Recently in Home Health Workers Category

Source: UCLA Center for Health Policy Research, June 2009

From the press release:
In Los Angeles County, being disabled can cost a year's income. That's because the annual cost of in-home care services for seniors living alone is now $319 more than this group's median income of $17,029.

Combine long-term care expenses with other basic expenses, such as food and rent, and a Los Angeles senior living alone will need twice the median income to survive, according to new data released today by the UCLA Center for Health Policy Research and the Insight Center for Community Economic Development.

Source: Allison N. Canton, Martin F. Sherman, Lori A. Magda, Leah J. Westra, Julie M. Pearson, Victoria H. Raveis, Robyn Gershon, Home Healthcare Nurse. Vol. 27 no. 6, June 2009
(subscription required)

From the abstract:
Workplace violence, defined as violent acts directed toward workers, includes physical assault, threat of assault, and verbal abuse and is widely recognized as a threat to workers' health and safety. Healthcare workers, especially nurses, are known to be at high risk. As employees who work alone, have access to drugs, provide care to people in distress, and/or have frequent close contact with clients, they face a greater likelihood of exposure to violence. Nurses' risk has been correlated with degree of patient contact; the odds of physical violence are 7.2 and 9.0 times greater for healthcare workers with moderate and high patient contact, respectively, compared with those with little or no contact.

Source: AARP Public Policy Institute, Fact Sheet, June 2009

From the summary:
Expansion of home and community-based long term care services (HCBS) can significantly help address the health care needs of many older adults.

Medicaid--which pays for half of all long term care services and supports--has a strong institutional bias. Changing Medicaid priorities can be cost effective.

Only a handful of states--New Mexico, Oregon, Washington, Alaska, and California --now spend more Medicaid dollars on HCBS than nursing homes.

As part of comprehensive health reform, we can improve support for Medicaid HCBS and for family caregivers.

Source: Peggy Smith, Direct Care Alliance, June 2009

From a summary:
In Protecting Home Care Workers under the Fair Labor Standards Act, (PDF) the second in a series of Direct Care Alliance policy briefs, Smith says the decision "threatens to destabilize the home care industry, erode the precarious economic status of home care workers, and undermine the quality of care that they provide to home care clients."

She outlines two approaches the federal government could take to reverse the ruling:
1. Amend the FLSA to explicitly include home care workers; and
2. Revise Department of Labor (DOL) regulations to significantly limit the reach of the companionship exemption.

Source: Marie R. Squillace, Robin E. Remsburg, Lauren D. Harris-Kojetin, Anita Bercovitz, Emily Rosenoff, and Beth Han, The Gerontologist, Vol. 49 No. 2, April 2009

From the abstract:
One in three CNAs received some kind of means-tested public assistance. More than half of CNAs incurred at least 1 work-related injury within the past year and almost one quarter were unable to work for at least 1 day due to the injury. Forty-two percent of uninsured CNAs cite not participating in their employer-sponsored insurance plan because they could not afford the plan. Years of experience do not translate into higher wages; CNAs with 10 or more years of experience averaged just $2/hr more than aides who started working in the field less than 1 year ago.

Source: John C. Gilliland, II, Esq., Home Health Care Management & Practice, Vol. 21 no. 4, 2009
(subscription required)

From the abstract:
As union organizing of home health agencies increases, many agencies will be asked by a union to enter into a "neutrality agreement" with the union. Whether to agree to such an agreement is a very significant decision for an agency. It requires an agency to understand how such an agreement affects the unionization of its employees and the agency's own goals with regard to unionization.

Source: William D. Cabin, Home Health Care Management & Practice, Vol. 21, No. 4, 2009
(subscription required)

From the abstract:
A neglected area of discussion in home care is the relationship and dissonance between evidence-based research on effective home and community-based interventions, Medicare home health practice, and the Medicare Home Health Prospective Payment System (PPS). PPS is critical because the literature increasingly indicates that the PPS reimbursement framework drives home health agency and practitioner resource allocation and practice decisions. However, the PPS system does not have an evidence-based evaluation process to evaluate the effectiveness and cost-effectiveness of new, or existing, intervention. The article reviews existing evidence-based research on the effectiveness of home-based environmental skills building, counseling, and support group interventions, which benefit patients, caregivers, home health agencies, and Medicare. The article indicates these interventions have never been evaluated, nor are they covered by Medicare. The article asserts the need for such an evaluation process to evaluate intervention cost-effectiveness and related changes in Medicare coverage, eligibility, reimbursement, and outcomes measurement criteria necessary for their adoption.

Source: Sherry White and Beth C. Vaughan-Wrobel, International Longevity Center-USA, Caregiving Brief, Volume 1, Number 2, 2008

The establishment of a multi-tiered educational pathway for geriatric home caregivers would support efforts to meet the needs of an increasing number of community dwelling older adults who require assistance with activities of daily living, while generating a cadre of qualified employees for an expanding non-medical private home care market. An educational pathway for geriatric home caregivers would also standardize the training of home care assistants while providing these individuals access to routine, high quality continuing education opportunities and the potential for career advancement.

Source: Paraprofessional Healthcare Institute, Health Care for Health Care Workers, April 2009

New York State's home care workers, who each day serve our health care system, too often lack access to affordable, quality health insurance coverage. At the same time, employers find it challenging to recruit and retain enough workers to meet the increasing demand for services. While lack of adequate, affordable health insurance for home care workers and their families is known to contribute to workforce instability and vacancies, accurate and timely data on the availability of health insurance is simply not available to guide New York policymakers.

There are numerous reasons for policymakers to make this a priority. Direct-care workers comprise the largest group of workers in the state's health sector and their numbers are expected to continue to grow. In addition, these workers are employed by agencies that are heavily dependent on public funds to provide services; i.e., these workers could be described as subcontracted "public employees." In addition, direct-care workers face high rates of chronic health conditions and workplace injuries. This situation, in concert with low rates of insurance coverage, contributes to high rates of turnover, which undermines the quality of services for consumers.
See also:
- Is New York Prepared to Care?
- Press release

Source: Robert J. Rosati, Joan M. Marren, Denise M. Davin, Cynthia J. Morgan, Journal for Healthcare Quality, Volume 31 Issue 2, March/April 2009
(subscription required)

From the abstract:
Greater accountability for patient outcomes, reduced reimbursement, and a protracted nursing shortage have made employee and patient satisfaction results central performance metrics and strategic imperatives in healthcare. Key questions are whether the two interact and if so, how can that relationship be leveraged to obtain maximum gains in both employee and patient satisfaction. This article examines the experience of a large, nonprofit home care agency in exploring these issues. The agency found that organizational commitment to patient care and customer service are fundamental to patient satisfaction. The more employees perceived that the organization is focused on quality and customers, the more patient satisfaction increased. Among nurses, work-life balance, fair compensation, and regard for employees all influenced patient satisfaction.