Direct Care Workforce

In many ways, consumers are the best experts on their disabling conditions, including their own needs for support and the effectiveness and quality of programs. As a result, obtaining consumer participation and input at all stages of program design, implementation, evaluation and quality assurance is important. Effectively and efficiently involving consumers and obtaining their input, however, requires creative and innovative methods. This checklist will help to enhance full participation.

This report offers the findings of an outreach project conducted with direct-care employers and employees in Maine to help connect them with a new health insurance product called DirigoChoice. The research suggest that “states experimenting with innovative health coverage plans will need to address major challenges -- such as the part-time nature of direct-care work, low wages, and low reimbursement rates -- to ensure coverage for these critical health care workers.”

What incentives help encourage in-home supportive services workers to remain in caregiving? A Connecticut College research team explores this question by surveying 2,200 workers. \"Flexibility and wages matter,\" the researchers note, \"research clearly shows that giving workers $10/hr plus access to decent benefits significantly increases the supply and retention rate of home care workers, making it possible for consumers to find good caregivers.\" The executive summary offers further results.

As the number of those needing care at home continues to grow, it is becoming more difficult to find workers. One solution is to rely on consumer-directed services, in which clients hire friends and family as paid caregivers (whom we call “related caregivers”). This study explored the experiences of related caregivers, most of which had not considered direct-care work if a loved one had not needed them and sought to understand who might represent potential home care workers in the future.

The 2006 Annual Research Meeting is AcademyHealth's premier forum for health services research. Leading health services researchers and policymakers attended the meeting to hear the latest findings on critical health care delivery topics such as Medicare, coverage & access, disparities, health information technology, long-term care, health care quality, and patient safety. Review the agenda, presentations and webcasts covering 18 major areas of health services research & policy.

To improve long-term care quality, state and federal policymakers are experimenting with positive incentives to reward providers who can demonstrate better quality. Incentive payment systems are part of a broader trend in the health care field, referred to as “pay-for-performance” and may consist of either financial payments or non-financial recognition. This paper describes the challenges involved in designing effective quality incentive payment systems in the long-term care sector.

In 2004, Congress requested that HHS conduct a study on the shortage of direct support professionals (DSPs) supporting persons with intellectual disabilities and other developmental disabilities (ID/DD). The study includes an examination of the causes associated with high vacancy and turnover rates, and an examination of the impact this shortage may be having on services for people with ID/DD. The report offers figures on projected needs and future demands of worker recruitment and retention.

This manual is intended to address two identified training needs for consultants/support brokers working with participants in self-directed care. MODULE ONE: Facilitating the Paradigm Shift for Consultants and MODULE TWO: The Dynamics of Choice and Decision-Making for Participants. The program identifies training needs by addressing the philosophical framework necessary for successful implementation of a participant-directed service and was designed to be delivered in two half-day sessions.

Managed by the Home Care Quality Authority (HCQA), a public agency in Washington, this Registry is a customized internet-based system designed to match the needs of publicly funded in-home consumers/employers with pre-qualified individual providers. The day-to-day operations are administered by Referral and Workforce Resource Centers (RWRCs). Local sites offer programs and services including referral searches, a Resource Clearinghouse and outreach materials such as the attached newsletter.

The CMS Systems Change conference, Transforming Systems: Keys to Success was held April 10-12 in Baltimore. Presentations from the 2006 sessions are available in both PDF and text formats. Topics range from ideas on system transformation, stakeholder involvement, coalition building, strategic planning, sustaining systems change, and the Deficit Reduction Act. Full titles are listed in the keywords section.