Direct Care Workforce

Direct-care workers provide 70-80% of the paid hands-on long-term care and personal assistance received by the elderly or individuals living with disabilities or other chronic conditions. They also constitute one of the largest and fastest-growing workforces in the country, playing a vital role in job creation and economic growth, particularly in low-income communities. This analysis shows that the wages and benefits for these frontline health care workers continue to be woefully inadequate.

The new issue of Generations, the quarterly journal of the American Society on Aging, is devoted entirely to the eldercare workforce. The Winter 2010-11 issue covers: the current state of the nation’s eldercare workforce; the eldercare workforce’s makeup, deficiencies, and strengths; and strategies for much-needed workforce recruitment, training and management, policy development, and fostering of cultural competencies.

Self-directed programs that allow individuals with intellectual and developmental disabilities to exercise greater control over their finances have become increasingly common, however challenges in the recruitment, retention and training of direct support workers have grown more acute. In this article, the authors investigate the status of the Direct Support workforce for people using self-directed supports in one Midwestern state, based on the results of a statewide survey of service users.

States are confronting challenging budgets along with the need to implement health reform. Many are looking to improve long-term care as a way to control costs and serve seniors and people with disabilities in settings they prefer. This newsletter describes provisions in the Affordable Care Act that assist states in expanding HCBS, the growing movement to improve facility-based care, and innovative programs in three states that seek to provide consumer-directed long-term care.

The Kaiser Family Foundation's Commission on Medicaid and the Uninsured (KCMU) held a briefing to examine the challenges facing states as they continue to struggle with the lingering impacts of the recession and begin preparing to implement health reform. Find links to three reports released at the event, archived presentations, video, podcast, transcript, agenda and more.

To better understand the dynamics of the workforce challenges that factor in to the implementation of health reform, an initiative was undertaken to examine the situation in five states (Connecticut, Michigan, Massachusetts, North Carolina and Washington). These states represented a range of geographic and political experiences as they continued to struggle with the lingering impacts of the recession and began preparing to implement health reform. Six key findings are summarized.

Included are several quarterly reports from Employment Coordinators in Florida that detail which training programs they have attended and the intended benefits of the programs. These reports may be replicable by states seeking to have their employees chart their participation in training programs in a uniform way.

How is California disseminating information to its disabled college students and newly graduated college students about work incentives and who to connect to in the community to obtain assistance? The California Ambassadors Program hires and trains disabled college students to provide outreach and education for fellow disabled peers. Attached, find a multitude of resources, presentations, and trainings put out by the state of California regarding this important program.

This program was established so workers with disabilities and earned income under 250% of the Federal Poverty Level could keep coverage by paying a monthly premium. It provides choice and opportunity to Californians with disabilities who would otherwise be ineligible for full scope Medi-Cal coverage due to earned income and work activity. Included are presentations and resources intended to educate consumers on this and other MIG programs.

According to the results of this survey, the most significant factors that drive turnover among home care workers are wages, intrinsic rewards, age (older workers are less likely to leave their jobs), and education level (more years of education result in higher retention). The study involved a sample of 116 home care aides employed by three agencies.