A planning session with (L to R) Vicki Purgavie of Home Care & Hospice Alliance, Diana Scully and Doreen McDaniel from DHHS, me, Leo Delicata of Legal Services for the Elderly, and Louise Olsen from the University of Southern Maine, Muskie School
As I explained in an earlier blog post, Maine is putting four pieces of legislation that would affect the home- and community-based part of Maine’s long-term care system — including its direct care workers – through a LEAN process. The aim of the process is to make service delivery more efficient, address inequalities in the services provided, and hopefully gain some cost savings, which can be passed on to workers in the form of livable wages and benefits such as paid time off and health care coverage. We’ve made a lot of progress toward that goal in the last few weeks.
Two direct care workers, Julie Moulton and I, were appointed to the core team that will lead the process of coming up with a plan for a streamlined system. Another direct care worker, Cathy Bouchard, became an alternate, stepping up when Julie was unable to stay on the team. I am also part of a Direct Care Workers’ Task Force that was put together to recommend changes for the issues directly affecting home care workers. This is the first time workers have been involved at this high a level of working on system change in Maine.
The core team started our work by mapping out the system’s current state, so we could identify duplications and inefficiencies. Then we mapped out our new proposal. From that map, we developed the implementation plan, identifying areas that need changing and streamlining the system into three programs instead of seven.
Our implementation plan has an aggressive timeline, which was driven by the legislation. Now it’s time for the real work to begin.
Some of that work centers around seven activities affecting direct care workers, which have been identified by members of the Maine PASA Leadership Council. The Direct Care Workers’ Task Force has already addressed those issues and recommended changes. Our recommendations will be part of the report that goes back to the legislature.
The workers on the task force are Dee Dee Strout, Ted Rippy, Cathy Bouchard, Joyce Gagnon and me. All five of us are members of Maine PASA, three are graduates of the Voices Institute National Leadership Program, and three are members of Local 771 of MSEA-SEIU.
The seven areas we addressed, which are all currently proposed as part of the LEAN implementation plan, are:
- Create a single, inclusive title for home care workers. We currently have too many different titles for people who do essentially the same work but in different settings or with different types of clients. That makes it hard to gather statistics on the workforce. It also makes it harder for workers to move from one setting to another, and contributes to the pay inequities that give some direct care workers much better pay and benefits than others.
- Encourage workers to work together as a team for the consumer, providing coverage for each other as needed.
- Provide higher incentives for home care workers, including better pay and benefits, mileage reimbursement, pay differentials for nights/weekends, and raising wages to $12/hour across all programs
- Make it easier for workers to pick up more hours elsewhere when someone they were caring for goes into the hospital or nursing home and no longer requires their services
- Enhance opportunities for all direct care workers to receive training, making it easier for workers to access and afford the training they need
- Review training requirements and identify ways to make sure they are adequate, more consistent, and appropriate across program/modes of service and types of workers.
- Provide training for clients and direct care workers on how to use specialty equipment (mechanical lifts, oxygen apparatus, etc.)
The Workers’ Task Force met four times. After the first meeting, we workers met on our own with DHHS, with no providers present. We talked about issues that we face in our day to day work and gave the department feedback on some of its current policies, talking about what worked and what didn’t. This was our chance to shine – and to talk freely without fear of reprimand from employers.
DHSS also set aside time to talk with us after the second December meeting. No issues came up, but I thought that was a good gesture on their part. As I mentioned, workers have not been involved at this level of policy making before, as far as I know, so this was a rare opportunity for us to talk directly with DHHS staff.
At our last meeting, on January 4, the task force fine-tuned our report to the legislature. I am not at liberty to reveal our recommendations until the report is released, but I can tell you that they’re good. We got at some of the key issues faced by consumers, workers and providers in Maine.
We also talked about how to make sure our recommendations turn into real changes to the system. I learned that something new about why this won’t be easy. It turns out that several state agencies have jurisdiction over our workforce – not just DHHS but the Department of Labor, the Department of Education (because of CNA training), and the Board of Nursing – and the different departments sometimes have conflicting interests or goals.
DHHS is now preparing the report from us all, which will go to the Maine legislature this month. This is a very exciting time for Maine PASA, Local 771, and the workers we are advocating for.
Related materials
Helen Hanson, CNA
Graduate, 2009 Voices Institute National Leadership Program
