Recently in Home Health Workers Category

Source: Matt Ozga, Paraprofessional Healthcare Institute (PHI), January 14, 2010

Supportive services workers who care for people with Medicaid in community-based residential care settings are not exempt from federal minimum wage and overtime requirements, confirmed a U.S. district court in Western Missouri.

The case of Solis v. Firstcall Staffing Solutions, Inc. (pdf) involved 10 developmentally disabled consumers sharing four dwellings in an Independence, MO, apartment complex. The employer, Firstcall Staffing Solutions, had argued that because the community-based care facility had been set up as individual apartments, it should be treated as the recipients' homes.

Source: Family Caregiver Alliance, National Center on Caregiving, December 2009

From the summary:
States are currently struggling with one of the deepest recessions on record. As a result, funding for essential services, including family caregiver support programs, has been reduced or, in the worst cases, eliminated.

This paper is intended to help advocates, program administrators, service providers and caregivers fight for their state and local caregiver support programs. It includes background information, statistics, talking points and a list of additional resources to help make the case for maintaining public funding for crucial caregiver support services.

Source: National Alliance for Caregiving in Collaboration with AARP; Funded by The MetLife Foundation, December 2009

From the summary:
Caregiving is still mostly a woman's job and many women are putting their career and financial futures on hold as they juggle part-time caregiving and full-time job requirements. This is the reality reported in Caregiving in the U.S. 2009, the most comprehensive examination to date of caregiving in America. The first national profile of caregivers, Family Caregiving in the U.S. was published in 1997, and an updated version of the study, Caregiving in the U.S., was reported in 2004.

The sweeping 2009 study of the legions of people caring for younger adults, older adults, and children with special needs reveals that 29 percent of the U.S. adult population, or 65.7 million people, are caregivers, including 31 percent of all households. These caregivers provide an average of 20 hours of care per week. The 2009 reports also begin to trend the findings from all three waves of the study.

Source: Steven P. Wallace, Valentine M. Villa, Lauren Smith, Delight E. Satter, Nadereh Pourat, D. Imelda Padilla-Frausto, Rosana Leos, Eva Durazo, A.E. (Ted) Benjamin, UCLA Center for Health Policy Research, October 2009

California was once a leader in innovating new ways to provide long-term care services that allow older adults and the disabled to remain safely in their homes as long as possible. In the early 1970s, for example, a San Francisco organization called On Lok innovated a comprehensive program that created an adult day health center and supportive in home services to allow seniors to remain out of nursing homes. By 1990 this model, now called the Program of All-inclusive Care for the Elderly (PACE), had been successfully replicated elsewhere and became a Medicare/Medicaid waiver program that is now available nationally (http://www.npaonline.org/website/article.asp?id=12). The state was also a laboratory for the development of the Social HMO, consumer directed home care services, and caregiver support services.

Hundreds of thousands of seniors are likely to lose some or all of the assistance they rely on to remain at home. Available program data suggest that budget cuts are not necessarily targeting the least disabled. Studies from other states document that such cuts increase emergency room, hospital and nursing home use. Experts from a range of organizations dealing with the elderly in California who served as key informants for this research concur that these are likely outcomes from California's budget cuts, along with increased stress on family caregivers (for those fortunate enough to have a family caregiver) and reduced jobs and benefits for paid caregivers. This report begins with a summary of the cuts and provides detailed discussions of how those cuts will impact the major programs and populations affected. It offers a summary of our key informant interviews on this topic as well as a summary of the published literature on the effectiveness of these types of programs. We end with a call for California to return to its past innovative spirit of designing new ways to help disabled older adults remain safely at home.
See also:
Policy Brief

Source: Paraprofessional Healthcare Institute, 2009

PHI's analysis of the 2009 Current Population Survey data on health insurance coverage shows that an alarming number of direct-care workers lack health insurance.

Overall, more than one in four direct-care workers (26.1 percent) -- over 800,000 individuals in total -- reported no health coverage in 2008, according to the analysis (pdf). This compares to an uninsurance rate of 17.3 percent for the general U.S. population under age 65.

Source: Gerontologist, Volume 49, Number 5, October 2009
(subscription required)

Articles include:

Intrinsic Job Satisfaction, Overall Satisfaction, and Intention to Leave the Job Among Nursing Assistants in Nursing Homes by Frederic H. Decker, Lauren D. Harris-Kojetin, and Anita Bercovitz

Nursing Home Work Practices and Nursing Assistants' Job Satisfaction by Christine E. Bishop, Marie R. Squillace, Jennifer Meagher, Wayne L. Anderson, and Joshua M. Wiener

A Dual-Driver Model of Retention and Turnover in the Direct Care Workforce by Vikas Mittal, Jules Rosen, and Carrie Leana

Quits and Job Changes Among Home Care Workers in Maine: The Role of Wages, Hours, and Benefits by Lisa Morris

Source: MetLife Mature Market Institute, October 2009

This market survey, conducted in conjunction with LifePlans, Inc., contains daily private-pay rates for private and semi-private rooms in licensed nursing homes, monthly base rates for assisted living communities, hourly rates for home health aides from licensed agencies and agency-provided homemaker companion services, and daily rates for adult day services across the United States.

Source: Sherry Baron, Kathleen McPhaul, Sally Phillips, Robyn Gershon, and Jane Lipscomb, American Journal of Public Health, Vol 99, No. S2, October 2009

From the abstract:
The home health care sector is a critical element in a pandemic influenza emergency response. Roughly 85% of the 1.5 million workers delivering in-home care to 7.6 million clients are low-wage paraprofessionals, mostly women, and disproportionately members of racial and ethnic minorities.

Home health care workers' ability and willingness to respond during a pandemic depends on appropriate communication, training, and adequate protections, including influenza vaccination and respiratory protection. Preparedness planning should also include support for child care and transportation and help home health care workers protect their income and access to health care.

We summarize findings from a national stakeholder meeting, which highlighted the need to integrate home health care employers, workers, community advocates, and labor unions into the planning process.

Source: Paraprofessional Healthcare Institute, October 2009

A series of PHI issue briefs describes the direct-care workforces in several states.

Indeed, the direct-care industry is positioned to grow significantly over the next several years, creating tens of thousands of new jobs in the six states highlighted. Illinois alone will add more than 42,000 direct-care positions by 2016, an increase of 40 percent.

* Illinois
* Pennsylvania
* Michigan
* Massachusetts
* Iowa
* Vermont

Source: Tracy Bach, Vermont Law School Research Paper No. 10-11, August 3, 2009

From the abstract:
In Choices for Care: Consumer Choice and State Policymaking Courage Amid Medicaid's Shifting Entitlement to Long-Term Care, Professor Bach analyzes a leading state program intended to encourage the delivery of care in the home and community, thereby avoiding admission to nursing homes. Choices for Care, Vermont's Medicaid Demonstraion Waiver program, has clearly enabled more Vermonters to receive health care in their homes. After its first two years, it is seen as a model by other states and the federal government. But Bach questions the results. She argues that CFC is reshaping the landscape of long-term care providers, with resulting industry effects both intended, on nursing homes, and unintended, on home health agencies. Moreover, she observes that the initial success in shifting care away from institutions does not provide a clear answer to the cost trade-off between nursing home and home and community-based care. To date, Vermont has not shown that CFC has solved the overall long-term care spending problem. Likewise, the question of whether expanding home and community-based services for those on the eligibility edge successfully staves off their eventual admission to a nursing home is still an open one. Finally, the demographic question about the home care provider pool underlines the fact that the experience of CFC, as a very small state experiment, might be hard to replicate in other states. In this article, Bach puts the CFC results into the perspective of long-term health care system design.