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Experts Discuss Improving Training and Employment for Direct-Care Workers

May 10, 2012

(L-R) E.J. Dionne, Marki Flannery, PHI President Steven Dawson, Laine Romero-Alston

The Aspen Institute Workforce Strategies Initiative (Aspen WSI) convened an audience of 100 long-term-care and workforce development stakeholders in Washington, D.C., on May 3, for an expert discussion on the challenges that direct-care workers face and strategies workforce development leaders can use to improve the quality of these long-term-care industry jobs.

Better Care through Better Jobs: Improving Training and Employment for Direct Care Workers, the thoughtful and lively discussion, was moderated by E.J. Dionne, a Brookings Institution senior fellow and Washington Post columnist, and featured:

  • Steven Dawson, PHI President
  • Marki Flannery, Partners in Care President, and
  • Laine Romero-Alston, Ford Foundation Program Officer.

Maureen Conway, executive director of the Aspen Institute Economic Opportunities Program, framed the conversation by explaining that 40 percent of the jobs created since 2010 are low-wage jobs and direct-care occupations are the “lowest-paid jobs” with “uncertain hours.” She asked whether poor quality, direct-care jobs had “to be that way?”

Low-Wage, Not Low-Skill Jobs

Dawson explained the employment and income characteristics (pdf) of the direct-care workforce and that personal care aides and home health aides were projected to be the first and second fast-growing occupation in the nation by 2020.

He highlighted the particular challenges of home care workers, such as working in isolation and the need to have “emotional intelligence” to navigate a client’s home and the relationships within it.

“These are low-wage jobs but certainly not low-skill jobs,” Dawson said.

Valued and Respected

Flannery reported that her agency employs 9,800 home health aides — the largest licensed home care agency in the country — and described the profile of people seeking jobs as home health aides since the economic downturn.

Partners in Care has a turnover rate of 23 percent — significantly lower than the 60 percent national average, Flannery said. She attributes her agency’s high retention rate to its training partnership with PHI.

Using the PHI Coaching ApproachSM, Partners in Care’s managers, supervisors, and aides were trained in communication techniques that made the aides feel “valued and respected,” she explained, adding that the training also led to improved worker satisfaction and better patient outcomes.

Flannery also discussed the challenges of being a “high road employer” that pays aides a decent wage while reimbursement rates from public funding and private insurers go down.

Multi-Prong Strategies

Romero-Alston spoke on the importance of using “multi-prong strategies” to both “raise the floor” of direct-care jobs and “create opportunities for career pathways.” She identified a specific barrier to a good job that needed to be overcome: the exclusion of home care workers from basic labor protections such as minimum wage and overtime pay.

Romero-Alston added that the Obama Administration has “taken great strides” over the last few months to revise the so-called “companionship exemption” through a rule change proposed by the U.S. Department of Labor.

Video and Handout Available

To watch the discussion, including audience questions, an 80-minute video is available on the Aspen Institute website along with its overview (pdf) of the direct-care workforce.

“Better Care through Better Jobs: Improving Training and Employment for Direct Care Workers” was the Aspen WSI’s second discussion this year in a series entitled, “Reinventing Low-Wage Work: Ideas That Can Work for Employees, Employers and the Economy.”

— by Deane Beebe

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