26 th National HCBS Conference

Transcription

1 26 th National HCBS Conference Atlanta, GA - September 2010 Training Low-income Seniors for the HCBS Workforce: Best Practices & Future Opportunity Bob Harootyan, SSAI Kelsey Walter, NASUAD Dana Wolf, JHL Jan Abushakrah, PCC

2 26 th National HCBS Conference Atlanta, GA - September 2010 Promoting the Linkage of SCSEP to the HCBS-LTC Workforce: SSAI s Pilot Projects Bob Harootyan, MS, MA Manager of Research Senior Service America, Inc. bharootyan@ssa-i.org

3 The Question: Can the Senior Community Service Employment Program (SCSEP) help fill the staffing gaps and train participants for unsubsidized jobs in various types of HCBS and LTC services?

4 SCSEP Terminology Title V of the OAA National grantee Sponsor (subgrantee) Participant Community service assignment Host agency Unsubsidized employment

5 Senior Service America s SCSEP 2009 Fellows Program Pilot projects at seven SCSEP sponsor sites nationwide. Goals: Recruit new host agencies and participants for long-term care training assignments. Market SCSEP participants to HCBS and LTC service providers.

6 Strategies to Recruit LTC Service Providers as Host Agencies AAHSA member organizations and key contact persons in sponsor s area Sponsor s existing relationship with LTC providers Snowball referral process , phone, fax, brochures, flyers Face-to-face meetings

7 Strategies to Recruit LTC Service Providers as Host Agencies Long-Term Care Ombudsman Program Senior Companion Program Aging and Disability Resource Centers Area Agencies on Aging Health fairs, senior centers, community service events, etc.

8 Initial Results from the Pilots The following results are based on data from five of the seven SCSEP pilot project service areas. Total of 682 different long-term care providers were contacted. Total of 1175 cases representing possible SCSEP assignments or unsubsidized jobs were mentioned.

9 Building Linkages: Lessons Learned It s All About Relationships Type and size of sponsor s umbrella organization: Large multi-service organizations are more likely to have linkages with LTC providers. Sponsor staff leadership and tenure: SCSEP directors with long tenure provided greater opportunity to reach potential LTC host agencies.

10 Possible Long-Term Care Positions It s not just skilled nursing care. Transferable or generic job skills 26 different job titles General or paraprofessional LTC skills 33 different job titles Professional skills 11 different job titles

11 Recruitment Outcomes Chart 1 Responsiveness of LTC Service Providers to SCSEP Recruitment, by Type of Provider Ownership 100% 80% % % 20% 0% Non-Profit or Public For-Profit/Private No Response Not Agree to HA or Hire Agree/Possible HA or Hire Current HA

12 Recruitment Outcomes Chart 2 In-Person Meeting with LTC Service Provider Contact Person, by Type of Provider Ownership 100% 80% % 40% % 0% Non-Profit or Public No Meeting For-Profit/Private Meeting

13 Building Linkages: Lessons Learned Service area s provider characteristics: Compared to medium-size cities and urban metro areas, small town/highly rural areas: have lower percentages of non-profit and public LTC providers than urbanized areas. have similar degree of responsiveness to recruitment efforts. are more likely to be selective in acceptance of proposed SCSEP participants.

14 Recruitment Outcomes Chart 3 Responsiveness of LTC Service Providers to SCSEP Recruitment Efforts, by Type of SCSEP Sponsor s Service Area 100% % 41 60% % 35 20% 0% AMD CTN EWI SIA WNY Small Town/Rural Medium City/Rural Large Metro No Response Negative Response Positive Response Current HA

15 Building Linkages: Lessons Learned Responsiveness of current or previous host agencies versus non-host agencies: LTC and HCBS providers that are current or previous host agencies (HAs) are generally more likely to respond positively than providers that have never been host agencies (Not HAs).

16 Recruitment Outcomes Chart 4 Responsiveness of LTC Service Providers to SCSEP Recruitment, by Current Host Agency (HA) Status 100% 80% % % 20% % Not HA Negative Response HA Positive Response

17 Building Linkages: Lessons Learned Key Contact Persons at LTC Providers NP and FP providers had similar proportions of key contact persons across five job levels. Upper- and middle-level management were the most likely key contacts. Mid-level managers were more responsive than highest level management.

18 Recruitment Outcomes Chart 5 Types of Key Contact Persons Reached at LTC Service Providers, by Type of SCSEP Sponsor Ownership Exec Dir, CEO, Owner Administ'r, Gen'l Mgr Assist Dir, HR Mgr Program Mgr, Vol Coord'r Office Mgr, Admin Asst Non-Profit/Public For-Profit/Private

19 Recruitment Outcomes Chart 6 Responsiveness of LTC Service Providers to SCSEP Recruitment Efforts, by Type of Key Contact Person 100% % % % 20% 0% Exec Dir, CEO, Owner Administ'r, Gen'l Mgr Assist Dir, HR Mgr Program Mgr, Vol Coord'r Office Mgr, Admin Assist No Response Negative Response Positive Response Current HA

20 Building Linkages: Lessons Learned Non-profit/public (NP) compared to For-profit/private (FP) LTC providers: Both NP and FP providers are most likely to mention openings for LTC paraprofessionals, especially FPs. NP providers have a much higher proportion of opportunities for transferable skills jobs. FP providers are much less likely to be aware of the SCSEP.

21 Recruitment Outcomes Chart 7 HCBS and LTC Job Types Mentioned for Possible SCSEP Participant Assignment or Job, by Type of Provider Ownership 100% % 60% % 20% 0% 44.5 Non-Profit or Public 18.6 For-Profit/Private Transferable or generic skills Professional healthcare skills General or paraprofessional skills

22 Building Linkages: Lessons Learned Types of Possible SCSEP Assignments or Jobs for Hire Transferable Skills: Clerical is most common. Paraprofessional Skills: Most common are CNAs and HHA/PCAs, followed by HCAs and Activity Aides (definitions vary). Professionals: LPNs and RNs are most common, followed by Physical and Occupational Therapists.

23 Recruitment Outcomes Chart 8 Transferable and Generic Skills: Job Types Mentioned for Possible SCSEP Assignment or Job Clerical Other Office Housekeeper Other Bldg/Grnds Dietary Aide Dishwasher Other Food Service

24 Recruitment Outcomes Chart 9 General LTC or Paraprofessional Skills: Job Types Mentioned for Possible SCSEP Assignment or Job CNA HHA/PCA HCA Activity Aide DCW Dining Aide Adult Day Aide Therapy Aide Med Tech Home Meals Other

25 Recruitment Outcomes 10 Chart 10 Professional LTC-Healthcare Skills: Job Types Mentioned for Possible SCSEP Assignment or Job LPN RN Other

26 Building Linkages: Lessons Learned Preconceptions about long-term care positions and participants preferences: Program staff as well as SCSEP participants may have inaccurate conceptions, which may thwart recruitment of LTC participants. Participants assignment preferences versus available positions: Providers tend to seek direct care positions, but participants may not qualify without specific training. The most likely direct care positions are CNAs, HHAs/PCAs, Activity Aides, and HCAs.

27 Building Linkages: Lessons Learned Large conglomerates vs. smaller providers: Although large providers have more and varied positions, they are less accessible and have complex decision-making processes, including legal review. Smaller LTC providers have fewer opportunities, but are more accessible. Smaller providers are less likely to be able to devote necessary staff time for training.

28 Building Linkages: Lessons Learned LTC Providers and the Host Agency Agreement Concerns about Liability The standard insurance policy required for all SCSEP sponsors provides liability and hold harmless coverage for all parties.

29 Building Linkages: Lessons Learned Special requirements for assignments: Only a few direct care positions require certification or other training prior to the agency assignment. Participants assignment preferences versus available positions: Participants are more likely to prefer non-direct care positions. Providers are more likely to need hands-on staff.

30 Training for LTC Positions Training for LTC positions: Except for nurses, occupational therapists and other healthcare professionals, training for most paraprofessional LTC positions can be conducted on the job. Training for CNAs, PCAs or HHAs usually comprises 80 to 120 hours of formal instruction and a test. But many LTC providers do not provide or pay for such training.

31 Training for LTC Positions LTC training (continued): SCSEP training focuses on basic job skills (e.g., computer basics) and job searching (e.g., writing a resume, interview skills, appropriate attire). Training is often provided by WIA One Stop centers. But WIA performance incentives lessen the likelihood that One Stops will provide effective service to older displaced workers (focused on full-time employment, 6-month retention, earnings, and educational credentials).

32 Training for LTC Positions LTC training (continued): SCSEP projects may devote additional funds for specialized training to prepare participants for unsubsidized employment. Training can be classroom-based, online, or on-the-job. Participants are paid SCSEP wages while in training. SCSEP projects are encouraged to seek training through local resources at no cost or reduced cost.

33 Training for LTC Positions Best Practice Example NYC Department on Aging SCSEP Program Trains participants to be PCAs by directly providing 35 hrs/week formal training for 4 weeks. Participants receive SCSEP wages during training. From 2005 to 2009, more than 170 SCSEP participants completed the PCA training. All graduates were immediately placed in an unsubsidized job after course completion.

34 Training for LTC Positions Best Practice Example Community Colleges: Training Older Adults About 85% of community colleges have programs or curricula for seniors. AACC Plus 50 Initiative (persons age 50+): Promotes growth in 3 program areas: workforce training, enrichment, and/or volunteering. Recent shift in emphasis from enrichment classes toward workforce training courses.

35 Training for LTC Positions Best Practice Example Potential role of community colleges for LTC and HCBS job training: Most community colleges have WIA training programs. The most common is certified training for specific types of jobs. Few of these programs provide training in LTC or caregiver work.

36 Training for LTC Positions Best Practice Example Portland (OR) Community College Special career-based curriculum for certification in LTC job skills Curricula and certificates developed with employer input and endorsement Meets state/local standards and linked to national certifications Courses for Resident Assistant I and II are jobbased training (comparable to PCA criteria)

37 Training for LTC Positions Best Practice Example Jewish Home Lifecare (NYC) SCSEP host agency since 2005 On-the-job LTC training for SCSEP participants In 2009, 42 SCSEP participants were serving in clerical or direct care (dining assistant) positions. JHL has hired 14 of its SCSEP participants as dining assistants and home health aides.

38 SCSEP and LTC-HCBS Training Senior Community Service Employment Program: A Win-Win for LTC Providers Unemployed low-income participants seek community service opportunities. The host agency benefits from participants whose wages are paid by SCSEP. The investment by the host agency is returned (in-kind with skilled workers. SCSEP assignments and special training develop skills for jobs in either the nonprofit and for-profit LTC workforce.