Direct Care Workforce

A wage pass-through is an additional allocation of funds provided through Medicaid reimbursement for the express purpose of increasing compensation for direct-care workers. Twenty-one states have implemented these programs in expectation that doing so will help address the worker shortage. The purpose of this issue brief is to: describe the structure in selected states; summarize what is known about the impact of these programs on recruitment and retention; and identify key design elements.

The survey results highlight inconsistencies and gaps in training, testing, and other pre-employment requirements for nursing assistants. The results from the nurse aide registries are presented in a series of charts. The survey notes who pays for pre-certification training in each state, whether candidates are allowed to become certified by passing the test without undergoing training, whether nurse aides pay a fee to be licensed or certified, who does criminal background checks, and more.

This issue explores the theory that improving pre-employment training and continuing education reduces turnover by giving workers the competence and confidence they need to do the job well. The brief describe federal and state pre-employment and on-the job training requirements; examine the costs involved and how to pay for it; summarizes the research on the impact of training programs on recruitment, retention, care quality; and identifies key questions in developing initiatives.

Handouts, attendee lists, reports presentations and speaker bios from a national symposium on the direct-care workforce are now available through the U.S. Department of Health and Human Services (HHS) Office of Disability, Aging and Long-Term Care Policy website. Hosted last May by the HHS and the U.S. Department of Labor, convened policymakers, workers, and practitioners from the fields of long-term care and workforce development to meet and learn from each other.

A two-year study in Los Angeles County showed that offering health care coverage improves retention rates. This study tracked workers in the city’s In-Home Support Services program, which offers home-based care and services to consumers who direct their own care. The report includes many findings, including an initial study done showing that workers who enrolled in the health benefits program were more likely to be in the workforce at month 12 than workers who did not enroll.

Informal caregivers, primarily family, but also friends and volunteers, have been and continue to be integral to the system of providing critical assistance to persons age 65 or older who need long-term care. This Data Profile provides an overview of informal caregivers today compared to caregivers a decade ago. This brief also offers excellent data and charts that offer a pictorial overview of the changes.

The Compendium contains basic information about each of the Real Choice Systems Change Grantees. The Compendium will help you learn more about how these grants will be used to allow more people of all ages with a disability or long term illness to live and participate in their communities. Real Choice Systems Change Grantees will also find the Compendium useful to identify other Grantees with similar goals and activities. The fourth edition of the Compendium replaces all previous editions.

This website is the site for the Maine Quality Choices grant. Maine’s Work Group for Community-Based Living includes a broad array of consumer and state representatives from five departments (Transportation, Labor, Education, Human Services, and Behavioral and Developmental Services). The website offers information on the Work Group, Accessing Services, Community Living, Data Integration, Person-Centered Services, Quality Improvement, Workforce and a Project Index.

The Ticket to Work and Self-Sufficiency Program is an employment program for people with disabilities who are interested in going to work. The quarterly newsletter covers marketplace news, opportunities and experiences. This Winter 2005 issues details a new EN Promising Practices Anthology and spotlights a South Florida program. The Newsletter also has an events calendar and a list of Recently Approved Employment Network Providers.

Gainful employment is entirely possible for people with disabilities and yet it remains outside the grasp for many who remain unemployed or grossly underemployed. Success in employment is caught in a vicious circle with the insufficiency of employment supports, health care coverage, education and training, and income potential. Further aggravating that cycle are barriers in transportation, child care, accessible and affordable housing.