NC-PHCAST – The Community College Connection

1. NC-PHCAST – The Community College Connection Margaret Roberton, NC Community Colleges Kathy Turner, NC Division of Health Service Regulation

2. Statistics and Projections • In the next 20 years the number of persons 65 and older will almost double from 1.3 million to 2.3 million • North Carolina is 10th nationally in size of total population, we are 9th in those 60 and older. • By 2025, 86 of the NC’s 100 counties are projected to have more people over age 60 than age 17 and under

3. Statistics and Projections • In 2025, one in four North Carolinians will be 60 and older • Over the next two decades, the 75-84 age group will be the fastest growing of those ages 65 and older • The number age 85 and older will grow fastest beginning in 2030,when the oldest of our 2.4 million baby boomers near their 85 birthday

4. Demographics • Status of North Carolinians 65 and older: • Living alone 29% • Veterans 22% • Have a disability 38% • Median household income 27% • Income below poverty level 10% ($10,778) • Income is between 100-199% of the federal poverty level 25%

5. Statistics and Projections • NC currently has more than 17,000 older adults with Alzheimer’s or other types of dementia most of whom are being cared for at home or by family and friends. By 2030, the total number is projected to rise to nearly 300,000. • For those age 75 and older, 13% live below the federal poverty level and 30% live at or between 100-199% of the FPL

6. Builds on prior Direct Care Worker Initiatives Creates 4-phased framework for training and competency to better prepare new and incumbent workers Training Venues: Community Colleges High Schools Increasing demand for direct care workers Personal Care Aides and Home Care Aides are the fastest growing occupations Plus, Nurse Aides are in the top 11 jobs in terms of largest job growth Trained, competent workers are essential to quality care Create a “Gold Standard” for minimum training Key Concepts of NC PHCAST

7. Overview of NC’s 4-Phase Approach • Phase I – Introduction to Direct Care Work • Phase II – Direct Care Basics (pre-Nurse Aide level) • Phase III – Nurse Aide I • Phase IV – Advanced NA training/competency • Home Care Nurse Aide • Geriatric Nurse Aide • Medication Aide • Option for in-service use across settings

9. Community College Pilot Sites Includes both pilot years Excludes Halifax CC & Cape Fear CC/Elder House

10. Phase III - 57 Phase IV – 160 499 Pilot Participants Phase I – 203 Phase II – 262

11. Better matching/redirecting of prospective workers to job-more focused recruitment Competency based – certificate or credential at each phase New and incumbent workers can enter at various points Expands state recognized career path options; supports workers; responds to employer need Enhanced career paths, employability and responds to employer need (4-phase approach – specialties) Integration with other training & QI initiatives Builds on prior direct care initiatives in NC Removes some barriers to training Key Impacts

12. Phase I- Sample Comments (student) • This course has started me on the path to reaching my career goals. (88% agree) • I know about career options that I did not know about before the completing this course. (95% agree) • This course has put me further along in reaching my education goals. (89% agree) • I am considering career options that I was not considering before the course. (95% agree) • This course has made me more satisfied with my direct care job than I was before. (89% agree) • This course has made me a better direct care worker. (94% agree) • I would recommend this course to my coworkers. (94% agree) N = 18

13. Phase IV- Sample Comments (student) This course has started me on the path to reaching my career goals. (100% agree) I know about career options that I did not know about before the completing this course. (93% agree) This course has put me further along in reaching my education goals. (89% agree) I am considering career options that I was not considering before the course. (72% agree) This course has made me more satisfied with my direct care job than I was before. (92% agree) This course has made me a better direct care worker. (100% agree) I would recommend this course to my coworkers. (96% agree) N=29

14. Research Questions for Graduates/Instructors/Employers What were the barriers to effective PHCAST implementation? In what ways did partners leverage resources to implement and/or sustain the training program in local communities? What aspects of the PHCAST curriculum were the most valuable to each stakeholder group (e.g., students, educators, employers)?

15. Barriers • Administrators: Marketing and Recruiting • Instructors: Scripted curricula, content redundancy, instructor guide book Resources • Goodwill • Public Housing Authority • CCRC

16. What aspects of the PHCAST curriculum were the most valuable? Students – problem solving, adapting to difficult situations, understanding grief and dementia, applying person-centered care Instructors – seeing students get jobs, new alliances within our school Employers – reports were more pertinent, client compliments increased, (documentation)

17. Implementation Phase Curricula Evaluation Test banks Other 2010 – 2013, What’s Next?

18. Human Resource Development Governance • SBCC Code – HRD Program Continuation Each college shall operate a Human Resources Development (HRD) program to provide assessment services, employability training, and career development counseling to unemployed and underemployed individuals. FTE shall be generated from HRD programs. Each college shall provide HRD instruction and support necessary for unemployed and dislocated workers to be served within the college service areas. • Vision and Mission Statement HRD is a dynamic and vital workforce development program with proven economic, social, and educational success. The purpose of the HRD program is to educate and train unemployed and underemployed individuals for success in the workplace.

19. HRD Program Goals • Provide program outreach and student recruitment activities to targeted populations • Assist students in accessing meaningful training and/or employment opportunities • Enhance and develop the student’s employability skills • Develop and promote the student’s ability to move towards economic self-sufficiency

20. Core Services Skill assessment services Employability skills training Career development counseling Target Groups Unemployed adults Underemployed adults Core Components Assessment of an individual’s assets and limitations Development of a positive self-concept employability skills communication skills problem-solving skills Awareness of the impact of Information Technology in the workplace 1D SBCCC 300.3 Program Classifications Human Resources Development

21. HRD Fee Waiver Guidelines • Eligibility Requirements • HRD courses are not free… Fees are waived • Waiver is based on the individual’s income • Unemployed • Underemployed* • Notification of pending lay-off

22. HRD Eligibility • For HRD purposes, underemployed is defined as individuals… • working and is eligible for the Federal Earned Income Tax Credit (FEIT); or • working and earning wages at or below two hundred percent (200%) of the federal poverty guidelines.

23. PHCAST Needs Aligned to HRD Core Services • Assessment • Ability to appropriately identify individuals prepared to enter healthcare fields • Introduce occupational requirements to maximize success of students progressing into Nurse Aide I • Introduce workplace realities of personal/home care environments vs. residential/institutional settings • Outline pathway alternatives for health care fields • Personal Home Care Aide • Recognized & standardized curriculum

24. Employability Skills Concepts contextualized for healthcare field Communication, listening skills, teamwork, and time/stress management Career Development Ability to problem solve independently Decision-making and management skills PHCAST Needs Aligned to HRD Core Services

25. Specific HRD PHCAST Courses • Phase I – Introduction to Direct Care Work (Focus on job readiness skills, literacy, numeracy, keyboarding, and realistic job previewing) • Career Exploration • Self-Assessment • General soft skill requirements • CPR (lay person)

26. Specific HRD PHCAST Courses • Phase II – Direct Care Basics (Focus on non-nurse aide personal care tasks and soft skill development; 3) expanded nurse aide (NA-1) skills) • Introduction to base skills • Introduction to functional concepts within role • Enhanced soft skills training • Career counseling

27. Importance of PHCAST to Employers & Personal Care Clients • Growing need for Continuum of Care • Rising cost of care & shortage of trained workers • Greater efficiency in healthcare delivery (lowering cost while improving delivery) • Promote quality care for increasing numbers of older adults and persons with disabilities

28. Recruitment / Marketing: Getting Their Attention • Program Outreach • External Agencies • Internal Resources • Community

29. Recruitment / Marketing: Getting Their Attention • Program Outreach • External Agencies • JobLink Career Centers • Division of Workforce Solutions (ESC) • Social Services • US Committee for Refugees and Immigrants • Shelters • National Guard/Family Employee Assistant Center • Community-based Organizations

30. Recruitment / Marketing: Getting Their Attention • Program Outreach • Internal Resources • HRD classes • Introduction to Healthcare Occupations • HRD Strategies for Success • CE Healthcare classes • Back-to-Work intake sessions • Basic Skills Plus

31. Recruitment / Marketing: Getting Their Attention • Program Outreach • Community • Flyers and brochures • College catalogues • College website • Social Media • Email • Past HRD students (Phase I and Phase II) • Current and Past NA I students (Phase IV) • Local home care facilities

32. Recruitment / Marketing: Challenges • Communication of value • Home care agencies • Benefit of contextualized training • Benefit of advanced standardized training (Phase IV) • Participants • Benefit of credential for hiring • Benefit of commitment to entire pathway • Program schedule/mix

33. Audience Experiences

34. Want to Know More? Margaret Roberton robertonm@nccommunitycolleges.edu Kathy Turner Kathy.turner@dhhs.nc.gov