Issues facing direct-care workers were highlighted at a recent “Healthcare in the Heartland” forum in Des Moines, Iowa. The event, sponsored by the University of Iowa and the Iowa Department of Public Health, focused on the implementation status of numerous provisions of House File 2539, the Health Care Reform Act, passed by the Iowa General Assembly in 2008.
Several provisions in HF 2539 focused on direct care workers. A panel, which included John Hale, Policy Director of the Iowa CareGivers Association and Diane Frerichs, a Certified Nurse Aide from Estherville, Iowa discussed the emerging crisis in the direct care workforce and the activities underway to address their training, certification, wages and health care benefits.
The event was attended by 250 health care insurers and providers, elected leaders, representatives of state government agencies, citizen advocates and others interested in health care reform initiatives. United States Senator Tom Harkin, the featured speaker, spoke at length about the prospect for health care reform in an Obama Administration, and of his work with Senator Ted Kennedy to insure consideration of reform initiatives in 2009.
John Hale offered this comment on the day: “This forum provided us with an opportunity to discuss direct care worker issues on the same level and with the same seriousness as other health care issues. Having Diane speak from the heart about the work she does, and why she does it, brought a powerful human element to the day. Our hope is that attendees left thinking differently about direct care workers and the work they do, and recognizing the need to continue the efforts begun in Iowa to insure that direct care workers are well paid, adequately benefitted and receiving excellent initial and ongoing training.”
John Hale
Policy Director
Iowa CareGivers Association
hale_johnd@msn.com
The emerging crisis in the health and long term care workforce was up for discussion on August 20, when members of the Iowa Legislature and the Iowa Congressional delegation held a Healthcare Roundtable in Des Moines. The focus of the roundtable was coordinating state and federal efforts to expanding health care coverage.
I was there along with Di Findley of the Iowa CareGivers Association (ICA), Iowa’s HCHCW partner, to talk to the elected officials about the health coverage needs of direct-care workers. We also talked about the need to give attention to the crisis in the direct-care workforce. As a result of the conversations, ICA has scheduled follow-up meetings with several elected leaders in attendance.
Other topics disucssed include ERISA rules, Medicaid and Medicare reimbursement levels, S-Chip expansion, the need for federal electronic medical record standards, approaches to cost containment, medical homes, and chronic disease management.
John Hale
Policy Director, Iowa CareGivers Association
hale_johnd@msn.com
On August 16, members of the Health Care for America Now (HCAN) Coalition met with Iowa Senator Tom Harkin, sharing their concerns and stories about uninsured Iowans. They also talked about the struggles faced by both direct-care workers and the people they serve as a result of inadequate or no insurance.
That’s me in the back row of the photo right behind the senator, along with other members of the coalition, as he signs HCAN’s Which Side Are You On? pledge.
Senator Harkin supports the establishment of a comprehensive national health care plan. He mentioned two ways that goal might be achieved:
- Give all Americans the option to enroll in the Federal Employee Benefit Pool (the same insurance he has), with the rationale that enrolling more would lower the cost to individual members; or
- Expand Medicare to cover all Americans. It would be much more difficult to get Congress to pass the second, he noted.
Continue reading ‘Health Care Reform Advocates Meet with Senator Harkin’
On August 11, the Iowa Choice Health Care Coverage Advisory Council, which is charged with designing a comprehensive plan to cover all children and adults in the state without health care coverage, held its first meeting. The council was created by health care reform legislation passed by the 2008 Iowa Legislature and signed into law by Governor Chet Culver in May. The legislation calls for new plans to be available for purchase as of January 1, 2010.
At the first meeting, the coucil discussed the challenges of coming up with definitions and parameters of adequacy and affordability, potential ways to administer the plans, and key issues such as who is eligible for coverage and whether or not coverage should be mandatory. The council also requested data on the various health plans that currently exist in Iowa and the associated costs. The Council will meet every two weeks.
Continue reading ‘Iowa Digs into Health Care Design’
Health Care for America Now, a national grassroots campaign seeking to win affordable, quality health care for all Americans, launched on July 8 with events across the country. PHI’s Health Care for Health Care Workers campaign recently joined the new campaign.
In three key HCHCW states, HCHCW staff and partners participated in launch events, seizing the opportunity to focus attention on the health care needs of direct-care workers:
- Pennsylvania. HCHCW Community Organizer Simone Baer spoke about the thousands of direct-care workers caring for the state’s most vulnerable citizens who lack health care coverage of their own. The event was covered by the Pittsburgh Post Gazette.
- Iowa. Iowa’s HCHCW partner, the Iowa CareGivers Association, participated in the launch on the steps of the state capitol. The ICA is one of 18 initial members of a growing campaign in Iowa that is working to assure that the next President and Congress pass legislation guaranteeing quality, affordable health care for all. ”As a key battleground state in the Presidential election, Iowa will be a focal point for debate over the respective candidates’ plans to reform the health care system,” said ICA Policy Director John Hale. “The ICA and direct-care workers will be involved in those debates, and will insure that the candidates recognize the unique needs of direct-care workers in getting and keeping adequate and affordable health care coverage.”
- Maine. Helen Hanson, a direct-care worker from China, Maine, represented the Maine Direct-Care Worker Coalition, a HCHCW partner, at the launch event on the steps of her state’s capitol. Helen spoke of her struggle with health care bills after routine tests that were not covered by her catastrophic coverage plan. Another HCHCW partner, the Maine Center for Ecomomic Policy, also participated in the launch event, which was covered by the Portland Press Herald.
Things will be heating up as the Presidential campaign moves toward November. Visit the Health Care for America Now website to find out how you can get involved.
Allison Lee, HCHCW National Campaign Manager
alee@phinational.org
On May 13, Iowa Governor Chet Culver (pictured) signed HF 2539, a new law that will have a dramatic and lasting impact on the direct-care workforce. The bill, whose intent is to “progress toward achievement of the goal that all Iowans have health care coverage,” includes several clauses specific to direct-care workers.
This dramatic success flows from years of work on the part of Di Findley, the founder and executive director of the Iowa CareGivers Association, as well as extensive advocacy efforts by direct-care workers and their supporters. Lots of seeds have been planted over the years. This year, we had the opportunity to see them grow and bear fruit.
Being part of the Health Care for Health Care Workers campaign was also of great importance to the legislative effort. The activities of HCHCW – the research that’s been done, the publications that have been prepared, the ideas that we gained, and the help that was provided — were critical to our work.
Continue reading ‘Iowa Law Broadens Health Care Coverage for DCWs’
Members of the Iowa CareGivers Association (ICA) lobbied their legislators on January 29, talking about the need for better pay, better benefits, and better training and education for Iowa’s direct-care workers.
The caregivers also asked their legislators about their personal experiences with caregiving, as part of a push by the ICA to collect and publish stories of legislators and others who have been, in the words of the ICA’s theme for 2008, “touched by a caregiver.”
“The value of that is, it forces legislators to think completely differently about direct-care workers,” says ICA Policy Director John Hale. “When they start to think about direct-care workers in terms of their own lives, it becomes real, not just one of the hundreds of issues they have to deal with every day. It becomes more of a priority.”
“Invest in the nursing-facility work force, those who provide the care and have the most influence on the results produced. Hire the best people, train them and treat them well. Reward them with a livable wage and great benefits. Involve them in planning and decision-making. Have enough staff on board to ensure that the safety and well-being of residents can be assured. Acknowledge the good work being done,” urges an op-ed in today’s Des Moines Register. John Hale, the policy director of the Iowa CareGivers Association and the point person for the PHI Health Care for Health Care Workers campaign in Iowa, co-authored the piece with ICA Executive Director Di Findley. The two wrote in response to an expose on the quality of care in Iowa’s nursing homes.
“One of the more troubling aspects of the reporting to date has been the information pertaining to the million-dollar chief-executive salaries, $400-per-hour director fees and the off-shore, for-profit insurance companies used by the not-for-profit sector,” wrote Hale. “It’s particularly troubling when contrasted with the $10.77 average hourly wage of the certified nursing assistants who provide most of the hands-on nursing-home care. A quarter of these caregivers have no health-insurance coverage.”
The Iowa caucus may be over, but Iowa’s nursing assistants haven’t stopped asking the presidential candidates to acknowledge the importance of direct-care workers – and to offer them better health care coverage and other supports.
In a letter to the editor in the January 25 Des Moines Register, CNA Lin Salasberry and 10 colleagues refer to the letter they wrote in late December to presidential candidate Mike Huckabee, expressing “frustration and concern” about a comment he made about direct-care work on Larry King Live. They reiterate the points made in that letter, including “how low pay, lack of affordable health benefits and lack of respect contribute to a high level of turnover, and how that revolving door of workers leads to less care and less quality of care for Iowans.” The Huckabee campaign acknowledged receipt of the original letter, but no response has been received. “We hope that Huckabee and other candidates understand that there are more than 3 million professional caregivers in America who are concerned about his words and failure to respond,” the follow-up letter says.
In a commentary on the January 25 letter posted on the healthcare08 website, health care journalist Craig Stoltz noted: “The healthcare debate is often centered on more easily identified constituencies: the uninsured, doctors, insurance companies. But the millions of people who are working on the front lines of healthcare are rarely considered.
“Can caregivers earn a place at the table of healthcare reform?” Stoltz asked.
After Presidential candidate Mike Huckabee referred to nursing assistant work as “emptying a bedpan” during a discussion of criminal background checks, the ICA sent Governor Huckabee a letter objecting to that characterization. “We wonder whether you know how difficult it is to get talented people to enter and stay in this profession,” the letter asks. “Do you know that 25% of certified nurse aides in Iowa have no health insurance? Do you know how we struggle to make ends meet because of low pay? Do you know that turnover in many of these jobs is running over 70% annually? Do you know that ‘being looked down upon’ and not being respected is a big factor in people leaving the occupation?”
The ICA also sent the letter to the news media and all the other candidates then blanketing Iowa in the lead-up to the January 3 caucuses. Several media outlets picked up the story, including TV news stations KCCI and WHO in Des Moines.
“Having been a nurse aide in the past, I have emptied many bedpans, and quite frankly I believe it to be one of the most compassionate acts of caring that one can do!” said ICA Executive Director Di Findley in a January 2 email about the letter. “And while I realize that we may all say things off the cuff, this truly is an opportunity for us to educate the candidates and others.”
Findley also called on fellow advocates to contact Huckabee’s campaign headquarters and “ask him to publicly respond to our request for an apology to the three million direct care workers in the country.”
Cindy Ramer, a nursing assistant and powerful advocate for affordable health insurance, is a member of the Iowa CareGivers Association (ICA), which is spearheading the Iowa Health Care for Health Care Workers campaign. She has testified in many venues about her experience of having been bankrupted by medical costs.The September 26 hearing was hosted by former Governors Tom Vilsack and Terry Branstad.
Cindy Ramer
Public Hearing on Health Care Reform hosted by Governor Branstad and Governor Vilsack
September 26, 2007
Good evening Governor Branstad and Governor Vilsack and thank you for the opportunity to talk with you this evening.
At your first public meeting in Council Bluffs, you were given a packet of information by Kealy Andersen, a Certified Nurse Assistant from Shenandoah. Contained in that packet was a DVD featuring the stories of three direct care workers (wmv).
I am one of those workers. My name is Cindy Ramer, a CNA from Denver, Iowa. I, like Kealy, serve on the Leadership Council of the Iowa CareGivers Association, and I am proud to represent them here this evening.
I have told my story on numerous occasions over the past 2 years. Each time it becomes a little easier for me to tell it. While it gets easier, the story never gets better. It always ends the same way, with a result that is very sad, very difficult, and very unacceptable.
The short version of the story is this:
Several years ago my husband was working for a small construction company and I in direct care, we did not have health coverage at that time. My husband was diagnosed with diabetes which subsequently affected his heart. He went through surgery. The cost forced us to file bankruptcy. On November 6, 2005, he suffered a massive heart attack and passed away. Since then, I have had to deal with the loss of my life partner and the debts left behind by his illness and death.
Due to the medical debts I carry, I cannot see my family physician until I can at least pay off the smaller bills owed for my own health care needs.
I am a Baby Boomer fast approaching retirement age, who needs some answers on solving these problems. The thing I want to stress to you is this…this should never happen in Iowa. Whether it’s me as a direct care worker, or anyone else, NONE of us should be put in a position where we go without adequate and affordable health care, where we are forced to file bankruptcy due to medical debt, and where we are treated as a second class citizen and actually denied the opportunity for necessary medical care.
“Our hope is that the conversation that has been focused on how to pay for long-term-care services will expand into a conversation about the availability of long-term-care services. If it does not, we may be spending a great deal of time trying to find better ways to pay for services that won’t exist,” writes John Hale, policy director of the Iowa CareGivers Association (ICA), in today’s issue of the Des Moines Register.
In his opinion piece, Hale calls on Iowa residents to “work together on how to make jobs in long-term-care good jobs.” The long-term care system may collapse, he warns, if workers are not paid better, offered retirement plans, and provided affordable health insurance.
The ICA is spearheading the HCHCW campaign’s efforts in Iowa.
“It is simply wrong that so many people who provide care for others do not get care themselves because they do not have any health insurance or because the insurance they do have fails to meet their needs,” direct-care worker Kealy Andersen, a member of the Iowa CareGivers Association, told a group of special commissioners studying health care in Iowa. “The work we do is among the most important in society. We deserve good health coverage.”
A story in today’s SW Iowa News describes testimony from Andersen and others at a Council Bluffs public hearing held by the Legislative Commission on Affordable Health Care Plans for Small Businesses and Families. The commission was created by the Iowa Legislature to make recommendations on how to improve health care access and affordability to all Iowans. Its final report is due to lawmakers next year.
“The quality of care provided to our family members, friends and neighbors in health and long term care settings directly relates to the stability of the workforce,” Andersen told the commissioners. “If we have a revolving door of people entering and leaving the field – in large part due to the lack of adequate and affordable health care benefits – the quality of care provided will never be what we want it to be.”
The following testimony was given by certified nursing assistant Cindy R. at a press conference held at the Iowa state capitol in January 2005. She added the postscript ten months later, after her husband passed away.
Good morning all! I’m a direct-care worker and a member of the Iowa Caregiver’s Advisory Council. I have come here this morning to educate and be educated, so that we can all work together to improve the health care system for the direct-care workers and those that they assist or care for. Continue reading ‘Medical Bills Resulted in Bankruptcy’
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