction was from working with residents. At the same time, low wages, a lack of recognition from supervisors, and a dearth of advancement opportunities were among the aspects of their jobs that they liked the least. The study was published in the September 2011 issue of the Journal of Gerontological Nursing.

The PHI National Clearinghouse on the Direct Care Workforce is a national online library for people in search of solutions to the direct-care staffing crisis in long-term care. It houses over 1,000 articles, reports, issue briefs, and fact sheets on the direct-care workforce.

– by Matthew Ozga