Direct Care Workforce

Since 2002, MetLife Mature Market Institute has gathered data on the costs of long-term care in institutional and community-based settings. This 2008 report looks at home care and adult day services. Costs are broken down by state, metropolitan statistical area (MSA), and “rest of state,” or areas not in a MSA. Home care costs are measured in hourly private pay rates, and adult day costs are measured in daily private pay rates.

Watch a series of short, simple and direct videos meant to educate and train family caregivers. Videos cover a range of topics from infection control to paperwork. A “Beyond the Video” section offers video summaries and tips for applying lessons to each family's situation.

This report provides a summary of how long-term services and supports (LTSS) are financed and describes factors that contribute to uncertainty of the future costs for LTSS, including changes in how LTSS will be delivered. Three projections of future LTSS spending for senior populations under different scenarios are offered. These scenarios differ based on projecting the number of people with varying functional limitations and the resulting need for varying degrees of LTSS.

Presentations from NASHP’s 21st annual state health policy conference are now available. The conference is planned by state health policymakers for state agencies' staff, legislators, and legislative staff. Review the presentations to learn how others are improving and innovating healthcare through state-level policy.

Working Well, the Texas Demonstration to Maintain Independence and Employment, tests whether health and employment-related services can prevent workers with serious health issues from becoming disabled and dependent on federal benefits. These Issue Briefs introduce the program and present participant data. Brief 3 examines healthcare support workers participating in the project who are at risk for becoming disabled themselves. The website has participant stories and further project information.

The purpose of this report is to inform the efforts of states that are trying to develop and improve QA/QI systems by describing and analyzing how selected Systems Change Grantees went through this process. The initiatives examined fall into six categories: administrative technology and information technology; standards for services; discovery; remediation; workforce; and public information.

In Los Angeles County, personal care workers (PCW) that meet eligibility requirements can receive healthcare benefits. Since 2003, the Personal Assistance Services Council (PASC) of L.A. County has commissioned annual studies to examine how these benefits have effected retention and quality. Those studies are posted here along with an introductory letter. Visit the PASC website for updates.

This annual conference focuses on quality of services for people with developmental disabilities. Held Aug. 10-12 in Baltimore, this year’s conference featured agencies that have implemented person-centered planning and individualized support structures. One highlight was individuals who have developed their own micro-enterprises. In addition, innovations in policies, systems issues, and quality assurance methodologies were presented.

Direct care worker (DCW) training and education are challenging issues in all states. Iowa set up a taskforce to review existing requirements, streamline the process of training and education, and to establish a DCW registry by expanding the Iowa Nurse Aide Registry. The taskforce recommends classifying DCWs by function (rather than setting or population served) and developing a governing body, a single approved curriculum, and a certification system for all DCWs.

Using information from published literature, interviews and focus groups, this review covers a wide variety of characteristics of the jobs of direct care workers in the behavioral health field. It also looks at the prospects and requirements for developing more effective career paths that recognize and reward quality workers. It concludes with 12 policy recommendations.