Publications

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Workforce Analysis: Why Quality Jobs Matter Advocacy Strategies State-Based Initiatives Worker-Owned Cooperatives Teaching Tools

Recruitment & Retention Recruitment Training and Education Peer Mentoring Supervision Workplace Culture and Caregiving Practices Wages and Benefits

Wages and Benefits
	Health Insurance Vital to Job Retention Health Care for Health Care Workers, October 2007. This fact sheet reports on a growing number of studies that show a strong, positive link between health insurance benefits for direct-care workers and worker retention. Studies find that health insurance may be more important than wages in reducing turnover and increasing the supply of direct-care workers.
	Comprehensive Health Coverage for Consumer-Directed Home Care Workers; Case Study: Washington State By Ingrid J. McDonald, Health Care for Health Care Workers, March 2007. This case study describes the establishment of a Washington State multi-employer trust, which provides health benefits to home care workers. The report outlines eligibility requirements, benefits and costs of coverage, and then explores the lower than predicted enrollment rates. Many workers do not meet eligibility requirements or are eligible but unaware that coverage is available. The report concludes that while improvements can be made, the program meets nearly all design features necessary for quality coverage.
	Subsidizing Health Insurance Coverage for the Home Care Workforce in Two Wisconsin Counties: An Analysis of Option By Tameshia Bridges and Carol Regan of the Paraprofessional Healthcare Institute's Health Care for Health Care Workers initiative for The Wisconsin Regional Training Partnership, February 2007 (20 pp). This report describes a provider employer organization (PEO) in Wisconsin that makes affordable health insurance available to home care workers, calling it “a clear example of the kind of innovation that the state should support to improve recruitment and retention of direct-care workers, reduce administrative inefficiencies, and support quality care for Wisconsin’s elderly and disabled population.” It also describes the home care workforce in the two counties where the PEO operates, looks at the availability of health insurance coverage for these workers, and recommends ways to help subsidize premium costs for both employers and employees.
	Paying For Quality Care: State and Local Strategies for Improving Wages and Benefits for Personal Care Assistants By Dorie Seavey and Vera Salter. October 2006. AARP Public Policy Institute. This report examines state and local initiatives to improve wages and benefits for direct-care workers delivering Medicaid personal care services. The authors outline seven strategies -- wage pass-through legislation, rate enhancements linked to provider performance goals, updated reimbursement rates, litigation against state Medicaid agencies, collective bargaining, living wage ordinances and minimum wage improvements, and health insurance initiatives -- discussing the advantages and disadvantages of each.
	Health Insurance Coverage for the Home Care Sector: Experience from Early DirigoChoice Enrollment in Maine By the Paraprofessional Healthcare Institute's Health Care for Health Care Workers initiative in collaboration with Consumers for Affordable Health Care Foundation and the Institute for Health Policy at the University of Southern Maine's Edmund S. Muskie School of Public Service, March 2006 (28 pp). This report reviews the findings of an outreach project aimed at connecting direct-care employers and employees in Maine with DirigoChoice, an innovative state program aimed at expanding health care coverage. As a result of their research, the authors conclude: "other states experimenting with innovative health coverage plans will need to address major challenges-such as the part-time nature of direct-care work, low wages, and low reimbursement rates-to ensure coverage for these critical health care workers."
	The Facts About A Critical Gap in Long-Term Care: Caregivers Without Coverage The first in a series of policy briefs from the Health Care for Health Care Workers campaign, this four-page paper provides basic facts about the health care crisis for direct-care workers. More than one in three of these important health care workers has no health insurance, contributing to the instability of the workforce that undermines the quality of services for consumers. The brief also explains why direct-care workers lack access to health insurance and offers initial solutions for expanding coverage.
	State Wage Pass-Through Legislation: An Analysis By Paraprofessional Healthcare Institute and the Institute for the Future of Aging Services. Workforce Strategies #1, April 2003. (8 pgs.). A wage pass-through is an additional allocation of funds provided through Medicaid reimbursement for the express purpose of increasing compensation for direct-care workers. In this issue brief, the authors describe the structure of wage pass-through programs in several states; summarize what is known about the impact of these programs on recruitment and retention of direct-care workers, and identify key design elements that states should consider if they choose to implement a wage pass-through.
	Cheating Dignity: The Direct Care Wage Crisis in America By Paraprofessional Healthcare Institute. AFSCME, August 2001. (40 pgs.). This report provides a detailed analysis of how our nation fails to pay our direct-care staff "self-sufficient" wages and benefits, by comparing wages across several service sector occupations. To view comments by PHI’s President, Steven L. Dawson, presented at the AFSCME press conference announcing the report, click here.