Caregivers

A final rule that would allow more Medicaid beneficiaries to be in charge of their own personal assistance services, including personal care services, instead of having those services directed by an agency, was published in the Oct 3, 2008 Federal Register. The rule, effective Nov. 3, 2008, guides states that wish to allow beneficiaries who need help with activities of daily living to hire, direct, train or fire their own personal care, workers including qualified family members.

Policy makers and provider organizations continue to struggle to reduce turnover among direct-care workers in the long-term care field. Unfortunately, data elements used to measure turnover vary widely between programs and make it difficult to understand and counteract this problem. The authors discuss these challenges by drawing on their experience with the turnover tracking system of the Better Jobs Better Care Demonstration.

This resource presents ten key facts showing the economic and health insecurity of the direct care workforce. It can be used to advocate for improved public policies and increase public awareness of the needs and importance of caregivers. The figures presented also illustrate the linkage between quality of care available to the growing population of older Americans, recruitment and retention of workers, and wage and benefits levels.

Watch these videos to hear first-hand from direct-care workers about the services they provide. They share their thoughts on why they do this work, how they are viewed by families, friends, and service recipients, and how they deal with challenges such as discrimination and disrespect. They also provide advice on how to improve the field. The videos are available free at this website or can be ordered as a DVD or VHS with a discussion guide included.

Best practices in HCBS workforce development, Federal and state workforce initiatives, and research findings are highlighted in these slides and handouts. Presentations and workshops touched on wages and benefits, recruitment, credentials, peer support, policy, and more. The agenda, program, and evaluation results are also available. The symposium was hosted by the National Direct Service Workforce Resource Center May 8-9, 2008 in Baltimore, MD with support from HHS and the Dept. of Labor.

This policy paper proposes that the unionization of direct care workers can improve recruitment, retention, and service quality without limiting consumers’ rights and choices. The author explores the historical roots of efforts to address direct support workforce issues, reviews the role of unions in the field in the past, examines emerging support models, and comments on current union efforts.

Find thirteen examples of state level legislation that improve the wages, collective bargaining rights, or insurance of personal care workers and home health aides. The report also includes graphics illustrating workforce trends and a list of potential best practices that were not passed into law in their respective states.

This study examines dynamics affecting the direct-care workforce in Vermont. It found that only one third of those workers have employer-sponsored health insurance, one half of those surveyed expected to receive a raise, and 42% received formal job training. The report includes nine recommendations to strengthen the state’s direct-care workforce. In addition, the appendices include original surveys given to employers and direct-care workers.

Over the last eight years, federal, state, and local governments have re-envisioned how to deliver and pay for an ever-growing caseload of elderly individuals and persons with disabilities who need services at home, in the workplace, or in more costly nursing facilities. This discussion provides a vision and a context for HCBS reform consistent with CMS’ vision for reforming post-acute care that focuses on addressing system barriers and informing and empowering health care consumers.

This consumer guide from MetLife is one in a series of guides called "Since You Care" done in cooperation with the National Alliance for Caregiving. It provides information for family caregivers about locating potential home care aides, screening applications, conducting interviews, running background checks and administering payroll, including social security and other taxes. It also provides helpful resources, including books, publications, websites and a sample contract.