Learned Gerontology Skills

Elder Care: A Need for Learned Gerontology Skills for Informal
& Direct Care In-Home Health Aides.

Submitted in partial fulfillment of the requirements for
Cynthia K. Magelitz:
Introduction to the US Healthcare System
Shepherd University
MBA Studies: Health Concentration

11/20/2013

Elder Care: a Need for Learned Gerontology Skills for Informal
& Direct Care In-Home Health Aides.

I. Late Adulthood Years
A. Gerontology
B. Working With the Aging
C. A Growing Industry
II. Cost of In-Home Health Care
A. Expansion and Care
B. Medicare and Medicaid
C. Out of Pocket Cost
III. Legislation to Support Caregivers
A. In-Home Care Assessment
B. Direct Care: Federal and State
C. Family Caregiver
Department of Health and Human Services. 2013). The Medicaid Waiver Program has several core services: Case management, homemaker, home health aide, personal care, adult day care, rehabilitation, and respite care, (Hooyman, N.R., Kiyak, H.A. 739). Medicaid can cover long-term services provided by in-home aides three different ways: Under the Mandatory Home Health State Plan Benefit, the Personal Care Services Optional State Plan Benefit, and Home and Community Based Waiver Program. Only a handful of states finance a small amount of long-term home attendant care under the Home Health Benefit. Most states offer personal assistance services through the Personal Care Services Optional State Plan Benefit, (U.S. Department HHS. 2013). Most if not all are required to provide personal care services through state licensed home care agencies and many states allow the consumer to hire the PCA. For the consumer there is the freedom of choice built into the Medicaid program for home health care but are only extended to qualified providers of in-home care and leaves it up to each state to spell out the
The state of California has a Medicaid State Plan and waiver programs that do not require training for agency employed direct care aides. Even though California is awarded federal grant money to develop a training and certification program for PCA’s as part of the Personal and Home Care Aide State Training Program, a provision of the ACA. In the District of Columbia, PCA’s are required to have a certification as a home health aide, 120 hours of training and pass a competency evaluation. The District of Columbia does not offer directed services under Medicaid, (Marquand, A. 2012). A report released by the IOM in 2008, emphasized that there is a poor retention of direct care workers, a 70% turnover rate nationwide due to low wages compared to high expectation and level of care within the job requirement. Roughly 60% of direct care workers stay on the job for more than 12months but less than 24, (IOM, 2008). Through this report the IOM indicates that direct care workers, state and private have minimal training in long term in-home elder care. In 2010, HHS Secretary Sebelius announced that $320 million grant dollars was assigned to strengthen the health care workforce through the ACA. Of this grant $4.2 million will be used for the Personal and Home Care Aide State Training Program. The program is to support states in