Archive for September, 2009

Here I Grow Again: Democracy in Action

Posted by on September 23rd, 2009 at 3:33 pm | 8 Comments »
The DCA's DC contingent for EWA Hill Day. That's me in the middle

The DCA's DC contingent for EWA Hill Day. That's me in the middle

If you’ve read my earlier stories for this blog, you know about the journey I’ve made from “the mouse in the corner” to “the lion that roared.” Well, last week I was reminded of why that journey mattered when a legislative staffer in Washington, D.C., asked me to provide wording for a possible amendment to a Senate bill.

I was in D.C. on September 14 and 15 to participate in the Eldercare Workforce Alliance (EWA) Hill Day. This time around I felt pretty comfortable, since I knew what to expect — at least, I thought I did.

At a training on Monday evening, we were briefed on EWA’s mission and the “asks” they wanted us to make the next day on Capitol Hill. The next morning, I was paired up with Mike Malone, a geriatrician from Wisconsin. We talked about the meetings we were scheduled for that day over breakfast, practicing what we wanted to say and what order it should go in. Then we jumped in a van to catch a ride to the Capitol.

Our first visit was with a Wisconsin senator’s staffer. Mike and I introduced ourselves and explained the importance of an adequately prepared elder care workforce and how the need for workers is only going to increase as the baby boomers enter the long term care system. We explained that our elders deserve a workforce that is trained and prepared to care for them.

My mind was racing as I sat there. I knew I was there to represent direct care workers. “It’s now or never,” I thought. “Open your mouth and speak!” Continue reading »

Bankrupted by Health Care Costs, CNA Cindy Ramer Shares Her Story

Posted by on September 19th, 2009 at 3:16 am | 3 Comments »
Cindy Ramer with a photo of herself and her husband

Cindy Ramer with a photo of herself and her husband

A moving story in the September 7 issue of Iowa’s WCR Courier traces the troubles experienced by long-time CNA Cindy Ramer because she and her husband could not afford health insurance.

Rising medical costs forced the Ramers to file bankruptcy in 2003. Two years later, Cindy tells the paper, she lost her husband to a heart attack – and she still can’t afford to buy him a tombstone.

“It’s really a very, very sad commentary on our society when the very people that are providing care don’t have access to care themselves,” says Iowa CareGivers Association President Di Findley.

Ramer is a graduate of the 2009 Voices Institute National Leadership Program.

CNA Renee Tillman Makes News

Posted by on September 19th, 2009 at 3:02 am | Comments Off on CNA Renee Tillman Makes News
Renee Tillman

Renee Tillman

CNA Renee Tillman, a hospice worker and a contributor to this blog, was the subject of a feature story in the August 10 Killeen Daily Herald.

The article, titled “Tillman Makes a Difference in People’s Lives,” outlines the background that led Tillman into her career and the events that kept her working as a nursing assistant, though she periodically made plans to attend nursing school. “Every time I got ready to go to school, it was like our Lord guided me a different way. And I always rose up as a CNA,” she says.

The article also outlined the work Tillman has done to help professionalize direct care work, including her founding of the Texas Association for Nursing Assistants. “This is what I’m supposed to be doing,” she told the paper.

Direct Care Workers: Essential to Quality of Care and Quality of Life

Posted by on September 19th, 2009 at 2:48 am | Comments Off on Direct Care Workers: Essential to Quality of Care and Quality of Life

This blog post was adapted from a paper (PDF) published last month by NCCNHR at the request of The SCAN Foundation.

Sarah Wells

Sarah Wells

Direct care workers (DCWs) are essential to determining the quality of care and quality of life experienced by long-term care consumers. DCWs serve as a liaison to the nursing staff, reporting on the medical and emotional status of the person receiving care. They may also be the person’s key connection to the outside world.

Consider the following scenario:

You are an older adult receiving long-term care services who needs assistance with almost every aspect of your life. It is morning and you await the DCW assigned to you, who could decide the following:

  •   When and whether you get out of bed;
  •   How long you have to lie in wet pants;
  •   If you get to decide what you want to wear;
  •   Whether your teeth are brushed, your nails filed and your body washed;
  •   If the curtains are closed so that no one can see you naked;
  •   If the nurse is notified of the red spot on your heel that could easily become a bedsore;
  •   If you have enough to eat and are positioned correctly so that you will not choke;
  •   Whether the water by the bed can be reached and if there is a straw that you need;
  •   If you are taken to any morning activities;
  •   Whether you start your day hearing a few kind words;
  •   If you are rushed or relaxed; and
  •   Where you are able to call for help with a call bell or phone in reach.

Continue reading »

Direct Support Workers Launch New NADSP Affiliate

Posted by on September 19th, 2009 at 2:20 am | 1 Comment »
Shannon Gilbert

Shannon Gilbert

It’s official! The Direct Support Professionals of Indiana, better known as DSPIN, is the newest affiliate of the National Alliance for Direct Support Professionals (NADSP).

We submitted our contract agreement to NADSP on August 17. Before long, we were on their website, listed as one of their state affiliates.

But there was a lot of work to do before that happened, and there’s a lot more to be done.

I told you about our first meeting, where we had a kind of informal focus group, talking to the direct support workers and others who showed up about potential obstacles to setting up a state association and ways to get around them.

At our next meeting, we came up with our name and our first board of directors. I got elected president – I tried to give it to someone else, but they all said “No, you have to do it; you’re the one with the idea and all the information.” After that, people stepped up to fill in the slots and do what needed to be done.

There are 10 board members, and they’re all direct support professionals from around the state. I’ve never met any of them before they showed up for our meetings. In fact, I hadn’t even heard of the agencies some of them work for. That’s how distant we DSPs are from each other, most of the time. The more we work together on this, the more we share our stories and realize how much we have in common. It’s a really good peer group connection. Continue reading »

What I Told the IOM about Direct Care Workers and Swine Flu

Posted by on September 19th, 2009 at 12:43 am | Comments Off on What I Told the IOM about Direct Care Workers and Swine Flu
Jane Lipscomb

Jane Lipscomb

If you’re a direct care worker who may be exposed to people with swine flu, you should be fitted for a respirator and use it as needed to protect against becoming infected yourself. That’s what I told an IOM panel on August 20.

In a report that was published on September 3, the Institute of Medicine (IOM) recommended that health care workers use fit-tested respirators to reduce the risk of infection from swine flu.

Testifying before the IOM panel was another opportunity to explain why direct care workers should be included in the list of essential personnel who receive this protection article. This June, I made the same case in an article I coauthored for the American Journal of Public Health. Continue reading »

Poems by Direct Care Workers: In the Men’s Locker Room at the YMCA

Posted by on September 18th, 2009 at 7:48 pm | 1 Comment »
David Moreau

David Moreau

Donnie yanks his bathing suit around his knees
then forgets what he’s doing
cause he sees a guy from the Water Fitness class
taking off his suit as well.

Like a good support person, being a role model and all,
I avert my eyes and hope Donnie’s gonna do the same.
But Donnie stares right at It and points and laughs
and points down at himself and laughs some more. Continue reading »

Voices Institute Welcomes Another Remarkable Class

Posted by on September 10th, 2009 at 5:06 pm | 8 Comments »
Angel Saylor (R) with home care aide Kelvin Jefferson at a DCA focus group

Angel Saylor (R) with home care aide Kelvin Jefferson at a DCA focus group

The Direct Care Alliance’s signature program, the Voices Institute, is about to hold its second National Leadership Program. The week-long retreat is an intensive learning journey, and this year’s class is another remarkable group, which will surely join the pioneers from the VI inaugural class to leave its mark on the direct care worker movement. We are returning to the DeKoven Center, where the roots that were planted at the first Voices Institute National Leadership Program will again thrive.

This year, we are welcoming men and women who care for people of all ages in a variety of settings, including nursing homes, hospice, group homes, day programs, assisted living, and home- and community-based programs. Consistent with the DCA’s objectives to build a broadly inclusive movement of empowered direct care workers, the class of 2009 represents a wide spectrum of direct care workers. Continue reading »

Stimulus Funds Earmarked for Health Care Workforce Development

Posted by on September 9th, 2009 at 2:11 pm | Comments Off on Stimulus Funds Earmarked for Health Care Workforce Development

As recommended in a DCA policy brief published this March, the federal government has earmarked part of its economic stimulus funding for strengthening the direct care workforce. Organizations that train or provide career paths for direct care workers have until October 5 to apply for the funds, which are being granted by the U.S. Department of Labor Employment and Training Administration (DOL ETA).

About $125 million, in grants of $2 to $5 million each, will fund training, education, and job placement aimed at preparing workers to enter the health care field.

Related Materials

The DOL ETA grant description and application information

A PHI fact sheet on how to apply for the funding, which summarizes the DOL’s criteria and application process

 The DCA’s Using Recovery Act Funds to Improve Direct Care Jobs and the Quality of Direct Care Services policy brief (PDF)

Career Advancement and Supervisor Training Improve CNA Retention

Posted by on September 9th, 2009 at 1:39 pm | 1 Comment »

win a step up“It appears that the investment that North Carolina is making in quality improvement initiatives is having a positive and significant impact on nursing home performance and the stability of the nurse aide workforce,” says Workplace Interventions, Turnover, and Quality of Care Report.

The June 2009 report analyzes three workplace interventions aimed at improving turnover rates and care quality in North Carolina nursing homes:

  •   The WIN A STEP UP program. This gives nursing assistants an opportunity to advance in their careers and earn additional money by completing a 30-hour curriculum. They also commit to staying in their jobs. In addition, the program provides coaching supervision training for the CNAs’ supervisors.
  •   Culture change initiatives. 15 North Carolina nursing homes a year are granted civil monetary penalty funding to transition from medical-model care to a more homelike environment.
  •   Quality improvement collaborative. About one in five North Carolina nursing homes participate in this effort to improve reduce the rate of pressure sores and the use of restraints.

Continue reading »

Recruiting Public Housing Residents as PCAs

Posted by on September 9th, 2009 at 11:43 am | Comments Off on Recruiting Public Housing Residents as PCAs
Glenwood High-Rise

Glenwood High-Rise

A case study from the DSW Resource Center outlines a model for recruiting people in public housing buildings as personal care attendants.

Work Where You Live (PDF) describes a program in the Glenwood High-Rise, a 154-unit, mixed-population building in Annapolis. Eligible residents were both elders and younger adults with disabilities.

“Finding workers to provide services in congregate housing can be particularly challenging due to the stigma associated with public housing,” the case study notes. “Many individuals with disabilities prefer to directly hire and manage their own workers, but they often cannot afford to do so, and public funding is not always available.” The Annapolis program solved that problem while offering employment to public housing residents. Continue reading »

Real Wages Keep Falling for Personal and Home Care Aides

Posted by on September 9th, 2009 at 11:17 am | 1 Comment »

state chartbook coverAs every direct care worker advocate knows, personal and home care aides earn far too little for the important work they do. And now an updated version of PHI’s State Chart Book on Wages for Personal and Home Care Aides (PDF) gives advocates a valuable tool, proving that real wages are actually getting worse.

The chart book analyzes data from the U.S. Bureau of Labor Statistics, adjusting last year’s wages for inflation to see how their earning power compares to average wages in 1999.

Nationwide, these inflation-adjusted rates, which the chartbook calls “real wages,” have decreased by 3 percent over the past nine years, dropping from $7.50 an hour to just $7.31. Real wages increased in more than half the states during that period, but not enough to make up for their decline in the other 21.

Median wages in 2008 ranged from $7.05 an hour in Texas to $12.55 in Alaska in 2008, or real wages of $5.61 to $9.90. “Wages for personal and home care aides are so low,” says PHI Director of Policy Research Dorie Seavey, “that about 20 percent of these workers received a raise on July 24 when the minimum wage increased to $7.25/hour.”

The chartbook also compares wages to federal poverty level wages for a one-person household.

Elise Nakhnikian
Communications Director
Direct Care Alliance

Pioneer Conference is “Perfect Fit” for DCA

Posted by on September 9th, 2009 at 8:07 am | Comments Off on Pioneer Conference is “Perfect Fit” for DCA
Renee Tillman and Roy Gedat

Renee Tillman and Roy Gedat

It’s always a treat to meet the long-term care providers, advocates and other pioneers at the Pioneer Network’s annual conferences, who “get it” about the need to put the “home” back in “nursing home” – and the importance of direct care workers. So I was glad to be invited to host a session at their 9th national conference in Little Rock, Arkansas, last month.  CNA Renee Tillman, the founder and leader of the Texas Association for Nursing Assistants, met me there.

The focus of the conference was Coming together-Creating Community, and the conference organizers and presenters included direct care workers and talk about direct care worker issues throughout. It was great to be about to talk about direct care work and workers with leaders of nursing homes and other residential care facilities that are working hard to make their facilities into truly welcoming, empowering, respectful places to live and work.

I was also glad to see how many people showed up for my workshop on Developing Direct-Care Worker Leaders as Advocacy Partners. I talked about the impact activists and involved direct care staff are having, their roles in coalitions, strategies for developing meaningful partnerships between employers, workers, consumers, and advocates, and gave an overview of the issues the DCA and our National Direct Care Partnership are advocating for. Then I opened it up for a Q&A session and fielded some smart, thoughtful questions. Continue reading »

Worker Associations Plan Fall Conferences

Posted by on September 8th, 2009 at 2:53 pm | Comments Off on Worker Associations Plan Fall Conferences

NM conference cover artThe Iowa CareGivers Association (ICA), the Florida Professional Association of Care Givers (FPACG), and the New Mexico Direct Caregivers Coalition are all hosting their annual conferences this fall.

Iowa CareGivers Association

The ICA’s event, Cracking the Caregiver Code, will be held on October 9 in Des Moines. It will feature educational sessions on caregiving topics, like “The Top 10 Things to Know About Autism” and “A Crash Course in Preventing and Managing Conflict,” as well as sessions aimed at honing attendees’ self-care and leadership skills. Attendees can get free bone density, blood pressure, and body mass index screenings, and blood lipids and glucose screenings will be offered for a minimal fee. Continue reading »

ANCOR Seeks Direct Support Professionals for Technology Survey

Posted by on September 8th, 2009 at 1:08 pm | Comments Off on ANCOR Seeks Direct Support Professionals for Technology Survey

ANCOR’s National Advocacy Campaign has extended the deadline for its nationwide DSP technology survey to September 11.

The aim of the survey is to learn about how much and how well direct support professionals use certain forms of technology. DSPs who want to participate may complete the survey online.

Study Finds Home Health Aides Particularly Vulnerable to Labor Law Violations

Posted by on September 8th, 2009 at 12:59 pm | 5 Comments »

Broken Promises coverMost low-wage workers put in some unpaid overtime, but home health aides are particularly likely not to be paid, according to a new study. “Home health care workers are especially vulnerable to violations, both because of the nature of the job and because they’re not fully covered by the protections that most of us take for granted,” said Annette Bernhardt, the policy co-director of the National Employment Law Project and one of the co-authors of Broken Laws, Unprotected Workers: Violations of Employment and Labor Laws in America’s Cities.

The report is based on a survey of 4,387 workers in low-wage industries in the three largest U.S. cities—Chicago, Los Angeles, and New York City. It found that employment and labor laws are “regularly and systematically violated” in home health care and other low-wage work settings.

“More than two-thirds (68 percent) of our sample experienced at least one pay-related violation in the previous work week,” says the report’s executive summary. “The average worker lost $51, out of average weekly earnings of $339. Assuming a full-time, full-year work schedule, we estimate that these workers lost an average of $2,634 annually due to workplace violations, out of total earnings of $17,616.”

While home health aides were less likely (12%) than the average low-wage worker (26%) to earn less than minimum wage, they were more likely not to be paid extra if they put in more than 40 hours a week. Of the home health aides who had worked overtime in the previous week, 83% were not paid extra for that time, compared to 76 percent of the workers overall who had put in overtime. Continue reading »

Hanson Calls for Better Health Care for DCWs in Maine Editorial

Posted by on September 8th, 2009 at 11:26 am | Comments Off on Hanson Calls for Better Health Care for DCWs in Maine Editorial
Helen Hanson

Helen Hanson

The good news just keeps coming from Maine, where a federal grant will provide health care coverage for thousands of uninsured direct care workers and others and where direct care workers Helen Hanson and Julie Moulton have been appointed to the group that is revamping the state’s long-term care system.  On August 28, The Portland Press Herald/Maine Sunday Telegram published a strong editorial by Hanson, in which she calls for “a health care plan that meets the needs of direct-care workers and millions of other low-wage workers across America.”

Hanson applies what she has learned from her work in Maine to the national situation in her editorial, which begins by describing her struggle to find affordable health insurance for her family in the years before her husband got a job that offers health insurance. She also writes about the high rate of uninsurance among direct care workers and how it contributes to the profession’s high turnover rates. “When our family didn’t have insurance, I always feared that if I were to get cancer, I would have to give up my caregiving work and find a job that offered health coverage,” she says. “This was a choice I didn’t want to make, but it is one that faces Maine’s direct-care workers every day.”

Hanson makes the connection between a stable direct care workforce and quality care for elders and people with disabilities and lays out ground rules for insurance that would adequately cover direct care workers and other low-wage employees.

Introducing Voices Institute Trainer and DCW Brenda Nachtway

Posted by on September 8th, 2009 at 11:06 am | Comments Off on Introducing Voices Institute Trainer and DCW Brenda Nachtway
Brenda (L) with Jackie Merkel at the 2008 Voices Institute National Leadership Program

Brenda (L) with Jackie Merkel at the 2008 Voices Institute National Leadership Program

 In a few short weeks, the direct care worker movement will grow stronger and more unified when direct care workers come together in Racine, Wisconsin for the Voices Institute‘s second National Leadership Program (NLP).

The workers in this year’s class will share their stories and learn from one another. They will also learn from a training team that includes graduates of last year’s Voices Institute NLP. I’d like to introduce you to one of them, my treasured colleague Brenda Nachtway.

Brenda will be one of the first people that the class members will meet. She will welcome the class as they arrive on Sunday evening and get settled in and coordinate an evening program where the class will get personally acquainted, after long-distance exchanges on web seminars and orientation and community-building conference calls. Since she is one of the most joyful, humorous, and warm people you will ever meet, it is safe to say that the class will find a week-long home away from home in Brenda’s company. Continue reading »

DSPAM Event Celebrates Direct Support Professionals in Minnesota

Posted by on September 8th, 2009 at 9:56 am | 1 Comment »

Muhannah S. Kakish

Muhannah S. Kakish

You know how usually you get a sponsor and then create an event? Well, we created an event and then got the sponsor.

On September 13, DSPAM (Direct Support Professional Association of Minnesota) is commemorating National Direct Support Professional Recognition Week with a special day for direct support professionals (DSPs). That’s the term NADSP uses for the personal care assistants, personal attendants, in-home support workers, and other direct care workers who provide support for people with disabilities.

We started out planning to just having a picnic. Then the DCA gave DSPAM some incentive money to seed a grassroots fundraising effort, and we started to think bigger. Our idea grew into Making Changes Together (PDF), which is a full-fledged event with catered picnic food, beverages, door prizes, games for the kids, and entertainment – all free for direct support workers and their friends and families. We’ll also have free haircuts, mani-pedis, makeovers, and massages, because DSPs work so much and we wanted to do something for them. And we’ll be giving out the DSP Choice Awards (PDF) to honor five outstanding direct support workers. Continue reading »