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How do hired workers fare under consumer-directed personal care?
Stacy Dale1, Randall Brown, Barbara Phillips
1Mathematica Policy Research, Inc., Princeton, NJ 08543, USA.
The Gerontologist
|October 4, 2005
Summary
Consumer-directed care models, like Cash and Counseling, offer high job satisfaction for hired workers, including friends and relatives. This model does not appear to cause adverse consequences for workers providing essential care services.
Area of Science:
- Health Services Research
- Social Gerontology
- Health Policy
Background:
- Consumer-directed care allows individuals to hire their own support workers.
- The Cash and Counseling demonstration evaluated this model.
- Understanding worker experiences is crucial for program effectiveness.
Purpose of the Study:
- To describe the experiences of workers hired under consumer direction.
- To compare experiences of directly hired workers with agency-provided care workers.
Main Methods:
- Randomized controlled trial comparing consumer-directed care with agency care.
- Survey of paid workers approximately 10 months post-enrollment.
- Analysis of worker satisfaction, wages, strain, and training.
Main Results:
- Directly hired workers were often friends or relatives.
- Both groups reported high job satisfaction and similar wages.
- Directly hired relatives experienced more emotional strain; injury and physical strain were similar to agency workers, despite less training.
Conclusions:
- The Cash and Counseling model is not associated with adverse worker consequences.
- Directly hired workers report high satisfaction and manageable hardship.
- States can support workers by providing educational materials and monitoring well-being.