Core competencies strengthening the home and community based workforce
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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

Core CompetenciesStrengthening 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

Lori Sedlezky, MSWDirector of Knowledge Translation

Annie Johnson Sirek, MSWProject Coordinator

U of M, Institute on Community Integration, Research &Training Center on Community Living


Phenomenal fact

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


Phenomenal fact1

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


Unprecedented increases in minnesota s 65 population

Unprecedented Increases in Minnesota’s 65+ Population

Source: Minnesota State Demographer using 2010 Census Data


Minnesotans age 85 increases 150 over next 30 years

Minnesotans Age 85+ Increases 150% Over next 30 Years

64.9%

32.0%

17.4%

Source: Minnesota State Demographer using 2010 Census Data


Minnesota household growth 2010 2020

Minnesota Household Growth 2010-2020

The New Norm: Empty Nesters

and Older Adults Living Alone

Source: Minnesota State Demographic Center projection, 2012


12 139 total beds statewide percent of capacity in parentheses

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


More than twice as many housing with service units as care center beds

More Than Twice As Many Housing-with-Service Units as Care Center Beds

Source: Minnesota Department of Health, March of each year


Phenomenal fact2

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


Labor force growth about to slow sharply

Labor Force Growth About To Slow Sharply

Source: Minnesota State Demographer, 2011


Minnesota saw a 30 jump in employees turning age 62 in 2008

Minnesota Saw a 30% Jump in Employees Turning Age 62 in 2008

Source: Minnesota State Demographer, 2011


Minnesota to develop 46 more healthcare practitioners to meet needs

Minnesota To Develop 46% More Healthcare Practitioners To Meet Needs

Source: Minnesota Department of Employment and Economic Development (DEED) Occupation Forecasts, 2002-2012


Employee retention percentage declining in care centers

Employee Retention Percentage Declining in Care Centers

Source: DHS Nursing Home Cost Reports


The wage gap

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


Core competencies strengthening the home and community based workforce

Direct Care Workers will be Largest Occupation Group in US by 2020

Source: Paraprofessional HealthCare Institute May 2012


Core competencies strengthening the home and community based workforce

US Demand for Workers from 2010-2020 Grows Most for Home-Based Services

Source: Paraprofessional HealthCare Institute, May 2012


Core competencies strengthening the home and community based workforce

QUESTIONS?


Resources

RESOURCES


Core competencies applied in the direct service workforce

Core Competencies Applied in the Direct Service Workforce

Annie Johnson Sirek, MSWResearch Project Coordinator


Agenda part 2

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


National direct service workforce resource center partners

National Direct Service Workforce Resource Center Partners


A cross disability perspective on the national direct service workforce

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


Direct service worker dsw roles

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


Occupational titles

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


Where dsws work the continuum of long term care settings

Where DSWs Work:The continuum of long term care settings


Trends across service sectors

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


Direct support workforce challenges experienced across sectors

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


Strategic areas for collaborative planning and action

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


Defining competencies

Defining Competencies


Role of competencies

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)


Outcomes associated with competency based training

Outcomes Associated with Competency-Based Training

(Direct Service Workforce

Resource Center, in draft)


Building quality in hcbs

Building Quality in HCBS


Core competencies strengthening the home and community based workforce

Road Map of Core Competencies for

the Direct Service Workforce


Project framework

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.


Road map of core competencies for the direct service workforce

Road Map of Core Competenciesfor the Direct Service Workforce


Project framework1

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.


  • Proposed final project phase

    Proposed Final Project Phase


    Structure of the dsw core competencies

    Structure of the DSW Core Competencies


    Structure of the dsw core competencies1

    Structure of the DSW Core Competencies


    Competency based training model

    Competency-Based Training Model

    (O’Nell & Hewitt, 2005; Hewitt & Larson, 1994)


    Core competencies strengthening the home and community based workforce

    • College of Direct Support (CDS) - UMN

    • College of Employment Services - UMASS

    • College of Personal Assistance & Caregiving - UCSF

    • College of Recovery & Community Inclusion - Temple


    Core competencies strengthening the home and community based workforce

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


    Core competencies strengthening the home and community based workforce

    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


  • Dsw performance development applying the core competencies

    DSW Performance Development applying the Core Competencies


    Dsw performance development with core competencies and cds

    DSW Performance Development with Core Competencies and CDS


    Contact information

    Contact Information

    Annie Johnson Sirek, MSW

    [email protected]

    (612) 626-0535

    Research and Training Center on Community Living

    Institute on Community Integration,University of Minnesota


    Discussion

    Discussion:

    What are your goals

    for preparing our workforce

    to better meet individuals’ needs?


    Reasons to collaborate

    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.


    Strategic areas for collaborative planning and action1

    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


    Building quality in hcbs1

    Building Quality in HCBS


    For further information

    For Further Information

    www.DSWResourceCenter.org

    [email protected]


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