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Matching Service Registries Hold Promise for People Seeking Home Care Aides, Study Finds — April 21, 2011

April 21, 2011

For Immediate Release
April 21, 2011

Registries Could Help States Meet CLASS Plan's Workforce Infrastructure Requirements

Bronx, NY — Matching service registries — which help link people who want to self-manage their home care to compatible personal care aides — could prove to be a valuable building block under the CLASS Plan, according to a new PHI study, which is the first to focus on the workforce issues raised by the new voluntary long-term care insurance program created under national health reform.

CLASS (Community Living Assistance Services and Supports) requires states to ensure "adequate infrastructure for the provision of personal care attendant workers."

"The legislative framers of CLASS were clearly concerned with creating a sufficient supply of home care workers and with adequate infrastructure to meet new demand," says PHI Director of Policy Research Dorie Seavey, Ph.D., one of the authors of the study. "Given that many elders and people with disabilities prefer to manage their in-home care themselves, this begs the question of how consumers and workers are literally going to find one another, with or without CLASS."

In Building Infrastructure to Support CLASS: The Potential of Matching Service Registries (pdf), Seavey and Abby Marquand, PHI policy research associate, report on state efforts to create matching service registries — dynamic search platforms that allow consumers in need of a worker to tap into an up-to-date bank of available workers.

For consumers and workers who prefer not to use home care agencies, the default is to fend for oneself, relying on word-of-mouth, posting ads, or perhaps putting a notice in a church or synagogue bulletin. This works fine for some, but not others, according to the study authors.

"Creating a more adequate supply of personal care aides to meet demand and to alleviate burdens on family caregivers is extremely important," Seavey says, "but that's not enough. We also need more effective and efficient mechanisms for deploying these aides in millions of consumer homes on a daily basis. And we need to create access to high-quality, supportive resources like training and peer mentoring for both self-directing consumers and independent providers."

Findings from State-by-State Study of Matching Service Registries

The new 50-state study identified 16 publicly funded, state-based matching services registries and six additional ones that are regionally based [see map]. Two-thirds of states lack matching service registries.

While all of the state-based registries are designed to accommodate consumers who need personal care services under specific Medicaid programs, 13 states allow private-pay consumers to access the registries, and nine of those give private-pay consumers access to the registry at no charge.

The matching service registries described in the study allow consumers to search for workers by geographic location, and most allow consumers to search by availability of workers with respect to day and time.

The most robust services also offer search criteria, such as the experience, education, and training of workers, and their access to transportation.

A small number provide additional services, such as access to training opportunities for both consumers and workers, in an effort to address quality of care.

Recommendations for Leveraging Matching Service Registries

The study concludes that matching service registries in general are still in their infancy but that their role and potential is compelling. "There's a lot of room to bring matching services registries to scale and there is some exciting work going on around the country," Seavey says.

One of report's recommendations is that public/private partnerships be explored to create sustainable financing structures for registries. Right now, registries in Michigan (Michigan Quality Community Care Council) and Wisconsin (Wisconsin Quality Home Care Commission) may be eliminated due to budget cuts and changes in state leadership.

More broad-based financial support for registries could be drawn from a variety of entities, according to the authors, such as corporations interested in providing supports to employees who are caring for aging parents, and hospitals and nursing homes invested in supporting successful care transitions back to people's homes and preventing re-hospitalization.

More information about the potential of matching services registries for consumers who choose to direct their own home care services and supports, as well as considerations for building more robust registries when the CLASS Plan is implemented, is available in Building Infrastructure to Support CLASS: The Potential of Matching Service Registries (pdf).

The issue brief was made possible with support from The SCAN Foundation and is part of a series of Technical Assistance Briefs that address key issues for successful implementation of the CLASS Plan.

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PHI ( is a national nonprofit working to improve the lives of people who need home and residential care — and the lives of the workers who provide that care. Our goal is to ensure caring, stable relationships between consumers and workers, so that both may live with dignity, respect, and independence.

The SCAN Foundation is dedicated to creating a society in which seniors receive medical treatment and human services that are integrated in the setting most appropriate to their needs. For more information, please visit

Deane Beebe, PHI Media Relations Director

718.928.2033 (office); 646.285.1039 (cell)

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