Where Policy Meets Practice: Employer Perspectives on Scheduling and Hours for Home Care Aides. (November 2019)

• Record Type: Journal Article
• Authors: Nisbet, Elizabeth; Morgan, Jennifer Craft
• Other Names: Stone Robyn guest-editor.
• Is Part Of: Journal of applied gerontology. Volume 38:Number 11(2019)
• Page Start: 1615
• Page End: 1634
• Publication Date: 2019-11
• Subjects: public policy -- Medicaid -- home care work -- home health aides -- direct care workers; Gerontology -- Periodicals; 362.6
• DOI: 10.1177/0733464817739153
• Languages: English
• ISSNs: 0733-4648

Abstract

In a context of growing demand for home-based direct care services, the need to retain direct care workers (DCWs) is clear. The Patient Protection and Affordable Care Act, changes to the Fair Labor Standards Act, and state-level changes in Medicaid support for home-based care together have affected agencies that hire DCWs, with implications for an issue that affects worker satisfaction: scheduling. Many home-based aides employed by agencies cannot count on consistent or sufficient hours. Hours shortfall and instability have been recognized as important issues for retail and restaurant workers, but focused on less for care aides. This study uses semistructured interviews with agency representatives to examine these issues from an employer perspective, with a focus on how the competing influences of health care, labor, and employment policy shape scheduling and a review of how recommendations for changes in policy and practice in other sectors might apply to home care.