A new law in New York State will require nursing homes, hospitals, and diagnostic and treatment centers to publicly disclose staffing information beginning March 16, 2010.

As a result of the Nursing Care Quality Protection Act, which Gov. David Paterson (D) signed on September 16, patients and families will be able to review the staff-patient ratios on units and shifts in those health care facilities. Consumers will also be able to find out how the facilities determine direct-care staffing. Read the full story

“We need a little more money for those who have worked for so long. You get fussed at, hit at, bitten, kicked, scratched, slapped, ” said Ronnie Fisher, Sr., a CNA in Wisconsin for the last 23 years.

The Kenosha County Long Term Care Project is working to help people like Fisher, in a state where the average caregiver earns just over $9 an hour.

The organization is working alongside others to launch a state-wide public awareness campaign, said the Kenosha County LTC Project’s Barb Wisnefski.

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“More and more LTC leaders are changing their workplace practices, de-institutionalizing their physical environments, and embracing person-directed care in order to get to the next level in terms of quality,” says the August cover story for Provider magazine. The article explores this phenomenon, looking at why there is “a general consensus that it is more than just the ‘right’ thing to do.”

For “Investing in Culture,” (pdf) the magazine interviewed 14 long-term care leaders, including Anna Ortigara, President and CEO David Horazdovsky of the Evangelical Lutheran Good Samaritan Society, and Barbara Frank, cofounder of B&F Consulting.

The experts talk about how improving direct-care jobs improves care quality in long-term care – and vice versa. Horazdovsky says his organization has experienced “decreased staff turnover, highly developed direct care staff skills, and increased staff satisfaction on surveys” as a result of its move to person-centered care.

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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

The nursing home regulatory system sets unrealistically high standards of care because “there has been no analysis of the resources – and particularly the labor resources – necessary to achieve these standards,” said John Schnelle (pictured) of Vanderbilt University at a July 11 Capitol Hill briefing on long-term care reform. “Some studies suggest that twice the number of aides as are currently present in most homes would be needed to meet current standards of care.”

The briefing, which was co-hosted by The New School and the Brookings Institution, focused on ways of improving care quality and addressing the challenges of financing long-term care. More than a dozen panelists – including senators, other policy experts, academics, advocates and providers – discussed policy and political options.

Schnelle called for either setting more realistic care standards or increasing the amount of money we pay for long-term care. “I would prefer the latter,” he said, adding that either would be an improvement.

Elise Nakhnikian, Senior Online Editor
enakhnikian@phinational.org

Judging by a couple of recent articles in Canadian papers, the issues affecting direct-care workers don’t change much when you cross the border.

A July 25 article in the Prince George Citizen describes a British Columbia public relations campaign that aims to generate interest in direct-care work as a career, which was spurred by “a critical need for care aides and home support workers to care for B.C.’s elderly.”

The article says more than 1,500 qualified graduates are needed immediately to fill current positions in nursing homes, assisted living, and home care. To meet fast-growing demand, the government plants to complete 5,000 new long-term care beds and assisted living units by the end of the year, creating the need for more workers.

The $160,000 B.C. Cares Campaign includes a student loan forgiveness program.

And a July 4 article in The Canadian Press called on Ontario to “turn its understaffed, institutional long-term care homes, where residents are more likely to be restrained and medicated, into small community homes where staff have the time to drink coffee with their elderly charges.”

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