Joan Fitzgerald is professor of urban and public policy at Northeastern University. She is the author of Emerald Cities: Urban Sustainability and Economic Development, and is working on a new book, Greenovation.
Joan FitzgeraldNov 05, 2001
Nobody is happy with the nation's nursing homes. Too many patients are receiving substandard care. Workers, particularly nurse's aides who provide the majority of direct care, suffer from low wages, lack of benefits, understaffing, inadequate training, and limited career opportunities. Families are often appalled at how their loved ones are treated. Owners and managers struggle with government reimbursements that do not allow higher pay or better treatment. Clearly, the $96.2-billion-a-year nursing home industry is failing its residents and workers. Government is deeply implicated, since the majority of nursing home bills are paid by Medicaid or Medicare. Yet the Bush administration's tax-and-budget program precludes a national strategy to upgrade nursing homes and professionalize the caregivers who work in them. States vary widely in their strategies. Massachusetts and California have made recent gains in upgrading care quality and professionalizing care. In Florida, with its large...
Joan FitzgeraldNov 30, 2000
One promising strategy for rewarding work seeks to create career ladders to enable low-wage workers to advance through a progression of higher-skilled and better-paid jobs. This approach requires several elements. Employers need to become more explicit about how they structure jobs and routes to career advancement. Workers need access to job-specific training. Institutionally, this endeavor usually requires both an intermediary, such as a community college or a union, and a supportive government strategy to fund and connect all the elements. Even so, many low-wage jobs do not logically lead to higher-paid ones, and a career-ladder strategy is a complement, not a substitute, for better pay, professionalization, and security throughout the job chain. Most career-ladder programs are organized by industrial sectors or clusters of occupations. For example, in Chicago, a community organization, Bethel New Life , is trying to move women who work as certified nursing assistants into jobs as...