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.

Challenged by this critical need, the Vermont Department of Labor, with funding from the DOL’s Workforce Education and Training Fund, is supporting a unique education and career ladder training program for 65 Personal Care Assistants (PCAs) at four sites in northwestern Vermont:

• VNA of Chittenden and Grand Isle Counties
• Franklin County Home Health Agency
• Armistead Caregiver Services
• Home Instead Senior Care

PHI — a nationally recognized training and organizational development consulting firm focused exclusively in the eldercare/disability services industry, with a regional office in Vermont for many years— will be serving as project manager of the entire initiative. PHI will be collaborating with the Vermont Department of Labor (DOL), the Northwest Technical Center, the Community College of Vermont, Vermont Adult Learning, and all four community partner sites throughout the project.

“These educational opportunities will be the next steps in what has proven to be a valuable and mutually important collaboration,” said Churchill Hindes, VNA President and CEO. “This initiative will benefit the agencies involved, the trainees who participate in the instruction, and ultimately — and most importantly — the people who will benefit from their skills and caring.”

An Innovative Solution with Growth Opportunities

The initiative will address the state’s shortage of direct-care workers with the development of a career ladder training program to improve workforce retention and ultimately, it is hoped, increase the number of PCAs available to care for Vermont’s aging population. The program will assist incumbent workers to advance in their health care careers, and allow participating workers and organizations to:

• Earn while they learn. PCAs will be paid for at least 50 percent of their time while in training—a critical component of success in incumbent worker training programs for low-wage workers.
• Work toward meaningful promotions and raises: At some locations, training will enable a PCA to be promoted to PCA II. At other sites, training will enable a PCA to be certified as a Licensed Nursing Assistant (LNA), with the requisite increase in wages.
• Participate in a flexible and robust learning opportunity. Each provider will provide a customized training program for its workers.
• Encourage a more diverse group to enter health care professions. Non-native English speaking participants will be able to take contextualized ESOL classes at their worksite, in conjunction with their clinical skills classes.
• Improve workforce retention.

The CareWell curriculum, a 40-hour course developed by the Visiting Nurse Association (with support from the Community of Vermont Elders through their Better Jobs Better Care initiative), will be a cornerstone of the PCA training. PHI, in addition to its role as project manager, will also be providing its “Coaching Approach to Communication” training at all sites.

“One of the fastest-growing occupational areas in Vermont over the next 20 years will be in direct-care services,” said Greg Voorheis, Senior Grant Administrator for the Vermont Department of Labor. “The state’s Workforce Education and Training Fund grant to PHI creates the opportunity for multiple long-term care employers to hire well-trained direct-care workers who will be participating in the development of a career ladder.

“PHI’s leadership in this work will benefit not only long-term care employers, but many direct-care workers already in the field — or individuals who aspire to work in the field. And, most importantly, their work will improve the quality of health care provided to individuals. We look forward to sharing what we learn with others,” Voorheis concluded.

The program, which was officially launched in early June, will conclude in June of 2010.

For more information about this project, call Alexandra Olins, PHI Regional Director, Northern New England, at 802-655-4615.

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

Recommendations for Establishing a Credentialing System for Iowa’s Direct Care Workforce, (pdf) a recent publication from the Iowa Direct Care Worker Task Force, is a useful tool for advocates in any state who want to create “an accessible, comprehensible, flexible, quality system of education and training for all direct care workers.”

The report documents work to be done to implement recommendations published by the task force in December 2006.  Work began on the project last month.

Iowa’s proposed three-tiered credentialing system is intended to ensure that all direct-care workers are adequately prepared for the job. It also aims to make workers’ duties and qualifications clear to the consumers and family members who hire them, to acknowledge their special skills, and to correct the inequities of the current system, which requires training in some settings but not in others even when the same set of services is delivered in both.

Read the full story

The July issue of The Gerontologist is devoted to findings from the Better Jobs Better Care research and demonstration project. BJBC, which began in 2002 and ended in 2006, was the largest initiative in the nation ever created to address the high vacancy and turnover rates of direct-care workers by improving the quality of direct-care jobs. The initiative involved changing both public policy and employer practice. Demonstration grants were made to groups in Iowa, North Carolina, Oregon, Pennsylvania, and Vermont.

A nine-page overview lays out how and why the project came into being, the problems affecting the direct-care workforce, and how awareness of and responsiveness to those problems is changing. The essay is by Robyn Stone (pictured), executive director of the Institute for the Future of Aging Services, and PHI President Steven Dawson. FAS and PHI conceived of BJBC and provided technical assistance to the grantees. Funding was supplied by the Robert Wood Johnson Foundation and The Atlantic Philanthropies.

Among the findings detailed in the issue:

• Direct-care workers across long-term settings identified more pay, improved communication, better supervision, and being treated with respect as the most important things employers could do to improve jobs.
• After accounting for satisfaction with wages, benefits, and advancement opportunities — good basic supervision was most important in affecting CNAs to stay in their jobs.
• There is a positive correlation between CNA job commitment and resident satisfaction.
• After accounting for satisfaction with wages, benefits, and advancement opportunities, good basic supervision was the most important factor behind commitment to the job. Read the full story

If you want to reduce nursing assistant turnover at your facility, you need to improve working conditions — maybe hire more direct-care staff, give your supervisors management training, or include direct-care workers more in decision making and care planning. But motivating nursing assistants to stay in the profession long-term requires a whole different set of incentives. According to a new study, stemming the flow of workers from the profession will require system-wide changes like higher wages, better benefits, and more career advancement opportunities for all direct-care workers.

Many previous studies have analyzed nursing assistant turnover within a facility, but few have looked into why workers leave the profession. “Staying the Course: Facility and Profession Retention Among Nursing Assistants in Nursing Homes,” a study published in  the Journal of Gerontological Research Series B: Psychological Sciences and Social Sciences, used data for 2,328 nursing assistants (NAs) from the 2004 National Nursing Assistant Survey to compare the reasons for both.

Read the full story

“If I had only one sentence, this would be it: Direct support work is a highly skilled job,” says Amy Hewitt.

“It’s not viewed that way by society – or, frankly, by many employers – but not everybody can do this job. You have to be smart; you have to be able to problem solve; you have to be flexible and a quick thinker. You also need patience and empathy and creativity. We’re not going to get anywhere in terms of policy advocacy or getting the supports we need in place without clearly articulating that this is a highly skilled job.”

Hewitt is a senior research associate at the University of Minnesota’s Research and Training Center on Community Living. The center’s mission is to support community living for people with intellectual and developmental disabilities – and that has led to a focus on strengthening and supporting the direct support workforce.

Read the full story