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Core Competencies Strengthening the Home and Community Based Workforce

Core Competencies Strengthening the Home and Community Based Workforce. Pat Schommer , MA Associate Director U of M, Center on Aging & MN Area Geriatric Education Center Laurissa Stigen, MS Executive Director Central MN Area Health Education Center

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Core Competencies Strengthening the Home and Community Based Workforce

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  1. Core CompetenciesStrengthening the Home and Community Based Workforce

  2. Pat Schommer, MA Associate Director U of M, Center on Aging & MN Area Geriatric Education Center Laurissa Stigen, MS Executive Director Central MN Area Health Education Center Lori Sedlezky, MSW Director of Knowledge Translation Annie Johnson Sirek, MSW Project Coordinator U of M, Institute on Community Integration, Research & Training Center on Community Living

  3. PHENOMENAL FACT 2/3 of the people, in the world, who have achieved the age of 65, are still alive today Robyn Stone, DPH of Leading Age, Distinguished Lecture 4.17.13 at the U of M

  4. PHENOMENAL FACT Minnesota is expecting a 54% increase in the 65 and older population between 2015 and 2030. United Health Foundation, June 2013, 2013 Senior Report

  5. Unprecedented Increases in Minnesota’s 65+ Population Source: Minnesota State Demographer using 2010 Census Data

  6. Minnesotans Age 85+ Increases 150% Over next 30 Years 64.9% 32.0% 17.4% Source: Minnesota State Demographer using 2010 Census Data

  7. Minnesota Household Growth 2010-2020 The New Norm: Empty Nesters and Older Adults Living Alone Source: Minnesota State Demographic Center projection, 2012

  8. 12,139 total beds statewide (percent of capacity in parentheses) 29 Percent of Minnesota Care Center Beds Closed or Laid Away Since July 2000 (29.7%) (24.5%) (25.2%) (27.7%) (36.3%) (28.9%) (35.0%) Source: Minnesota Department of Health, March 2013

  9. More Than Twice As Many Housing-with-Service Units as Care Center Beds Source: Minnesota Department of Health, March of each year

  10. PHENOMENAL FACT Minnesota is ranked at the top of the list of healthiest states for older adults. United Health Foundation, June 2013, 2013 Senior Report

  11. Labor Force Growth About To Slow Sharply Source: Minnesota State Demographer, 2011

  12. Minnesota Saw a 30% Jump in Employees Turning Age 62 in 2008 Source: Minnesota State Demographer, 2011

  13. Minnesota To Develop 46% More Healthcare Practitioners To Meet Needs Source: Minnesota Department of Employment and Economic Development (DEED) Occupation Forecasts, 2002-2012

  14. Employee Retention Percentage Declining in Care Centers Source: DHS Nursing Home Cost Reports

  15. The Wage Gap Senior Living Workers Underpaid in the Marketplace Gap=$17.39 per hour or $36,171 per year Gap=$15.77 per hour or $32,802 per year Gap=$2.07 per hour or $4,306 per year Gap=$1.81 per hour or $3,765 per year Gap=$5.79 per hour or $12,043 per year Gap=$6.13 per hour or $12,750 per year Sources: 2011 LTC Imperative Salary Survey and 2011 MN Health Care Cost Information Service Hospital Salary Data

  16. Direct Care Workers will be Largest Occupation Group in US by 2020 Source: Paraprofessional HealthCare Institute May 2012

  17. US Demand for Workers from 2010-2020 Grows Most for Home-Based Services Source: Paraprofessional HealthCare Institute, May 2012

  18. QUESTIONS?

  19. RESOURCES

  20. Core Competencies Applied in the Direct Service Workforce Annie Johnson Sirek, MSWResearch Project Coordinator

  21. Agenda (Part 2) • Overview of the Direct Service Workforce • Role of Competencies • CMS Road Map Project to Define Core Competencies in Long Term Services & Supports • Strategies to promote quality outcomes in HCBS • Plan next steps: How to prepare our workforce

  22. National Direct Service Workforce Resource Center Partners

  23. A Cross-Disability Perspective on the National Direct Service Workforce • Long-term Services and Supports (LTSS) Sectors: • Aging • Behavioral Health • Intellectual and Developmental Disabilities • Physical Disabilities

  24. Crisis intervention Assessment, referrals Teaching new skills Self-determination/ self-direction Working with families Community integration Companionship/ relation-ships Direct Service Worker (DSW) Roles • Personal care/ hygiene • Home skills • Health and safety • Monitoring health/ health tasks • Transportation • Employment • Positive behavior support

  25. Occupational Titles No single, unified title… • More commonality in aging and physical disabilities services • Nurse Aide • Home Health Aide • Personal Care Assistant • Paraprofessional vs. professionalism within I/DD • Direct Support Professional • Behavioral Health • Peer Support Specialist

  26. Where DSWs Work:The continuum of long term care settings

  27. Trends Across Service Sectors • Deinstitutionalization • Community based settings • Smaller in size • Increase in variety and difference in places • Geographic dispersion of service delivery locations • Implications • DSW roles requiring greater skill, judgment, and accountability • Greater autonomy and responsibility • More independent problem-solving, decision-making • Need for adequate supervision and co-worker interaction

  28. Direct Support Workforce Challenges Experienced Across Sectors • Status and Image • Vacancy rates • High Turnover / Low wages • Poor access and utilization of benefits • Limited access to training and education • Increasingly absent or ineffective supervision

  29. Strategic Areas for Collaborative Planning and Action • Training and education • Retention • Wages and benefits • Payment rate and procurement structures • Data collection, research and evaluation • Status and awareness

  30. Defining Competencies

  31. Role of Competencies Used as a guidepost for workforce development activities and tools: • Recruitment, hiring, and selection • Curriculum development • Training program implementation • Career pathways, ladders and lattices: • Apprenticeship programs • Credentialing and certification systems • Continuing education and ongoing staff development • Performance evaluation (Campion et al., 2011)

  32. Outcomes Associated with Competency-Based Training (Direct Service Workforce Resource Center, in draft)

  33. Building Quality in HCBS

  34. Road Map of Core Competencies for the Direct Service Workforce

  35. Project Framework • Objective: Identify a common set of core competencies across community-based long-term services and supports (LTSS) sectors: • Aging • Behavioral health (mental health and substance use) • Intellectual and developmental disabilities • Physical disabilities • Goals: Application of core competencies to facilitate: • Evidence-based practices for DSW training and employment. • Interagency collaboration in workforce development activities. • Assessment of workforce capacity within states and agencies. • Effective training policies to meet participants’ needs.

  36. Road Map of Core Competenciesfor the Direct Service Workforce

  37. Project Framework • Focus on Community-Based Settings • As defined by Section 2401 of the Affordable Care Act: Community First Choice State Plan Option: Home and Community-Based Setting Requirements (§ 441.530) • Content Based on Best Practices • Balance between best practice and “here and now.” • Strive for Common Language and Terminology • Structured to translate to workforce development tools. • A Foundational Lens for Direct Support Workers • Audience of all DSWs and those who supervise and train them.

  38. Proposed Final Project Phase

  39. Structure of the DSW Core Competencies

  40. Structure of the DSW Core Competencies

  41. Competency-Based Training Model (O’Nell & Hewitt, 2005; Hewitt & Larson, 1994)

  42. College of Direct Support (CDS) - UMN • College of Employment Services - UMASS • College of Personal Assistance & Caregiving - UCSF • College of Recovery & Community Inclusion - Temple

  43. Every lesson is designed to give DSPs the knowledge, skills and attitudes they need through innovative, engaging and interesting training.

  44. CDS Instructional Design • Competency-Based • Accredited by NADSP • Evidence-Based • Best Practices in HCBS • Research translation (e.g. self-determination, social inclusion, community living, employment) • Adult learning • Highly interactive and multi-media • Reflective exercises • Used in combination with classroom and mentoring • Self-paced, asynchronous, just in time • Various Assessments Methods • Moving toward pad and handheld

  45. DSW Performance Development applying the Core Competencies

  46. DSW Performance Development with Core Competencies and CDS

  47. Contact Information Annie Johnson Sirek, MSW joh02055@umn.edu (612) 626-0535 Research and Training Center on Community Living Institute on Community Integration,University of Minnesota

  48. Discussion: What are your goals for preparing our workforce to better meet individuals’ needs?

  49. Reasons to Collaborate • Collective voice is needed to bring attention and solutions. • Efforts to improve financing, reimbursement, and regulatory structures should benefit all sectors. • We do not have the resources to duplicate efforts.   • Must share innovative solutions across sectors.     • State agencies & providers are increasingly cross-sector. • States are seeking cross-sector solutions & efficiencies. • In many ways, it is the same workforce. • Health and quality of life of individuals served is not organized by silos.

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