Lindsay Short
I am honored to have been elected president of the Direct Support Professional Association of Minnesota as of next year.
Being a part of DSPAM over the last two years has been an eye-opening, life-changing experience. I’ve had the opportunity to work with amazing people on the DSPAM board of directors, and I’ve watched DSPAM turn into an amazing organization, overcoming many milestones and accomplishing many of its goals.
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 »
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 dward@directcarealliance.org. 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 »
Next time someone asks you how to find a good home care worker, you might try referring them to this article.
Written 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
If 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.
Elise Nakhnikian
Communications Director
Direct Care Alliance
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 »
David Moreau
Ellie’s reading the community college brochure
and talking about becoming a CNA or a PT assistant,
complaining to Gina how long it takes,
Just to make fifteen bucks an hour
instead of ten oh nine.
Extra money for cigarettes and tattoos,
I tweak them. I can be an asshole, I know.
It’s more than that really. It’s having enough
to buy oil for the winter or bring your kids
to the doctor.
Of course she wants the government to pay
and remains convinced it’s the Somalians
in Tall Pines or the girl down the street on AFDC
taking all the tax money. I’m always arguing
she’s got it wrong. It’s the rich who cost
more than the poor.
For an academic but accessible take on what motivates – or demotivates – direct care workers, check out this month’s issue of The Gerontologist. The main focus is a section titled Direct Care Worker Job Satisfaction and Retention, which includes four reports on the factors that make direct care workers like or dislike their jobs.
“Intrinsic Job Satisfaction, Overall Satisfaction, and Intention to Leave the Job Among Nursing Assistants in Nursing Homes” reports that nursing assistants who feel supported by their supervisors and satisfied with their pay are likeliest to be satisfied with their jobs. “Other job characteristics, such as the workload structuring the time to assist residents with ADLs, also seem important aspect of NAs’ work experience [that are] amenable to change,” note authors Frederic H. Decker and colleagues.
In “Nursing Home Work Practices and Nursing Assistants’ Job Satisfaction,” Christine E. Bishop and colleagues analyze data from the recently released 2004 National Nursing Assistant Survey, finding that workers are more satisfied when they earn higher wages, get paid personal leave and sick days, and have enough time to complete their work (that last point is also associated with higher staffing levels). Also associated with higher satisfaction are feeling respected and valued by employers, having good relationships with supervisors, having challenging work, not being subjected to mandatory overtime, and working in a home where food is not delivered to residents on trays. Continue reading »
From Home Care Workers: Keeping Granite Staters in Their Homes as They Age.
As Terry Lynch pointed out in his most recent blog post, the popular – and federally mandated – trend of using Medicaid to pay for less nursing home care and more home care cannot continue unless states can attract and keep more home care workers. A pair of recent papers from New Hampshire looks at just what that means for the state of New Hampshire.
In Home Care Workers: Keeping Granite Staters in Their Homes as They Age, (PDF) Kristin Smith of the University of New Hampshire’s Carsey Institute profiles home care workers. The 12-page policy brief provides a demographic and economic overview of the state’s licensed nursing assistants, personal care service providers, personal care assistants (PCA), and homemakers and companions. It also discusses the implication of low pay and high turnover among direct care workers for those who rely on their services. Continue reading »
“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:
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