The following is a list of PAS Workforce resources related to Wisconsin.
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.
Reinhard, Susan, and Robyn Stone. (January 2001). Promoting quality in nursing homes: The Wellspring model. The Commonwealth Fund.
Abstract:
This paper primarily highlights the various components of the Wellspring model, a quality-care improvement program for nursing homes. The Wellspring model has six core elements: 1) an alliance of nursing homes that have committed to making quality care a top priority; 2) shared services of a geriatric nurse practitioner (GNP) who trains the care teams in each nursing home; 3) the formation of care teams (multidisciplinary) who learn best clinical practices from the GNP and subsequently educate the rest of the nursing home staff; 4) networking between facilities to discuss best practices; 5) empowerment of all nursing home staff to make decisions regarding care and work environment; and 6) continuous monitoring and reviews by all staff regarding performance data on resident outcomes and physical environment. Although not the main focus of the paper, Reinhard and Stone make a link between quality care and CNA empowerment and a link between management style and CNA turnover.
Workforce Development Workgroup. (May 1999). Workforce development workgroup report. Department of Health and Family Services.
Abstract:
The Workforce Development Work Group was an official state taskforce brought together to analyze the problem of the direct-care worker shortage and to make recommendations to address the problem of recruitment and retention of competent workers. The report is a compilation of suggestions based on discussions with service providers, analysis of research findings, and focus groups responses. The workgroup made eight general recommendations in the areas of recruitment, retention, training, wages and benefits and organizational culture. These recommendations were to assist the Department of Health and Family Services in their efforts to begin a dialogue between the State of Wisconsin and provider agencies.
Obtain the Full Version: To get a hard copy of this report, send you request to:Hollister Chase, Dept. of Health & Family Services chasehl@dhfs.state.wi.us
or call her at 608/261-8877.
Ondrejka, Jennifer, and Howard Mandeville. (24 January 2002). A common understanding of the direct service workforce crisis. Wisconsin Council on Developmental Disabilities.
Abstract:
This position statement formulates an approach to the direct service workforce crisis guided by the Wisconsin Council on Developmental Disabilities' core values of self-determination, opportunity, independence and interdependence, and inclusion for people with developmental disabilities. The paper identifies three goals: to transform direct service work into jobs that are fairly and adequately compensated, achievable, and meaningful.
Sarbacker, Chris, and Howard Mandeville. (June 2002). Direct service workforce crisis. Survival Coalition of Wisconsin Disability Organizations.
Abstract:
This workgroup paper identifies specific policy changes to improve recruitment and retention of frontline workers providing service for individuals with disabilities by increasing wages and benefits. Recommendations include increasing Medicaid waiver rates, including base re-estimate adjustments in budgets to account for rising costs, reforming health insurance regulations, and investing in training initiatives to improve organizational support for direct service work.
Eleson, Charity. (March 2002). The workforce riddle for counties. The Developmental Disability Network, Wisconsin Council on Developmental Disabilities.
Abstract:
This article argues that a real commitment to the Wisconsin Council on Developmental Disabilities' core values of self-determination, opportunity, independence and interdependence, and inclusion can only be realized through substantial funding increases sufficient to fund living wages and health benefits for direct service workers. Eleson argues that a service system's values are only as effective as the infrastructure, tools, and budget that enact those values.
Wenger, Gaye. (March 2002). The workforce riddle in a rural county. The Developmental Disability Network. Wisconsin Council on Developmental Disabilities.
Abstract:
In this autobiographical narrative, Wenger describes the direct service workforce crisis in the Community Integration Program (CIP) for people with developmental disabilities in Marinette County, Wisconsin, which has been unable to fund wage increases for frontline workers since 1994. Wenger encourages stakeholders to work together to achieve a living wage for frontline workers, arguing that the workforce crisis is so grave that CIP is unable to fully accommodate any new consumers.
Stone, R.I. et al. (August 2002). Evaluation of the Wellspring model for improving nursing home quality. The Commonwealth Fund.
Abstract:
The purpose of this project was to evaluate the Wellspring model of nursing home quality improvement. The study, based on a 15-month evaluation using qualitative and quantitative methods, and conducted by a team of researchers from the Institute of the Future of Aging Services (IFAS) sought to show the outcomes associated with the model's adoption. Wellspsring is a quality improvement effort of 11 freestanding nursing homes in Eastern Wisconsin.
Governor's Health Care Worker Shortage Committee. (September 24, 2002). Health Care Wisconsin: A collaborative agenda for solving Wisconsin's health care worker shortage and securing delivery of high quality health care for Wisconsin's citizens.
Abstract:
A committee of stakeholders from health care, labor, education, and government identified four major issues affecting the shortage of health care workers in Wisconsin: education; retention and recruitment; investment, resources, and infrastructure; and workplace redesign. The committee's recommendations include increasing the number and diversity of health care workers, improving retention, and establishing a committee to coordinate solutions to the workforce shortage.
Wallace, Amy, et al. (February 2002). Martin Luther King Economic Development Corporation. Putting the pieces together: Connecting industries, workers, and communities to strengthen traditionally low-wage sectors. The National Economic Development and Law Center.
Abstract:
The Martin Luther King Economic Development Corporation (MLKEDC) aims to improve the job prospects of low-income, minority residents from Harambee and other surrounding areas in Wisconsin. Since 1996, the Martin Luther King Economic Development Corporation has managed the Maximizing Opportunity in a Restructuring Economy (MORE) project. The MORE project is an intermediary agency that offers a two-week pre-employment training that focuses on job readiness, resume completion, filling out employment applications, and interview techniques.
Obtain the Full Version: To get a copy of this report, contact The National Economic Development and Law Center at (510) 251-2600
Paraprofessional Healthcare Institute and the North Carolina Department of Health and Human Services. (March 2004). Chart of direct-care workforce activities in Wisconsin.
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.
Zitske, Judy and Julie Whitaker. (April 2003). Community Links Workforce Project four-year program summary, 1999-2002. Wisconsin Bureau of Aging and Long Term Care Resources, Department of Health and Family Services.
Abstract:
This summary reviews all of the Community Links Workforce projects from January 1999 through December 2002. The workforce projects were funded by Wisconsin's Community Options Program in an effort to encourage initiatives which strengthen or expand the workforce in their respective communities. Awards were granted to projects which were designed to recruit home care workers, retain and support current workers and informal networks, and support self-sufficiency and community based resources.
Obtain the Full Version: More information click here.
Waushara County Department of Human Services. (June 2003). Cooperative Care: The first year.
Abstract:
This evaluation and analysis of the first year of Waushara County's care worker cooperative is organized into three parts. The first gives a background on Waushara County, its workforce issues, a description of how the cooperative was built, and a discussion on the future of cooperative care. Part two summarizes the results of surveys given to cooperative members as well as their consumers. Part three includes the survey instruments and raw data.
Hatton, Erin and Laura Dresser. (October 2003). Caring about caregivers: Reducing turnover of frontline health care workers in South Central Wisconsin. The Center on Wisconsin Strategy.
Abstract:
This report investigates how job quality for frontline caregivers affects the quality of care in federally certified nursing homes in South Central Wisconsin. 'Caring about caregivers' shows a strong correlation between low wages, poor training, and lack of opportunity for career advancement and the high turnover rates among frontline caregivers. These high turnover rates are costly, and are damaging to productivity and quality of care.
Melissa Mulliken Consulting. (July 2002). Staff retention among direct support workers in Wisconsin: A passion for their work fuels longevity and commitment among a dedicated core of workers.
Abstract:
This project looked at worker satisfaction and found that, for a group of vested direct support workers, the relationship with their people with developmental disabilities was their primary motivator. This helped mitigate factors such as low pay and status with which they were dissatisfied
Melissa Mulliken Consulting. (June 2003). Wage and benefits for Wisconsin direct support workers.
Abstract:
Results of a statewide survey of community direct service agencies supporting people with developmental disabilities confirm that low wages and eroding health insurance benefits contribute to high staff turnover rates, putting at risk the continuity of support relied upon by people with developmental disabilities.
Obtain the Full Version: Copies of this report are available from:
Wisconsin Council on Developmental Disabilities (WCDD)
600 Williamson Street, Suite 1
PO Box 7851
Madison, WI 53707-7851
t: (608) 266-7826
e: wiswcdd@dhfs.state.wi.us
Visit the WCDD on the web at www.wcdd.org
Available at the National Clearinghouse on the Direct Care Workforce website: http://www.directcareclearinghouse.org/download/WB_survey_report_BDDS_2003.pdf
Keigher, Sharon M. (August 1999). Handle with care: Fragile elders and caregivers in the Milwaukee Community Options Program. School of Social Welfare - University of Wisconsin-Milwaukee.
Abstract:
This report examines services provided through the Community Options Program (COP) in Milwaukee County. The Community Options Program (COP) allows service users to select their own home care worker who is then paid by the county. The author conducted interviews with 21 workers, 21 elders, and 8 families in 1997, and follow-up interviews were held 4 to 6 months later. The report investigates what strategies service users and their families employed to get COP financial support, and how they find and manage personal care workers on their own. The study also looks at working conditions of personal care workers, and how they get hired.
Bau, Margaret and Dianne Harrington. (May/June 2003). House calls: In-home care givers form cooperative to provide vital service for elderly, disabled in rural Wisconsin. Rural Cooperatives.
Abstract:
Cooperative Care was highlighted in the May/June 2003 issue of "Rural Cooperatives" magazine. The article outlines the demand for in-home care, and the shortage of in-home direct-care workers. The authors then trace the history of Cooperative Care from the initial planning stages in 1999 to the challenges that will meet the co-op in the future.
Harrington, Dianne. (November 2002). Cooperative care - 2002 Innovation in American Goverment Awards proposal.
Abstract:
This essay gives an overview of Cooperative Care located in Wautoma, Wisconsin. Cooperative Care is a worker-owned cooperative providing homemaker services and nursing assistant care to elderly and disabled people in their homes. This essay outlines the history of Cooperative Care, recent achievements, it's target population, defines key individuals and organizations, the program's budget, and media coverage.
Obtain the Full Version:
The Waushara Arugus. (2002). Cooperative Care named semi-finalist for award. The Waushara Arugus. Wautoma Newspaper, Inc.
Abstract:
This newspaper article from 2002 highlights Cooperative Care's inclusion as one of 99 semi-finalists in the 2002 Innovations in American Government Awards, a program of the Institute for Government Innovations at Harvard University's John F. Kennedy School of Government. The article also gives a brief summary of Cooperative Care, and its success in achieving better pay and more benefits for home care workers.
Obtain the Full Version:
Tilley, Jane, Kristen Black, Barbara Ormond and Jennie Harvell. (November 2003). State experiences with minimum nursing staff ratios for nursing facilities: Findings from case studies of eight states. U.S. Department of Health and Human Services.
Abstract:
Conducted by the Urban Institute for the U.S. Department of Health and Human Services' Office of the Assistant Secretary for Planning and Evaluation, this study was commissioned as a follow-up to the Phase I and Phase II nursing home staffing studies conducted for the Centers for Medicare and Medicaid Services by Abt Associates. The researchers surveyed all state laws mandating minimum staffing ratios and conducted case studies of eight states (Arkansas, California, Delaware, Minnesota, Missouri, Ohio, Vermont, and Wisconsin) that either instituted, modified or eliminated nursing staff ratios in recent years. The report concludes that minimum staffing ratios can help impose a standard on facilities that have inadequate staffing, but staffing ratios are not the only factor affecting the quality of care residents receive.
Abstract:
This study examines the factors that make caregivers stay in their jobs. The study includes a literature review, focus groups with caregivers, employer forums, educator and trainer forums, and a caregiver survey. The study notes the need to foster new models of community collaboration through multi-stakeholder coalitions. These coalitions are essential to achieve the priorities identified in the study: the need for support services, supervisor training, and career ladder development/improved wages and benefits.
For a copy of the Caregiver Survey click here
Wisconsin Long Term Care Workforce Alliance. (January 2004). Creating local coalitions to address long term care workforce issues.
Abstract:
This guide describes how community members with common interests can form local alliances to create locally-tailored solutions to direct-care workforce problems. It identifies potential coalition members and recommends ways to get started and maintain interest. It also describes five local coalitions that are currently active in Wisconsin.
Obtain the Full Version: Copies can be ordered from:
Wisconsin Long Term Care Workforce Alliance
Madison, WI 53718
608.224.6304
e-mail:kellermanb@mailbag.com Available at the National Clearinghouse on the Direct Care Workforce website: http://www.directcareclearinghouse.org/download/Alliance Newsletter-Jan04.pdf
Wisconsin Long Term Care Workforce Alliance. (March 2004). Improving public awareness of work in long term care.
Abstract:
This guide describes Kenosha County's experience as one example of what a local stakeholder coalition can do to improve public awareness of the important role that direct care workers perform in the lives of older persons and those with disabilities. It describes the strategies, campaign goals, target groups, methods and theme of the county's 'Make More Than A Living: Make A Difference' campaign.
Obtain the Full Version: Copies of this guide can be ordered from:
Wisconsin Long Term Care Workforce Alliance
2850 Dairy Drive, Suite 200
Madison, WI 53718
608.224.6304
email: kellermanb@mailbag.com Available at the National Clearinghouse on the Direct Care Workforce website: http://www.directcareclearinghouse.org/download/Alliance Newsletter-Mar04.pdf
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.
Institute for the Future of Aging Services (IFAS) and Paraprofessional Healthcare Institute (PHI). (June 2003). State-based initiatives to improve the recruitment and retention of the paraprofessional long-term care workforce. U.S. Department of Health and Human Services.
Abstract:
This report identifies a range of workforce improvement initiatives at the state level to reduce high vacancy and turnover rates among direct-care workers and improve the quality of their jobs. The report summarizes the experiences of five states (California, Massachusetts, North Carolina, Pennsylvania, and Wisconsin) that have pursued several strategies to address the serious shortage of direct-care workers.
Whitaker, Julie, Stu Schneider, and Margaret Bau. (February 2005). Home care cooperatives: Worker ownership in focus. Wisconsin Long Term Care Workforce Alliance.
Abstract:
This paper explores the use of worker-owned home care cooperatives as a strategy to create a more stable long-term care workforce. The authors highlight three different models of worker-owned home care cooperatives: the job-training model, the cooperative conversion model, and the multi-stakeholder model. The authors argue that home care cooperatives offer workers a number of benefits including: living wage jobs, a democratic organizational culture, and the opportunity to take part in quality care giving.
Abstract:
A new report released by the Wisconsin Hospital Association (WHA) calls for immediate action to address growing shortages in the health care careers including those in long-term care. The report found that hospitals will not be able to fill vacant positions due to a shrinking applicant pool as experienced, knowledgeable employees retire. WHA suggests that finding a viable, long-lasting solution to ensure an adequate health care workforce will require collaboration among health care providers, educators, and state government officials. Some of the action steps they suggest to improve recruitment include: support new entrants in the health care workforce, encourage new educational strategies, and continue efforts to create interest in health care careers.
Wisconsin Long Term Care Workforce Alliance. (March 2004). Wisconsin long term care workforce fact sheet. Wisconsin Long Term Care Workforce Alliance.
Abstract:
This fact sheet estimates the number of nurse aides, attendants, home health aides, personal care aides, and other direct-care workers in the state of Wisconsin. The one-page fact sheet also comments on pay, turnover, and the steady rise in employer expenses.
Direct Care Workforce Issues Committee. (June 2005). Strengthening Wisconsin's direct-care workforce. Wisconsin Council on Long Term Care Reform.
Abstract:
This paper discusses Wisconsin's direct-care worker staffing shortages. It highlights the effect of shortages on agencies, family caregivers, and the quality of care for consumers. The authors suggest that without serious intervention, staffing shortages in Wisconsin will worsen. To change this, the author recommends that employers improve compensation, offer benefits, and create career ladders for workers.
Kathleen McGwin. (May 2005). The possibilities of relationships. Cooperative Care.
Abstract:
This article, written by Kathy McGwin of Cooperative Care, a worker owned home care cooperative, discusses the importance of relationships in long-term care. McGwin looks at how maintaining positive relationships within a work environment is key to retention and quality care. She suggests that caregivers should set personal goals about their motivations in life and apply them in their everyday relationships with people and at work.
(November 2004). Long-term care direct service arrangements in Wisconsin counties, survey results, 2004. Wisconsin Department of Health and Family Services, Division of Disability and Elder Services, Bureau of Aging and Long Term Care Resources.
Abstract:
In an effort to better understand the makeup of the home and community based long-term support workers, Wisconsin conducted an on-line survey in July 2004. Each county's lead agency administering the state's Community Options Home and Community Based Waiver was asked to fill out a survey. This report provides an overview of the ways in which counties purchase direct care and support services for elderly people and people with disabilities under the Community Option and Home and Community Based Waiver Programs.
Center for Health Workforce Distribution Studies, University of Washington, Seattle. (November 2004). Effects of the Workforce Investment Act of 1998 on health workforce development in the states. Health Resources and Services Administration, Bureau of Health Professions, Health Resources and Services Administration.
Abstract:
The goals of the Workforce Investment Act of 1998 (WIA) are to increase the employment, retention, and earnings of participants in Department of Labor (DOL) employment and training programs. This report explores how WIA resources have been used to support the healthcare workforce across the states, including, but not limited to, the direct-care workforce.
Hernandez-Medina, Esther, et al. (March 2006). Training programs for certified nursing assistants. AARP Public Policy Institute.
Abstract:
This report examines certified nurse aide (CNA) training programs in 10 states. Information was gathered by interviewing key informants, including CNAs and experts in CNA training and testing. Recommendations include increasing the federal requirement for initial training to at least 100-120 hours, ensuring that CNAs are reimbursed for the cost of training, and screening training program applicants to identify needs such as remedial English or ESL classes.
Whitaker, Julie. (2002). Preventing a ''revolving door'' workforce: Lessons from the literature. Bureau of Aging and Long Term Care Resources, Wisconsin Department of Health and Family Services.
Abstract:
This article analyzes the causes of high turnover among direct-care workers through a review of literature and research. According to the author, the most promising strategies for reducing turnover are rooted in improving workers' pay and benefits, building opportunities for broader worker participation, and providing meaningful training. The article also provides examples of worker cooperatives, which have been successful in reducing turnover rates.
Bridges, Tameshia and Carol Regan. (February 2007). Subsidizing health insurance coverage for the home care workforce in two Wisconsin counties: An analysis of options. Health Care for Health Care Workers.
Abstract:
This report describes a provider employer organization (PEO) in Wisconsin that makes affordable health insurance available to home care workers. TRIADA, a union-sponsored PEO, will offer insurance to home care and child care providers and aims to lower the cost of coverage through a purchasing pool and subsidization. The paper provides background information on the workforce and TRIADA, analyzes potential sources of funding for subsidization, and recommends options in making health insurance affordable.
