CLASS Act Provision To Expand Personal Care Workforce

The health reform legislation includes a provision for Community Living Assistance Services and Supports (CLASS) which would implement a national, voluntary insurance program for purchasing long-term care, including community living assistance services and support.

Sec. 8002 of the CLASS Act requires the Department of Health and Human Services to establsih within 90 days after the law’s enactment a Personal Care Attendants (PCA) Workforce Advisory Panel to advise HHS and Congress on issues related to that workforce’s work circumstances. Among the workforce issues the PCA advisory panel would review are the following:
• Adequacy of the number of PCA workers;
• Compensation (salaries and wages);
• Benefits; and
• Access to PCA workers’ services.

Members of the advisory panel are to include...
• Persons with disabilities in all age groups;
• Elderly; and
• Representatives of the disabled, elderly, workforce and labor organizations, home and community-based service providers, and assisted living providers.

A PCA’s main responsibility is to help ill, weak or elderly clients with their personal needs such as hygiene, exercise, medication and communication, grocery shopping and meal preparation, and other activities of dailiy living.

Individuals can hire their own PCAs independently or through a home health agency. One benefit of hiring a PCA through an agency is convenience—presumably, the agency screens applicants for character and reliability, as well as for experience. Too often, however, training and experience are not required. Also, an agency often will provide back-up care in the PCA’s absence. Among the disadvantages of hiring a PCA through an agency are higher costs, and potential lack of control over choosing the caregiver.

Historically, there has been a shortage of qualified workers to care for disabled and elderly who need personal assistance to be able to remain in their homes. The shortage is primarily due to the fact that these workers typically are paid minimum wage and provided few, if any, benefits, including paid time off for sick days or other personal time, health insurance, or retirement.

Home health care agencies provide varied levels of care providers and their services are costly. State regulation of home care agencies and providers is highly varied as is the quality of service providers. Furthermore, few people buy long-term care insurance, also expensive, to help them cover these expenses should they need them’.

The CLASS Act’s required advisory panel, it is hoped, would help expand the qualified PCA workforce that will be necessary with the growth of the aging baby boomer population. That is, should it pass the health reform hhurdles.