Nursing Assistant Resources On The Web

We all like to sit back and demand better pay, better benefits and what not. We all agree this might help solve the pending shortage of CNA’s and direct care workers. Yet we all forget where the money comes from for all this; and we forget to look at consumers’ choices and preferences.

I’d like to share a couple articles I found for the purpose of showing how states’ are grappling with health care decisions.

Paralyzed since he broke his neck in a 1996 diving accident, Clay Freeman depends on 11 machines and around-the-clock care to stay alive.

With assistance from in-home caregivers who took him to classes, Freeman graduated from Chemeketa Community College in 2006.

He also has relied on caregivers to take him to movies, on shopping trips and other outings, including school functions and sporting events for his five nieces and nephews.

Distressingly, the Salem quadriplegic has had a hard time retaining the caregivers who serve as his conduit to daily life. Some have burned out tending to his complex needs. Others have resigned to take less rigorous work that pays better.

When another caregiver called it quits early this month, Freeman, 34, was left with two of the five hands-on assistants he needs to monitor his machines and assist him with breathing, eating, toileting and more.

Mr. Freeman wants to remain free- he doesn’t want to be institutionalized. Who can blame him? His chances of complications with his health will increase a lot with an admission to a nursing home. His independence will cease to be. His education will go unheeded. Not to mention the sheer fact that staying in his own home costs MUCH less than living in a nursing home would cost.

The caregiver crisis posed life-threatening complications for Freeman and crimped his federally mandated rights to live with as much independence as possible, according to a lawsuit brought against the state of Oregon on his behalf.

“Mr. Freeman is now at risk of being forced to live in a nursing facility — an institutional setting — because he has been unable to hire and train three of the five personal attendants needed to meet his daily needs,” states the lawsuit.

The federal civil-rights lawsuit asks that the state be required to provide enhanced caregiver compensation so that Freeman can hire the help he must have to deal with his daunting disabilities.

Mr. Freeman is suing his state to ensure it increases the rate of pay for his home health care aides. A good thing. Home health aides are very important to consumers who rely upon them to keep them out of the nursing homes.

Under contract terms with the state, average pay for Oregon’s 11,500 unionized home health care workers is slightly less than $10 per hour. To recruit and retain caregivers for Freeman, the state must pay at least $12.90 per hour, his lawyers say. The state also has to ensure that his caregivers get proper training, the lawsuit asserts.

A federal judge has issued a temporary ruling in Freeman’s favor. A week ago, U.S. District Court Magistrate Thomas Coffin ordered the state to provide Freeman with five caregivers at the $12.90-per-hour rate. Coffin also directed the state to supply Freeman’s caregivers with training provided by a licensed registered nurse.

Freeman’s lawyers are asking for a permanent court order that would enforce the higher pay rate. Opposing lawyers are expected to make oral arguments before Coffin at a hearing this summer.

Of course no state or union can force anyone to work for a private citizen who is seeking services. We are free to choose. But it is cited as being the ideal working environment for CNA’s: Private home care.

The second article highlights the clash between state government and nursing home industry lobby groups, unions and others. Each state receives a certain sum of money to cover ALL nursing care- from the federal government. The states must match this sum with a percentage of cash as well. And the state has the final say in where this money goes to. In these tough times, and in good times as well, it makes fiscal sense to keep people in their own homes as long as possible. Preventing nursing home admissions is key to keeping costs low for everyone.

Nursing homes get 80 percent of the money Pennsylvania spends to help people who are too old or disabled to care for themselves. The Rendell administration says that must change.

The administration has the goal of an eventual 50-50 funding split between nursing homes and programs that help people remain in their homes and communities. Rendell’s proposed budget includes no increase for nursing homes, while giving a $20 million increase to programs that help people stay at home rather than entering nursing homes.

The federal government has marked certain sums of money given to each state to be used for home care situations only. These are not small amounts of money: We’re talking billions from the fed. By slowly cutting back the nursing home admissions and increasing the home health options, states are saving millions and millions of dollars that are budgeted to other programs. The nursing homes are fighting this move. The costs of a nursing home bed is falling short of the payment received. Who pays the difference? We all do via cut backs. It’s a lose-lose situation.

Groups representing nursing homes said state funding for nursing home residents covered by Medicaid — about 60 percent of Pennsylvania’s 82,000 nursing homes residents — is $12 per day short of what it costs to care for those residents. “Pay your bill,” one of their leaders shouted.

But what about Mr. Freeman? Doesn’t he have the right to stay at home? Or are we heading towards a society that forces people to enter nursing homes for the better of “all”?

In a separate rally, groups representing disabled people applauded Rendell’s proposal to increase funding for home and community-based programs. They characterized nursing homes as profit-driven organizations that underpay and overwork their workers while robbing their residents of freedom.

Very true. Are nursing homes bleeding the system so much now they have become a liability with regard to funding? It’s starting to look that way.

The Rendell administration says nursing homes receive an average of $173 per day for people covered by Medicare, and that rate is one of the best in the country. It costs about $70 per day for a home or community-based program, they claim.

I did the math quick and it’s a little off, but the costs savings are pretty close to these numbers.

The two states highlighted here, Oregon and PA, are facing the same issues every state is struggling with. The question used to be how can fund BOTH options. We can’t. As a country we would go bankrupt very fast. No one could afford the tax burden, which would be upwards of 50%…we already pay high taxes….and, to boot, our tax rates now are less than what they were ten years ago when these problems were just beginning to surface. We couldn’t afford this all then and we certainly cannot afford it now.

To give to one means taking away from another. The Robin Hood thing? Not really…it’s not about stealing from the rich to give to the poor. It’s more about stealing from all to give to a few. It’s also about being smart with budgets and choices.

I believe most of us have some form of a personal budget we follow. Cash for food shopping; cash for gas. Cash for the rent…the car payment.

When we decide we need more food to feed our families, we have to take from the other budgeted money- we might drive less to save gas money and move some of it to cover the extra food. Or the rent might be paid late. We have to make choices about where to cut back. When we’re at the grocery store, we might decide to spend less on store brand products or buy the lower octane gasoline to save money. In tight times we eliminate spending that isn’t required to live.

State governments must do the same thing. Funding programs and the like that cost much more than viable options is foolhardy and stupid. Nursing homes cost a lot more to maintain. Home health care is a viable alternative that consumers prefer. We can’t blame the states for standing up to what is fiscally sound and consumer driven, no matter what it means to us personally.