Direct Care Workforce

The Benjamin Rose Institute on Aging sponsored PPAR’s Winter/Spring 2010 issue. It includes seven articles written by national experts describing recent and notable changes in LTC policy, with its increasing emphasis on HCBS services. An introductory essay provides a 30-year review of the evolutionary process of LTC. Consumer-directed initiatives, caregiver and workforce issues, maturation of the service delivery system, and a review of recent state-level initiatives are discussed.

Examine factors associated with the use of personal care services (PCS) and the amount of authorized hours in California in 2004-2005. Of those Medicaid-eligible individuals with developmental disabilities living at home, 31% received PCS. When this study controlled for client need, gender, and age, those who were Asian/Pacific Islanders, African Americans, Hispanics, and other races had higher odds of receiving PCS than Whites but were authorized between 16 and 39 hours fewer than Whites.

Examine a snapshot of workforce competencies that have been identified for professionals who work in LTC settings. It focuses on providers who serve long-term care needs of the older population. The paper also examines whether the competencies are the same or different from what is needed to care for the geriatric population in acute and ambulatory care settings.

Several of ACA’s provisions directly impact eldercare and disability employers and direct-care staff. This is the first in a series of fact sheets describing these. Key health reform provisions related to investments in direct-care worker training and workforce development are highlighted. These include national advisory panels as well as grant opportunities for states and individual employers. These provisions will be enacted over several years.

Learn about innovative practices that aim to improve the recruitment, training, and retention of direct-care workers. This online collection of profiles was created to help providers learn from one another. The growing collection of practices profiled are among the best examples of the “quality care through quality jobs” school of thought.

Review an analysis of the size and characteristics of the PAS workforce during the period 2005-07. Data is available by state and nationwide and is based on a three-year combined sample of data from the U.S. Census Bureau's American Community Survey. Data include gender, age, ethnicity, birthplace, income, and type of employment.

Explore this collaborative initiative geared towards propelling state progress in the support of a more “successful and financially secure aging experience.” The West Virginia Long Term Care Partnership seeks to bring together varied efforts to create an integrated network of thought and action, with an emphasis on collaboration and communication. Also included is a link to the proceedings of their 2010 Partner Summit, through which you can access the presentations and handouts.

To inform long-term care reform efforts, a web-based survey of over 1,000 LTC specialists nationwide was conducted. Findings included the need for LTC to be rebalanced toward HCBS settings, though few supported doing so by limiting nursing home bed supply. Although virtually all felt that the federal government was doing a poor job regulating LTC providers, most believed that the approaches used to oversee nursing homes should also be applied to assisted living.

A Southwestern Pennsylvania demonstration program has been initiated to promote relationship-centered care for elders and people living with disabilities in need of home and community-based services and supports. It involves a series of five three-day train-the-trainer programs based on the state model for personal care aides (PCAs). Included are the announcement and a fact sheet on direct-care workers in Pennsylvania.

More than two dozen proven examples of direct-care worker retention strategies are outlined in this report. The report includes key research findings in the literature that show which factors lead to an increase in retention, as well as key successful strategies and programs, including many tools, resources and contacts.