THE GERONTOLOGIST Vol. 49, No. 2 (April 2009)

An article in The Gerontologist (April 2009) examines the results of a first-ever National Nursing Assistant Survey and reports on the prevalence of work-related injuries, use of public assistance, and lack of health insurance among certified nursing assistants.

The lead author of the article, The National Nursing Assistant Survey: Improving the Evidence Base for Policy Initiatives to Strengthen the Certified Nursing Assistant Workforce, is Senior Policy Analyst Marie Squillace, Ph.D., of the Office of the Assistant Secretary for Planning and Evaluation within the U.S. Department of Health and Human Services. Read the full story

Jan 28, 2009 front page

A New York Times editorial titled “Caring for the Caregivers” makes the link between quality care and quality direct-care jobs — calling for improved labor protections in an area that is “one of the fastest growing” but “one of the lowest paid and most exploitable.”

The piece calls home health care “a 21st-century growth industry,” pointing out that, at a time when record layoffs are being reported, the health care sector continues to add jobs — with 32,000 positions added in December 2008 alone.

Referring to federal labor laws that permit home care aides to be exempted from overtime and minimum wage requirements, the editorial says, “It is unconscionable that workers who are entrusted with the care of some of the nation’s most vulnerable citizens are themselves unprotected by basic labor standards.” Read the full story

This is the second in a series examining how state budget cuts are affecting long-term care across America.

New York lawmakers took no action in Tuesday’s emergency state legislative session on budget cuts proposed by Gov. David Paterson. The cutting of state and matching federal funds could have meant over $300 million in multiyear reductions to home care. 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

We all know that improving wages and benefits for direct-care workers would benefit not only the workers and their families but also the consumers who depend on them – not to mention the employers who often struggle to recruit and retain them. But who knew it could also be good for the insurance business?

In a page on its website that helps make the case for buying long-term care insurance, Genworth Financial notes: “In 2008 the average annual rate for a private nursing home room is $76,460 – up 17% since 2004. The demand and costs for in-home care are on the rise. And, we face an impending caregiver shortage that could drive costs even higher.”

The page is linked to a document outlining the impending care gap. (pdf) “This gap has the potential to negatively impact Americans and the American health care system in two ways: the costs of health care may rise significantly as the workforce supply diminishes, and the quality and availability of care may decrease, placing added pressures on family members and friends to care for loved ones who may require long term care,” it says.

Genworth sells long-term care insurance and other financial products.

Elise Nakhnikian, Senior Online Editor
enakhnikian@phinational.org

Getting real about retention

This is the fourth in a series of PHI Expert Interviews, which bring you insights from four senior PHI staff. They’re an impressive group — among the nation’s leading experts on long-term care’s direct-care workforce — and collectively they’ve spent decades studying the challenges facing the workforce and how to address them. We think you’ll be interested in what they’ve learned.

When Steven Dawson came out of the workforce development field in 1992 to join Peggy Powell in heading up the Paraprofessional Healthcare Institute, PHI’s sole purpose was to raise funds and provide technical support for Cooperative Home Care Associates. Over time, Steven led PHI into the broader long-term care arena, where its policy and practice experts work with employers and lawmakers to support and stabilize the nation’s direct-care workforce.

Steven has written about the impending direct-care workforce crisis (pdf) and the link between quality jobs for direct-care workers and quality care for long-term care consumers. Through the years, his emphasis has been on creating workplaces that are intentionally re-designed to retain direct-care staff.

“A constantly churning workforce is the enemy of quality care — ask anyone whose mother has had to deal with five different home health aides within a month, or with a blur of CNAs in the nursing home. The industry still manages to attract hundreds of thousands of skilled, caring workers every year, but once hired, these frontline staff are too often treated as if they were invisible. So, of course they leave,” he says. Read the full story