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PAS Workers and Caregivers 
About this project
This project concerns the PAS workforce, the people that provide the Personal Assistance Services. These workforce individuals are referred to by many names, including caregivers, personal care attendants, personal assistants and direct care workers. They may provide these services free of charge (informal PAS) or be paid (formal PAS); they may also be friends or family.
To help support individuals with disabilities, a larger and better prepared PAS workforce is required. In order to provide this, a better understanding of the PAS workforce is needed, along with assessments of existing workforce development interventions.
The PAS Center's workforce projects will continue the existing research of the PAS Center, studying the needs and unmet needs of formal and informal caregivers and developing tools and strategies for improving the retention of care workers.
- Develop tools and supports for unpaid caregivers that reflect the changing needs of caregivers as they age.
- Develop health promotion and education tools, supports and interventions to improve the health of caregivers and PAS users on health promotion. Study conducted by Robert Newcomer, Susan Chapman, and Mel Neri.
- Examine the needs of children and family caregivers and the impact of family caregiving on employment. Study conducted by Amy Houtrow.
- Analyze the needs and supports for aging minority caregivers. Study conducted by Anna Napoles and Letha Chadiha.
- Examine the kinds of assistance individuals received and the amount and type of caregiving provided by family and friends over time and the consequences of caregiving. Study conducted by Joseph Mullan.
- Develop strategies that lead to a PAS workforce that is geographically diverse and maximizes recruitment, retention, compensation and benefits, professional training, development, and networking.
- Monitor and analyze PAS workforce trends and demographics. Study conducted by Stephen Kaye.
- Analyze state geographic differences in workforce availability. Study conducted by Stephen Kaye.
- Identify and track state strategies to improve the PAS workforce and evaluate the effectiveness of state efforts. Study conducted by Dorie Seavey and Radha Biswas at PHI.
- Identify and evaluate interventions and labor resources, such as job training services that help to improve workforce capacity of PAS providers.
- Identify and evaluate states strategies and training requirements to improve the PAS workforce. Study conducted by Dorie Seavey and Radha Biswas.
- Train workers and PAS users on safety and injury prevention. Study conducted by Robert Newcomer, Susan Chapman, and Mel Neri.
- Participate in and evaluate a collaborative community training program for PAS workers. Study conducted by Susan Chapman.
Promising Programs
The National Clearinghouse on the Direct Care Workforce has produced a database that includes profiles of programs implemented by service providers, educators, and worker and community organizations to improve the recruitment, training, and retention of direct-care workers across the spectrum of facility- and home- and community-based long-term care services. These practice profiles were researched and written by staff of PHI and the Institute for the Future of Aging Services (IFAS).
PHI and IFAS identified the practices through conversations with experts around the country and through broad distribution of a call for nominations. Those selected for inclusion have been in place for at least six months and can provide some quantitative or qualitative evidence of their results.
Go to the Workforce Best Practices Database.
Caregiver Resources
In an effort to provide helpful training tools and programs for caregivers, here you will find listings of various resources. These listings include family and professional caregivers resources, consumer-directed caregiving resources, and self-care resources for people with disabilities. Various information is included with each resource, such as cost, where available, evidence-based results, and the content of the materials. Many of these products are free and available on the web; others may have costs associated with them.
Check back periodically for updates to these lists.
State legislation regarding wages and benefits. Thirteen promising practices.
Home and personal care workers for Medicaid personal care services programs earn considerably less than their counterparts who are direct support workers or work for home health agencies and assisted living facilities. Even with differences between different types of home care workers (and whether they work for private agencies or state personal care programs), there can be variation in hourly rates by state and county. One method of increasing wages and benefits of home care workers is by legislation
In this report we focused on promising examples of state legislation seeking to specifically increase the hourly wages or benefits of home, direct or personal care workers. The final list of promising practices consists of 11 bills and 2 legislative appropriations (LA and WY) from 2001-2007. Seven of the 13 bills or legislative appropriations considered ‘promising practices’ (AK, DC, LA, MI, NH, NY 2001-02,WY) increased wages for workers and six (ME, MA, MT, NY 2007-08, WA 2006, WA 2004) related to collective bargaining agreements/insurance coverage.
Go to the Thirteen Promising Practices report.
National Clearinghouse on the Direct Care Workforce
The National
Clearinghouse on the Direct Care Workforce tracks national and state
policies that relate to the PAS workforce. This includes a national
survey of state workforce initiatives and information on recruitment,
training, mentoring, career advancement, management and supervisory
training, workplace culture and caregiving practices, wages and benefits,
worker supports and other valuable information. Information on innovative
programs considered to be "best practices" can be found in
the
Practice Profiles section of the Direct Care Clearinghouse web site.
Successful strategies for recruiting and retaining direct service workers (CMS)
CMS Issues Progress Report on Grantees
Updates on the progress of the 2006 Centers for Medicare and Medicaid Services' National Direct Service Worker (DSW) Resource Center grantees outline 10 successful strategies for recruiting and retaining direct service workers.
Among the initiatives described are:
- Recruitment and training of people with disabilities and people 55 and older to work as DSWs in Arkansas;
- A realistic "job preview" video made in Delaware;
- An effective candidate screening tool in Kentucky; and
- Initiatives to increase the number of workers with health coverage in participating home health agencies in Maine.
The full report is available online.
 State
by State Workforce Data and Resources Available
PAS Workforce Library
Contains citations to resources related to each state.
The library 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.
Number of Home and Personal Care Workers by State
The Center for PAS has tabulated, by state, estimates of
the number of PAS workers and workers per persons with self-care difficulty.
Workforce Development Projects in Personal Assistance Services
More than 100 recently funded and currently funded research and demonstration
projects to expand and improve the Personal Assistance Services workforce
in the U.S.A. can be searched by state, category, and major federal, state,
or foundation initiative. (updated 1/20/05)
PAS Center Reports and Publications
A list of publications produced by the PAS Workforce project. The citations
provide links to abstracts, press releases, and either the entire publication,
or information about where to obtain it.
All PAS Center reports and publications related to Workforce PAS
Recent additions:
Solovieva, T.I., Walls, R.T., Hendricks, D.J. & Dowler, D.L. Cost of workplace accommodations for individuals with disabilities: With or without personal assistance services. Disability and Health Journal, Volume 2, Issue 4, October 2009, Pages 196-205
View Abstract and Obtain Full Version Paraprofessional Healthcare Institute. (October 2009). Pennsylvania’s Direct-Care Workforce: State Facts. Bronx, NY.: Paraprofessional Healthcare Institute.
View Abstract and Obtain Full Version Paraprofessional Healthcare Institute. (October 2009). New York City’s Home Care Workforce: State Facts. Bronx, NY.: Paraprofessional Healthcare Institute.
View Abstract and Obtain Full Version
Library
Citations and abstracts of important publications related to Home and
community-based PAS. Information on how to obtain the complete text is provided with each citation.
All PAS Workforce publications
Recent additions:
Anderson, G. (February 2010). Chronic Care: Making the Case for Ongoing Care. Princeton, NJ: Robert Wood Johnson Foundation.
View Abstract and Obtain Full Version Wallace SP, Padilla-Frausto DI, Mendez-Luck CA, Benjamin AE, Durazo E, Pourat N. (February 2010). Budget Proposals Turn Back Clock 30 Years in Long-Term Care Services for California Seniors. Los Angeles, CA: UCLA Center for Health Policy Research.
View Abstract and Obtain Full Version Solovieva, T.I., Walls, R.T., Hendricks, D.J. & Dowler, D.L. Cost of workplace accommodations for individuals with disabilities: With or without personal assistance services. Disability and Health Journal, Volume 2, Issue 4, October 2009, Pages 196-205
View Abstract and Obtain Full Version
Presentations
Presentations given by the PAS Workforce project
All PAS Workforce presentations
Recent additions:
Wiener, J.M (2009, March 9). Long-Term Care: Options in an Era of Health Reform. Presented at the Alliance for Health Reform Session on Long-Term Care hosted by Alliance for Health Reform.
More information
Scherzer, T. (2006, November 7). How do diverse homecare workers address occupational hazards and injury?. Presented at the American Public Health Association 134th Annual Meeting and Exposition hosted by APHA.
More information
Newcomer, R., Scherzer, T. (2006, November 7). Who counts? On (not) counting occupational injuries in homecare. Presented at the American Public Health Association 134th Annual Meeting and Exposition hosted by APHA.
More information
Links
The Center for PAS has assembled a list of links to organizations,
resources and information available on the web related to PAS Workforce.
All PAS Workforce links
Recent additions: Caring for a Person with Alzheimer's Disease
http://www.nia.nih.gov/NR/rdonlyres/6A0E9F3C-E429-4F03-818E-D1B60235D5F8/0/100711_LoRes2.pdf This guide is for people who care for family members or others with Alzheimer's disease (AD) at home. Includes information about how AD changes a person; coping with these changes; helping family and friends understand AD; making your home safe for the person with AD; and managing everyday activities like eating, bathing, dressing and grooming. Disability.gov
http://www.Disability.gov Disability.gov, is a redesigned federal Web site that connects more than 50 million Americans with disabilities to thousands of trusted resources on disability-related issues, programs and services. Formerly known as DisabilityInfo.gov, the site has been completely redesigned and updated with new social media tools, such as a blog and a Twitter feed, to encourage feedback and interaction among visitors. Disability.gov is not just for Americans with disabilities, but also for parents of children with disabilities, employers, workforce and human resource professionals, veterans, educators, caregivers and many others. PHI PolicyWorks
http://phinational.org/policy/ PHI PolicyWorks gives users access to, up-to-date statistics, timely research and analysis, and strategic legislative and regulatory recommendations. PolicyWorks features:
- Strategic Areas - Frameworks for understanding the leading policy issues affecting the direct-care workforce
- Workforce Facts - An introduction to the demographics, size, and economic impact of the direct-care workforce
- Policy Recommendations - Strategic recommendations on the critical issues affecting direct-care workers
- Chart Gallery - High quality graphics highlighting key data on the direct-care workforce
- Guide to Accessing Federal Recovery Act Funds - Help for those interested in taking advantage of the unprecedented level of public resources now available
- Health Reform Resource Center - Resources to help ensure that national health reform works for the direct-care workforce
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