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What about the quality of care.

As the numbers of homemaker-home health aide services grow, it is clear that there is an urgent need to improve and maintain the quality of paraprofessional services. Because homemaker-home health aide services affect the public good, it is important that the federal government be involved in developing and enforcing quality assurance standards. The establishment of national standards must become a priority for the government as well as for national, state, and local associations.

Home Care Services↗

The provision of high levels of personal assistance services in the U.S.

State programs which provide personal assistance services (PAS) were surveyed to determine how many offer 24-hours of PAS per day if necessary. A total of 103 programs in 44 states were contacted and of these 23 (22.3%) in 7 states said that they offered 24-hour PAS in at least some circumstances. Persons with significant levels of disability who do not have extensive informal supports and live in states which do not offer 24-hour PAS may be placed in nursing homes or other institutions. The research highlights problems in defining 24-hour PAS and determining who needs this level of service. The economic and policy implications of 24-hour PAS are discussed and specific research is recommended on the cost of different models of service provision.

Activities of Daily Living↗

Improving the lives of home care workers: a partnership of social work and labor.

A school of social work with an occupational program specialization entered into an agreement with one of the largest trade unions in New York City to do a social and health services needs assessment for the union's newest members: home care workers. The vast majority of these home attendants are low-income African American and Latina women who care for frail aged and disabled Medicaid recipients to prevent nursing home placement. Structured interviews with a sample of 400 union members indicated a need for better health care coverage, especially for stress-related illnesses, along with personal social services to assist with housing, debt, child care, and family issues. The union used this independent university data in its subsequent collective bargaining and won expanded benefits for its members based on demonstrated need. The school then established a union-funded member assistance program to institutionalize ongoing support for these members. In the end, action research helped to create both social services and social change; low-income women of color have gained tangible new benefits; and social work's important ties to organized labor have been strengthened.

Female↗