Archive for November, 2009

Stop Making it So Hard for Direct Care Workers to Stay on the Job

Posted by on November 25th, 2009 at 7:57 am | 1 Comment »
Mike Harrison

Mike Harrison

My name is Mike Harrison. I am a displaced factory worker who has found refuge in the direct care workforce.

I do what is called “in-home care” for a single quadriplegic client in his residence. It took me over two years to get the seniority to schedule myself for 40 hours a week. That leaves me 8 hours’ leeway to do emergency fill-in without accruing overtime, which my agency will pay but highly discourages. I am very fortunate to get this benefit, which I will expound on later.

In my job as a DSP (direct support professional), I cook, clean, shop, wet nurse, bathe, and take care of his dog. Basically, I fill in the gaps his spinal muscular condition creates. It’s a pleasure and a privilege to support my client, who is one of the smartest, most driven people I know. I strive to support his independent living and provide some dignity to an otherwise difficult situation.

There are many problems in the direct care world that I am immune to. My wife’s health care benefits from her job are superior and less expensive then the plan offered by agency. Without that option, I’d have to take the less desirable plan or seek another job that offers a better benefit package. Many of my colleagues across the country have no health plan offered, leaving them sick from not seeking treatment to running the risk of financial ruin by paying for pricey medical treatment. Fifty percent of the bankruptcies in this country are caused by medical bills. Continue reading »

Health Care for Health Care Workers Issues Health Care Reform Tools

Posted by on November 25th, 2009 at 7:55 am | 4 Comments »
Helen Hanson

Helen Hanson

PHI’s Health Care for Health Care Workers initiative has issued two new resources for people working to improve health care coverage for direct care workers.

Health Care Coverage for Direct-Care Workers: 2008 Update, (pdf) a brief overview of the most recent available federal data on health care coverage among direct care workers, finds that direct-care workers continued to have considerably higher rates of uninsurance than the general public under 65 years of age (26.1 percent vs. 17.3 percent) in 2008. “If direct-care workers are to rely on employer-sponsored coverage, policy makers must establish effective payment methods that build the cost of health coverage into the reimbursement rates that eldercare and disability service providers receive,” the three-page report concludes.

The other resource is a series of testimonials from five direct care workers and one employer about how they have been affected by inadequate health insurance. The first two are from graduates of the Voices Institute’s National Leadership Program: home care worker Helen Hanson and CNA Cindy Ramer.

DSW Resource Center Issues Core Competencies Bibliography

Posted by on November 25th, 2009 at 7:32 am | 1 Comment »

core competency bibliography report coverShould all new direct care workers be trained in – or tested for – the same basic set of core competencies? If so, what should those competencies be?

An annotated bibliography created by The Lewin Group for the Direct Service Workforce Resource Center summarizes current thinking about developing core competencies for all direct care workers, regardless of the setting they work in. The Direct Service Workforce Core Competencies Annotated Bibliography (pdf) includes recommendations from six state-level reports, two national studies, and the federal Retooling the Health Care Workforce for an Aging America Act.

Elise Nakhnikian
Communications Director
Direct Care Alliance

Issue Brief Offers Tips on How to Strengthen the Rural DCW Workforce

Posted by on November 25th, 2009 at 7:31 am | Comments Off on Issue Brief Offers Tips on How to Strengthen the Rural DCW Workforce

Another recent publication by The Lewin Group for the DSW Resource Center, Strengthening the Direct Service Workforce in Rural Areas, summarizes the challenges faced by the direct service workforce in rural areas. The 10-page issue brief also lists strategies rural stakeholders can use to improve recruitment and retention rates and provide higher-quality services and supports. These include:

  •   Supporting family caregivers
  •   Creating worker-owned cooperatives
  •   Offering advanced training to direct care workers through online courses and other innovative methods
  •    Improving workers’ access to transportation

Alzheimer’s Association Issues Home Care Guide

Posted by on November 25th, 2009 at 6:51 am | Comments Off on Alzheimer’s Association Issues Home Care Guide

Alz home care dementia guide coverA comprehensive manual from the Alzheimer’s Association outlines things to consider, care goals, and recommended practices for direct care workers and other professionals who care for people with dementia in their homes. The recommended practices include guidelines for assessment, suggested provider approaches and tips for modifying the environment.

Dementia Care Practice Recommendations for Professionals Working in a Home Setting (pdf) is the fourth in a series of dementia care manuals from the association. It is based on a person- and family-centered approach to dementia care, which involves tailoring care to the abilities and needs of the individual and counting family members as part of the care team.

Additional sections cover personal autonomy, home safety, end-of-life care, home care provider training, and more.

Elise Nakhnikian
Communications Director
Direct Care Alliance

Committed Caregivers Flock to New Mexico Conference

Posted by on November 25th, 2009 at 4:49 am | 1 Comment »
(L to R) Connie, Alex and me on our panel

(L to R) Connie, Alex and me on our panel

The New Mexico Direct Caregivers Coalition’s 2009 summit was our first conference – we just started our coalition this year – so we were a little nervous going into it. But by the end of the day on November 6, we all felt great.

About 125 people from all across the state got a lot out of the summit. We packed the day with educational sessions, running three at a time in four time slots, and we had some great speakers.

Our educational sessions ranged from self-advocacy to job-related skills to what caregivers need to know about technology. Topics included Affordable Health Insurance for Direct Caregivers, Dementia vs. Hearing Loss – How to Recognize when Hearing Loss is Causing the Misunderstanding, Caring for Yourself First, Family Caregivers as Advocates, and Advocating your Cause: Caregiver Advocacy 101.

I was on one of the panels, along with my fellow 2009 Voices Institute National Leadership Program graduates Connie Kreider and Alex Brandt. I talked about why we direct care workers need respect and recognition. Connie told people about the DCA, and Alex talked about our generally low wages and why they need to improve. The people who came to hear us asked a lot of good questions. Continue reading »

Pennsylania Seeking Nominations for Direct Care Worker of the Year

Posted by on November 25th, 2009 at 4:34 am | Comments Off on Pennsylania Seeking Nominations for Direct Care Worker of the Year

If you know an outstanding home care worker in Pennsylvania, you may want to nominate him or her for the state’s second annual Direct Care Worker of the Year Award.

The Pennsylvania Department of Aging is currently accepting nominations for the award. Contact Rocco Claroni at 717-772-2932 or for more information.

NCCNHR Offers Free Memberships

Posted by on November 25th, 2009 at 4:12 am | Comments Off on NCCNHR Offers Free Memberships

Direct care workers and others who care about providing high-quality care may want to take advantage of the free membership drive at NCCNHR: the National Consumer Voice for Quality Long-Term Care. Anyone who was not a member of NCCNHR in 2008 or 2009 can join free of charge through the end of this year. The free memberships will be good from January 1 through December 31, 2010.

The person who refers the most new members to NCCNHR will receive a complimentary registration to the group’s conference next year.

Making Sense of Health Care Reform: What Does it Mean for Direct Care Workers?

Posted by on November 12th, 2009 at 12:21 pm | 12 Comments »
David Ward

David Ward

Send us your questions: We figure you have plenty of thoughts and questions about this issue, so we published this update in this blog and our Direct Care News newsletter in late October, and we’ll keep updating it until a health care reform bill is passed or vetoed. If you have any questions about health care reform and how it would affect direct care worker and the people they assist, please send them to me at And if you just want to tell us what you think about this issue, please leave a comment below.

Everybody has heard a lot about health care reform, but with so many conflicting opinions about the impact that it will have on our health care system, it has been very difficult to make sense of it. The health care reform bills in the House and Senate range from about 1,000 to 1,500 pages, giving supporters and naysayers lots of material to applaud and oppose. Continue reading »

Video from the Voices Institute: Direct Talk from Direct Care Workers

Posted by on November 12th, 2009 at 12:21 pm | 1 Comment »

In this video, shot by and starring graduates of the 2009 Voices Institute National Leadership Program, direct care worker advocates speak out about why they love their work and what needs to change.

Smith Presents on Home Care Worker Rights at NELP Conference

Posted by on November 11th, 2009 at 5:58 pm | Comments Off on Smith Presents on Home Care Worker Rights at NELP Conference
David Ward

David Ward

The National Employment Law Project’s Reclaiming our Wages conference was an energizing meeting of people from universities, non-profit organizations, unions, and government agencies. What we all had in common was a commitment to strengthening the rights of workers who are often victims of injustices such as poor working conditions and wage theft.

The November 6 and 7 conference was a great opportunity to learn more about the creative approaches that some of our allies are taking to address the needs of their constituents and to build partnerships in confronting some of the common challenges that we face. One of the conference highlights was Peggie Smith’s presentation on policy and organizing strategies to address the needs of home care workers. It was very gratifying to hear her recognize the DCA and its state affiliates for our work to improve direct care jobs!

Peggie is the author of a DCA policy brief on extending wage and overtime protections to home care workers. (PDF)

David Ward
Director of Policy and Planning
Direct Care Alliance

Study Finds Lessons in Massachusetts Health Reform on How to Cover DCWs

Posted by on November 11th, 2009 at 4:42 pm | Comments Off on Study Finds Lessons in Massachusetts Health Reform on How to Cover DCWs

PHI MA study cover with borderDespite the overall success of Massachusetts’ health care reform, too many of the state’s direct care workers still cannot afford employer-sponsored health insurance, according to a new study from PHI and the Department of Public Health and Community Medicine at Tufts University School of Medicine.

According to Coverage for Caregivers: Lessons from Massachusetts Health Reform, (PDF) only one in every five direct care workers in the state have enrolled in an employer’s health care plan. Statewide, nearly three-quarters (71 percent) of working-age adults are covered through their employers.

Direct care workers often opt out of their employers’ plans because the premiums and copays are too costly. Instead, many work part-time in order to qualify for the state’s insurance plan, which costs less than most employer plans.“This disincentive to work undermines state efforts to build a quality, stable direct-care workforce,” said PHI Massachusetts Policy Director Amy Robins. Continue reading »

How Do You Find and Keep Good Caregivers? Stand Up for Their Rights

Posted by on November 11th, 2009 at 4:05 pm | Comments Off on How Do You Find and Keep Good Caregivers? Stand Up for Their Rights

Next time someone asks you how to find a good home care worker, you might try referring them to this article.

disaboom-logo copyWritten by care recipient Laura Hershey for the Disaboom Network, an online resource for people with disabilities, the article is a realistic and respectful collection of tips on how to attract and keep a caregiver. In addition to discussing where to place ads and how to word them, Hershey recommends that employers pay well if possible and offer regular raises.

She also recommends advocating for better wages, health care coverage, and other benefits for direct care workers. “Granted, this is a longer-term strategy; it’s not going to get you a new personal care attendant tomorrow,” she writes. “On the other hand, when your current personal care attendants see you advocating for their rights, they just might think they have a pretty cool boss — and that might encourage them to want to keep their job.”

Elise Nakhnikian
Communications Director
Direct Care Alliance

NCCNHR Conference Attendees Learn about Direct Care Workforce, DCA

Posted by on November 11th, 2009 at 3:40 pm | Comments Off on NCCNHR Conference Attendees Learn about Direct Care Workforce, DCA
Roy with Di Findley (L) and Diane Frerichs at the conference

Roy with Di Findley (L) and Diane Frerichs at the conference

The DCA was front and center at “Quality Care, No Matter Where,” the 34th annual conference of NCCNHR – The National Consumer Voice for Quality Long-Term Care.

In my last week as the DCA’s national advocacy director last month, I presented a workshop titled Improving the Direct Care Workforce: A Job for Consumers and Workers with Iowa Caregivers Association leaders Di Findley and Diane Frerichs.

I talked about the DCA’s advocacy agenda, initiatives with consumers and direct care workers, and our priority focus of empowering workers as activist leaders. I also talked about the need to address teh egregious conditions that direct care workers often endure when providing long-term care services. I told attendees that the DCA’s main advocacy priorities are to secure living wages, health benefits, and safer working conditions. Continue reading »

What I Learned in a Nursing Home: It’s All About Relationships

Posted by on November 11th, 2009 at 3:01 pm | 1 Comment »
Alice Li during her stay in a nursing home

Alice Li during her stay in a nursing home

I’m a third-year medical student at Mount Sinai School of Medicine. Last summer, I spent two weeks in a nursing home in Maine as part of the Learning by Living Project, where medical students are admitted to nursing homes as residents to gain insight into how it feels to be an elder in a nursing home. The observations that follow are taken from the journal I kept while I was there.

It is really amazing how much the CNAs know about the people they take care of. They are what make the medical system tick. They bring up names and stories and what the residents did that endeared them to the CNAs. They know what each resident’s preferences are. Those they really love become family, and when the resident dies, they shed tears. That is the kind of relationship that I hope I will have one day with my patients.

Yes, sometimes they are spit upon, peed upon, hated upon, but other times they are loved, appreciated, and always needed. They all have favorites. Some even have favorite floors – for many, the dementia floor, it seems. Continue reading »

Webinar, Report Relay Tips on Finding and Keeping Direct Service Workers

Posted by on November 11th, 2009 at 2:24 pm | 1 Comment »

rand_logoIf you want to find out what a CMS-funded study learned about how to improve retention rates among direct service workers, you can read a report by the Rand Corporation. Or you can sign up for a free webinar next Monday.

Sarah Hunter from RAND and Laura Steighner from American Institutes for Research will present the results of the Direct Service Workforce Demonstration grants on November 16 at 2:30 p.m. Eastern time. The webinar will be hosted by the National Direct Service Workforce Resource Center.

The Centers for Medicare and Medicaid Services awarded 10 demonstration grants in 2003 and 2004 to test the effectiveness of different workforce interventions on recruiting and retaining direct service workers. RAND’s report on their findings was published last month.

According to the report, the biggest hurdle to finding and keeping direct service workers is wages, which are too low for a job that is so challenging.

Many interventions failed because of an incomplete understanding of workers’ needs. “For example, the study found that some grantees who tried to implement health care coverage or training initiatives offered a package that did not meet the needs of the workers, thereby rendering the initiative ineffective at improving recruitment or retention,” the authors write.

Even when they failed to provide any concrete benefits, however, the attempted interventions sometimes boosted retention rates. That may mean that direct service workers are so used to being overlooked and underappreciated that they are more likely to stay when their employers make an effort to improve their jobs, even if that effort is not successful, since at least it lets them know that they are valued.

An intervention in which prospective new employees got a realistic job preview also improved outcomes, indicating that employers could reduce turnover by telling new hires more about the job before they start.

Register for the webinar

Elise Nakhnikian
Communications Director
Direct Care Alliance

Caring for Our Veterans

Posted by on November 11th, 2009 at 2:11 pm | Comments Off on Caring for Our Veterans

veterans day_iStock_000001089566XSmallWhen we talk about the need for direct care workers, we tend to focus on the growing population of elders with dementia and other age-related disorders. But a lot of children and young adults need chronic care, and their numbers are growing too.

On this Veteran’s Day, the staff of the DCA is thinking of the hundreds of thousands of soldiers who have sustained lifelong impairments in the line of duty. We honor their sacrifice – and we honor the direct care workers who help them regain and maintain their independence and quality of life.

In a piece in today’s Huffington Post, journalist Bob Woodruff, who was seriously injured by a roadside bomb while reporting in Iraq, notes that 320,000 veterans of Iraq and Afghanistan have sustained traumatic brain injuries, and nearly 20 percent will report symptoms of post traumatic stress disorder or major depression.

These wounded warriors and their families need a lot of support and assistance to heal their physical and emotional wounds and to adjust to a new way of living. We wish them luck, and we thank the direct care workers who provide much of that support.

Elise Nakhnikian
Communications Director
Direct Care Alliance

Why So Many of Us Don’t Have Health Care Insurance

Posted by on November 11th, 2009 at 12:53 pm | 4 Comments »
Don Krutsinger

Don Krutsinger

I work as a direct support professional with developmentally disabled adults in residential settings. One thing I have in common with just about all my coworkers is that we need to work more than 40 hours a week to make ends meet – and even so, too many of us can’t afford our employers’ health care coverage.

With the recent cutbacks by our state (Minnesota), most of our residential programs have cut out overtime and cut down the number of full-time positions, reducing the number of positions that receive health insurance and paid time off. That means nearly all of us have to work two to three jobs to make ends meet. Chances are, we don’t get enough hours from any one of them to qualify for health insurance. That’s a difficult, demoralizing way to live, especially for those of us who are dedicated to direct support work and have invested years of our lives in our careers. Continue reading »