Measuring Home Care Aide Job Quality, Issue 2 in #60CaregiverIssues Campaign

February 22, 2017

PHI released the second issue in its #60CaregiverIssues campaign, a national, online public education campaign to tackle the growing crisis in paid caregiving.

The second issue – Job Quality for New York’s Home Care Aides – looks at how states can use a “quality jobs” framework to assess the impact of system changes on the quality of home care jobs.

Using New York as a case study, the report examines how the shift to Medicaid managed care, along with changes in labor rules, have affected the jobs of home care aides. Managed care, according to author Allison Cook, has the potential to improve job quality, if aides are valued as part of the care team. But more often, New York is seeing a “race to the bottom,” with fiscal pressures pushing home care agencies to reduce their investments in “nonessential” costs such as quality training.

Job quality improvements have primarily been the result of government actions, the report concludes. Over the last seven years, New York has used the legislative process to raise the minimum wage and to create an Advanced Home Health Aide occupation that provides a new career path for home care aides. In addition, home care aides have benefitted from the federal Fair Labor Standards Act, which in recent years extended minimum wage and overtime protections to this workforce.

Finally, the report concludes that policymakers and industry stakeholders would benefit from a comprehensive and up-to-date workforce information system that collected key performance data from employers and training programs and made this information publicly available.

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