Archive for ‘Maine’

Impacting Your State’s System: My work in Maine

Posted by Helen Hanson on March 4th, 2010 at 3:07 pm | No Comments »

For the complete LEAN Report, visit http://www.maine.gov/dhhs/reports/ltc-services-adults.shtml and see the last item under Direct Care Workers Taskforce Materials.

Helen Hanson

I have been working with friends and allies across the state to push the Department of Health and Human Services to present the LEAN Report.  After meeting with Senator Mitchell’s office and several others, it finally happened.

On February 24, Diana Scully, the Director of the Office of Elder Services, presented the report. She took the committee through the process we went through as part of the Lean Team and described the many issues workers face on a daily basis. We had reached consensus that the system’s seven programs should be consolidated into just three, and Ms. Scully outlined the changes that would need to take place.  She also described the recommendation on rebalancing the funding of Maine’s Long-Term Care System so that home and community-based care receives as much funding as nursing home care.

Following Ms. Scully’s presentation, Mollie Baldwin spoke. Ms. Baldwin is CEO of Home Care for Maine, one of the state’s largest employers of direct care workers in home-based care.  She expressed concern that the consumer waiting list issue was not addressed and that home-based care in Maine has never sufficiently funded. She voiced concerns that the recommendations would not lead to cost savings, but that she was not opposed to change if it meant the system would work better for elders and those with disabilities.

I then had the chance to speak and presented a letter from Maine PASA, thanks to Nicole Brown. In it, we voiced concerns that the LEAN recommendations would not be implemented – we want to ensure that this work will continue to move forward! The letter also requested comparative budgets so that we can see what the current system costs versus the recommended three-program system.  In January I’d told them that the LEAN Team had not done a budget analysis, and at this meeting I reinforced the need for a comprehensive budget.

I felt compelled during my presentation to also speak out about how important direct care has been to the elderly people I’ve worked with over the years. None of them have ever told me they’re ready to sell everything they own and go into a nursing home. After my comment, someone mentioned an AARP survey that found seven percent of elders do want to go into a nursing home. I tell you this: those 7% are not elders I’ve worked with.

This process has been an incredible experience, and the real work will begin if the Department actually begins implementation. Though some of the timelines may get pushed back, the Department is willing to start on the programs that are state funded and don’t need rules changes from CMS. I will monitor the implementation of the recommendations and look forward to continuing to work with the LEAN Team.

It is an exciting time to be a direct care worker in Maine!

Independent living & disability rights advocate takes up the case of direct care workers

Posted by Leonila Vega on February 25th, 2010 at 1:31 pm | No Comments »

On a recent trip to Maine, I sat down with Representative Matthew Peterson of District 92 to discuss his work on behalf of direct care workers in the state.  He has worked in direct care for years, and is currently an Independent Living Specialist at Alpha One, a center for independent living. As an elected official, Matthew is able to advocate for change in direct care and believes it is an essential and valuable workforce. It is inspiring and encouraging  – Matthew has linked his personal passion and commitment to independent living  to advocating the need for a well-trained, respected and well-paid direct care workforce.   Watch the brief interview I was able to record with Matthew, below. 

Imagine if more disability leaders and independent living advocates joined the Direct Care Alliance  and made their voices heard on the issues that matter.  What if, like Matthew, you could advance change in your community, your state, and eventually, across the country?  Matthew shows that we can be heard. More importantly, Matthew shows that independent living and well trained, respected, well paid direct care workers are essential to autonmy and quality of services and supports for people living with disabilities.  Most of the issues Matthew discussed in the video apply to us all. There are more than 22,000 direct care workers in Maine, and despite the fiscal crisis Matthew has kept issues like livable wage and appropriate titles on the docket. He believes that there is no better advocate than the workers and consumers, and I couldn’t agree more.

Remember – we don’t have to be elected officials to have an impact. By being involved with the Direct Care Alliance and sharing your passion with others, you can advance change.  I hope you’ll continue working with me and with your colleagues across the country to make your voices heard.

Maine Tables Report on Improving Home- and Community-Based Care

Posted by Helen Hanson on February 11th, 2010 at 4:45 pm | 3 Comments »

Helen Hanson

Well, our report is complete, but it has not yet been presented to the Legislature.

As you know if you’ve been reading this blog, I am part of a team that was appointed by the state of Maine to recommend ways that the Legislature’s Health and Human Services Committee could streamline long-term care service delivery, address equalities 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 finished our work in early January, and the report was supposed to be released later that month.

But I just learned that the Department of Health and Human Services (DHHS) has put it on the back burner instead. Continue reading »

Maine Makes Progress toward Improving Home Care Delivery

Posted by Helen Hanson on January 15th, 2010 at 12:12 pm | No Comments »

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. Continue reading »

A New CNA’s Hopes for Her Classmates

Posted by Helen Hanson on December 30th, 2009 at 9:47 pm | 4 Comments »

Helen Hanson (L) at her graduation with instructor Ida Hall

I gave this speech on December 21 to the other students in my CNA certification class. After years as a home care worker, I got my CNA certification so I’d be eligible for a wider range of direct care jobs. Our instructor asked the group to pick someone to make a speech when we graduated. The class nominated me, and I figured it would help with my public speaking skills. But speaking in front of a group is getting better for me, I must say. I wasn’t at all nervous – it actually felt good!

I want to thank the Veteran’s Administration-Togus and Augusta Adult Education for making this CNA course available. It was a grueling course of 200 hours – 50 hours more than the current state requirement. I’m grateful for the opportunity and challenge this course offered.

I want to thank Lisa Theriault and Ida Hall, our instructors, for their patience, knowledge, and expertise in the field of nursing that they have imparted upon us. Personally, I enjoyed Ida’s “old school” teaching methods and her high expectations of us. One of my high school teachers was the same way, and she’s the one that inspired me to push myself beyond my comfort zones and to do the best that I can with the knowledge I have. She’s the teacher I remember from my high school years – twenty-five-some-odd years ago.

With our graduation this evening, we now have the skills and knowledge to work as CNAs. Through this work, we all have the opportunity to make a difference in the lives of those in our care. Continue reading »

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

Posted by Alice Li 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 »

What Motivates – and Demotivates – Direct Care Workers?

Posted by Elise Nakhnikian on October 8th, 2009 at 2:03 pm | No Comments »

gerontologist cover October 2009For 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 »

Voices Institute Welcomes Another Remarkable Class

Posted by Bridget Siljander 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 »

Real Wages Keep Falling for Personal and Home Care Aides

Posted by Elise Nakhnikian on September 9th, 2009 at 11:17 am | No Comments »

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

Hanson Calls for Better Health Care for DCWs in Maine Editorial

Posted by Elise Nakhnikian on September 8th, 2009 at 11:26 am | No Comments »
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.

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