A Compendium of Three Discussion Papers: Strategies for Promoting and Improving the Direct Service Workforce: Applications to Home and Community-Based Services

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Long Term Care, Home and Community Based Services, Workforce Planning, Disability and Aging, Cutler Institute, USM Aging Initiative, Policy


This is a compendium of three discussion papers on the topics of direct service workers in long-term care and strategies for improving the quality of their jobs and services. The first paper, Home and Community-Based Services: Workforce and Quality Outcomes describes HCBS programs, the direct service workforce, recommended practices for improving quality, and discusses possible approaches for integrating workforce initiatives into HCBS quality management systems. What is the Impact of Unions on Quality of Care? discusses effects of unionization on wages, turnover, and quality care and provides an overview of Service Employees International Union (SEIU) initiatives in key states. Health Coverage for Direct Care Workers, Emerging Strategies discusses work being done to make health insurance benefits more accessible and affordable to individuals working in direct-care and support jobs. The discussion of recent grant-funded projects and initiatives to raise awareness and to implement policies and programs provides a summary of models being used in a number of states. The papers are not meant to be inclusive for all sectors of the direct care and direct support workforce, nor are they an exhaustive review of the research and demonstration literature. They are meant to provide insight and resource information that highlight current issues and approaches for building and maintaining a quality direct service workforce.

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This document was developed under Grant No. 11-P-92015/2-01 from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services. However, these contents do not necessarily represent the policy of the U.S. Department of Health and Human Services, and you should not assume endorsement by the Federal government. Please include this disclaimer whenever copying or using all or any of this document in dissemination activities.