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Direct-Care Wages, Benefits Obstacle to Rebalancing LTC Services in Rhode Island
June 21, 2006
A study of community-based long-term care services in Rhode Island found a shortage of qualified direct-care workers to be an obstacle to 'rebalancing' the state's long-term care offerings from nursing home care to community-based services.
The problem, says Community-Based Long-Term Care Services in Rhode Island, is due largely to the differential in wages and benefits between home care and nursing homes and other institutional settings. 'Overall, hourly wages and employee benefits decline on the provider continuum as it moves from institutional care toward community care and home care,' the authors report, with CNAs in hospitals earning the most and homemakers, chore workers, and other home-based direct-care workers earning the least. Tables illustrate average wages by setting in Rhode Island and five neighboring states.
The same decline is seen in benefits, with the institutional providers contributing more to employee health insurance and providing more paid vacation and sick leave. Other competitive disadvantages for home care staff include unpaid time spend traveling between clients, unpredictable hours, and the difficulty of working full-time if desired.
The report, which was prepared for the Rhode Island Department of Human Services, also reviewed service rates and rate methodologies for four types of community-based services and recommended ways of restructuring state funding to support assisted living, home care, respite care, and adult day care.
Elise Nakhnikian
Communications Specialist
Paraprofessional Healthcare Institute
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