Personal Notes and Article about Home Healthcare Aides

I see I've lost a follower.  I can understand if you got tired of political posts and cries for help.  But if you stopped reading because I did not answer your invitation to join you on Facebook, I can't set up an account with them independently.  And at the moment I am going through a change in healthcare aides myself.  The new person doesn't have computer skills.   Or maybe I didn't talk enough about dolls.

New Subject:  If we had allowed more undocumented workers to Become documented, would we have more home healthcare aides?

What if an undocumented worker was subject to a background check, both in the U.S. and his/her country of origin, (except where defection itself is a crime) then had to go to English and all other classes all naturalized citizens do?  I think being forced to hide from authorities makes it Easier, not Harder to commit violent crimes.  The commission of violent crimes has been used as an argument for keeping illegal workers out.  That is why I bring it up. 

Actually, it is to the benefit of many corporations and wealthy persons to Keep workers undocumented so that they can be forced to accept low wages, poor working conditions, and no legal protections or unionizing activities.

But If we trained such workers for the jobs Needed and paid them decently, it Could be a "win, win" situation.  Our immigrants and their children are mostly young.  The nations from which many of them come have a much younger "average age" than does the U. S. If such workers were paid decently, they could send money home and help improve the lives of some of the world's poorest people.

But then, we Could pay our Own citizens better wages to be home healthcare aides.  We Could even use Both strategies to make the playing field more equal.  Around here there are home healthcare aides who work for Less than Eight Dollars per Hour and who are expected to drive their own cars to take clients/comsumers to appointments and shopping. 

Is this Totally due to a lack of reimbursement from Medicare and Medicaid?  Office staff often get paid vacations, health benefits or other benefits which aides themselves do Not.

The article below is a good general introduction to the home healthcare aide issue, I think.

Aging baby boomers face home health care challenge

By John Seewer, Associated Press

CLEVELAND (AP) -- For the past three years, Taura Tate's mornings have revolved around

caring for a woman who suffers from the effects of a stroke and diabetes. She cooks

her oatmeal for breakfast, helps with showers and makes sure she takes the right

medicine.

Without the help of a home health aide

, the woman, who's in her 70s, would be in a nursing home instead of living on her

own.

But Tate has her own struggles. Until a recent promotion, her pay amounted to what

she could make at McDonald's. She doesn't get health or retirement benefits and has

worked at five agencies in the

Cleveland

 area, some simultaneously, to guarantee she'll have enough clients.

"If they go into the hospital or go on vacation, you don't get paid," she said.

Demand for home health care workers is soaring as baby boomers — the 78 million Americans

born between 1946 and 1964 — get older and states try to save money by moving people

out of more costly

nursing homes

. But filling more than 1 million new home care positions over the next decade will

be a challenge.

Most home health aides are paid about the same as maids and manicurists and don't

get sick days or

health insurance

 themselves. Many who are self-employed must pay for their own gas for driving to

appointments and cover their own medical bills if they're hurt on the job.

The U.S. Labor Department projects that home health and personal care aides will

be among the fastest-growing jobs over the next decade, adding 1.3 million positions

and increasing at a rate higher than any other occupation. If those jobs can't be

filled, many older Americans are likely to face living with relatives or in nursing

homes, which will only cost families and taxpayers more money.

Some aides say they have no choice but to say no when people call looking for help

because they can't afford to take on someone else.

"It's hard because I love helping people, but at the same time I've got three kids,"

said Kimberly Ingram, a home health aide in Lancaster, S.C. "When you add up your

miles, your gas money, you don't make nothing."

Her part-time job delivering newspapers pays better when you factor in the time and

travel some home care jobs need, she said.

Nearly half of all home care workers live at or below the poverty level, and many

receive government benefits such as food stamps, unions and advocacy groups say.

The median pay a year ago was $9.70 per hour — 4 cents less than fast-food workers

and short-order cooks, according to the most recent statistics from the Labor Department.

Agencies that supply home health workers blame states and the federal government

for failing to increase reimbursement rates for Medicaid and Medicare patients at

a time when costs are going up.

Home health services are an easy target for cuts because they're not required by

federal law, and legislators in states with big deficits say they have no choice

but to cut Medicaid spending, the second-costliest item for states behind education.

At the same time, some states, including Ohio, are changing how they coordinate medical

care and trying to move some of the most expensive and hard-to-treat patients into

home and community-based settings instead of nursing homes.

The result, home care agencies say, is that there's little room for them to make

a profit. And that means they can go only so far to attract new workers.

"We compete with McDonald's, Wendy's and the discount stores," said Jennifer Witten,

owner of Imani Home Health Co. in Cleveland. "You can't afford to raise your salaries,

yet you want to hire the best people."

Home care agencies say trying to fill jobs will become even more difficult in a few

years if the economy improves and job options increase.

"The real staffing challenge is 10 years away," said David Tramontana, president

of Home Care by Black Stone in Cincinnati. "If we can't pay them more than they get

at McDonald's, we're in big trouble."

The qualifications and training for home care aides varies. A high school diploma

isn't usually a requirement, and some states call for only on-the-job training, while

others insist on more formal instruction about basic nutrition and personal hygiene

at community colleges or elder care programs. Home care agencies that are reimbursed

by Medicare or Medicaid must hire aides who have passed a competency test or received

state certification.

Despite the relatively low pay, many aides say they like the flexible hours and find

the work rewarding.

Tate, a home care aide since 1999, doubts she could get by if it weren't for her

husband, a truck driver who also has health insurance. She could make more money

at a nursing home or hospital but relishes the connections she makes in home care.

"I get attached to the people," said Tate, who made $8.50 an hour until she received

a promotion and a $2 raise earlier this summer. "How could you not if you're with

them every day? Sometimes you're the only person they see."

Retired hospital nurse and home health aide Judith Mezey-Kirby, born a few years

ahead of the baby boom, said she worries about who will take care of boomers in the

coming years.

Home health care workers need not only better pay, she said, but also better training

on how to take care of basic needs. She had good and bad experiences with aides who

help her with the laundry and chores that require heavy lifting around her home in

Fairview Park, a Cleveland suburb.

"It needs attention bad," said Mezey-Kirby, 73. "You just can't take people off the

streets."

Wittens' company considered adding a 401(k) plan for its workers but decided it was

too costly. Home aides she hires start at $8.50 per hour and can earn up to $10.

Most work 30 to 40 hours a week, and all but a few have other part-time jobs, Witten

said.

Jareese Mitchell, a personal care attendant in Manchester, Conn., spends 30 hours

a week with two quadriplegics, helping them eat, dress and bathe. He also goes to

school and works three nights a week at a clothing store.

"Everybody has a job outside; you pretty much have to," said Mitchell, who until

recently was receiving food stamps. He said he might look for different work if the

pay doesn't increase.

That's not unusual. The turnover rate among home health aides is estimated to be

anywhere from 30 percent to 50 percent, sometimes higher.

The revolving door is especially tough on those who depend on home aides for help

throughout the day.

"My mom gets nervous when she has brand-new people. There's always a trust issue,"

said Beth Cramer, who lives with her 74-year-old mother in the Cleveland suburb of

Willowick. An aide comes to the house to help her mother with dressing and cooking

while Cramer is at work.

"They're doing the most intimate of intimate things," she said. "Imagine a stranger

walking into your house and giving you a bath."

Gail Williams, a personal assistant in Tampa, Fla., said many people have no one

else.

"You just can't quit the job because these people need you," she said.

Chris Hradisky, who relies on a personal assistant to help him with meals and clean

his apartment in Waukegan, Ill., said he wouldn't be on his own without help.

His aides, he said, are like family. "You build a bond with them."