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.
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.
Source: SCAN Foundation, August 2009
On any given day, 126,000 Californians in nursing homes receive care from Certifed Nursing
Assistants (CNAs). An additional number of the State's residents receive care in their own homes from the 54,260 registered Home Health Aides (HHAs). Each of these persons is dependent on Direct Care Workers (DCWs) to address at least some of their most fundamental human needs. The DCW is also a liaison to the nursing staff, reporting the care-receiver's medical and emotional status and she or he may also be the person's key connection to the outside world.
This paper was developed as a "think piece" to stimulate dialogue among stakeholders who are
discussing the needed components of training for DCWs. For 35 years, NCCNHR has maintained this kind of dialogue with long-term care consumers including nursing home and board and care residents, their families, and their advocates, and more recently those receiving services in their own homes. As our experience has shown in this paper, DCWs are essential to the quality of life for and quality of care of older adults. Furthermore, there is a critical need to better support DCWs through cultural sensitivity, involvement in care planning, by addressing systemic issues and through comprehensive training opportunities.
Source: National Association of State Units on Aging, June 2009
From the press release:
The National Association of State Units on Aging (NASUA) released the findings today of its fourth economic survey of the state units on aging in the last year. The survey conducted in May 2009 revealed that despite the funding provided by the American Recovery and Reinvestment Act of 2009 (ARRA), 60 percent of states must reduce their agencies' budgets for FY10.
While ARRA funding appeared to have the effect of allowing states to maintain services for food and nutrition programs, over 20 percent of the states indicated that they will have to resort to cutting back services to consumers. Those services include Older Americans Act programs, disability programs, Medicaid, and home- and community-based services and supports.
See also:
- PowerPoint Presentation
- NASUA Economic Survey
- Economic Downturn Follow up Report
Source: David C. Grabowski, Haiden A. Huskamp, David G. Stevenson, Nancy L. Keating, Journal of Aging & Social Policy, Volume 21, Issue 2 April 2009
(subscription required)
From the abstract:
Few studies have analyzed for-profit and nonprofit differences in the home health care sector. Using data from the National Home and Hospice Care Survey, we found that patients in nonprofit agencies were more likely to be discharged within 30 days under Medicare cost-based payment compared to patients in for-profit agencies. However, this difference in length of enrollment did not translate into meaningful differences in discharge outcomes between nonprofit and for-profit patients, suggesting that--under a cost-based payment system--nonprofits may behave more efficiently relative to for-profits. These results highlight the importance of organizational and payment factors in the delivery of home health care services.
Source: PHI PolicyWorks, Paraprofessional Healthcare Institute, July 2009
From the summary:
PHI PolicyWorks has released an updated State Chart Book on Wages for Personal and Home Care Aides (pdf). The chart book tracks wages in all 50 states and the District of Columbia for the period 1999-2008. It shows that nationally, the median real wage (adjusted for inflation) for personal and home care aides has decreased by 3 percent over nine years, from $7.50 to $7.31.
Source: New York City Labor Market Information Service, May 2009
Home health care services is one of ten industry groups being profiled by the New York City Labor Market Information Service (NYCLMIS) for the public workforce development system in 2009. The NYCLMIS identified the ten groups in an earlier report, Gauging Employment Prospects in New York City, 2009. In that report, we found that home health care services compared well with the rest of the local labor market on several measures including employment trends and performance during the two previous recessions in New York City.
This profile is meant to help account managers with business development and job placement, career advisors with job counseling, and education and training professionals plan and refine their curriculum and placement activities in the industry. Jobseekers can also use this information to help make career decisions. Icons appear throughout this profile to highlight findings and recommendations of special interest to these audiences.
Source: Paraprofessional Healthcare Institute, 2009
PHI announces the launch of PolicyWorks, an online strategy center promoting national and state policy solutions to strengthen the direct-care workforce.
PolicyWorks features:
•Strategic Areas - Learn more about our 7 strategic policy areas for transforming direct-care jobs: Wages & Benefits, Health Care, Jobs & the Economy, Training & Credentialing, State Workforce Monitoring, Public Payment & Procurement, Consumer Direction
•Workforce Facts - An introduction to the demographics, size, and economic impact of the direct-care workforce
•Policy Recommendations - Strategic recommendations on the critical issues affecting direct-care workers
•Chart Gallery - High quality graphics highlighting key data on the direct-care workforce
•Guide to Accessing Federal Recovery Act Funds - Help for those interested in taking advantage of the unprecedented level of public resources now available
•Health Reform Resource Center - Resources to help ensure that national health reform works for the direct-care workforce
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