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Service Use and Transitions: Decisions, Choices and Care Management among an Admissions Cohort of Privately Insured Disabled Elders
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Author(s): Marc A. Cohen, Jessica S. Miller and Xiaomei Shi |
Organization(s): LifePlans, Inc. |
The purpose of this study is to obtain a comprehensive demographic, health and attitudinal profile of individuals with private long-term care (LTC) insurance policies at the time that they begin using paid LTC services in their current service setting. The authors also seek to understand the factors involved in the decision about how and why to use paid services in particular care settings (i.e., the home, assisted living or nursing facilities). Equally important, the authors wish to understand how and why people transition between care settings throughout the course of their disability and also assess the role of care management in the process. In order to do this, the authors focused on an admissions cohort of LTC claimants and traced their experience and service utilization over time and in multiple settings. That is, they completed in-person interviews with LTC insurance policy holders at or near the time they began using paid services (in either a residential care setting or the community) and then followed them telephonically over a roughly two year period. For the purposes of this report, the authors only discuss findings from the initial in-person interviews. [61 PDF pages] |
Published: December, 2006 |
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An Introduction to the National Nursing Assistant Survey
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Author(s): Marie R. Squillace, Robin E. Remsburg, Anita Bercovitz, Emily Rosenoff and Laura Branden |
Organization(s): Office of the Assistant Secretary for Planning and Evaluation, National Center for Health Statistics, Westat |
The National Nursing Assistant Survey is sponsored by ASPE; its design and fielding were made possible through collaborations with two independent research organizations and a sustained partnership with the National Center for Health Statistics (NCHS). As the first in a series of papers produced by ASPE and NCHS, this report highlights relevant research that led to federal interest in sponsoring this survey, provides a comprehensive overview of the procedures undertaken, describes the advantages of combining establishment and worker surveys, and highlights the potential uses of these data. Subsequent papers will report on survey findings to inform improved planning, decision-making and policy development. [70 PDF pages] |
Published: September, 2006 |
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Ensuring a Qualified Long-Term Care Workforce: From Pre-Employment Screens to On-the-Job Monitoring
(Report)
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Author(s): Lewin Group |
Organization(s): Lewin Group |
In an effort to improve the quality of care provided in long-term care settings, as well as ensure a committed and qualified long-term care workforce, ASPE contracted with The Lewin Group to study the efficacy of various approaches to pre-employment screening and on-the-job monitoring of nurse assistants to prevent resident abuse in nursing homes. This study is intended to inform policymakers, providers, consumers and other interested parties about the relative contributions and perceived effectiveness of existing federal mandates and state and provider based strategies for preventing or reducing the abuse of vulnerable adults. [93 PDF pages] |
Published: May, 2006 |
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The Supply and Demand of Professional Social Workers Providing Long-Term Care Services: Report to Congress
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Author(s): Department of Health and Human Services, Department of Veterans Affairs and Department of Labor |
Organization(s): Office of the Assistant Secretary for Planning and Evaluation |
This report discusses the current and future availability of professional social workers in long-term care settings. Recommendations for addressing any identified future shortage areas, including cooperative strategies involving federal agencies, professional associations, and school of social work are also addressed. [31 PDF pages] |
Published: March, 2006 |
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The Supply of Direct Support Professionals Serving Individuals with Intellectual Disabilities and Other Developmental Disabilities: Report to Congress
(Report)
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Author(s): Department of Health and Human Services |
Organization(s): Office of the Assistant Secretary for Planning and Evaluation |
In 2004, Congress requested that HHS conduct a study on the shortage of direct support professionals (DSPs) supporting persons with intellectual disabilities and other developmental disabilities (ID/DD), including an examination of the root causes associated with high vacancy and turnover rates, and an examination of the impact this shortage may be having on services for people with ID/DD. This report is a product of collaboration between many offices within HHS in response to the request from Congress. Staff throughout the Department worked collaboratively to share information and data pertaining to DSPs. The results of these efforts are presented in this unified Report to Congress. [69 PDF pages] |
Published: January, 2006 |
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Linking TANF Recipients with Paraprofessional Long-Term Care Jobs
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Author(s): Jacqueline Kauff, Gretchen Kirby and LaDonna Pavetti |
Organization(s): Mathematica Policy Research |
This brief is based on Mathematica's study of Temporary Assistance for Needy Families (TANF) recipients as long-term care (LTC) workers. The study examined the suitability of TANF recipients for employment as certified nurse aides and home health aides and the feasibility of training recipients for these paraprofessional jobs. The authors used two data sources: (1) a survey of single-parent TANF recipients in three states and the District of Columbia; and (2) in-person visits to five programs that train TANF recipients and other low-income individuals for these jobs. The study shows that more than half of those on the TANF caseload have the potential to succeed in paraprofessional LTC jobs and that there are many different ways to design and implement successful LTC training programs for TANF recipients. [8 PDF pages] |
Published: March, 2005 |
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TANF Recipients as Potential Long-Term Care Workers: An Assessment of the Prospects in the District of Columbia, Illinois, Maryland and South Carolina
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Author(s): Gretchen Kirby, LaDonna Pavetti, Jeffrey Max and Jesse Gregory |
Organization(s): Mathematica Policy Research |
The LTC industry's need for workers and TANF recipients' need for jobs could be mutually beneficial if, indeed, recipients' characteristics, skills, and circumstances match the requirements, accessibility, and availability of LTC jobs. In this paper, the authors provide a brief overview of what is already known about the characteristics of long-term care jobs and the individuals who hold them, focusing on nurse aides and home health aides. They use survey data from the District of Columbia and three states (Illinois, Maryland and South Carolina) to examine the characteristics and circumstances of all single-parent TANF case heads, and of those recipients who are or have recently been employed in the long-term care industry. Finally, the authors use multivariate analysis to predict the likelihood of employment among current TANF recipients and use the results to estimate the proportion of the current TANF caseload that could potentially be employed in the long-term care industry and describe their characteristics. They conclude this paper with a brief discussion of the potential policy and/or program initiatives that this analysis suggests. [82 PDF pages] |
Published: March, 2005 |
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Training TANF Recipients and Low-Income Populations for Long-Term Care Paraprofessional Jobs
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Author(s): Jacqueline Kauff |
Organization(s): Mathematica Policy Research |
The LTC industry's need for workers and TANF recipients' need for jobs could be mutually beneficial if (1) the characteristics of TANF recipients are well-matched to the requirements of the paraprofessional jobs in demand; (2) available LTC jobs offer the hours and pay that TANF recipients need to move toward self-sufficiency; and (3) workforce development programs can create routes to the LTC industry that are accessible, attractive, and easily navigable for TANF recipients. In an effort to assess the suitability of TANF recipients for such jobs and the feasibility of training recipients for such jobs, ASPE contracted with Mathematica Policy Research, Inc., to conduct the Study of TANF Recipients as Long-Term Care Workers. An earlier report from the study presented findings on the suitability of TANF recipients for employment in the LTC industry based on analyses of administrative data from three states and the District of Columbia and concluded that over half of the TANF caseload meets the basic requirements for LTC jobs. This report presents findings from a qualitative analysis of five programs that train TANF recipients and similar low-income populations for paraprofessional jobs in the LTC industry to assess the feasibility of and challenges embedded in such efforts. |
Published: January, 2005 |
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Recent Findings on Frontline Long-Term Care Workers: A Research Synthesis 1999-2003
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Author(s): Lauren Harris-Kojetin, Debra Lipson, Jean Fielding, Kristen Kiefer and Robyn I. Stone |
Organization(s): Association of Homes and Services for the Aging |
The purpose of the synthesis paper is to review, summarize, and discuss the significance of available research findings on the frontline long-term care (LTC) workforce since 1999, in both home and community-based and nursing home settings. This paper provides an updated review of the status of empirical findings, focusing on what has been learned between 1999 and 2003. The primary goal is to learn what initiatives have worked to reduce LTC direct care workforce recruitment and retention problems. A secondary goal is to provide empirically-based insights on the factors that contribute to recruitment and retention problems. This paper is intended to help policymakers, providers, worker and consumer groups, and researchers create a framework for future evidence-based policy, practice, and applied research initiatives to address LTC direct care workforce shortages. [36 PDF pages] |
Published: May, 2004 |
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Recruiting and Retaining a Quality Paraprofessional Long-Term Care Workforce: Building Collaboratives with the Nation's Workforce Investment System
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Author(s): Michael E. Fishman, Burt Barnow, Asaph Glosser and Karen Gardiner |
Organization(s): Lewin Group |
This paper provides the fundamental context of both the long-term care sector and the workforce investment system in order to build understanding among members of each system. It is not intended to be comprehensive but to provide enough information to stimulate dialogue. Section II briefly describes the characteristics of the long-term care paraprofessional workforce. Section III outlines the growth in the long-term care sector. Section IV discusses workforce shortages from an economic perspective and why they exist in the long-term care sector. Section V describes the response of the long-term care sector to the shortage of paraprofessionals. Section VI describes the Workforce Investment Act (WIA) and the role of the workforce system. Section VII provides some examples of workforce investment initiatives in the long-term care sector. Finally, Section VIII presents some opportunities for collaboration. [24 PDF pages] |
Published: May, 2004 |
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