Health Insurance Coverage of Direct Support Workers in the Developmental Disabilities Field

Ebenstein, W. L.

doi:10.1352/0047-6765(2006)44[128:hicods]2.0.co;2

Cited by 5 publications

(4 citation statements)

References 6 publications

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“…Employer provided health insurance is a critical factor in recruiting and retaining DSPs [Ebenstein, 2006]. Most organizations offer health insurance benefits to some DSPs [Larson et al, 2005c].…”

Section: Wages and Benefitsmentioning

confidence: 99%

The direct support workforce in community supports to individuals with developmental disabilities: Issues, implications, and promising pactices

Hewitt

Larson

2007

Ment. Retard. Dev. Disabil. Res. Rev.

126

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Difficulties in finding, keeping, and ensuring the competence of the direct support workforce in community developmental disability services has long been a challenge for individuals, families, providers, and policy makers. Direct support staff recruitment, retention, and competence are widely reported as one of the most significant barriers to the sustainability, growth, and quality of community services for people with developmental disabilities (ANCOR [2001] State of the states report. Alexandria, VA: ANCOR; Colorado Department of Human Services, [2000] Response to Footnote 106 of the FY 2001 appropriations long bill: Capacity of the community services systems for persons with developmental disabilities in Colorado; Hewitt [2000] Dynamics of the workforce crisis. Presentation at the NASDDDS Fall meeting. Alexandria, VA). While long in existence, these challenges are ones of growing concern because the number of people demanding community services is increasing and the population of people from which to recruit workers is declining (Office of the Assistant Secretary for Planning and Evaluation [2006] The supply of direct support professionals serving individuals with intellectual disabilities and other developmental disabilities: Report to Congress. Washington, DC: Office of Disability, Aging and Long-Term Care Policy, ASPE, U.S. Department of Health and Human Services). As the service system moves towards consumer direction, managed care, and more noncategorical service delivery systems, the difficulties of providing for an adequate and well-prepared workforce to support people with developmental disabilities becomes more complex and multifaceted. The solutions to those challenges are also more complex. This article reviews the literature regarding the complexity of the direct support workforce crisis, the effects of this crisis on various stakeholder groups, promising practices designed to address the challenges, and the related practice and policy implications.

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Section: Wages and Benefitsmentioning

confidence: 99%

The direct support workforce in community supports to individuals with developmental disabilities: Issues, implications, and promising pactices

Hewitt

Larson

2007

Ment. Retard. Dev. Disabil. Res. Rev.

126

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“…By contrast, the mean hourly wage in 2007 for physicians was more than $70 per hour 30. Most low-income workers cannot afford health insurance premiums and copayments, even when coverage is offered by their employer 12,31,32. On the basis of a review of studies on characteristics of direct care workers and the wages and health insurance benefits available, Stone reported that most home care workers earning low incomes cannot afford health insurance 31…”

Section: Discussionmentioning

confidence: 99%

“…The Kaiser Family Foundation reported that the uninsured rate among workers in the health and social services industry was 23% in 2007 11. On the basis of a review of the literature in the health and human services occupations, Ebenstein concluded that the health insurance plans offered to direct care workers in the developmental disabilities field are “inferior … with less coverage and more out-of-pocket expenses” and that fewer direct care workers “are able to afford health coverage even if they are eligible.”12(p132)…”

mentioning

confidence: 99%

Health Care Coverage and the Health Care Industry

Chou¹,

Johnson²,

Ward³

et al. 2009

Am J Public Health

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Objectives-We examined rates of uninsurance among workers in the US health care workforce by health care industry subtype and workforce category. Methods-We used 2004 to 2006National Health Interview Survey data to assess health insurance coverage rates. Multivariate logistic regression analyses were conducted to estimate the odds of uninsurance among health care workers by industry subtype.Results-Overall, 11% of the US health care workforce is uninsured. Ambulatory care workers were 3.1 times as likely as hospital workers (95% confidence interval [CI]=2.3, 4.3) to be uninsured, and residential care workers were 4.3 times as likely to be uninsured (95% CI=3.0, 6.1). Health service workers had 50% greater odds of being uninsured relative to workers in health diagnosing and treating occupations (odds ratio [OR]=1.5; 95% CI=1.0, 2.4).Conclusions-Because uninsurance leads to delays in seeking care, fewer prevention visits, and poorer health status, the fact that nearly 1 in 8 health care workers lacks insurance coverage is cause for concern.For complex socioeconomic reasons, private health insurance, typically provided by an employer, is "the dominant mechanism for paying for health services" in the United States. 1 (p According to the Kaiser Commission on Medicaid and the Uninsured and the Urban Institute, analyses of data from the Current Population Survey (CPS) show that, in 2006, 54% of the US civilian, noninstitutionalized population had employer-sponsored health insurance; 5% had private, non-group health insurance; and 26% had public health insurance coverage. Approximately 46 million US residents (16% of the population) are currently uninsured. 2 Numerous studies have shown that, relative to people with health insurance, uninsured people receive less preventive care, are diagnosed at more advanced disease stages, and, once diagnosed, tend to receive less therapeutic care and have higher mortality rates.3 -8

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“…Yet there is mounting evidence that employer-provided health insurance is an important factor in recruiting and retaining a competent and motivated direct support workforce within health and human services occupations (see Ebenstein, 2006, for a review of the literature). Between 40% and 45% of all paraprofessional home care workers lack health care coverage, signifi cantly undermining the fi nancial stability of home care workers and their families (Feinberg, Hunt, Dawson, Braunstein, & Cameron, 2004).…”

mentioning

confidence: 99%

Enhanced Care Assistant Training to Address the Workforce Crisis in Home Care: Changes Related to Job Satisfaction and Career Commitment

Coogle¹,

Parham²,

Jablonski³

et al. 2007

Care Management Journals

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Changes in job satisfaction and career commitment were observed as a consequence of a geriatric case management training program focusing on skills development among personal care attendants in home care. A comparison of pretraining and posttraining scores uncovered a statistically significant increase in Intrinsic Job Satisfaction scores for participants 18-39 years of age, whereas levels declined among the group of middle aged participants and no change was observed among participants age 52 and older. On the other hand, a statistically significant decline in Extrinsic Job Satisfaction was documented over all participants, but this was found to be primarily due to declines among participants 40-51 years of age. When contacted 6-12 months after the training series had concluded participants indicated that the training substantially increased the likelihood that they would stay in their current jobs and improved their job satisfaction to some extent. A comparison of pretraining and posttraining scores among participants providing follow-up data revealed a statistically significant improvement in levels of Career Resilience. These results are discussed as they relate to similar training models and national data sets, and recommendations are offered for targeting future educational programs designed to address the long-term care workforce shortage.

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Health Insurance Coverage of Direct Support Workers in the Developmental Disabilities Field

Cited by 5 publications

References 6 publications

The direct support workforce in community supports to individuals with developmental disabilities: Issues, implications, and promising pactices

The direct support workforce in community supports to individuals with developmental disabilities: Issues, implications, and promising pactices

Health Care Coverage and the Health Care Industry

Enhanced Care Assistant Training to Address the Workforce Crisis in Home Care: Changes Related to Job Satisfaction and Career Commitment

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