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Benchmark Senior Living

A New England-based company that manages dozens of senior living communities and an Alabama long-term care facility are profiled in the latest case studies in PHI’s The Business of Caregiving series.

Benchmark Senior Living, headquartered in Wellesley, Massachusetts, provides its workers with plentiful career advancement opportunities, designed to maintain a high retention rate.

Benchmark also operates a unique “Culture Compensation” program, in which employees are monetarily rewarded for demonstrating values consistent with the Benchmark mission of providing quality care for residents.

The Birmingham-based St. Martin’s in the Pines, meanwhile, adopted The Green House model to better care for its nursing home residents.

St. Martin's in the Pines

The Green House model calls for a wholesale physical and philosophical reorganization of traditional nursing home-based care.

Under the Green House model, for example, direct-care workers — known as “Shahbazim” — provide a range of services, including personal care, meal planning, and laundry service for residents.

In turn, Shahbazim are empowered by being given additional responsibilities, including self-scheduling each day with their resident, and participating in self-managed work teams to manage the facility.

All Shahbazim are required to undergo a 120-hour training before working in a Green House facility.

Both Benchmark and St. Martin’s were selected to be subjects of PHI case studies because they exemplify PHI’s “quality care through quality jobs” approach to eldercare/disability services.

Four other Business of Caregiving case studies are available at the PHI Training & Organizational Development Services website.

The case studies, as well as a series of 20 best practice profiles, were made possible with support from the Hitachi Foundation.

– by Matthew Ozga

Dozens of workforce development experts, policymakers, providers, funders, researchers, and advocates gathered in Washington, D.C., on May 26 for an in-depth examination of innovations in practice and policy for bolstering the direct-care workforce in the eldercare and disability services sector.

“Building Ladders and Raising the Floor,” which was organized by Jobs for the Future (JFF) and PHI, aimed to engage all stakeholders in dialogue to identify strategies and opportunities for both creating career advancement opportunities and improving the quality of direct-care jobs.

PHI President Steven Dawson noted that in the last 20 years, the workforce development field has invested a great deal in creating ladders to good jobs for direct-care workers, but far less in strategies to raise the floor of entry-level jobs.

Dawson highlighted the impact that the direct-care workforce has on elders and disabilities, saying, “The direct-care worker is the face, hands, and voice of long-term care for literally millions of elders and people with disabilities. The quality of this job undeniably determines the quality of their care.”

Two direct-care workers — Darlene Scott of Porter Hills Green House and Ancil Alexander of Cooperative Home Care Associates (CHCA), a PHI affiliate — shared their love for their work and desire to stay on the front line while receiving better training, compensation, support, and good supervision.

Best practices, such as those implemented at Porter Hills and CHCA, offer direct-care workers more time, control, authority, and pay, and encourage access to and sharing of information.

Stakeholders Express Concerns, Suggest Strategies

Participants included a wide variety of stakeholders concerned about the direct-care workforce.

“An elder and disability services sector strategy aimed at building the direct-care workforce is essential,” said Olga Merchan, director of workforce strategy for YouthBuild USA. “A common strategy will help YouthBuild and other workforce programs to achieve placement goals, ensure higher retention in employment and training opportunities, and position participants for higher wages.”

The keynote speaker, Gerri Fialla, deputy assistant secretary, employment and training administration, U.S. Department of Labor (DOL), detailed DOL’s commitment to investing in the direct-care workforce and to partnering with other federal agencies to do so. In an environment of budget cutting, she emphasized strategies to “do more with less.”

PHI National Policy Director Steve Edelstein noted how one state was handling the budget crunch:

Responding to the need for budget cuts in New York, stakeholders recently hammered out an agreement on unprecedented reforms of the Medicaid program. Without a doubt, budgets at both the federal and state level are challenging, but I hope that, working together, we can use these challenges as an opportunity for improvements and reform.

Participants at the event began a conversation about how to meet the challenge. Henry Claypool, director, Office on Disability, U.S. Department of Health and Human Services, offered one strategy for meeting the challenge: engagement with the 15 states that received grants from the Federal Coordinated Health Care Office at the Centers for Medicare and Medicaid Services to improve coordination of services for individuals who are dually eligible for Medicare and Medicaid.

Participants discussed this and other partnerships and strategies for growing and strengthening the direct-care workforce.

– by Gail MacInnes, PHI National Policy Analyst

On April 8, Ohio’s Long-Term Direct Care Workforce Initiative convened a unique meeting of health and human services stakeholders to provide input regarding a unified strategy for improving the long-term direct service workforce in Ohio.

The event, “Cultivating a Workforce for Person Centered Long-Term Services and Supports,” featured keynote presentations in the morning by Sheryl Larson, Ph.D., of the Direct Service Workforce Resource Center, and Workforce Policy and Program Administrator Tiffany Dixon, from the Ohio Department of Aging.

Fostering Person-Centered Care

Directors and deputy directors from multiple Ohio state agencies participated in an afternoon panel discussion exploring the concept of person-centered care from the perspective of the service recipient. The state leaders described their respective agency goals in fostering a person-centered system of long-term services and supports.

“What does it mean to be a qualified direct-care worker?” asked Bonnie Kantor-Burman, Sc.D., the new director of the Ohio Department of Aging and former executive director of the Pioneer Network.

“We don’t yet have a system in place to empower direct-care workers to grow. For that, we need relationship-based education and training, including a coaching approach to working together that moves us toward flattening the hierarchies that exist.”

Stackable Certificates to Promote Career Pathways

Kathy Maybriar, bureau chief, Workforce Investment Act Programs at the Ohio Department of Job and Family Services, emphasized the importance of “stackable certificates” for direct-care workers as a way to promote career pathways and to allow employers to be responsive to the changing needs of the marketplace.

“The development of Ohio’s stackable ‘core + specialization’ framework is intended to create a highly portable credentialing system that develops links between entry and advanced skills,” Dixon said. “The framework increases opportunities for direct service workers to provide more complex services and supports while building the academic foundation for an advanced certificate or degree in health or human services, which further expands their employment opportunities.”

“By linking this framework to college credit,” Dixon continued, “we hope to increase interest in direct service work, while creating a pipeline of learners with experience working with individuals with disabilities of all ages.”

Small group discussions in the morning and afternoon provided an opportunity for attendees to offer input on the workforce skills and competencies shared across disciplines and service sectors.

“The core skill set will provide a unifying thread through system silos, while also allowing us to acknowledge the valuable differences between settings and sectors through specializations,” Dixon said.

The Long-Term Direct Service Workforce Initiative was established in response to the efforts of multiple Ohio state government agencies (Job and Family Services, Aging, Education, Health, Mental Health, Developmental Disabilities, Alcohol and Drug Addiction, and the Board of Regents) to develop a highly trained and flexible direct service workforce that is responsive to the needs of employers and consumers of long-term services and supports.

– by Joe Angelelli, PHI Pennsylvania State Director

On April 27, The Robert Wood Johnson Foundation and The Hitachi Foundation jointly received the 2010 Critical Impact Award from The Council on Foundations, in recognition of their work on a program that benefits frontline healthcare workers. Read the full story

PRESS RELEASE
For immediate release
July 6, 2009

Contact: Alex Olins
PHI Northern New England Director
Phone: (802) 655-4615
Email: aolins@PHInational.org

Rewarding Skill and Improving Care
New initiative provides career advancement opportunities for direct-care workers in Vermont

Burlington, VT — Few issues are more important to people today than health care. Both from a personal and societal perspective, Americans are deeply concerned about what the future holds for them when it comes to health care. In many states, the growing needs of an aging “baby boomer” generation are creating an enormous shortage in qualified direct-care workers, who provide most of the “hands on” home and community-based care that elders and people living with disabilities depend upon. Read the full story

Tapping the Power of Peer Mentoring

This is the second in a series of PHI Expert Interviews, which bring you insights from four senior PHI staff. They’re an impressive group – among the nation’s leading experts on long-term care’s direct-care workforce – and collectively they’ve spent decades studying the challenges facing the workforce and how to address them. We think you’ll be interested in what they’ve learned.

Peggy Powell is one of the founders of Cooperative Home Care Associates, the worker-owned home health agency that started PHI, where she served as director of education. Since joining PHI in 1991, she has worked with CHCA and other employers to develop strategies for recruiting, training, supervising, and supporting direct-care staff.

One of those strategies, peer mentoring, is gaining in popularity – and no wonder. Done right, a peer mentor program helps new direct-care workers get oriented to the job and the organization, bolstering their skills and their confidence. It also creates a career ladder for experienced workers.

And that’s not all, as Peggy has learned. Read the full story