Listmates,
       I hope this newsletter gets forwarded to you.
       This is the latest edition of Quality Jobs/Quality Care produced by PHI's National Clearinghouse on the Direct Care Workforce.  Even though it is produced by my colleagues, I have to say that this edition is really chocked full of interesting information....efforts by The Arc US to draw attention to direct support professionals, minority workers talking about the racism they face on the job, and stakeholders fighting to hold on to training standards.
       I just had to pass it along to folks in the MADSP.
       You can get this newsletter directly by signing up at www.directcareclearinghouse.org.  And, you can also see the articles at the same address.
       Hope to see you at tomorrow's meeting in Flint.

Hollis Turnham
Michigan Policy Director
PHI

Quality Jobs/Quality Care
August 20, 2003
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Quality Jobs/Quality Care is a free e-mail newsletter that covers issues concerning direct-care workers in long-term care. It’s published twice a month by the National Clearinghouse on the Direct Care Workforce, (www.directcareclearinghouse.org), which provides reliable, up-to-date information related to the direct-care workforce nationwide. The Clearinghouse is a project of the Paraprofessional Healthcare Institute (www.paraprofessional.org)
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Dear Friend:
So what did you do on your summer vacation?

As you can see, we finally came up with a name for our newsletter, since we thought (and some of you said in our reader survey) that we needed to call it something other than "the Clearinghouse newsletter." We've left the "From" line in your e-mail the same this week so you'd know what it was, but that'll change as of the next issue. So please keep an eye out for an e-mail from Quality Jobs/Quality Care in the middle of September - and every couple of weeks from then on.

Meanwhile, an upcoming conference or two might be worth squeezing into your calendar if it's not already full. At the U.S. Administration on Aging's National Summit on Creating Caring Communities (http://www.hsrnet.net/AoASummit), scheduled for September 21-23, a presentation by Andreas Frank of the U.S. Department of Health and Human Services, titled "The Long-Term Care Workforce Shortage: Implications and Solutions," should be of particular interest. Other sessions will also touch on the link between quality jobs for direct-care workers and quality care for consumers. And at the Pioneer Network's conference September 19-22 (http://www.pioneernetwork.net/pdfs/PN_Cruise_Booklet.pdf), direct-care workers will be both presenters and attendees. The Pioneer conference is exploring new territory in more ways than one with this conference, which will take place on a cruise ship traveling between Miami and the Bahamas.

In this issue, we have news of:

• An essay by CNA John H. Booker about discrimination against workers of color
• New guidelines from OSHA on how to address violence by residents and clients against staff in hospitals, nursing homes, and personal care homes.=
• Calls for support of direct-care workers by two major long-term care and disability associations
• A letter to the editor by a Montana CNA about her work that was singled out for an award
• NAGNA CEO Lori Porter's new book, which calls on CNAs to develop their problem-solving skills in order to transform the culture of care
• A proposal to reduce the number of training hours for Rhode Island CNAs that was withdrawn due to objections from a group of long-term care stakeholders
• A report on how to incorporate workers with limited English language skills into the workforce

The Invisible Barrier
In this essay, CNA and worker advocate John H. Booker writes about the discrimination often encountered by workers of color in long-term care, using some of his own painful experiences as examples. Although we tend to avoid talking about racial discrimination, Booker says, we need to face it head-on, for the sake of the field as well as the people who are hurt by discrimination. "If we are ever to solve the workforce crisis that is growing by the day," he writes, "we must be courageous enough to own up to and change the bad habits that may be driving away good workers - even the habits that are hardest to admit to."

Booker is president of a new group, the National Association for Direct Care Workers of Color, which we'll report on soon.

To read his essay, go to: http://www.directcareclearinghouse.org/voices_17.jsp

OSHA issues new guidelines
OSHA's new Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers addresses violence by residents and clients against health care staff in hospitals, nursing homes, and personal care homes.

These workers are among the nation's most vulnerable to assault on the job, notes the report, which says workplace assaults and violent acts resulting in injury was 2 per 10,000 workers for all types of workers, 9.3 for health-service workers, and 25 for workers in nursing homes and personal care facilities in 2000. What's more, the risk is increasing. Reasons cited include an increased likelihood that patients or consumers and their relatives will own guns and a lack of training in how to recognize and manage aggressive behavior.

The report outlines the elements of a successful violence prevention program, the role of management commitment and employee involvement, and how employers can conduct a workplace security analysis, minimize hazards, and respond to incidents of violence. It also describes types of training.

To download a copy, go to: http://www.osha-slc.gov/Publications/osha3148.pdf

Associations call for action on workforce
Two major associations, one representing providers of long-term care services and one representing consumers, are urging their members to support direct-care workers.

In a letter to his members dated July 29, American Association of Homes and Services for the Aging President Larry Minnix describes what he told members of Congress after the recent Senate hearing on nursing home quality. "It all comes down to this," he wrote. "The key to quality improvement is people - staffing! Direct care staffing." Minnix identified three keys to quality staffing: Competitive compensation, training and respect for direct-care staff; better training and support for supervisors; and culture change. "The key to all this," he concludes, "is creating healthy cultures."

Meanwhile, the ARC is calling on its members to urge their legislators to support matching resolutions introduced in March in both the House and the Senate. The resolutions would express "the sense of the Congress that community inclusion and enhanced lives for individuals with mental retardation or other developmental disabilities is at serious risk because of the crisis in recruiting and retaining direct support professionals, which impedes the availability of a stable, quality direct support workforce."

To read Minnix's message, go to: http://www2.aahsa.org/Document/Display.asp?MsgID=9-@-MC730200313148.eml&SC=

To read more about the ARC's call for support, go to: http://capwiz.com/thearc/issues/alert/?alertid=1847691&type=CO

Montana paper highlights CNA's letter
For her letter to the editor of the Billings Gazette in Billings, Montana, CNA Mikki Thompson-Taylor won a Golden Pen Award last week. The paper awards the Golden Pen to one outstanding letter every week. The editors' introduction to Thompson-Taylor's letter described it as being about "a difficult but tremendously important job that isn't properly valued in our society."

Addressing medical professionals and others who don't appreciate what direct-care workers do, Thompson-Taylor writes: "[U]nless you walk in those shoes in your daily life, you can't see what is most obvious. Sitting behind desks, computers and doling out medications, you can become blinded behind roles that are much inflated, and the air between the brain that isn't used transcends into robotic space.… Look around you and see the workers, look far enough to enjoy the beauty of unique people who, at heart, really love what they do. Most of them are pleasant, quiet and conscientious."

The letter may be found at:
http://www.billingsgazette.com/index.php?tl=1&display=rednews/2003/08/17/build/opinion/pengold.inc (if it's no longer on the home page, type Thompson-Taylor's name into the search engine)

NAGNA leader calls on CNAs to transform the workplace
In her new book, Everything I Learned in Life … I Learned in Long Term Care, former CNA and nursing home administrator Lori Porter urges CNAs to use their problem-solving abilities to help transform their workplaces and their work lives.

Porter, who is co-founder and CEO of the National Association for Geriatric Nursing Assistants, encourages CNAs to act as mentors, not "tormentors," to new nursing assistants. "The number one reason new nursing assistants quit is not because of the work, not because of the residents, not because of how supervisors treat them, but rather how they are treated by the CNAs," she says.

In the book, which draws "life lessons" from her experiences in long-term care, Porter recounts the negative behaviors that grew out of her initial dislike of CNA work, as well as key encounters that made her see things differently. After she had spent her first six months on one job complaining bitterly about how things were handled, she writes, a seasoned nursing assistant shocked her by saying: "You're a pretty good nurse aide, but your attitude is going to kill you. We need nurse aides, but we do not need anyone that badly."

Porter believes that "most any problem that had occurred in the nursing homes I had worked in as a CNA and those I had been managing could be solved by the CNAs if given a chance."

The book may be ordered through http://www.nagna.org/

Rhode Island withdraws proposal to reduce CNA training
Long-term care stakeholders in Rhode Island blocked an effort this month by the Department of Health to reduce the state's CNA training requirement from 100 hours to the federal minimum of 75.

A DOH official told The Providence Journal that the department was considering the change in order to make it easier for CNAs from Massachusetts and other states that require fewer hours to get jobs in Rhode Island. However, the long-term care stakeholders brought together by the DOH to hear the proposal "unanimously objected," he said, so the proposal was withdrawn from consideration.

In a letter objecting to the proposal, Lieutenant Governor Charles J. Fogarty, chairman of the state's Long-Term-Care Coordinating Council, said reducing the required hours would lead to poorer care and harm the state's "vulnerable population" of elders and people with disabilities who depend on nursing assistants and home health aides. Most Rhode Island training programs, he noted, opt to provide more than the required 100 hours.

OTHER REPORTS OF INTEREST
The following report, while not primarily about direct-care workers, is about a topic of importance to the workforce.

Incorporating workers with limited English-language skills into the workforce
Expanding Employment Prospects for Adults with Limited English Skills explains how Americans with limited English language skills can best be incorporated into the workforce by trainers and employers. The report outlines the size and anticipated growth of this population, which already makes up a significant part of the direct-care workforce, and explains how it differs from the immigrant population. The document was prepared by Elise Richer of the Center for Law and Social Policy for her presentation at the National Association for Welfare Research and Statistics' annual conference on July 15.

To download the report, go to: http://www.clasp.org/DMS/Documents/1058473058.18/LEP_presentation.pdf

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If you have information, questions, or suggestions for the Clearinghouse, please contact Director Vera Salter (vera@...; 718-402-2788). To comment on this newsletter or provide ideas for future issues, please contact Elise Nakhnikian (elise@...; 609-430-1881).

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