The Experiences of Workers Hired Under Consumer Direction in ...

Finally, results from a companion analysis suggest that consumers received satisfactoryhealth care under IndependentChoices (Foster et al. 2003a) in spite of their workers’ apparentlack of training. Directly hired workers’ access to the consumer’s family health care providercould partially account for why consumers received adequate health care. About 44 percent ofdirectly hired workers consulted the consumer’s doctor with health care questions, and12 percent consulted the consumer’s nurse (not shown). In contrast, 72 percent of agencyworkers consulted the home care agency with health care questions, while few consulted with theconsumer’s doctor or nurse (9 percent and 4 percent, respectively).6. Supervision and SchedulingThe supervision of agency workers and directly hired workers is somewhat different.Agency nurses periodically supervise agency workers in the home, while directly hired workersreport being supervised mainly by the consumer and consumer’s representative or family.Despite the differing nature of the supervision received, similar percentages of directly hiredworkers and agency workers (84 and 86 percent, respectively, Table 6) were satisfied with thesupervision they received. However directly hired workers expressed greater satisfaction withthe amount of feedback they received on how care was provided, and they were less likely toreport having been asked to do things to which they had not agreed. Compared to agencyworkers, directly hired workers’ may have been more satisfied with the feedback they receivedbecause they had closer (and perhaps better) relationships with the consumer. Finally, similarpercentages (approximately 3 percent) of both directly hired workers and agency workersreported that close supervision interfered with their work.Over 70 percent of workers in both groups were satisfied with the flexibility of theirschedules, and few reported scheduling disagreements with their client. However, directly hiredworkers were more likely to report having to hurry to meet the consumer’s needs, perhaps24