A new DCA fact sheet answers frequently asked questions about the Affordable Care Act (ACA), the health reform act frequently referred to as Obamacare. The two-page document explains how the law is already benefiting millions of Americans and how it will help millions more-including more than a million direct care workers-after it is fully implemented in 2014.
As the fact sheet explains, “the reform makes health care more secure for low and middle-income families by increasing access to affordable care. It will also help control health care costs.” It estimates that more than 1.1 million direct care workers who would otherwise be uninsured will be eligible for health insurance after the law is fully implemented, though some will still be left without coverage if their states choose not to implement the Medicaid expansion that is part of the law. Continue reading »
Posted by Direct Care Alliance on July 24th, 2012 at 7:34 am | Comments Off on How to Strengthen Social Security and Protect Direct Care Workers
“We can strengthen Social Security without cutting benefits for the working- and middle-class people who depend so much on it,” says Shawn Fremstad, director of the Inclusive and Sustainable Economy Initiative at the Center for Economic and Policy Research (CEPR). Fremstad explains how that can be done in Caring for Caregivers in Retirement: Social Security Works for Direct Care Workers, a new issue brief from CEPR and the Direct Care Alliance (DCA).
The five-page issue brief explains why commonly discussed proposals to cut Social Security benefits —increasing the full retirement age above age 67 and reducing the annual cost-of-living adjustment (COLA) to Social Security benefits—are particularly troubling for direct care workers. It also recommends ways to improve Social Security for all workers, especially direct care workers and others in poorly compensated jobs, who face the greatest risks in retirement. Continue reading »
“The personal, often intimate nature of caregiving relationships can make it difficult to define, detect, and deter the abuse of elders and people with disabilities by the caregivers they rely on. Nonetheless, there are a number of steps that employers and policymakers can take to support good care and prevent abuse,” says No Excuse for Abuse, the ninth in a series of Direct Care Alliance policy briefs.
Arguing that we cannot reduce abuse until we understand its root causes, the nine-page issue brief looks at what we know—and what we don’t know—about how and why care recipients get abused by their caregivers. Author Elise Nakhnikian notes that the great majority of abuse appears to be committed not by paid professionals but by informal caregivers, usually close family members, and that it is often caused by “complex and stressful dynamics between caregiver and care recipient, with one party’s actions and attitudes affecting the other and creating a ‘reactive pattern or feedback loop.’”
Simply blaming and punishing those who abuse will not solve the problem, she writes. In fact, demonizing caregivers can make things worse, pushing the issue even further underground and tarnishing the reputation of an honorable profession. Continue reading »
Posted by Direct Care Alliance on June 27th, 2011 at 5:20 pm | Comments Off on By Our Sides: The Vital Work of Immigrant Direct Care Workers
Evelyn Coke was a Jamaican immigrant and an American hero. For more than twenty years, she cared for sick, elderly and dying people in their homes. She worked tirelessly, without overtime pay or health insurance coverage, while fighting to overturn regulations that exclude home care workers from basic labor protections. Her lawsuit went all the way up to the U.S. Supreme Court, although in the end the Court decided against her. Despite her decades of service to ailing people in need, when Evelyn herself became ill in the last years of her life, she could not afford a health care worker to be by her side (Martin 2009).
Evelyn’s work—and that of thousands of other immigrant direct care workers across the country—provides vital support to families struggling to assist elderly, disabled and seriously ill relatives. As the Baby Boom generation (born between 1946 and 1964) ages, more and more elderly and sick Americans will rely on these immigrant workers. Read the brief.
I have to say that it was an intimidating project, but the more I thought about it the more excited I got. Working with the DCA’s communications advisor on this toolkit has allowed me to share one of the most empowering experiences of my life. I hope we will empower other people to experience the same thing.
I’ve been part of a worker-owned home care co-op in Wisconsin for eight years, on the board for seven, and the board chair for three. Being a worker-owner has many advantages – having a voice, being heard, and owning part of a business, which includes sharing in the profits at the end of the year. The skills I have learned and the experiences I’ve had there have broadened my horizons in all kinds of directions.
Co-ops are also a good way to create stable jobs and quality care for rural communities like mine. DCA Executive Director Leonila Vega says: “Co-ops are a good way to address the shortage of qualified home care providers in rural America, not to mention the long distances and lack of contact with coworkers that makes too many rural home care workers feel isolated and alone. We hope this toolkit will help bring providers together around this model to improve access to health care for rural residents.”
I would love to see at least one worker owned home care co-op in every state of the union. If you think you might be interested in belonging to one, check out our toolkit. It lays out what’s involved in starting and operating a home care co-op and links you to the websites, experts, forms, and other resources you’ll need. And since I’m a direct care worker just like you, it’s written in down-to-earth language.
Posted by David Ward on April 6th, 2010 at 9:05 am | Comments Off on What Health Care Reform Means for Direct Care Workers and Their Families
Families and businesses across the country continue trying to understand the many ways health care reform will impact them. We’re right there with you – we want to know how employers and direct care workers will be affected by this sweeping reform. We know that it holds promise and that thousands of direct care workers will now have insurance. But every situation is different. We’ve put together a fact sheet exploring different situations and giving examples, such as:
Direct Care Worker #1—An uninsured single-parent with two children and an income of $20,500 (earning $9.84 per hour—the median wage for home health aides—and working full-time, year-round). Because this worker’s income is below 133 percent of the federal poverty line ($24,352), she or he would be eligible for Medicaid coverage starting in 2014. Some states already provide Medicaid or other public coverage to workers in this income range.
I’m thrilled to announce the Direct Care Alliance’s new national credentialing program. Thanks to a generous grant from the Ford Foundation and the support of employers, direct care workers and consumers across the country, this credential is expected to become the gold standard credential for personal care workers.
The Direct Care Alliance launched the pilot phase of the credentialing program on March 5, in Portland, Maine. Additional pilot tests have been administered in Tucson, Arizona, and by the Pennsylvania Direct Care Workers Association. Workers who complete the pilot test will be among the first to receive the credential, which meets criteria outlined by the Institute for Credentialing Excellence and will be rolled out nationwide later this year. Read the complete announcement and the fact sheet.
This week we’re happy to present the newest Direct Care Alliance Policy Brief, courtesy of Candace Howes of Connecticut College. This brief, “The Best and Worst State Practices in Medicaid Long-Term Care“, explains why Medicaid policies lead to so much variation in current state Medicaid long-term care programs.
We also explore how those policies have been used in some states to expand the range and availability of services, drawing on lessons from innovative states to suggest reforms in national Medicaid policies that would make home- and community-based services more accessible. Candace has spoken out about wage and benefit increases for direct care workers; see her short video, below.
A full set of DCA Direct Care Fact Sheets, one for each of the 50 states and the District of Columbia, is now available in the Resources section of our website.
The one-page sheets were created as a resource for direct care worker advocates and their allies, legislators, policymakers, members of the media, and others interested in direct care issues. They include key facts such as:
The number of home health aides, nursing assistants, and personal and home care aides in the state in 2006 and the projected numbers of each in 2016
The average hourly wage for the state’s direct care workers
What percentage of direct care workers in that state or region are without health insurance
Direct Care Alliance
“Federal reform is urgently needed to provide home care workers with the compensation and respect they deserve,” says Peggie Smith.
Smith, who is the Murray Family Professor of Law at the University of Iowa College of Law and a graduate of Harvard Law, is talking about a U.S. Supreme Court decision that excluded home care workers from protection under the federal Fair Labor Standards Act (FLSA). The court said the workers were providing companionship services.
She outlines two approaches the federal government could take to reverse the ruling:
1. Amend the FLSA to explicitly include home care workers; and
2. Revise Department of Labor (DOL) regulations to significantly limit the reach of the companionship exemption.
Smith recommends that the government do both, with the DOL taking immediate action to revise the companionship exemption while Congress works to reverse the impact of the Supreme Court decision by passing the Fair Home Health Care Act. Continue reading »
A new Direct Care Alliance policy brief helps direct care worker advocates, employers, educators, researchers and others make the case for investing part of the federal funding available through the Recovery Act in the direct care workforce.
DCA Executive Director Leonila Vega calls this window of opportunity “a once-in-a-lifetime opportunity.”
But that window will close in just a few weeks, once all the funds have been allocated. “Funds made available through the fiscal stimulus can do great things, but direct care advocates need to move quickly to figure out what they can use–and how. This brief offers them a terrific road map,” says labor economist Nancy Folbre, a member of the editorial committee that produced the brief.
Vega held a conference call this month with leaders of state direct care worker associations to go over a draft of the brief and discuss ways they could use it. “Nearly a trillion dollars is being sent to states by the federal government with the express purpose of stimulating the economy and building our infrastructure so more Americans join the middle class,” she says. “Let’s make sure we don’t use these funds for Band-Aid solutions, but instead for systems change programs that can help renew our economy by improving these crucial and fast-growing jobs.” Continue reading »
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