The following is a list of PAS Workforce resources related to Maine.
The list 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.
Maine Health Care Association Labor Task Force. (February 1999). The shortage of CNAs and PCAs in Maine: Short and long term solutions. Maine Health Care Association.
Abstract:
This report outlines the scope of the shortage of direct-care workers in Maine; provides data on the direct-care workforce, including wages, benefits, job satisfaction levels, stress factors, and reasons for leaving; and recommends sector-wide actions to improve retention. The report's major recommendation is the construction of a comprehensive career ladder for entry-level direct-care workers, which will ensure that workers' skills are transferable among different health care settings.
Obtain the Full Version: To order the report, contact the Maine Health Care Association at (207) 623-1146.
Bratesman, Stuart. (December 28, 2000). Direct care workforce challenges: Improving the recruitment and retention of workers who provide direct support to persons with disabilities. Plan Development Workgroup for Community-Based Living.
Abstract:
After describing the scope and causes of difficulties recruiting and retaining paraprofessionals to care for people with disabilities, this article identifies possible solutions and documents promising initiatives undertaken in Maine. Recommendations include increasing wages and benefits, providing career ladders, cross-training paraprofessionals, promoting consumer direction, and instituting more selective recruiting practices.
Pohlmann, Lisa. (February 2003). Without care: Maine's direct care worker shortage. Maine Center for Economic Policy.
Abstract:
This report identifies the causes of the shortage of certified nursing assistants, personal care attendants, home health aides and other direct-care workers in Maine's long-term care system, and recommends actions to address them.
Paraprofessional Healthcare Institute and the North Carolina Department of Health and Human Services. (March 2004). Chart of direct-care workforce activities in Maine.
Abstract:
This chart describes existing or enacted direct-care workforce initiatives in this state as of March 2004. The information was collected as part of a national survey of state initiatives on the long-term care direct-care workforce. Additional details about this state may be found in the full report.
W. L. Taylor Associates. (April 2002). Home Care Alliance of Maine wage and salary survey 2002. Home Care Alliance of Maine.
Abstract:
This report summarizes wage and salary data provided by fourteen Maine home care agencies in April 2002, with an update in January 2003. The document provides hourly wage information for 52 individually defined positions, job summaries/descriptions, and a full description of benefits offered by the 14 agencies, including availability of health insurance and vacation policies.
Obtain the Full Version: To order this report, contact:
Home Care Alliance of Maine
20 Middle Street
Augusta, Maine 04330
www.homecarealliance.org
Anderson, Wayne L., Joshua M. Wiener, Angela M. Greene, and Janet O'Keeffe. (April 2004). Direct service workforce activities of the Systems Change grantees. RTI International.
Abstract:
In 2001 the Centers for Medicare and Medicaid Services (CMS) awarded Real Choice Systems Change (RCSC) Grants to states and other entities working to improve state long-term care systems. Twenty grantees began one or more initiatives to improve the recruitment and retention of direct service workers. This report focuses on the workforce initiatives of these 20 grantees, with an in-depth look at 7. The report strongly recomends that policymakers, providers, and consumers address workforce problems.
Pohlmann, Lisa. (April 2005). Direct care remains a critical workforce challenge. Choices. The Maine Center for Economic Policy.
Abstract:
This issue brief is part of the Maine Center for Economic Policy's series of Choices issue briefs. It is an update to the Without Care: Maine's Direct Care Worker Shortage issue brief. The author discusses the state of wages and benefits for direct-care workers in Maine, stating that they are disproportionately low. In addition, the author discusses the growing 'care gap' highlighting the fact that the aged (65+) population in Maine is growing faster than the pool of available direct-care workers. The author suggests that low wages, poor benefits, and inadequate Medicaid reimbursement rates makes it difficult to attract and retain workers and provide quality care.
PHI's Health Care for Health Care Workers initiative, in collaboration with Consumers for Affordable Health Care Foundation and the Institute for Health Policy at the University of Southern Maine's Edmund S. Muskie School of Public Service. (March 2006). Health insurance coverage for the home care sector: Experience from early DirigoChoice enrollment in Maine. PHI.
Abstract:
This report reviews the findings of an outreach project conducted during the first six months of 2005. The aim of the project was to help connect direct-care employers and employees in Maine with DirigoChoice, an innovative state program aimed at expanding health care coverage. As a result of their research, the authors conclude that ''other states experimenting with innovative health coverage plans will need to address major challenges -- such as the part-time nature of direct-care work, low wages, and low reimbursement rates -- to ensure coverage for these critical health care workers.''
The American Network of Community Options and Resources (ANCOR). (March 2006). Tapping into the public workforce network: ANCOR/DoL Business Relations Group pilot project partnership white paper.
Abstract:
In 2004, pilot projects in four cities (Rochester, New York; Phoenix, Arizona; Portland, Maine; and Louisville/Lexington, Kentucky) were launched in order to help connect direct support professionals and the public employment network of One-Stops. This white paper summarizes the progress of the pilots' model practices in their first year. The Department of Labor plans to expand the project to additional states in the future.
Scala, Elise. (2005). The illustrated history of Maine PASA: Establishing an association for direct care and direct support workers in Maine. Muskie School, Institute for Health Policy.
Abstract:
The history of Maine PASA, how it started and grew, is illustrated in this report as a timeline of activities, challenges, and outcomes. Over the grant period of 2001-2005, the project went from an idea to address the workforce shortages by building a worker organization to an incorporated, non-profit worker association with a statewide membership of over 600.
Paraprofessional Healthcare Institute (PHI). (April 2006). CMS direct service workforce demonstration grants: Overview and discussion of health coverage interventions. U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS).
Abstract:
This report provides an overview of the efforts of six Center for Medicare and Medicaid Services (CMS) grantees to make health care coverage more affordable and accessible to direct-care workers. It discusses the key advantages and disadvantages of three approaches employed by grantees: subsidization of employer-based coverage, combining basic insurance and tax-free accounts, and funding outreach programs, which promote public-private partnerships. An attached spreadsheet provides a description of each intervention, identifying key components, costs, and their potential sustainability.
The Maine Health Care Association. (2002). An opportunity to respect our elders: Facing facts about care for Maine's older loved ones.
Abstract:
This white paper argues for legislation to increase funding allocated to Maine's long-term care facilities. Spending on the state's nursing homes was reduced by 15% between 1995 and 2001, while at the same time it increased 9% nationally. The paper contends that facilities are unable to provide wages and benefits that will retain workers. The outcome is a labor shortage and increased costs associated with a high turnover rate.
Pohlmann, Lisa. Many of Maine's direct care workers do not have health insurance. Health Care for Health Care Workers and Maine's Direct Care Worker Coalition.
Abstract:
Arguing that ''quality long-term care depends on healthy direct-care workers (DCWs)'' and pointing out that many of these workers lack health insurance, this Maine-based fact sheet provides information about why this is the case and why it matters to workers, employers and consumers.
Pohlmann, Lisa. (September 2006). Meeting Maine's need for frontline workers in long term care and service options. Muskie School of Public Service and Maine Department of Health and Human Services.
Abstract:
This report examines Maine's emerging care gap and the growing need for direct-care workers (DCWs) in the state. The author argues that uncompetitive wages, inadequate Medicaid funding, and lack of training and supervision for DCWs has lead to a workforce crisis demanding public policy solutions. The report describes initiatives currently taking place in the state and offers a possible direct-care workforce policy agenda.
McDonald, Ingrid. (January 2007). Emerging strategies for providing health coverage to the frontline workforce in long term care. Paraprofessional Healthcare Institute (PHI) and the Lewin Group.
Abstract:
This paper provides an overview of health coverage interventions tested by Centers for Medicare and Medicaid Services direct service workforce grantees. Four case studies in North Carolina, New Mexico, Maine, and Washington State are examined and individually assessed. The author then draws out common challenges, key design features necessary for success in providing health coverage to the direct-care workforce, and concludes with a discussion of policy implications in addressing these issues.
Maine Department of Health and Human Services. (March 2007). Study of Maine's direct care workforce: Wages, health coverage, and a worker registry.
Abstract:
A Department of Health and Human Services study of direct-care workers in Maine assesses the current state of the workforce, the state's care gap, the cost of raising wages, health benefit options, and the Maine direct-care worker registry. Among the report's recommendations are an expansion of Maine's DirigoChoice and an extension of state employee health benefits to workers employed by MaineCare. The report also discusses methods of upgrading the direct-care worker registry.
University of Minnesota, Research and Training Center on Community Living and The Lewin Group. (December 2006). CMS direct service workforce demonstration promising practices in marketing, recruitment and selection interventions. Centers for Medicare & Medicaid Services (CMS).
Abstract:
This report identifies promising practices in direct care worker marketing, recruitment, and selection in states receiving Centers for Medicare & Medicaid Services (CMS) grants. Grantees used different techniques to improve recruitment and retention outcomes, including computer-based registration, marketing campaigns, realistic job previews, structured interviewing, and expanded orientation or mentoring of new employees. The report concludes that sustaining and replicating these interventions will require further research about associated costs and benefits and dissemination of this information.
Wong, Alice, H. Stephen Kaye, and Robert Newcomer. (July 2007). State legislation regarding wages and benefits of home care workers: Thirteen promising practices. Center for Personal Assistance Services.
Abstract:
This report focuses on examples of state legislation seeking to increase the hourly wages or benefits of direct-care workers. The thirteen bills or legislative appropriations included in the report increase wages through Medicaid reimbursement rates, amending current laws, or providing health insurance parity.
Barrett, Jocelyn. (July 2007). Leadership stories from Maine: The voices of direct-care workers in culture change. Northern New England LEADS Institute, PHI.
Abstract:
Interviews with ten workers involved in leadership teams of the Northern New England LEADS (Leadership, Education, and Advocacy for Direct-care and Support) Institute are provided here. The LEADS Institute is a regional culture change initiative aimed at building a core of strong leaders among direct-care staff, supervisors and administrators. The workers describe their experiences in the program, changes they have been involved in, successes, and challenges.
Health Care for Heath Care Workers. (2007). Coverage models from the states: Strategies for expanding health coverage. PHI.
Abstract:
This report describes successful strategies for expanding health care coverage to direct-care workers. Five strategies are discussed: making employer-based insurance more affordable, expanding public insurance coverage, establishing coverage through collective bargaining, building insurance costs into Medicaid reimbursement, and assisting workers with health care expenses. The report provides examples and models for each strategy that can be adapted by advocates and policymakers in other states.
PHI. (September 2008). Northern New England LEADS Institute: An evaluation.
Abstract:
This report evaluates measurable outcomes of the LEADS Institute, an initiative that sought to develop person-centered care at 12 long-term care facilities by providing training, technical assistance, and cross learning opportunities. Interviews with stakeholders, job satisfaction and work environment surveys, data on turnover and absences, document review, and ''lessons learned'' discussions provide evidence of improvements in management, job quality, public policy, and the quality of communication within long-term care settings.
