Barriers to documenting occupational injuries among personal assistance services workers

Using workers' compensation claims to investigate occupational injuries among residential day laborers and domestic workers

BACKGROUND

While many states have legal provisions to extend workers' compensation eligibility to day laborers or domestic workers hired directly by homeowners or families, little is known about the nature or frequency of injury claims submitted on behalf of these "residential employees."

METHODS

We examined California workers' compensation claims records for injuries that appear to have occurred in residential settings between 2008 and 2018 and where the employer of record was an individual or family. We examined the demographic, occupational, and injury characteristics of our sample and analyzed factors that contribute to the likelihood of a claim resulting in some sort of payment.

RESULTS

We identified 5,463 workers' compensation claims that were likely submitted on behalf of residential employees. Claims most commonly reflected injuries to workers performing housekeeping tasks, followed by construction/maintenance and caregiving. Workers performing construction/maintenance or gardening/landscaping tasks were more likely to be injured on the same day of hire and were more likely to require hospitalization or emergency treatment for their injuries; however, these workers also had a smaller proportion of claims that resulted in payment. We found that employment tenure had the biggest impact on the likelihood of payment, with the odds increasing sharply after the first day of work.

CONCLUSIONS

Although the claims in our data set likely represent only a small fraction of all injuries to residential day laborers and domestic workers during this period, we suggest that workers' compensation claims can provide valuable clues for better understanding occupational injuries among workers in this largely informal sector.

Slips, Trips, and Falls Among Home Care Aides: A Mixed-Methods Study

OBJECTIVE

To address the gap of knowledge about slips, trips, and falls (STFs) among home care aides (HCAs) who work in clients' homes.

METHODS

This mixed method study used survey and focus group data of HCAs in a Medicaid-funded homecare program.

RESULTS

STFs were common with over 12% of HCAs reporting occurrence in the previous 12 months, of whom 58% fell to the ground. Both survey and focus group data identified ice, clutter, workload, rushing and other hazards. Focus group data explained the reasons for not reporting STFs, even among those who sustained injury, and added HCAs' voices to the understanding of causes, consequences and prevention strategies for STFs.

CONCLUSIONS

Empowering HCAs with knowledge, training, and involvement may transform "near miss" STFs into opportunities to prevent STFs among care workers and their clients.

Personal service assistance: musculoskeletal disorders and injuries in consumer-directed home care

BACKGROUND

Like other types of care for disabled or elderly adults, consumer-directed personal assistance services may present multi-factorial risks for work-related musculoskeletal disorders (WRMSDs).

METHODS

Using survey data, we compared providers experiencing WRMSDs in the previous year to those who did not, seeking to identify functional, temporal, physical, and relationship risk factors for transient and chronic conditions.

RESULTS

Longer work experience with the recipient and more frequent bending increased the risk of being in the most chronic group (≥12 painful episodes), whereas predictable work hours with rest breaks and greater social support from the recipient appeared protective. For transient conditions (one to two episodes), longer work experience with the recipient and predictable hours with rest breaks appeared protective.

CONCLUSIONS

We offer recommendations to improve hazard assessment as well as training and information distribution related to home care programs. With the population aging, home care jobs require increasing oversight to prevent WRMSDs.

Personal assistance services in the workplace: A literature review

BACKGROUND

Personal assistance services (PAS) can be valuable adjuncts to the complement of accommodations that support workers with disabilities. This literature review explored the professional literature on the use of PAS in the workplace.

METHODS

Bibliographic sources were used to locate relevant research studies on the use of PAS in the workplace. The studies in this review used both qualitative and quantitative methods to identify current definitions of work-related and personal care-related PAS, agency-directed versus consumer-directed PAS, long-term and short-term funding issues, development of PAS policy, and barriers to successful implementation of PAS.

RESULTS

The studies uncovered issues related to (a) recruiting, training, and retaining personal assistants, (b) employer concerns, (c) costs and benefits of workplace PAS, (d) wages and incentives for personal assistants, and (e) sources for financing PAS as a workplace accommodation.

CONCLUSION

The findings reveal the value and benefits of effective PAS on the job. PAS can lead to successful employment of people with disabilities when other accommodations cannot provide adequate workplace support. Additionally, the evolution of workplace PAS is dependent on development of realistic PAS policy and funding options.

Protecting home health care workers: a challenge to pandemic influenza preparedness planning

The home health care sector is a critical element in a pandemic influenza emergency response. Roughly 85% of the 1.5 million workers delivering in-home care to 7.6 million clients are low-wage paraprofessionals, mostly women, and disproportionately members of racial and ethnic minorities. Home health care workers' ability and willingness to respond during a pandemic depends on appropriate communication, training, and adequate protections, including influenza vaccination and respiratory protection. Preparedness planning should also include support for child care and transportation and help home health care workers protect their income and access to health care. We summarize findings from a national stakeholder meeting, which highlighted the need to integrate home health care employers, workers, community advocates, and labor unions into the planning process.