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PHI is sponsoring a webinar on the newly adapted Eden Alternative version of the PHI Coaching Approach^SM series, which is designed to infuse fundamental communication skills throughout an organization.

Two PHI staff members — Sue Misiorski, national director of training and organizational development, and Cean Eppelheimer, Midwest training and organizational development specialist — will lead the webinar and focus on elements of the coaching process, how they support the Eden journey and why they are essential to sustainable transformation.

Date: November 9, 2011
Time: 3:00-4:00 p.m. EST

There is no fee to participate; registration is required.

– by Deane Beebe

New York City Council Speaker Christine Quinn

New York City Council Speaker Christine Quinn outlined her vision for how the city can both create jobs and build long-term economic security in an October 18 speech.

Among the initiatives intended to help recent immigrants and low-income workers improve their job prospects is an expansion of training for home care workers to help them get jobs in the growing health care sector.

The City Council is working with PHI and 1199 SEIU to train an additional 200 New Yorkers per year in home health care and to also address stabilization efforts across the home care sector.

“PHI thanks Speaker Quinn and the City Council for investing in the home care workforce to ensure quality jobs for low-income workers and better care for elders and people with living with disabilities in New York City,” said PHI President Steven Dawson.

Increase in Demand for Home Care Workforce

Quinn says that the following recent state changes are expected to have a large impact on the home care workforce, making it an ideal time to support this vital industry:

• As the population ages, there will be an increased demand for health professionals who care for disabled or home-bound individuals.
• New York State has mandated that all home care workers serving Medicaid recipients within geographic areas that have local living wage laws be paid a living wage (to be phased in beginning in 2012).
• New Yorkers who need more than 120 days of home and community-based long term care services — mostly dual eligibles — will be required to enroll in Managed Long Term Care (MLTC) plans beginning in April 2012, pending federal approval. Most MLTC plans will likely employ home health aides to ensure compliance with federal regulations and because these workers can perform health-related tasks.

“An enormous amount of upgrade training will be necessary to ensure that tens of thousands of personal care aides do not become unemployed due to these changes,” Quinn said.

Initiative Specifics

The City Council’s partnership with PHI will fund a RN-certified trainer to make it possible for PHI and its affiliate, Cooperative Home Care Associates (CHCA), to train new home health aides and help transition personal care aides who might not otherwise retain their jobs.

CHCA guarantees a job to any trainee who successfully completes the entry-level training.

Through the City Council’s partnership with 1199 SEIU, the 1199 SEIU Bill Michelson Home Care Education Fund will provide additional training and education services to support all home care workers — including individuals from CHCA — to achieve higher levels of education and employment by providing extensive ESL training, preparation for college enrollment, and other skill-building initiatives.

“By partnering with 1199 SEIU and PHI, the City Council is supporting a field that will see increased growth due to demographic shifts, and an agency that is committed to improving the quality of the profession and the stabilization of this field,” Quinn said.

– by Meghan Shineman, PHI New York Policy Analyst

Washington State residents will be able to vote on a ballot initiative in November that will impose new requirements on home care workers for training and background checks.

The measure, Initiative 1163 (pdf), requires home care aides to complete 75 hours of training in order to become certified. The requirements also apply to aides working in most community-based settings, such as adult family homes.

Currently, the minimum requirement for training hours for Washington State home care aides is just 34 hours.

Initiative 1163 further mandates that all long-term care workers undergo state and federal criminal background checks before beginning their employment.

The initiative is similar to a 2008 initiative, which passed by an overwhelming margin. The earlier ballot initiative, however, was never implemented by the legislature because of budget shortfalls.

The measure is sponsored by SEIU, and is the focus of a social media campaign called Yes on 1163. The campaign also includes a Facebook page and a Twitter account. Supporters submitted 340,000 signatures in order to get the initiative on the ballot, nearly 100,000 more than necessary.

Initiative 1163 is one of five ballot initiatives that Washington voters will decide on next month.

– by Matthew Ozga

The Centers for Medicare & Medicaid Services (CMS) has endorsed an adult abuse and neglect prevention training program designed for direct-care workers.

The 12-module curriculum — developed collaboratively by BEAM (Bringing Eden Alternative to Michigan), Michigan State University, and PHI with leadership from the Michigan Office of Services to the Aging -– is available as a free download at the PHI Training and Organizational Development Services website.

The adult learner-centered curriculum “includes highly interactive trainings that focus on actively building person-centeredness and self-management skills within individuals and organizations,” said PHI training and organizational development specialist Maureen Sheahan, who supported the curriculum design.

Kari Sederburg, director of the Michigan Office of Services to the Aging, added that the Michigan State evaluation of the training found that “almost every staff person who used the skills reported that it helped to prevent abuse or neglect.”

CMS’s endorsement came in an August 12 memorandum (pdf) to State Survey Agency directors recommending several training resources that deal with abuse prevention and dementia care.

Section 6121 of the Affordable Care Act mandates enhanced training on each of those subjects for nurse aides working in nursing homes.

– by Matthew Ozga

The PHI Center for Coaching Supervision and Leadership (CCSL) produced numerous positive, tangible outcomes for employers, according to a just-released PHI evaluation summary of the program.

Participants in the CCSL, for example, reported improvements in quality of care as well as statistically significant gains in job satisfaction among all staff.

The four-year CCSL program was designed to refine the PHI Coaching Approach to Supervision, a training program that teaches long-term care supervisors the core communication skills necessary to effectively engage and support their teams.

Eleven providers in the Northeast U.S., including five nursing homes and six home health agencies, were involved in the CCSL initiative.

Specific Findings

PHI’s evaluation of the CCSL program found that:

• Trained supervisors retain the lessons of PHI Coaching Supervision^SM. One year after their training, more than three-fourths (77 percent) of supervisors involved in CCSL said they “often” or “always” used the communication skills they were taught.
• Job satisfaction increased. Direct-care workers surveyed showed significant improvements in job satisfaction following the CCSL intervention.
• Some employers experienced efficiencies. Three out of 10 supervisors and managers reported spending less time solving other people’s problems. All told, 25 supervisors reported a total of 75 hours saved per week, or nearly four weeks each year for each supervisor.
• Certain participants reported increased care quality. For example, one of the CCSL participants — Orchard Cove, a continuing care retirement community in Massachusetts — recorded downward trends in fall prevalence, urinary tract infections, pressure ulcers, and other quality indicators.
• Providers invested in sustainability. Evaluation respondents expressed their interest in sustaining the positive outcomes they gained from PHI Coaching Supervision training. To that end, they have instituted numerous strategies — including booster sessions and the use of cross-functional teams — intended to “keep coaching alive.”

CCSL was funded by the John A. Hartford Foundation and The Atlantic Philanthropies.

More information about the PHI Coaching Approach is available at the PHI Training & Organizational Development Services website.

More information about the evaluation of PHI initiatives and services is available at the PHI Evaluation page.

– by Matthew Ozga

Massachusetts State House in Boston

PHI Massachusetts lent its support to two bills at a July 19 hearing on home and community health care provider policies, held by the Joint Committee on Public Health.

“An Act Relating to Training for Certified Nurses’ Aides and Direct-Care Workers,” Senate Bill 1121, calls for a review of current training standards for home health aides and certified nurse aides (CNAs) in the state.

“An Act Relative to Home Health Aides,” Senate Bill 1138, would expand the current role of home health aides (HHAs) in the state and, with appropriate training and oversight, allow them to administer some medications.

Facilitating a Career Lattice

Passage of the training standards bill would be well-timed: Massachusetts is one of six states to receive a Personal and Home Care Aide State Training (PHCAST) demonstration grant from the Department of Health and Human Services.

“The PHCAST demonstration grant will position Massachusetts as a leader on training standards for personal care attendants and personal care aides nationally — and also lay the foundation for a portable credential in the state,” said PHI Massachusetts State Director Amy Robins in her hearing testimony.

“A close examination of training standards for CNAs and HHAs could help facilitate the creation of a clearly articulated and intentional career lattice among direct-care occupations. This would allow workers to advance to new positions and move across settings — keys to cultivating, recruiting, and retaining the direct-care workforce Massachusetts will need in the coming years,” Robins’ testimony (pdf) concluded.

Medication Administration

Senate Bill 1138 provides a very attainable advancement opportunity for HHAs who are interested in medication administration.

“The experience of others demonstrates that this can be done safely and effectively — and that this strategy also helps ensure the best value for our health care spending, with all working to the top of their training and licensing,” Robins’ testimony (pdf) said.

The bill “would send a clear signal that the state recognizes the importance of this vital workforce and the need to do more to improve these jobs and create meaningful advancement opportunities,” her testimony continued.

There are nearly 100,000 direct-care workers in Massachusetts. Direct-care jobs are the second largest occupational grouping in the state and are expected to grow by 22 percent by 2016, dramatically outpacing the growth of other jobs.

Home and community-based direct-care jobs are among the state’s lowest-paying jobs, paying wages that fall below the state’s low-wage threshold.

“Quite simply, the state must do more to cultivate a high-quality, well-trained and stable workforce,” Robins says. “These two bills are important steps in the right direction.”

For more information on the direct-care workforce in Massachusetts, see State Facts: Massachusetts’ Direct-Care Workforce (pdf).

– by the PHI Policy team