Printer-friendly page

A pdf version of this newsletter can be found at http://www.pascenter.org/newsletter/CenterforPASBulletinApr07.pdf

Previous newsletters can be found at http://www.pascenter.org/newsletter/index.php

Center for Personal Assistance Services Bulletin

April 2007 - Volume 4, Issue 2

In this issue:

• Center for Personal Assistance Services State of the Science Conference
• On the Center for PAS website
• Resources
• News
• Research articles and reports
• SELECTED CONFERENCES DURING April, May and June 2007

The Center for Personal Assistance Services provides research, training, dissemination and technical assistance on issues of personal assistance services (PAS) in the United States. Personal assistance services (PAS) refer to help provided to people with disabilities to assist them with tasks essential for daily living. These tasks include bathing, dressing, getting around, toileting, eating, shopping, remembering things, and other activities. PAS, along with assistive technology such as wheelchairs, text readers, and hearing aides, help people with disabilities to participate in activities at home, at work, and in the community.

The purpose of this newsletter is to provide the latest news on issues relating to formal and informal PAS, home & community-based services, the PAS workforce, and workplace PAS within and outside of the Center.

Further detail about the Center staff and advisors can be found at http://www.pascenter.org/about/

Center for Personal Assistance Services State of the Science Conference

"Meeting the Nation's Need for Personal Assistance Services: State of the Science", hosted by the Center for Personal Assistance Services at the University of California, San Francisco will be held this month on Friday, April 27, 2007 at the National Press Club in Washington, DC.

The Center is pleased to have as our keynote speaker Andrew Imparato, the President and CEO of the American Association of Persons with Disabilities (AAPD) who will be speaking about "Navigating the Washington Political Minefields" concerning policy and legislation for people with disabilities in general and personal assistance services in specific. 

The full agenda is as follows:

Meeting the Nation's Needs for Personal Assistance Services
State of the Science Conference
National Press Club, Washington, D.C.
April 27, 2007

Registration for the conference is free but space is limited so please register in advance. Registration and hotel information is available on the PAS Center website at http://www.pascenter.org/sos_conference.

The Center is funded by the National Institute on Disability and Rehabilitation Research (NIDRR) #H133B031102. In addition to NIDRR funding, the Center has received a conference grant from the Agency for Healthcare Research and Quality (#1R13 HS016608-01) to assist with the funding of the conference in Washington, DC, allow the conference to be hosted without a registration fee.

For those who cannot attend, the meeting will be webcast live on the National Press Club website as well as being archived there and on the Center for Personal Assistance Services website after the conclusion of the conference. 

On the Center for PAS website

The following are new resources available on the Center for PAS website (http://www.pascenter.org):

• Home & Community Based Services: State-only funded programs 
  This is an update of the report and data, now current through February 2007. 

  To retrieve data on these topics by state, go to http://www.pascenter.org/state_based_stats/state_only_funded.php?title=State+Only+Funded+HCBS 

• Medicaid Managed Long-Term Care: An Introduction

  To retrieve the report, go to http://www.pascenter.org/publications/publication_home.php?id=546

• Nursing Facilities, Staffing, Residents, and Facility Deficiencies, 1998 through 2005
  This is an update that has data through 2005. 

  To retrieve the report, go to http://www.pascenter.org/nursing_homes/nursing_trends_2005.php

Resources

Quality of Care Measures for Home and Community-Based Services Under Medicaid.

The Deficit Reduction Act of 2005 directs the Agency for Healthcare Research and Quality (AHRQ) to develop quality measures for home and community-based services (HCBS) offered under State Medicaid programs. As the first step to implement this legislative mandate, AHRQ is conducting a state-of-the-art environmental scan and assessment of measures and instruments that could be used, or adapted for use, in this HCBS measures development effort.

To retrieve the report, go to http://www.ahrq.gov/research/ltc/hcbs.htm

Medicaid Home and Community-Based Services: National Program Trends

Bnet.com presents a White Paper on Medicaid HCBS that was authored by PAS Center researchers. Long-Term Care (LTC) policymakers face mounting pressures to expand Medicaid home and community-based services while the cost of institutional provision continues to rise and consume the bulk of Medicaid LTC spending. This paper presents the latest program trends in the three Medicaid home and community-based services programs and reports a national survey of cost control policies used on waiver programs in 2002. The findings show slowing annual rates of participation growth on individual programs, widespread use of cost controls on waivers including waiting lists, and the persistence of large interstate variations in Medicaid's provision of these services.

To retrieve the report, go to http://jobfunctions.bnet.com/whitepaper.aspx?docid=155921 

Management Review of the Home and Community Based Services Waiver Projection Process

The Office of the Inspector General, Agency for Persons with Disabilities (Agency), conducted a management review of the internal controls surrounding the compilation process of the Home and Community Based Services (HCBS) waiver budget surplus/deficit amounts. The scope of this review did not address the technical aspects of the projection methodologies used by the Agency. The initial scope encompassed an examination of the HCBS waiver budget projections in the agency Quarterly Reports for fiscal year 2005/2006.

To retrieve the report, go to http://apd.myflorida.com/news/docs/hcbs-projections.pdf  

Family Caregiver Support: State Facts at a Glance

The National Association of State Units on Aging (NASUA) in collaboration with the National Conference of State Legislatures and funded by the U.S. Administration on Aging, has released Family Caregiver Support: State Facts at a Glance. The report provides information by state about family caregivers, the state-level programs that serve them, and legislation introduced and enacted. 

To retrieve the report, go to http://www.nasua.org/familycaregiver or  http://www.ncsl.org/programs/health/forum/caregiversupport.htm 

Issue Brief Examines Link Between Family and Paid Caregiving

A 12-page Better Jobs Better Care Issue Brief lays the groundwork for a new care giving paradigm that would acknowledge the complex connections between family and paid care giving and provide better supports for both. 

For more information, go to  http://www.directcareclearinghouse.org/n_news_det.jsp?res_id=175610&res_type=6&txn_type

News

Independent Living Centers and Relocating Persons from Nursing Homes

In his Bulletin #203, Steve Gold reported that, using a Freedom of Information request, his group obtained the number of "individuals who were successfully relocated from nursing homes"  by Independent Living Center in each State for both 2004 and 2005  In 2004, the ILCs reported that they "successfully relocated" 2,864 persons and in 2005, they reported 2,867 persons were "relocated."

To retrieve this bulletin, go to  http://www.stevegoldada.com/stevegoldada/archive.php?mode=A&id=203;&sort=D

Long Term Care Insurance Benefit Bill to Be Introduced in Senate

The Community Living Assistance Services and Supports Act (CLASS Act) is nearing introduction in the United States Senate.  Introduced originally in the previous Congress as Senate Bill 1951, the current bill has been revised and is being carried by Senator Ted Kennedy.  The purpose of the bill is to help adults with severe functional impairments obtain the services and supports they need to stay functional and independent, while providing them with choices about community participation, education and employment.  The CLASS Act will establish a national insurance program, financed by voluntary premium payments to be collected through payroll withholding and placed in a “National Independence Fund.”  The Department of Health and Human Services will manage the Fund as a new insurance program, and may enter into contractual agreements with those entities that states direct to assume administrative/program implementation roles.  

For more information, contact Connie Garner in Senator Kennedy's office.  

To see the text of the bill, go to  http://www.pascenter.org/documents/CLASSACT2007.pdf

Supreme Court to Hear Case Concerning Home Care Workers

In Long Island Care at Home v. Coke, No. 06-593, the Supreme Court will decide whether the federal Fair Labor Standards Act, which requires payment of the minimum wage and premium pay for overtime, applies to homecare workers employed by third-party agencies.

In 2003, Evelyn Coke, a home care worker employed by a home care agency that did not pay her overtime, sued her employer, Long Island Care at Home, alleging that the regulation construing the “companionship services” exemption to apply to agency employees is inconsistent with the law.

Coke argues that Congress intended to progressively expand protections for workers engaged in formalized work relationships. The Fair Labor Standards Act as passed in 1938 was not applied to domestic workers because it was believed they were not engaged in interstate commerce. The Act was amended in 1961 and again in 1966 to reach all employees, including domestics who were employed by enterprises engaged in interstate commerce. Finally, the Act was amended again in 1974 to extend coverage to domestics employed by private households.

At the same time, Congress created an exemption for "any employee employed on a casual basis in domestic service employment to private babysitting services or any employee employed in domestic service employment to provide companionship services for individuals who (because of age or infirmity) are unable to care for themselves." While the Department of Labor initially stated that Congress did not intend to exempt companions employed by third-party agencies (because it did not intend to take away preexisting coverage of such companions employed by enterprises engaged in interstate commerce), in 1975 DOL promulgated a regulation stating that companions employed by third-party agencies are exempt from coverage of the Act.

The United States Court of Appeals for the Second Circuit agreed with Ms. Coke, and refused to follow the regulations.  The Second Circuit held that it was inconsistent with Congress’ intent and also inconsistent with another DOL regulation defining the term "domestic service employment" to require employment by the household rather than by a third-party agency. The validity of the DOL’s "third-party regulation" is the issue before the Court.

Home care workers provide the assistance that people with disabilities and older adults rely on to live at home instead of an institution. Currently, there are over 1 million workers in the United States providing help with activities of daily living such as dressing, bathing, cooking, cleaning, and transferring.

The application of the “companionship exemption” to home care workers employed by third party agencies hurts efforts to build the stable, professional workforce needed to meet the growing demand for home care as the Baby boomers age and the US elderly population doubles in the coming years. The widening workforce care gap between the shrinking population of care workers (women between the ages of 25 and 44) and the growing elderly population of persons 65+ poses a significant public policy challenge for states around the country.

The Court will hear arguments in the case on April 16 and a decision is expected by summer.  As the nation’s long term care union, the Service Employees International Union offered pro bono legal services to Ms. Coke and has provided legal counsel during the appellate phases of the litigation.

For more information, go to  http://www.nytimes.com/2007/03/25/nyregion/25aides.htm (Note: New York Times requires free registration before providing articles)

Research articles and reports

Two new publications related to home care workers available

PHI has posted two new publications concerning home care workers on its homepage.  The first is a Case Study of Washington State that examines health care coverage for direct care workers in that state.

To retrieve the report, go to http://www.phinational.org/Sections/documents/CaseStudy-WA-1.pdf

The second document, a joint project of PHI and the Service Employees International Union (SEIU) Training and Education Fund, is a blue print for the future of long-term care training, support and career development. 

To retrieve the report, go to http://www.phinational.org/Sections/documents/BlueprintSEIU775.pdf

For more information on PHI, go to http://www.phinational.org/

SELECTED CONFERENCES during April, May and June 2007

April

May

June

This document was developed by the Center for Personal Assistance Services, funded by the National Institute on Disability and Rehabilitation Research (NIDDR) of the US Department of Education, grant #H133BO31102. The opinions contained in this publication are those of the grantee/contractor and do not necessarily reflect those of the US Department of Education. Please credit the source and support of federal funds.

To unsubscribe to this Newsletter, please send listserv@listserv.ucsf.edu an email from the email address you wish to unsubscribe with:

signoff PAS_NEWS
in the body of the message.