Future of Health Care Employment for Low-Income Workers and Ex-Offenders

1. Future of Health Care Employment for Low-Income Workers and Ex-Offenders March 12, 2014

2. To submit a question, simply type your question in the space provided at the bottom of the Q&A box and click the Ask button to the right.

3. Webinar Structure • Overview of the Health Care Labor Market, Benjamin Kushner, ICF International • Projections for Health Care Employment, Josh Fangmeier, CHRT • Barriers and Best Practices for Placing Ex-Offenders in Health Care CareersBrenda Palm-Barber, North Lawndale Employment Network (NLEN) • Questions & Answers

5. Future of Health Care Employment for Low-Income Workers and Ex-Offenders March 12, 2014

6. Overview of the Health Care Labor Market

7. 20-year Trends Source: Bureau of Labor Statistics, Current Employment Statistics

8. 20-year Trends, Continued Source: Bureau of Labor Statistics, Current Employment Statistics

9. 20-year Trends, Continued Source: Bureau of Labor Statistics, Current Employment Statistics

10. 20-year Trends, Continued Source: Bureau of Labor Statistics, Current Employment Statistics

11. Factors Affecting Health Care Employment • Aging Population and Disease Prevalence • Expansion of Insurance Coverage (ACA) • Changes in Health Care Delivery • Shift to Home and Community-based Services • Scope of Practice Reforms • Investments in Primary Care • New ACA Models and Reimbursement Cuts • Potential Increase in Automation • Macroeconomic Effects

12. Barriers to Health Care Employment • Education and Training • Variation in Training Programs • Licensing Issues • Local Environment • Criminal History • Other Social Factors

13. Polling Question

14. Projections for Health Care Employment

15. Employment Data Sources • Bureau of Labor Statistics: Occupational Employment Statistics • Bureau of Labor Statistics: Employment Projections for 2012-2022 (December 2013) • Based on Aggregate Factors and Industry-specific Demand • Occupation Projections • New Job Openings • Replacement Openings • Not a Projection of Labor Surpluses/Shortages • State-level Projections

16. Analysis of Leading HPOG Occupations • Registered Nurses • Cardiovascular Technicians • Pharmacy Technicians • Licensed Practical Nurses • Health Information Technicians • Home Health Aides • Nursing Assistants and Orderlies • Medical Assistants • Medical Secretaries • EMTs and Paramedics Note: Occupation list based on the top enrolled occupations as of 2/17/14

17. Previous 10 Years for HPOG Occupations Source: Bureau of Labor Statistics, Occupational Employment Statistics

18. Employment Trends and Projections Source: Bureau of Labor Statistics, Occupational Employment Statistics and Employment Projections for 2012-2022

19. Employment Projections Source: Bureau of Labor Statistics, Employment Projections for 2012-2022

20. Regional Variation in Projections Source: Bureau of Labor Statistics, Employment Projections for 2012-2022; New York State Department of Labor; Wisconsin Workforce Information, Bureau of Labor Statistics Programs

21. Current Status of Medicaid Expansion Decisions, 2014

22. Other Occupations with High Growth Projections – National Source: Bureau of Labor Statistics, Employment Projections for 2012-2022

23. Summary • HPOG occupations projected to continue high rates of growth • Growth will vary across states due to market and policy factors • Growth is projected to be higher in non-hospital settings • Practice transformation efforts may increase the role of mid-level practitioners

24. Polling Question

25. Barriers and Best Practices for Placing Ex-Offenders in Health Care Careers

26. Healthcare jobs for Returning Citizens A Partnership with the North Lawndale Employment Network and Advocate Health Care system.

27. North Lawndale Community Profile • Mission is to improve the earnings potential of the residents of North Lawndale through innovative employment initiatives that lead to an improved quality of life. • The North Lawndale community has an unemployment rate of 26 percent • 34 percent of the annual household incomes in the community are below $10,000 • 59 percent of households have an annual income of less than $25,000 • 57% of adults have been engaged in criminal justice system

28. NLEN and Advocate Trinity Hospital Partnership – Hitachi Foundation Making Work,Work 2003 - 2006 • Advocate Trinity Hospital, serves 90,000 patients annually, developed an on site training program to give formerly-incarcerated, individuals/returning citizens, the skills required to secure self-supporting jobs with benefits and a future. • Area of Skills Training - Trinity’s Environmental Services or Nutritional Services Departments

29. NLEN Provided • Graduates of U-Turn Permitted, a 4-week job readiness program - 110 hours of cognitive-based workforce training and court approved anger management and; • Job seekers who were job ready, well-screened with appropriate felony classifications and met the job requirements for the positions. • NLEN also provided transportation support for first 60 days • Trinity absorbed the cost of the physicals, TB tests, and blood work necessary to begin work at the hospital, as well as free lunches and Illinois Healthcare Background Checks. • Upon completion of training, participants received coaching and retention support.

30. The Numbers • Trinity trained four cohorts totaling 15 participants at the hospital. Started with 4 graduates to pilot. • All 15 completed the program, and 12 trainees were hired directly at Advocate Trinity Hospital. • Two were placed in jobs outside of the healthcare industry • Of the 12 hired at Trinity, 8are still working and have retained this employment for more than 10 years. • Starting pay was between $9.00 and $10.50 an hour with full benefits. • Advocate Health Care hospitals offered a work-school program that assisted employees in acquiring the education and skills necessary to advance in a medical career.

31. Real Costs Savings • Advocate’s internal study showed that NLEN employees had a 25% reduction in absences and time off compared with other employees. • Trinity also estimated a savings of $180,000 for labor provided during OJT at no cost to the hospital. • In addition, because of the high costs of employee turnover, Trinity estimates that it conservatively saved $17,000 per employee who retains employment per year. • Therefore, a total savings from this partnership resulted in upwards of $367,000.

32. Barriers to Prepare for in Implementation • Individual Fear and Social Stigma of the formerly incarcerated • Liability • Public Relations • Unqualified, Not Job ready, Job seekers • Buy-in of the benefits of hiring people with backgrounds up to bottom and bottom up. • Surviving Turnover of Senior Management and Hiring Personnel • Unions

33. Potential Barriers to Implementation • Identify a champion(s) in the company motivated by more than the bottom-line to explore a hiring partnership. • Small, independent healthcare providers can often be more receptive with less red tape, and owner-driven values. • Local political forces can be an important factor in both developing and damaging business partnerships.

34. Vincent’s Story • Cycled in and out of the prison system – 8 bits - Sick and tired of being sick and tired • Drug-related offenses • High School education • Hired by Advocate Trinity in environmental services at $9.00 an hour in 2003 • Retained employment 11 years and makes $38,000 with Benefits

35. Questions and Answers

36. HPOG Reminders Technical Assistance Coaching Calls are ongoing Instructor Engagement Roundtable for HPOG Programs is in Wednesday, April 23, 2014 through Thursday, April 24, 2014. Make sure your program’s designated representative is signed up. For registration information, please refer to Stan Koutstaal’s email from February 12 located in the “Announcements” section of HPOG Connect. Continue the conversation on HPOG Connect in the Future of Health Care Employment Webinar Sphere and look for the resources mentioned in this Webinar posted on the Sphere, including presentations and the Webinar recording