1. The Direct Care Workforce: Obstacles and Opportunities Elizabeth Royal, SEIU June 13, 2013 June 13, 2013 Direct Care Workers and HIT

2. SEIUSEIU 2.2 million members 2.2 million members Over 1 million health care workers Over 1 million health care workers Over 600,000 direct care workers Over 600,000 direct care workers 27 states, DC and Canada 27 states, DC and Canada 2.2 million members 2.2 million members Over 1 million health care workers Over 1 million health care workers Over 600,000 direct care workers Over 600,000 direct care workers 27 states, DC and Canada 27 states, DC and Canada

3. Facts about Direct Care Workers** CNAs, HHAs, Personal Care Workers CNAs, HHAs, Personal Care Workers 2.3 million in personal care and home health ** 2.3 million in personal care and home health ** 1.7 million CNAs 1.7 million CNAs 90% female 90% female Age 25-54 Age 25-54 Disproportionately minority Disproportionately minority Significant proportion are foreign born Significant proportion are foreign born **Source: “Caring for America.” PHI Dec. 2011. Direct Care Work : Low wages Low wages Few, if any, benefits Few, if any, benefits High turnover High turnover High rates of injury High rates of injury Chronic shortages Chronic shortages

4. HIT and Long Term Care: Why does it matter? Bulk of care in LTC settings where adoption lags Bulk of care in LTC settings where adoption lags Characteristics of LTC settings inhibit adoption Characteristics of LTC settings inhibit adoption ACA and Care Coordination ACA and Care Coordination Bulk of care in LTC settings where adoption lags Bulk of care in LTC settings where adoption lags Characteristics of LTC settings inhibit adoption Characteristics of LTC settings inhibit adoption ACA and Care Coordination ACA and Care Coordination

5. HIT in Home and Community- Based Care Portal Technology Portal Technology IHSS Home Care Workers: Members of Care Coordination Team under Managed Care IHSS Home Care Workers: Members of Care Coordination Team under Managed Care NY Care at Hand, VA, MA [https://careathand.com/#!home] NY Care at Hand, VA, MA [https://careathand.com/#!home]https://careathand.com/#!home Portal Technology Portal Technology IHSS Home Care Workers: Members of Care Coordination Team under Managed Care IHSS Home Care Workers: Members of Care Coordination Team under Managed Care NY Care at Hand, VA, MA [https://careathand.com/#!home] NY Care at Hand, VA, MA [https://careathand.com/#!home]https://careathand.com/#!home

6. Nursing Homes and CNA documentation** CNAs driving implementation and adoption CNAs driving implementation and adoption Digital pen technology, hand held computers Digital pen technology, hand held computers Important Lessons Important Lessons CNAs driving implementation and adoption CNAs driving implementation and adoption Digital pen technology, hand held computers Digital pen technology, hand held computers Important Lessons Important Lessons ** On-Time Quality Improvement for Long Term Care. Case Studies, “Digital Pen Technology Results in Better Care and Improves Staff Satisfaction.” http://www.ahrq.gov/legacy/research/ltc/casestudies.pdf http://www.ahrq.gov/legacy/research/ltc/casestudies.pdf

7. What do we know about how to train to this technology? Involve DCWs in planning and implementation Involve DCWs in planning and implementation Understand and plan for the needs of workers Understand and plan for the needs of workers Maintain constant and ongoing training Maintain constant and ongoing training Utilize various venues for training and make it flexible Utilize various venues for training and make it flexible Involve DCWs in planning and implementation Involve DCWs in planning and implementation Understand and plan for the needs of workers Understand and plan for the needs of workers Maintain constant and ongoing training Maintain constant and ongoing training Utilize various venues for training and make it flexible Utilize various venues for training and make it flexible

8. Setting the Stage for Successful Adoption Fund innovative pilots, especially those that expand DCW roles Fund innovative pilots, especially those that expand DCW roles Ensure adequate funding and support for the technology Ensure adequate funding and support for the technology Remember the needs of the setting and of the end users Remember the needs of the setting and of the end users Fund innovative pilots, especially those that expand DCW roles Fund innovative pilots, especially those that expand DCW roles Ensure adequate funding and support for the technology Ensure adequate funding and support for the technology Remember the needs of the setting and of the end users Remember the needs of the setting and of the end users

9. Elizabeth Royal elizabeth.royal@seiu.org Thank you