Direct Care Workforce

Follow the link for a comprehensive listing of state statutes, regulations, policies, and procedures regarding the use of emergency or planned physical, chemical, mechanical, or other restraints. Additional documents offer information on positive behavior support guidelines, training manuals, and other policy-related materials. Many emphasize the use of positive or non-aversive interventions. Links are provided to access documents on many state DD agency websites.

In addition to recommendations for reforming long-term care, this report goes over why it should be reformed and suggests the first steps for accomplishing change in the public and legislative arenas. Finance, service delivery, workforce, and quality are all identified as focus areas for improvement, and options are provided for each. Special attention is paid to low-cost options as a place to start with bipartisan cooperation. The report is accompanied by presentation slides.

Minnesota’s Legislative Auditor investigates the state of the personal care workforce and the regulation of these services and presents recommendations for improvement. Information is provided on eligibility and access as well as the demographics of people that are assessed for or receiving personal care services. Program traits examined include regulation, expenditure trends, fiscal integrity, and quality. Family caregivers are looked at in the final section.

Quality surveys were developed to be administered by consumers to other consumers and their families. They measure in-home attendant care, habilitation, and respite services delivered. In addition to surveys are materials used to train the interviewers, survey response thresholds, and a presentation outlining survey findings.

This website offers information on the range of funding sources available to State Medicaid and other agencies and stakeholders to support the development of a high quality direct service labor force. It breaks the information down into 5 categories including current, federal, state, foundation and other types of funding and includes examples of sources and strategies for funding future DSW initiatives.

This paper provides an overview of the health coverage interventions tested by CMS DSW demonstration grantees and examines four approaches in more detail through the following four case studies:(1)Subsidizing Employer Based Insurance(North Carolina),(2)Prescription Discounts, Basic Health Insurance and Tax-Free Accounts(New Mexico),(3)DirigoChoice and Outreach to Home Care Agencies(Maine)and (4)Outreach to Consumer-Directed Home Care Workers (Washington).

The trends in state Medicaid HCBS programs, target groups, participants, and expenditures are summarized and policy recommendations are made. The paper shows the progress in providing Medicaid HCBS but also identifies many current problems and policies. Inequities in access to services and limited funds result in unmet needs. Cost issues have been a primary focus of policy makers and quality problems are largely not addressed.

The authors advise Congress on how to meet the growing demand for long-term care and cope with rising health care costs by supporting HCBS. The main recommendations are: promote care coordination and disease prevention; strengthen the nonprofit home health nurse workforce; and ensure the financial viability of home-based care.

This White Paper recommends minimum data sets that states should collect to help assess the magnitude of workforce issues they face and to design and evaluate policy responses. The three basic data elements include: numbers of workers (full time and part time); stability of workforce (turnover and vacancies); and average compensation (wages and benefits). The authors also offer guidance on how to implement data collection.

Here are demographic, employment, and income characteristics of one of the largest and fastest-growing workforces in the country. Due to this dynamic, understanding the direct care workforce is critical for effective service delivery and policy making in areas from health reform to economic growth. Key figures include job titles and responsibilities, employment status, work setting, wages and benefits.