This presentation provides an overview of the innovative approaches and lessons learned from the Massachusetts Personal and Home Care Aide State Training (PHCAST) grant, a project managed by UMass Medical School for the Executive Office of Health and Human Services. PHCAST defined core competencies for direct care workers, and developed a standardized training in those competencie

Russell, Kate

Winchester, Leanne

English

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University of Massachusetts Medical School eScholarship@UMMS Commonwealth Medicine Publications Commonwealth Medicine 2014-03-03 Meeting Massachusetts' Growing Demand for Home and Community-Based Supports Leanne Winchester University of Massachusetts Medical School Et al. Let us know how access to this document benefits you. Follow this and additional works at: https://escholarship.umassmed.edu/commed_pubs  Part of the Health Economics Commons, Health Law and Policy Commons, Health Policy Commons, Health Services Administration Commons, and the Health Services Research Commons Repository Citation Winchester L, Russell K. (2014). Meeting Massachusetts' Growing Demand for Home and Community-Based Supports. Commonwealth Medicine Publications. https://doi.org/10.13028/3tdq-3n56. Retrieved from https://escholarship.umassmed.edu/commed_pubs/93 This material is brought to you by eScholarship@UMMS. It has been accepted for inclusion in Commonwealth Medicine Publications by an authorized administrator of eScholarship@UMMS. For more information, please contact Lisa.Palmer@umassmed.edu. Meeting Massachusetts' Growing Demand for Home and Community-Based Supports:   Innovative approaches and lessons learned from the Massachusetts Personal and Home Care Aide State Training (PHCAST) Grant Leanne Winchester, MS, RN  Kate Russell, MA  Massachusetts PHCAST Program 1 Presentation Outcomes • Participants will be informed of the development of the Massachusetts statewide competency-based training program to improve the personal and home care workforce.  • Participants will be informed of the challenges of training culturally diverse workers as well as the opportunities for partnerships and coalition building.  • Participants will be informed of Massachusetts lessons learned from the implementation of the training program, including the impact on trainees. 2 The Long Term Services and Supports Landscape in Massachusetts      The aging population is increasing      More individuals with disabilities are living independently     The demand for direct care workers to provide home and community based services is increasing     3 What is PHCAST? • Personal and Home Care Aide State Training • Authorized under Section 5507(a) of the Patient Protection and Affordable Care Act.  • ACA appropriated $5 million annually, for three years, to fund six states: California, Iowa, Maine, Massachusetts, Michigan, and North Carolina (FY 2010-2013). • Administered by HRSA BHPr DN • Purpose is to develop core competencies, pilot training curricula, and establish certification programs for personal and home care aides. • PHCAST offers an opportunity to establish a foundation for training a quality direct care workforce. 4 Setting the Scene  Personal and home care aides and Home Health Aides constitute the fastest growing occupations in the U.S. These direct care workers play a key role in aging-in-place strategies. Demographic trends such as a growing aging population and high rates of chronic illness are increasing demand for services.   Lack of training, competency standards, and funding impact the recruitment and retention of a quality direct care workforce.   MA PHCAST program emphasizes training a culturally diverse, transferable workforce, that is prepared to provide quality care and assistance to elders and individuals with disabilities, enabling them to remain in their homes and communities longer.  5 Massachusetts PHCAST • Curriculum development team created a 60 hour curriculum: ABCs for Direct Care Workers; consisting of 13 stackable modules 1.  Roles & Responsibilities 2.  Health care support 3.  Infection Control 4.  Basic Restorative 5.  Personal Care 6.  Nutrition 7.  Consumer needs specific 8.  Safety and emergency 9.  Consumer rights, ethics, confidentiality 10.Communication 11. Culture and Diversity 12. Housekeeping 13. Life skills o Targeting Home Care Aides and Personal Care Attendants 6 MA PHCAST Pilot Demographics 7  • Total Completers: 611 (full) and 271 (auxiliary) • Average trainee profile • Female (91%) • Age 30-39 (23%) • White, Non-Hispanic (49%) • Unemployed (37%) • Limited English Proficiency: 40% • Disadvantaged Under-represented *Minority: 42%  * This number is assumed to be higher since some minority groups (i.e. Brazilian) self report as white, non-Hispanic/ Latino   ABCs for Direct Care Workers 1. Roles & Responsibilities 2. Health care support 3. Infection Control 4. Basic Restorative 5. Personal Care 6. Nutrition 7. Consumer needs specific 8. Safety and emergency 9. Consumer rights, ethics, confidentiality 10.Communication 11. Culture and Diversity 12. Housekeeping 13. Life skills   Continuing Ed •  Care & Comfort of the dying •  Alzheimer's •  Safe Transfers/Overweight clients •  LGBT Training •  Asthma and cleaning tips  •  Awareness and Action •  Working with Deaf, Late-deafened, and hard of hearing individuals    Allied Health Professions PHCAST linkages with career lattice and professional development opportunities 8 Massachusetts PHCAST Career Lattice     Challenges and Opportunities 10 Training and Workforce Development Challenges Worker Challenges Trainer Challenges 11 • Language access o Limited English proficiency o Literacy: reading & writing • Limited Resources  o Case management o Access to Training o Life circumstances • Low wages o Not a living wage o Cliff effect – potential loss of benefits  • Cultural Competency o Training culturally competent and multi lingual facilitators o Diversity among direct care consumers • Recruitment and retention o Vacancy rates: 6% o Turnover rates: 23% • Attrition o Drop rates among trainees o Case management • Costs of training o Neither MassHealth (MA Medicaid) or Medicare reimburse providers for the cost of training staff  Case Management: A Means to Success • Design and Implementation o Recognizable need to support non-traditional students to become successful  o Case managers provided 1:1 support when needed o Case managers provided soft skills instruction:  • Work readiness • Life skills • Time management • Professionalism • Sustainability:  o Partnered with Community Colleges, Head Start, SCSEP o Incorporated the soft skills modules into the core curriculum 12 Language Access Challenge:  • 40% of MA PHCAST participants reported limited English proficiency  Partnerships: • Community Colleges ESL/ABE programs • Community Action organizations seeking jobs and training for their clients • Translated materials and bilingual and non-English trainings  13 Low Wages Challenge:  • In MA DCW wages are higher than average, but with a high cost of living, are still not considered a living wage to many MA residents o PCAs: $12.68 o PCHM: $11.30 - $12.73  Opportunities:  • Professional development and career latticing opportunities & additional training available with Home Care Aide Council (In-services and HHA training) and Community Colleges • Senior Community Service Employment Program (SCSEP) – provides individuals 55+ who are 125% FPL with training, on-the-job mentoring, job shadowing,& CDSMP training. • Community College Workforce Transformation Grant offers opportunities for college access  14 Limited Resources Challenge:  • Life circumstances • Supportive services • Cliff effect – potential lose of benefits  • 90% of MA PHCAST participants rely on public assistance  Partnerships: • Head Start  • SCSEP • Community College ESL/ABE • Regional Employment Boards/ Career OneStops • Case managers provided wrap around services 15 SCSEP Recruitment and Retention Challenge: • Vacancy rates: 6%* • Turnover rates: 23%* • Case management  Partnership: • Advisory Group informed the  development of a Job Preview Video to provide a realistic view of the direct care field • Sustainability subcommittee – informed sustainability plan • Case managers provided wrap around services  *Vacancy and turnover rate data from Massachusetts survey of Medicaid DCW Employers – not PHCAST specific data 16 Sustainability Training Infrastructure Post Grant Funding 17 ABCs for Direct Care Workers Beyond the PHCAST Grant  • MA PHCAST extended to September 2014 (NCE) • Advisory Group and Sustainability Committee provided a vision for sustainability for MA PHCAST including: o Website o Train-the-Trainer Model o Ongoing training integration across fields and services 18 Training Model:  Train-the-Trainer • Maintain Fidelity of the PHCAST program • Ensure Adult Learner Centered technique  • Demonstrate adequate understanding of direct care skills • Increase awareness of culturally competent training and care • Enhance understanding of spectrum of direct care worker types and roles across the state 19 Training Model:  Train-the-Trainer Organization sends training staff to TTT Training staff completes two day training including skills demonstration  Training staff register through MA Direct Care Website TTT attendance verified and secure log in access granted Training staff and organization gain access to MA Direct Care website secure log in Organization has online access to up to date curriculum, videos and resources 20 21 Workforce Typology  Direct Care Worker Title  Home maker PCHM HHA PCA CNA  MA Personal Care Service Provide (Assisted Living Facilities) AFC Direct Care staff MH Peer Specialists Developmental Service Workers Roles and Responsibilities                       Communication Skills                       Culture and Diversity                       Health Care Support                       Infection Control                       Basic Restorative                       Personal Care Skills                       Nutrition                       Housekeeping                       Consumer Needs Specific                       Safety & Emergency                       Consumer Rights, Ethics, and Confidentiality                        Life Skills                       ABCs for Direct Care Workers Website • ABCs for Direct Care website to house curriculum and ensure fidelity of the training   22 www.madirectcare.com  Lessons Learned • Partnership is power! o Engage stakeholder early and often • Recognize and build training around the diversity of the workforce o Language access o Wrap around services o Continuing education and professional development • Train the trainers  o Key to maintaining the fidelity of the curriculum and training program • Managing training costs o Keep printed materials to a minimum o Offer stackable modules to allow workers to participate in training over time 23 Questions? 24 Contact Information • Leanne Winchester, Project Director o Leanne.Winchester@state.ma.us o 617-573-1823 • Kate Russell, Project Coordinator o Kate.Russell@umassmed.edu o 617-886-8280 25 

Meeting Massachusetts\u27 Growing Demand for Home and Community-Based Supports

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Meeting Massachusetts\u27 Growing Demand for Home and Community-Based Supports

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