1. Long Term Care Initiatives in Vermont Patrick Flood Commissioner Vermont Department of Aging and Disabilities

2. As a Licensed Nurse’s Aide (LNA) in a Nursing Home, What I Wanted Most: More money More staff More continuity of care More of a say in how the work was done

3. Vermont Survey of Personal Care Givers The caregivers cited: – low wages and benefits – lack of respect and appreciation by supervisors and professional staff – poor working conditions such as lack of staff – inflexibility – desire to be more involved in care decision- making

4. Improved Nursing Home Staffing in Vermont Staffing Minimums Average staffing statewide increased. Increased Wages “Wage Supplements” appropriated twice. The average wage for an LNA in a nursing home has risen from $8.14 in 1998 to $10.41 in 2002.

5. Other Initiatives in Vermont “Career Ladder” opportunities – LNA II program Development of a Caregiver’s Association – To strengthen caregivers’ voice Development of a set of “best practices” to promote recruitment and retention – Coordination with Nursing Home Association and Home Health Association

6. Consumer-Directed Option Especially effective in home care Brings friends, neighbors and relatives into the work force who otherwise are unlikely to work for a facility or agency. Gets high customer satisfaction Costs less than agency or facility care