Category Archives: Home Health Workers

Conservatives Pushed a Strategy to Weaken Home Health Care Unions. The Trump Administration Bit.

Source: Rachel M. Cohen, Nick Surgey, The Intercept, May 31, 2019

Earlier this month, the Trump administration announced a new rule barring home health care workers from paying union dues through their Medicaid-funded wages. The new Department of Health and Human Services rule, which will impact more than 800,000 workers and was immediately met with a legal challenge, followed years of planning by anti-union activists to promote such measures in states across the country, and, more recently, on the federal level.

In anticipation of a crushing blow to public-sector unions by the U.S. Supreme Court last summer, conservative groups ramped up their efforts to bring the federal government’s attention to the issue of Medicaid-funded union dues, according to an audio recording obtained by The Intercept and Documented.

On an invitation-only call with donors last June, leaders with the State Policy Network — a corporate-backed umbrella group of right-wing think tanks across the country — raised the issue of directly deducting union dues from Medicaid-funded paychecks, what they call “dues-skimming.” Vinnie Vernuccio, a labor policy adviser to the State Policy Network told donors that its plan was to end this practice by getting “an administrative rule passed at Health and Human Services” and passing federal legislation with the assistance of Rep. Cathy McMorris Rodgers, R-Wash…..

Improving Job Quality for Direct Care Workers

Source: Paul Osterman, Economic Development Quarterly, Volume 33 Issue 2, May 2019
(subscription required)

From the abstract:
The prevalence of low wage work is a major challenge for American labor markets and health care is an industry in which many of these low wage workers are found. This paper provides data documenting these facts and then discusses strategies for upgrading job quality for long-term care workers who constitute the majority of low wage employees in health care occupations. In addition the paper briefly discusses approaches for upgrading the employment opportunities of low wage employees who are in the health industry but in jobs that are not health care specific.

The Role of Training and Work-Related Injury on Home Health Workers’ Job Satisfaction: Analysis of the National Home and Hospice Care Survey

Source: Hanadi Hamadi, Janice C. Probst, M. Mahmud Khan, Aurora Tafili, Home Health Care Management & Practice, OnlineFirst, Published April 13, 2019
(subscription required)

From the abstract:
The purpose of this study was to describe personal, job, agency, environmental, and ergonomic factors that affect job satisfaction among home health workers (HHWs). A cross-sectional design was conducted, and data from the National Home and Hospice Care Survey (N = 3,274) were analyzed using a multilevel structural equation model (generalized structural equation model). HHWs with excellent training knowledge were about 1.5 times more likely to report a higher degree of job satisfaction compared with those with poor training knowledge, and those who reported a work-related injury were 66% more likely to report lower job satisfaction score. Job satisfaction is associated with work environment, leadership support, and work-related training. Future research and a follow-up survey are needed to understand HHWs’ workforce and be better positioned to meet their need so that they may meet the need of the aging population.

State Options for Making Wise Investments in the Direct Care Workforce

Source: Madeline Twomey, Center for American Progress, April 10, 2019

From the introduction:
Policymakers must invest in strengthening the direct care workforce in order to improve the quality of care delivered to patients and to achieve better value for every dollar spent on long-term services and supports.

This report outlines a number of actions that lawmakers can take to support the existing direct care workforce while increasing the number of available workers. Several states have already taken innovative approaches to addressing workforce shortages, including implementing payment reform to incentivize workforce initiatives. Additionally, states have increased wages and invested in workforce development and training in order to attract and retain direct care workers. In order to meet the growing demand for LTSS, state lawmakers should prioritize policy changes addressing workforce challenges, and the federal government should make investments to support states implementing meaningful reform.

New Jersey Home Health Care Aides Survey Results

Source: Marilyn Lou Ridenour, Scott Hendricks, Daniel Hartley, James D. Blando, Home Health Care Management & Practice, OnlineFirst, Published February 27, 2019
(subscription required)

From the abstract:
The objective of the study was to report on what violence-based training home health care aides received, their participation in health promotion classes, and home health care aides’ experience with workplace violence. In 2013, a mail survey was completed by 513 home health care aides in the state of New Jersey. Ninety-four percent of the respondents were female. Respondents whose agency was part of a hospital were more likely to receive violence-based safety training than respondents whose agency was not part of a hospital (p = .0313). When the perpetrator of violence was a patient or family member, the respondents experienced verbal abuse the most (26%), then physical assault (16%) and exposure to bodily fluids (13%). Home health care aides whose agency was part of a hospital were more likely to receive violence-based safety training. Training is an important component of a workplace violence prevention program.

Low-Wage Jobs Held Primarily By Women Will Grow the Most Over the Next Decade

Source: National Women’s Law Center, Fact Sheet, August 13, 2018

The Bureau of Labor Statistics projects that personal care aides, combined food preparation and serving workers (including fast food workers), registered nurses, home health aides, and software applications developers will be the five occupations with the most job growth between 2016 and 2026. Among these five occupations, all except software applications developers are female-dominated, with workforces that are at least 60 percent women—and personal care aides, home health aides, and combined food preparation and serving workers have median wages of less than $11.50 per hour. Women of color—especially Black women—are particularly overrepresented in these three low-wage, high-growth jobs, which often also lack benefits and pose particular challenges for women with caregiving responsibilities. View our fact sheet to learn more.

Protecting workers in the home care industry: workers’ experienced job demands, resource gaps, and benefits following a socially supportive intervention

Source: Linda Mabry, Kelsey N. Parker, Sharon V. Thompson, Katrina M. Bettencourt, Afsara Haque, Kristy Luther Rhoten, Home Health Care Services Quarterly, Volume 37 Issue 3, 2018
(subscription required)

From the abstract:
The Community of Practice and Safety Support (COMPASS) program is a peer-led group intervention for home care workers. In a randomized controlled trial, COMPASS significantly improved workers’ professional support networks and safety and health behaviors. However, quantitative findings failed to capture workers’ complex emotional, physical, and social experiences with job demands, resource limitations, and the intervention itself. Therefore, we conducted qualitative follow-up interviews with a sample of participants (n = 28) in the program. Results provided examples of unique physical and psychological demands, revealed stressful resource limitations (e.g., safety equipment access), and elucidated COMPASS’s role as a valuable resource.

“Who’s Caring for Us?”: Understanding and Addressing the Effects of Emotional Labor on Home Health Aides’ Well-being

Source: Emily Franzosa, Emma K Tsui, Sherry Baron, The Gerontologist, Published: August 17, 2018
(subscription required)

From the abstract:
Background and Objectives:
Interventions to strengthen the home care workforce focus on workers’ economic and physical well-being, without acknowledging the caring labor affecting emotional well-being. Our study examined workers’ perceptions of the emotional effects of caring work, coping mechanisms, and desired support.

Research Design and Methods:
We conducted 4 worker focus groups (n = 27). Moderators cross-checked codes and themes, and aides provided input through report-backs.

Results:
Building close, trusting relationships with clients was central to aides’ emotional well-being. Well-being was also influenced by relationships with client families and agency supervisors, work–life balance, and the level to which aides felt their work was valued. Aides were largely alone in managing job stressors and desired more communication, connection, and support from supervisors and peers.

Discussion and Implications:
Recognizing and supporting the emotional demands of caring work is crucial to strengthening the workforce. Policy makers and agencies must realign reimbursement systems, job descriptions, and care plans to include measures of emotional labor, improve communication between workers and supervisors, and provide training, mental health benefits, and peer support.

Living in the Shadows: Latina Domestic Workers in the Texas-Mexico Border Region

Source: Linda Burnham, Lisa Moore, Emilee Ohia, A.Y.U.D.A. Inc., Comité de Justicia Laboral, Fuerza del Valle Workers’ Center, National Domestic Workers Alliance, 2018

In 2016, three community-based organizations that operate in the Texas–Mexico border region collaborated on a participatory research project. A.Y.U.D.A. Inc., Fuerza del Valle Workers’ Center and Comité de Justicia Laboral/Labor Justice Committee trained 36 women from the local communities as surveyors. The surveyors, most of them domestic workers themselves, interviewed 516 housecleaners, nannies and care workers for people with disabilities or for the elderly who work in private homes. The survey was conducted in Spanish and was composed of a standardized set of questions focused on work arrangements, working conditions, the impact of low pay on workers’ lives, injuries and abuse on the job and citizenship status.

This report, the result of the surveyors’ hard work knocking on doors, gaining trust and gathering data, is the very first quantitative study of a sizable number of domestic workers in the Texas–Mexico border region. The data provides us with a fact-based portrait of the difficult conditions domestic workers in the region face. The report findings will be used to shape ongoing organizing and advocacy to improve conditions and end workplace abuse. Our hope is that it will also shape the thinking of policy makers and encourage further research about working conditions along the border.

Related:

The Price of Domestic Workers’ Invisible Labor in U.S. Border Towns
Source: Sarah Holder, The Atlantic, June 25, 2018

At the Wage Floor: Covering Homecare and Early Care and Education Workers in the New Generation of Minimum Wage Laws

Source: Sarah Thomason, Lea Austin, Annette Bernhardt, Laura Dresser, Ken Jacobs and Marcy Whitebook, Center for Labor Research and Education (UC Berkeley), Center for the Study of Child Care Employment (UC Berkeley), and COWS (UW-Madison), May 2018

From the introduction:
In November 2012, fast-food workers in New York went on strike and the Fight for $15 was born. Over the last five years, the movement has lifted wages for more than 17 million workers across the nation by fighting for and winning numerous minimum wage policies (National Employment Law Project 2016).

Substantial minimum wage increases are underway in California, New York, Oregon, and more than 30 cities and counties around the country. In states and cities covered by them, these new minimum wages will increase earnings for 25 to 40 percent of workers (Reich, Allegretto, and Montialoux 2017; Reich et al. 2016). After four decades of wage stagnation and rising inequality, the movement has delivered real, much needed, and meaningful progress in a remarkably short period of time.

Fast food has been iconic in the discussions of the minimum wage, from the influential mid-1990s research that found no negative employment impact of wage increases in the industry, to the fast-food workers who have walked out on strike in cities across the country in recent years (Card and Kruger 1995). But of course the reach of these wage increases extends well beyond fast food to underpaid workers in multiple industries. The dynamics of minimum wage increases vary across industries based on each industry’s specific structure.

Nowhere are the distinct dynamics more pronounced and challenging than for those employed in human services industries. This paper focuses on an important subset of these workers: those who provide homecare and early care and education services to the very young, people with disabilities, and those who are frail due to age or illness. We explain the pressing need to raise these workers’ wages and the unique structure of their industries that results in a funding squeeze for wage increases—at the root of this is the fact that most families are unable to afford all of the homecare and child care they need, never mind pay enough to ensure that workers earn a living wage, and public human services are chronically underfunded.

These workers provide a critical (but too often unrecognized) public good; as such, we argue that a significant public investment is a necessary part of the solution, both to deliver minimum wage increases to these workers and to cover the significant unmet need for care. We provide background about the shared and divergent challenges in the homecare and early care and education industries, as well as review emerging policy initiatives to fund wage increases for homecare and early care and education workers and identify principles for public policy going forward.