1. New York City’s Home Care Workforce Profile and Recommendations 6 December 2010

2. Scale of the NYC home care workforce… 2

3. Categories of NYC direct-care workers… 3

4. NYC home care workforce wages… 4

5. Reimbursement to wage… 5 ServiceNYC Average Hourly Medicaid Rates Payment to LHCSA for Hour of Service NYC Hourly Wage (entry level) Occupation Home Health Aide Service $20.19$13.65$8.00 Home Health Aide Personal Care Service $17.48 $9.96 Home Attendant

6. Growth of NYC home care workforce… 6

7. Recommendations – reform delivery system… 7 Φ Consolidate and simplify multiple programs Φ Consolidate services in fewer providers Φ Standardize assessment Φ Adjust nursing home eligibility Φ Demand greater transparency

8. Recommendations – stabilize workforce… 8 Φ Raise wage floors; require parity Φ Build rates from the wages up Φ Re-structure payment to reward “high road” Φ Increase training standards Φ Consolidate training delivery system Φ Create “Advanced Aide”

9. Reform proposal “design principles…” 9 Φ Contains costs Φ Simplifies delivery system Φ Protects most vulnerable clients Φ Maximizes consumer direction Φ Stabilizes the workforce Φ Stabilizes the system