The following is a list of PAS Workforce resources related to US.
The list is provided and maintained by the National
Clearinghouse on the Direct Care Workforce. Each citation contains
an abstract and information about how to obtain the entire version.
Dawson, Steven L., and Rick Surpin. (May 2001). Direct-care health workers: The unnecessary crisis in long-term care. The Aspen Institute.
Abstract:
The authors examine the structure of long-term care, its financing, and the impact of the current labor crisis on the three key stakeholders: workers, providers, and consumers. The report recommends a sectorwide restructuring of long-term care, supported by new labor, welfare, and health care policies.
Obtain the Full Version: For information about ordering copies of this report, please contact the Clearinghouse at info@directcareclearinghouse.org or 718-402-4138.
Please note: There is a charge of $2 a copy for all orders of five or more, plus shipping and handling.
Available at the National Clearinghouse on the Direct Care Workforce website: http://www.directcareclearinghouse.org/download/Aspen.pdf
Scanlon, William J. (May 2001). GAO testimony: Nursing workforce: Recruitment and retention of nurses and nurse aides is a growing concern. General Accounting Office.
Abstract:
In testimony to Congress, the General Accounting Office (GAO) provides a comprehensive analysis of current and future long-term care staffing issues. This report includes data quantifying the shortage of nurses and paraprofessionals across all states and identifying the race, ethnicity, gender, and age characteristics of the workforce; an analysis of critical factors affecting labor, including wages, working conditions, and changing demographics; and a survey of strategies that states are using to address the current shortage of workers.
Wilner, Mary Ann, and Ann Wyatt. (September 1998). Paraprofessionals on the front lines: Improving their jobs; Improving the quality of long-term care. AARP.
Abstract:
This background paper explores the role of paraprofessionals in long-term care, highlighting the relationship between direct-care workers and their clients. After introducing basic demographic characteristics of the paraprofessional labor, the report assesses a variety of barriers to decent jobs and high-quality care, including staff shortages and high turnover; the association of caregiving with 'women's work'; inadequate supervision; and inadequate reimbursement keeping wages low. Includes an excellent list of references.
Obtain the Full Version: For information about ordering the full report,
please contact the Clearinghouse at info@directcareclearinghouse.org or 866-402-4138
Please note: There is a charge of $2 a copy for all orders of five or more, plus shipping and handling
Available at the National Clearinghouse on the Direct Care Workforce website: http://www.directcareclearinghouse.org/download/Paraprofessionals_on_the_Front_Lines_ExecSum.pdf
Noelker, Linda S. (Spring 2001). Who will care for older people? Workforce issues in a changing society. Generations.
Abstract:
The articles in this special issue describe the nature and scope of the shortage of frontline workers in long-term care and make recommendations for strengthening this workforce. The three sections of this issue outline demographic issues and policy perspectives; address the particular problems of professionals in long-term care; and examine strategies for recruiting and retaining paraprofessionals, suggesting ways to increase job commitment, lower stress, and improve performance.
Obtain the Full Version: To get a copy of this article, go to:www.generationsjournal.org
Stone, Robyn I., and Joshua M. Wiener. (October 2001). Who will care for us? Addressing the long-term care workforce crisis. The Urban Institute and the American Association of Homes and Services for the Aging.
Abstract:
This report analyzes current and future labor shortages across long-term care by analyzing factors that impact the supply and demand of direct-care workers. These factors include public policies as well as workplace culture and practices. The report also summarizes recent public and private efforts to address recruitment and retention issues and to develop a qualified, stable frontline workforce.
Rehnquist, Janet. (November 2002). Nurse aide training. Department of Health and Human Services, Office of Inspector General (OIG).
Abstract:
A study of nurse aide training conducted by the Department of Health and Human Services Office of the Inspector General (OIG) finds that nurse aide training has not kept pace with nursing home industry needs, teaching methods are often ineffective, clinical exposure is too short and unrealistic, and in-service training may not meet federal requirements. The report is based on interviews with federal and state officials and 29 nursing homes. 92 nursing aides were interviewed, 889 nurse aides completed surveys, and 17 participated in focus groups.
Dawson, Steven. (January 2003). Long term care financing and the long-term care workforce crisis: Causes and solutions. Citizens for Long-Term Care.
Abstract:
This paper examines the emerging 'care gap' in long-term care and the negative impact of staff shortages on the three primary stakeholders, consumer, providers, and workers. It recommends a national strategy--integrating both federal and state policy into a comprehensive system of long-term support and services--to address the direct-care crisis. Specific recommendations include: 1) Develop a national commitment to long-term care financing; 2) Make direct-care jobs competitively attractive by improving wages, training, opportunities for advancement, employee supports, improved use of technology, and accountability; and 3) Broaden supply by attracting younger and older workers, male workers, workers transitioning from public assistance, and new immigrants.
Department of Health and Human Services and Department of Labor. (May 2003). The future supply of long-term care workers in relation to the aging baby boom generation. Department of Health and Human Services and Department of Labor.
Abstract:
This report notes that the nation will need between 5.7 million and 6.5 million long-term care nurses, nurse aids, and home health and personal care workers to meet the needs of baby boomers by 2050. It lists a broad range of federal programs that work toward 'developing a committed and quality direct care worker pool in a variety of long-term care settings.' The report lists four issues that need to be addressed in order to retain current workers and attract new ones: 1) Finding workers in new populations 2) Conducting effective initial and continuing education and training 3) Improving working conditions in terms of hours, paperwork, respect, and safety 4) Improving compensation, benefits, and opportunities for advancement.
National Center for Health Workforce Analyses Bureau of Health Professions Health Resources and Services Administration (HRSA). (February 2004). Nursing aides, home health aides, and related health care occupations: National and local workforce shortages and associated data needs. Department of Health and Human Services.
Abstract:
This report on the growing shortage of direct-care workers notes that the supply of certified nursing assistants (CNAs) and home health aides is declining while demand is growing at a record pace. The report finds that the shortage shows no signs of improving, and that it is a matter of retention, not recruitment: the problem is high turnover due to low pay, too few opportunities for professional advancement, and other factors.
The report is based on a review of eight key federal data sets, CNA registries in 45 states and interviews and focus groups with long-term care providers and state officials in four states. The report notes the problem of developing an accurate picture of the shortage, due to data limitations including exclusions, inconsistency of definitions, and categorizations that are in some cases excessively broad.
Anderson, Wayne L., Joshua M. Wiener, Angela M. Greene, and Janet O'Keeffe. (April 2004). Direct service workforce activities of the Systems Change grantees. RTI International.
Abstract:
In 2001 the Centers for Medicare and Medicaid Services (CMS) awarded Real Choice Systems Change (RCSC) Grants to states and other entities working to improve state long-term care systems. Twenty grantees began one or more initiatives to improve the recruitment and retention of direct service workers. This report focuses on the workforce initiatives of these 20 grantees, with an in-depth look at 7. The report strongly recomends that policymakers, providers, and consumers address workforce problems.
Dorie Seavey. (October 2004). The cost of frontline turnover in long-term care. Better Jobs Better Care.
Abstract:
This report details information known about the cost of turnover among direct-care workers. The author argues that it is important to track these costs and presents a framework for measuring them. Research findings indicate that: An expanded accounting model that includes direct and indirect costs provides the most accurate estimate of turnover costs; indirect costs, which tend to be overlooked, may be substantial; and the direct cost of turnover is at least $2,500 per frontline worker. The report offers recommendations for providers, policy makers, and researchers that are designed to improve overall understanding of the costs related to turnover and the effectiveness of various strategies intended to reduce those costs.
Harmuth, Susan, and Susan Dyson. (September 2005). Results of the 2005 national survey of state initiatives on the long-term care direct-care workforce. The National Clearinghouse on the Direct Care Workforce and the Direct Care Workers Association of North Carolina.
Abstract:
This is the fifth national survey of the direct-care workforce conducted by these authors. It examines public policy actions taken by states to strengthen the direct-care workforce, and updates information collected in prior surveys. Responses were received from 38 states, representing a 76 percent response rate.
Obtain the Full Version: For information or copies contact the National Clearinghouse on the Direct Care Workforce at info@directcareclearinghouse.org or 866-402-4138 (toll-free) Available at the National Clearinghouse on the Direct Care Workforce website: http://www.directcareclearinghouse.org/download/2005_Nat_Survey_State_Initiatives.pdf
Schindel, Jennifer, et al. (2006). Workers who care: A graphical profile of the frontline health and health care workforce. Robert Wood Johnson Foundation.
Abstract:
This chart book provides comprehensive employment data on frontline health and health care workforce occupations. It includes three parts: a view of the frontline workforce as a whole; occupational variations across the workforce; and in-depth occupational profiles that provide key information such as per capita employment, occupational growth rates, reported wage gains, and other trends. Long-term care workers such as nursing aides, home health aides, and personal and home care aides are among those profiled.
Pattison, Brian T., et al. (December 2006). States' requirements for Medicaid-funded personal care service attendants. Office of Inspector General (OIG), Department of Health and Human Services (HHS).
Abstract:
This report examines state requirements for personal care attendants and policies for oversight of those requirements. It finds significant variation, with 301 sets of attendant requirements nationwide. The six most common requirements are background checks, training, age, supervision, health, and education. However, states defined these differently. Frequency and scope of the review process also varied. The report concludes that more consistency or standardization may make monitoring attendant requirements less cumbersome and enhance quality assurance.
(2007). NCSBN directory of nurse aide registries. The National Council of State Boards of Nursing, Inc. (NCSBN).
Abstract:
State contact information for nurse aide registries across the country are collected within this directory, compiled annually by the National Council of State Boards of Nursing(NCSBN).
Polzer, Karl. (March 2007). Assisted living state regulatory review 2007. National Center for Assisted Living.
Abstract:
This report summarizes the state laws and regulations that govern assisted living facilities, including requirements for staff criminal background checks and age minimums, CPR training, staff-to-resident ratios, and training requirements. It also provides contact information for each state's assisted living regulatory agency and offers brief commentary about regulations and legislation currently under consideration.
Harrington, Charlene. (January 2008). Nursing home staffing standards in state statutes and regulations. University of California San Francisco, Department of Social and Behavioral Sciences.
Abstract:
This set of charts lists the state staffing standards for nursing homes in all 50 states and the District of Columbia. It summarizes the requirements for direct-care staff, as well as for licensed staff and caregiving staff overall; estimates the difference between the state requirements and the federal standard for facilities with 100 beds; and includes links to each relevant statute and regulation.
PHI. (July 2008). State chart book on wages for personal and home care aides, 1999-2006.
Abstract:
This chart book provides information, based on data from the Bureau of Labor Statistics, on the wages received by personal and home care aides in all 50 states and the nation over a 7‐year period. The publication provides information on nominal and real median wages, a time‐series graph analyzing state wages, tables comparing wages across states, a national summary, and technical notes.
PHI. (January 2009). Who are direct-care workers?.
Abstract:
This fact sheet gives an overview of the direct-care workforce, describing job titles, responsibilities, worker demographics, wages, benefits, and the growing demand for workers.
