The John A. Hartford Foundation Community Initiative
Seeking Future Solutions

Staffing/Reimbursement Issues
Ideas from August 2, 2002 Initial
Interest Group Meeting

Clarifying priorities/goals:

  • Competing with acute care and other agencies for staff
  • Competing with other service jobs
  • Lack of control over hours- high absenteeism
  • Inability of staff of defining their own hours
  • Moonlighting by staff to make ends meet
  • Problems with transportation and childcare (especially for single mothers)
  • Lack of respect for staff in LTC (poor Image); lack of public understanding
  • Many staff have stressful lives (hard to leave "problems at the door")
  • Quality of workers; mismatch of workers abilities and skills with residents needs
  • Limited ability to do background checks outside of Monroe County
  • Low self-esteem; CNA work is not seen as a career

Identifying concerns/obstacles to goals:

  • Low reimbursement
  • Low staffing ratios
  • Restricted lines/roles of workers
  • Use of a medical model versus a focus on quality of life
  • PRIs/RUGs do not adequately capture care needs of persons with dementia
  • Paperwork- TOO MUCH!!
  • Restrictive regulations

Resources:

  • GRAPE/Studies done by GRAPE
  • Learning Institute – Alzheimer’s Association
  • Local Coalitions
  • LIFESPAN
  • Rochester Health Commission
  • Pioneer Network
  • Trainer Presentations- family focus and support
  • Other professional membership organizations

Strategies for achieving goals:

  • Support 24-hour day care through a community crisis center (a demonstration project of SPCC)
  • Empower workers at all levels through dementia specific education
  • Find ways to share Best Practices
  • Become involved in social action (i.e. assisting staff to buy houses and with fix-ups)
  • Explore "Buddy Back-up" program to reduce use of temporary staffing
  • Increase staff pay to be on call to fill in when necessary
  • Give staff more options in terms of choice regarding work schedules
  • Give a bonus for perfect attendance / pay for unused sick time a benefit
  • Work for changes in regulations to improve the work setting and staffing possibilities
  • Support and advocate for creative solutions to the transportation issue
  • Promote the value of staff in LTC
  • Networking with interested individuals and meeting on a regular basis