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

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ecause many held other jobs, or because they had to provide more hours than they were beingpaid for as part of their family responsibility for the consumers’ overall welfare.Finally, directly hired workers usually had to resolve one work-related issue that agencyworkers presumably were not responsible for: directly hired workers often have to find backupcare when they cannot come to work. Fifty-three percent of the directly hired workers in thesample were responsible for obtaining backup care, and 19 percent reported having at least somedifficulty arranging for it. (We did not ask agency workers this question, as we assumed thatagency workers would not be responsible for providing their own backup care.)7. Worker Well-beingMost workers experienced little physical strain as a result of their jobs, and the amount ofsuch strain reported by workers in the two groups was similar. About two-thirds of both directlyhired workers and agency workers reported little or no physical strain; conversely, only15 percent of agency workers and 17 percent of directly hired workers reported a great deal ofphysical strain (Table 7). Few were physically hurt on the job, although directly hired workerswere more likely than agency workers to be injured as a result of caring for the sample member(4 percent and 1 percent, respectively). The directly hired workers’ lack of personal care trainingmight have contributed to their higher rate of on-the-job injury. In addition, directly hiredworkers might have been more likely to be injured while caring for their client simply becausethey spent so much more time delivering that care. If we take into account the number of hoursof work provided (by weighting the observations on workers by the total number of hours of carethey provided to the sample member), directly hired workers were slightly (although notsignificantly) less likely than agency workers to be injured.26
TABLE 7WELL-BEING OF PRIMARY PAID WORKERS(Percentages)AgencyWorkersDirectly HiredWorkersPhysical Strain and InjuriesLevel of Physical StrainLittle or none (1 or 2) 68.3 65.2A great deal (4 or 5) 15.1 16.9Any Injury 1.4 3.6*Any Injury (Observations Weighted by Hours of Care WorkerProvided to Consumer) 5.7 4.6Relationship with ConsumerCaregiver and Consumer Get Along Very Well 94.4 91.4Had Very Close Relationship with Consumer 54.5% 84.7%***Emotional StrainLevel of Emotional StrainLittle or none (1 or 2) 70.1 60.2***A great deal (4 or 5) 8.9 15.2**Ever Had Disagreement with Consumer About Schedule 3.2 2.1Consumer Needs to Be More Respectful 12.4 16.1Consumer’s Family Needs to Be More Respectful 22.4 37.1***SOURCE:NOTE:Caregiver survey conducted by Mathematica Policy Research, Inc. between February 2000 and May2002.Sample sizes vary from measure to measure due to item nonresponse. The maximum sample sizes are281 for agency workers and 391 for directly hired workers.*Significantly different from agency workers at the .10 level, two-tailed test.**Significantly different from agency workers at the .05 level, two-tailed test.***Significantly different from agency workers at the .01 level, two-tailed test.27
Page 1 and 2: Subcontract No.: Q146901MPR Referen
Page 3 and 4: EXECUTIVE SUMMARYAn important consi
Page 5 and 6: While Medicaid supportive services
Page 7 and 8: 2. Cash and Counseling in ArkansasA
Page 9 and 10: hours and timing of care that worke
Page 11 and 12: members. During the nine-month foll
Page 13 and 14: • The worker’s physical and emo
Page 15 and 16: a paid caregiver by the time of the
Page 17 and 18: workers held jobs other than caregi
Page 19 and 20: worker was paid for less than one-t
Page 21 and 22: TABLE 3COMPENSATION AND SATISFACTIO
Page 23 and 24: workers might have viewed their pay
Page 25 and 26: TABLE 4TYPE OF CARE PROVIDED DURING
Page 27 and 28: TABLE 5TRAINING AND PREPAREDNESS FO
Page 29: TABLE 6SUPERVISION AND SCHEDULING(P
Page 33 and 34: Overall, both related and non-relat
Page 35 and 36: provided many more hours of unpaid
Page 37 and 38: Notably, directly hired workers (bo
Page 39 and 40: were randomly assigned to the treat
Page 41 and 42: REFERENCESArkansas Medicaid Program
Page 43 and 44: APPENDIXIn this appendix, we presen
Page 45 and 46: TABLE A.1 (continued)______________
Page 47 and 48: TABLE A.3TIMING OF CARE PROVIDED(Pe
Page 49 and 50: TABLE A.4 (continued)Suffered Littl
Page 51 and 52: TABLE A.5COMPARISON OF ADJUSTED AND
Page 53 and 54: • The consumer’s health and fun
Page 55 and 56: average predicted probability that

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