This appendix lists the members of the project advisory committee and project staff.

Committee

Susan Chapman, Project Director
Allied & Aux Health Care Workforce Project
UCSF Center for the Health Professions
3333 California Street, Suite 410
San Francisco, CA 94118

Pat Franks
Senior Research Associate
UCSF Center for the Health Professions
3333 California Street, Suite 410
San Francisco, CA 94118

L. Gary Hart, PhD, Director
WWAMI Health Workforce Center
Roosevelt Way, NE Suite 308
University of Washington
Seattle, WA 98195-4795

Thomas R. Konrad, PhD
Director, Program on Health Professions
Sheps Center for Health Services
725 Airport Road, CB 7590, Suite 210
Chapel Hill, NC 27599-7165

Joel Leon, PhD
Director, Polisher Research Institute
Philadelphia Geriatric Center
261 Old York Road, Suite 427
Jenkintown, PA 19046

Michele Reed, MPH
Research Specialist
Illinois Center for Health Workforce Studies
850 West Jackson Blvd, Suite 400
Chicago, IL 60607

Hollis Russinof, MUPP
Center Manager and Policy Analyst
Illinois Center for Health Workforce Studies
850 West Jackson Blvd, Suite 400
Chicago, IL 60607

Susan Skillman, Deputy Director
WWAMI Health Workforce Center
Roosevelt Way, NE Suite 308
University of Washington
Seattle, WA 98195-4795

Robyn I. Stone, DrPH
Executive Director
Institute for the Future of Aging Services
901 E Street, NW Suite 500
Washington, DC 20004

Jane Tilly, DrPH (for Joshua Wiener)
Senior Research Associate
The Urban Institute
2100 M Street, NW
Washington, DC 20037

Mary Ann Wilner, PhD
Director of Health Policy
Paraprofessional Healthcare Institute
349 East 49th Street, Suite 401
Bronx, NY 10451

Staff

Edward S. Salsberg, Executive Director
Center for Health Workforce Studies
School of Public Health, University at Albany
One University Place, Suite 200
Rensselaer, NY 12144-3456

Paul Wing, D Engin, Deputy Director
Center for Health Workforce Studies
School of Public Health, University at Albany
One University Place, Suite 200
Rensselaer, NY 12144-3456

Margaret Langelier, Senior Research Associate
Center for Health Workforce Studies
School of Public Health, University at Albany
One University Place, Suite 200
Rensselaer, NY 12144-3456

HRSA Project Officer

Stuart Bernstein
Health Statistician and Project Officer
National Center for Health Workforce
Information and Analysis
5600 Fishers Lane, Room 8A-08
Rockville MD 20857

Appendix B. Proposed State Data Collection Instrument

This appendix shows the proposed state data collection instrument.

Appendix C. Occupational and Industry Definitions

This appendix presents official categories and definitions for occupations and industries relevant to the long-term care paraprofessional workforce used in different national data systems. Policy analysts interested in comparing data across these systems should understand the differences in categories and definitions that may be involved. Separate sections are presented for occupations and industries.

Occupations
2000 Standard Occupational Classification (SOC)
21-1093: Social and Human Service Assistants
This group assists professionals from a wide variety of fields, such as psychology, rehabilitation, or social work, to provide client services, as well as support for families. It may assist clients in identifying available benefits and social and community services and help clients obtain them. It may assist social workers with developing, organizing, and conducting programs to prevent and resolve problems relevant to substance abuse, human relationships, rehabilitation, or adult day care. It excludes “rehabilitation counselor”, “personal and home care aide”, eligibility interviewers, government programs”, and “psychiatric technicians.”

31-1011: Home Health Aides
This group provides routine, personal health care, such as bathing, dressing, or grooming, to elderly, convalescent, or disabled persons in the home of patients or in a residential care facility.

31-1012: Nursing Aides, Orderlies, and Attendants
This group provides basic patient care under direction of nursing staff. Perform duties, such as feed, bathe, dress, groom, or move patients, or change linens. It excludes home health aides (31-1011) and psychiatric aides (31-1013).

31-1013: Psychiatric Aides
This group assists mentally impaired or emotionally disturbed patients, working under direction of nursing and medical staff.

39-9021: Personal and Home Care Aides
This group assists elderly or disabled adults with daily living activities at the person’s home or in a daytime non-residential facility. Duties this group performs at a place of residence may include keeping house (making beds, doing laundry, washing dishes) and preparing meals. It may provide meals and supervised activities at non-residential care facilities. It may also advise families, the elderly, and disabled on such things as nutrition, cleanliness, and household utilities.

Occupational Classification System Manual/1990 Census Occupation Classification
K446: Health Aides, Except Nursing
This group excludes physician’s assistants. It is involved in performing various duties under the direction of trained medical practitioners, such as mixing pharmaceutical preparations, issuing medicines, labeling and storing supplies, assisting during physical examinations of patient, giving specified office treatments, keeping patients’ records, preparing treatment room, maintaining inventory of supplies and instruments; and preparing, bottling, and sterilizing infant formulas. It may also assist in physical and other therapy. Workers may be designated as therapy aides, clinical laboratory aides, formula mixer, etc.

K447: Nursing Aides, Orderlies, and Attendants
This group excludes licensed practical nurses. It is involved in providing auxiliary services in the care of patients. It may bathe patients, record temperature and respiration rate. Other activities include answering patients’ call bells, serving and collecting food trays, feeding patients and performing other routine tasks. Orderlies are primarily concerned with the care of male patients, setting up of equipment, and relieving of heavier work.

K465: Welfare Service Aides
This group excludes social workers and eligibility clerks. It includes workers in occupations involved in going to the home or other place of residence to perform tasks agreed upon by the family, the professional supervisor, and the aide. Duties may include keeping house, caring for children, the handicapped, the ill or the aged. Workers may be caseworker aides, community aide, blind aides, etc.

1980 Standard Occupational Classification
5233: Health Aides, Except Nursing
This group includes occupations involving performing various duties under the direction of trained medical practitioners, such as mixing pharmaceutical preparations, issuing medicines, labeling and storing supplies; assisting during physical examination of patients, giving specified office treatments, and keeping patients’ records; preparing treatment room, inventory of supplies and instruments; preparing, bottling, and sterilizing infant formulas. It may also assist in physical and other therapy treatment.

5236: Nursing Aides, Orderlies, and Attendants
This group includes occupations involving providing auxiliary services in the care of patients. Activities include: answering patients’ call-bells, serving and collecting food trays, feeding patients, and performing other routine tasks. Orderlies are primarily concerned with the care of male patients, setting up of equipment, and relieving nurses of heavier work.

5263: Welfare Service Aides
This group includes occupations involving going into the home or other place of residence to perform tasks agreed to by the family, the professional supervisor and the aide. Duties may include keeping house; caring for children, the handicapped, the ill, or the aged. (Services required to help provide and maintain normal bodily and emotional comforts and to assist the patient toward independent living in a safe environment.)

Industries
North American Industry Classification System (NAICS)
Subsector 561: Administrative and Support Services
561310: Employment Placement Agencies
This industry comprises establishments primarily engaged in listing employment vacancies and in referring or placing applicants for employment. The individuals referred or placed are not employees of the employment agencies.

561320: Temporary Help Services
This industry comprises establishments primarily engaged in supplying workers to clients’ businesses for limited periods of time to supplement the working force of the client. The individuals provided are employees of the temporary help service establishment. However, these establishments do not provide direct supervision of their employees at the clients’ work sites.

561330: Employee Leasing Services
This industry comprises establishments primarily engaged in providing human resources and human resource management services to staff client businesses. Establishments in this industry operate in a co-employment relationship with client businesses or organizations and are specialized in performing a wide range of human resource and personnel management duties, such as payroll accounting, payroll tax return preparation, benefits administration, recruiting, and managing labor relations.

Subsector 621: Ambulatory Health Care Services
621490: Other Outpatient Care Centers
This industry comprises establishments with medical staff primarily engaged in providing general or specialized outpatient care (except family planning centers and outpatient mental health and substance abuse centers). Centers or clinics of health practitioners with different degrees from more than one industry practicing within the same establishment are included in this industry.

621510: Medical and Diagnostic Laboratories
This industry comprises establishments known as medical and diagnostic laboratories primarily engaged in providing analytic or diagnostic services, including body fluid analysis and diagnostic imaging, generally to the medical profession or to the patient on referral from a health practitioner.

621610: Home Health Care Services
This industry comprises establishments primarily engaged in providing skilled nursing services in the home, along with a range of the following: personal care services; homemaker and companion services; physical therapy; medical social services; medications; medical equipment and supplies; counseling; 24-hour home care; occupation and vocational therapy; dietary and nutritional services; speech therapy; audiology; and high-tech care, such as intravenous therapy.

Subsector 622: Hospitals
622110: General Medical and Surgical Hospitals
This industry comprises establishments known and licensed as general medical and surgical hospitals primarily engaged in providing diagnostic and medical treatment (both surgical and non-surgical) to inpatients with any of a wide variety of medical conditions. These establishments maintain inpatient beds and provide patients with food services that meet their nutritional requirements. These hospitals have an organized staff of physicians and other medical staff to provide patient care services. These establishments usually provide other services, such as outpatient services, anatomical pathology services, diagnostic X-ray services, clinical laboratory services, operating room services for a variety of procedures, and pharmacy services.

622210: Psychiatric and Substance Abuse Hospitals
This industry comprises establishments known and licensed as psychiatric and substance abuse hospitals primarily engaged in providing diagnostic, medical treatment, and monitoring services for inpatients who suffer from mental illness or substance abuse disorders. The treatment often requires an extended stay in the hospital. These establishments maintain inpatient beds and provide patients with food services that meet their nutritional requirements. They have an organized staff of physicians and other medical staff to provide patient care services. Psychiatric, psychological, and social work services are available at the facility. These hospitals usually provide other services, such as outpatient services, clinical laboratory services, diagnostic X-ray services, and electroencephalograph services.

622310: Specialty (Except Psychiatric and Substance Abuse) Hospitals
This industry consists of establishments known and licensed as specialty hospitals primarily engaged in providing diagnostic and medical treatment to inpatients with a specific type of disease or medical condition (except psychiatric or substance abuse). Hospitals providing long-term care for the chronically ill and hospitals providing rehabilitation, restorative, and adjustive services to physically challenged or disabled people are included in this industry. These establishments maintain inpatient beds and provide patients with food services that meet their nutritional requirements. They have an organized staff of physicians and other medical staff to provide patient care services. These hospitals may provide other services, such as outpatient services, diagnostic X-ray services, clinical laboratory services, operating room services, physical therapy services, educational and vocational services, and psychological and social work services.

Subsector 623: Nursing and Residential Care Facilities
623110: Nursing Care Facilities
This industry comprises establishments primarily engaged in providing inpatient nursing and rehabilitative services. The care is generally provided for an extended period of time to individuals requiring nursing care. These establishments have a permanent core staff of registered or licensed practical nurses w ho, along with other staff, provide nursing and continuous personal care services.

623210: Residential Mental Retardation Facilities
This industry comprises establishments (e.g., group homes, hospitals, intermediate care facilities) primarily engaged in providing residential care services for persons diagnosed with mental retardation. These facilities may provide some health care, though the focus is room, board, protective supervision, and counseling.

623220: Residential Mental Health and Substance Abuse Facilities
This industry comprises establishments primarily engaged in providing residential care and treatment for patients with mental health and substance abuse illnesses. These establishments provide room, board, supervision, and counseling services. Although medical services may be available at these establishments, they are incidental to the counseling, mental rehabilitation, and support services offered. These establishments generally provide a wide range of social services in addition to counseling.

623311: Continuing Care Retirement Community
This industry comprises establishments primarily engaged in providing a range of residential and personal care services with on-site nursing care facilities for (1) the elderly and other persons who are unable to fully care for themselves and/or (2) the elderly and other persons who do not desire to live independently. Individuals live in a variety of residential settings with meals, housekeeping, social, leisure, and other services available to assist residents in daily living. Assisted-living facilities with on-site nursing care facilities are included in this industry.

623312: Homes for the Elderly
This industry comprises establishments primarily engaged in providing residential and personal care services, i.e., without on-site nursing care facilities, for (1) the elderly or other persons who are unable to fully care for themselves and/or (2) the elderly or other persons who do not desire to live independently. The care typically includes room, board, supervision, and assistance in daily living, such as housekeeping services.

623990: Other Residential Care Facilities
This industry comprises establishments primarily engaged in providing residential care (except residential mental retardation facilities, residential health and substance abuse facilities, continuing care retirement communities, and homes for the elderly). These establishments also provide supervision and personal care services.

Subsector 624: Social Assistance
624110: Child and Youth Services
This industry comprises establishments primarily engaged in providing nonresidential social assistance services for children and youth. These establishments provide for the welfare of children in such areas as adoption and foster care, drug prevention, life skills training, and positive social development.

624120: Services for the Elderly and Persons with Disabilities
This industry comprises establishments primarily engaged in providing nonresidential social assistance services to improve the quality of life for the elderly, persons with mental retardation, or persons with disabilities. These establishments provide for the welfare of these of individuals in such areas as day care, non-medical home care or homemaker services, social activities, group support, and companionship.

624190: Other Individual and Family Services
This industry comprises establishments primarily engaged in providing nonresidential individual and family social assistance services (except those specifically directed toward children, the elderly, persons diagnosed with mental retardation, or persons with disabilities).

624210: Community Food Services
This industry comprises establishments primarily engaged in the collection, preparation, and delivery of food for the needy. Establishments in this industry may also distribute clothing and blankets to the poor. These establishments may prepare and deliver meals to persons who by reason of age, disability, or illness are unable to prepare meals for themselves; collect and distribute salvageable or donated food; or prepare and provide meals at fixed or mobile location.

624220: Community Housing Services
This industry comprises establishments primarily engaged in providing one or more of the following community housing services: (1) short term emergency shelter for victims of domestic violence, sexual assault, or child abuse; (2) temporary residential shelter for the homeless, runaway youths, and patients and families caught in medical crises; (3) transitional housing for low-income individuals and families; (4) volunteer construction or repair of low cost housing, in partnership with the homeowner who may assist in construction or repair work; and (5) repair of homes for elderly or disabled homeowners. These establishments may operate their own shelter; or may subsidize housing using existing homes, apartments, hotels, or motels; or may require a low-cost mortgage or work (sweat) equity.

624230: Emergency and Other Relief Services
This industry comprises establishments primarily engaged in providing food, shelter, clothing, medical relief, resettlement, and counseling to victims of domestic or international disasters or conflicts.

624310: Vocational Rehabilitation Services
This industry comprises (1) establishments primarily engaged in providing vocational rehabilitation or habilitation services, such as job counseling, job training, and work experience, to unemployed and underemployed persons, persons with disabilities, and persons who have a job market disadvantage because of lack of education, job skill or experience and (2) establishments primarily engaged in providing training and employment to persons with disabilities.

Subsector 814: Private Households
814110: Private Households
This industry comprises private households primarily engaged in employing workers on or about the premises in activities primarily concerned with the operation of the household. These private households may employ individuals, such as cooks, maids, nannies, and butlers, and outside workers, such as gardeners, caretakers, and other maintenance workers.

Standard Industrial Classification (SIC)
Industry Group 736: Personnel Supply Services
7361: Employment Agencies
These are establishments primarily engaged in providing employment services, except theatrical employment agencies and motion picture casting bureaus. Establishments classified here may assist either employers or those seeking employment.

7363: Help Supply Services
These are establishments primarily engaged in supplying temporary or continuing help on a contract or fee basis. The help supplied is always on the payroll of the supplying establishments, but is under the direct or general supervision of the business to which the help is furnished. Establishments that provide both management and staff to operate a business are classified according to the type of activity of the business.

Industry Group 805: Nursing and Personal Care Facilities
8051: Skilled Nursing Care Facilities
These are establishments primarily engaged in providing inpatient nursing and rehabilitative services to patients who require continuous health care, but not hospital services. Care must be ordered by and under the direction of a physician. The staff must include a licensed nurse on duty continuously with a minimum one full-time registered nurse on duty during each day shift. Included are establishments certified to deliver skilled nursing care under the Medicare and Medicaid programs.

8052: Intermediate Care Facilities
These are establishments primarily engaged in providing inpatient nursing and rehabilitative services, but not on a continuous basis. Staffing must include 24-hour per day personnel with a licensed nurse on duty full-time during each day shift. At least once a week, consultation from a registered nurse on the delivery of care is required. Included are facilities certified to deliver intermediate care under the Medicaid program.

8059: Nursing and Personal Care Facilities, NEC.
These are establishments primarily engaged in providing some nursing and/or health-related care to patients who do not require the degree of care and treatment that a skilled or intermediate care facility is designed to provide. Patients in these facilities, because of their mental or physical condition, require some nursing care, including the administering of medications and treatments or the supervision of self-administered medications in accordance with a physician’s orders.

Industry Group 806: Hospitals
8062: General Medical and Surgical Hospitals
These are establishments primarily engaged in providing general medical and surgical services and other hospital services.

8063: Psychiatric Hospitals
These are establishments primarily engaged in providing diagnostic medical services and inpatient treatment for the mentally ill.

8069: Specialty Hospitals, Except Psychiatric
These are establishments primarily engaged in providing diagnostic services, treatment, and other hospital services for specialized categories of patients, except mental.

Industry Group 807: Medical and Dental Laboratory
8071: Medical Laboratory
These are establishments primarily engaged in providing professional analytic or diagnostic services to the medical profession, or to the patient on prescription of a physician.

8072: Dental Laboratories
These are establishments primarily engaged in making dentures, artificial teeth, and orthodontic appliances to order for the dental profession.
Industry Group 808: Home Health Care Services

8082: Home Health Care Services
These are establishments primarily engaged in providing skilled nursing or medical care in the home, under supervision of a physician.
Industry Group 809: Miscellaneous Health And Allied Services, NEC.

8092: Kidney Dialysis Centers
These are establishments primarily engaged in providing kidney or renal dialysis services.

8093: Specialty Outpatient Facilities, NEC.
These are establishments primarily engaged in outpatient care of a specialized nature with permanent facilities and with medical staff to provide diagnosis, treatment, or both for patients who are ambulatory and do not require inpatient care.

8099: Health and Allied Services, NEC.
These are establishments primarily engaged in providing health and allied services, not elsewhere classified.

Industry Group 832: Individual and Family Social Services
8322: Individual and Family Social Services
These are establishments primarily engaged in providing one or more of a wide variety of individual and family social, counseling, welfare, or referral services, including refugee, disaster, and temporary relief services. This industry includes offices of specialists providing counseling, referral, and other social services. Government offices directly concerned with the delivery of social services to individuals and families, such as issuing of welfare aide, rent supplements, food stamps, and eligibility casework, are include here, but central office administration of these programs is classified in Public Administration (9441).

Industry Group 833: Job Training and Vocational Rehabilitation
8331: Job Training and Vocational Rehabilitation Services
These are establishments primarily engaged in providing manpower training and vocational rehabilitation and habilitation services for the unemployed, the underemployed, the handicapped, and to persons who have a job market disadvantage because of lack of education, job skill or experience.

Industry Group 836: Residential Care
8361: Residential Care
These are establishments primarily engaged in the provision of residential social and personal care for children, the aged, and special categories of persons with some limits on ability for self-care, but where medical care is not a major element.

Industry Group 881: Private Households
8811: Private Households
These are private households that employ workers who serve on or about the premises in occupations usually considered as domestic services.

1990 Census Industry Classification
731: Personnel Supply Services
This group includes employment agencies, executive placing services, headhunter services, labor pools, registries, and temporary employment agencies.

761: Private Households
This group includes baby-sitting, childcare, church rectory, domestic service, general housework, home care, house sitting, patient sitting, private family, summer estate, private yacht.

831: Hospitals
This group includes hospitals (children’s, city, state, college, community, general, mental, psychiatric, HMO, clinic, laundry, orthopedic, osteopathic, military), infirmaries, and medical centers.

832: Nursing and Personal Care Facilities
This group includes alcoholic sanitaria, convalescent homes, curative baths, epileptic colonies, geriatric care facilities, health camps, nursing homes, hospices, institutions for mentally retarded, medical spas, rest homes, sanitaria, retirement homes, spastic homes, veterans domiciliary centers.

840: Health Services, NEC.
This group includes abortion clinics, behavior clinics, biological/medical laboratories, blood banks, cerebral palsy centers, dental laboratories, diagnostic imaging laboratories, dialysis centers, dietitian services, eye training clinics, health consulting organizations, home health care services, mental health clinics, occupational therapy providers, organ banks, out-patient clinics for substance abuse, physical therapy facilities, speech defect clinics, x-ray offices.

861: Job Training and Vocational Rehabilitation Services
This group includes vocational rehabilitation facilities, job corps, sheltered workshops, and training centers for retarded adults.

870: Residential Care Facilities, Without Nursing
This group includes after-care homes, boarding homes, boys’ town facilities, homeless shelters, children’s communities, detention homes, halfway houses, orphanages, drug rehabilitation centers, foster homes, homes and institutions without medical or nursing care, maternity homes, retirement homes without nursing, veterans homes.

871: Social Services, NEC.
This group includes adoption agencies, block associations, child welfare facilities, community centers, crisis hotlines, adult day care facilities, family services, homemaker services, philanthropic organizations, senior centers, social services, suicide prevention centers, welfare agencies.