Allied Health Advisory Group

March 17th, 2017 9:30-11:30am UMass Medical School, Shrewsbury Campus Facilitator: Geoff Vercauteren Director of Healthcare Workforce Development

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Welcome

Please say your Name

Title

Organization

Introductions

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David Cedrone Budget Discussion and the Nursing and Allied Health

Initiative

▪ N&AHI rolled into larger SSA/STEM budget

▪ Gives Commissioner discretion on how much funds to allocate to which programs

▪ Senate budget expected mid-April

Questions about paying for clinical placements

▪ We will be reaching out for more information

Updates from DHE

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Job Fair 2.0 in Lowell – January 26th, 2017 Patricia Yu, Director of Policy and Research, MA Executive

Office of Elder Affairs

Discussion: What regions should be targeted next?

Willing partners?

Learning and Sharing

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Leanne Winchester, Project Director, Massachusetts AHEC

Interim Report on the “Scaling Efforts to Advance the Direct Care Workforce” grant

(Part II)

A Statewide Approach to Increasing

Education And Career Opportunities for

Direct Care Workers and Supervisors

A Statewide Approach to Increasing Education and Career Opportunities for Direct Care Workers that Aligns

with Employer Need Project is funded by the Massachusetts Department of Higher Education’s Nursing and

Allied Health Initiative: Scaling Efforts to Advance the Commonwealth’s Direct Care Workforce Grant

State Partners

• Executive Office of Elder Affairs

• Massachusetts Department of Public Health

• Executive Office of Labor and Workforce Development

Consortium Partners

• Massachusetts Department of Higher Education

• University of Massachusetts Medical School

• Bristol Community College • University of Massachusetts Dartmouth

• Greenfield Community College

• MassBay Community College

• Middlesex Community College

• Northern Essex Community College

• Quinsigamond Community College

• Partnership for a Skilled Workforce

• Home Care Aide Council

• Mass Senior Care

Direct Care Workforce Development Projects

PHCAST

- Acquiring Basic Core Competencies ABCs for Direct Care Worker

- Continuing Education/ Professional Development modules

- PCA Fundamentals

ABCs to NA Bridge

A 90-hour nurse aide bridge curriculum for PHCAST trained workers

DHE Scaling Efforts

Priority 1:

Direct Care Worker Pathways

Priority 2:

Transferable Training

Priority 3:

Development of Core Competencies

Priority 4:

Leadership Training

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Timeline

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Priority 4: Leadership Training • Update existing three hour supervision training

• Develop a hybrid model with an online component to

support employers and supervisor needs.

• Align with nursing continuing educational unit (CEU)

requirements.

Fundamentals of Supervision

• Ongoing development….

• Core modules and optional modules

Delivery Options:

• Online

• Hybrid

• Face to Face

Expected Outcomes 1. Updated PHCAST ABCs for Direct Care Worker curriculum that bridges into

a standardized nurse’s aide curriculum, then further bridges into a General Health Sciences Associates degree program

2. A mentoring and success coaching component that enhance QCCs Bridge to Health Care Careers program

3. A course articulation for the bridged programs that could provide credits towards a four-year Health Sciences bachelor’s degree

4. A How To Manual that can be adapted and utilized at colleges throughout the Commonwealth who wish to implement PHCAST and develop a healthcare educational and career pathway for Direct Care Workers

5. An updated, 4 hour supervisor training: Competency Based Leadership for DCW supervisors, delivered in-person and a web-based delivery option

6. Up to 60 trained facilitators in community colleges, long term care, and home and community based settings

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Questions, Comments, other Considerations

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Leanne Winchester, MS RN

Project Director

Direct Care Workforce Development

EOHHS/ELD/UMMS MassAHEC

One Ashburton Place, 5th floor

Boston, MA 02108

(617) 573-1823

Leanne.Winchester@state.ma.us

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“The Advanced Leadership in Geriatric Care Program for Certified Nurse Assistants” Carol Kronopolus, Professional Development & Career

Development Coordinator, Hebrew Senior Life

Special Guest Presentation

Advanced Leadership in Geriatric Care Program for Certified Nurse Assistants ©2012

Allied Health Advisory Group

17 March 2017

Carol S. Kronopolus, MS, RN

Professional Development & Career Development Coordinator

History

Hebrew Senior Life submitted a proposal to The

Boston Foundation to fund this education

project and was selected as a recipient in 2012

The Boston Foundation initiative was to

“promote career development and economic security

of low income individuals”

The grant supports the “Senior CNA” job training

program and promotes leadership skills within

their new role

HSL Leadership Exceptional Support

Embrace the role of “Senior CNA” that enhance the care of residents and promote knowledge, skills, self-confidence, and value of their CNA role

Modify CNA Job Description to incorporate additional education, a leadership role among their CNA team and increased responsibilities

Support pay rate increase to reflect additional education & role responsibilities

Participate in program and ongoing meetings with CNAs to provide ongoing support and discuss any concerns as they transition into their role

Criteria for Selection of CNAs

Focus on Experienced CNAs

Demonstrate leadership qualities & team work

Current CNA certification

“Good Standing” - no outstanding disciplinary actions

HSL Employee at least 1 year

Scheduled minimum of 32 regular hours per week

Agree to participate in all computer and classroom meetings

Recommendation by Nurse Manager

Computer Skills

Taught by Jewish Vocational Services - 40 hours

Microsoft Programs ~ HSL Intranet ~

Documentation of Resident Care

Online evaluation of current skills - provides a

baseline of abilities & individual learning needs

Retested at program completion to measure skills

attained (all improved)

CNAs report increased skill and proficiency with

computer skills to communicate with CNA team,

create informational flyers, and mentor peers with

use of HSL email & documentation

Advanced Leadership Curriculum

Curriculum developed by HSL Professional

Development

Attend 8 hour classes for 10 weeks

Content builds on initial CNA curriculum

Comprehensive review of elder care

Focus on Leadership, Coaching, Conflict

Resolution, Communication, Team Building

HSL Multidisciplinary Team Approach

HSL Specialists present their expertise • Communication for a Respectful Workplace

• Leadership - Mentoring - Coaching Skills

• The Aging Process & Common Health Concerns of Elderly

• Communicating Changes in Resident’s Status to the Nurse

• Dementia & Alzheimer’s & Multidisciplinary Care Approach

• Maintaining Skin Integrity & Pressure Ulcers

• Safe Patient Handling

• Palliative Care - End of Life Care - Hospice

• Expressive Therapy - Life Enhancement

• Physical Therapy - Occupational Therapy - Speech Therapy

• Accurate Documentation

• Culture Change

• American Heart Association CPR

Essential: Supporting the Senior CNAs!!

HSL contracted with Jewish Vocational Services to

provide a designated experienced job Coach

Coach met weekly with each CNA/RA to discuss

ongoing concerns, role transition, and offer

suggestions on addressing concerns

CNAs may contact the Coach as needed

Monthly group meetings with nurse leaders to

facilitate group discussion on concerns, role

transition, and provide focused education topic

within residents’ care (nutrition, activities)

Collaboration with PSW,

Community Colleges & LTC Facilities

2014 - HSL partner with PSW - 224 Grant - Team up with Massachusetts Bay CC & Quinsigamond CC

Graduates - 80 CNAs from 8 Local LTC Facilities

•Goal: Introduce CNAs to nursing / health careers

Outcome CNAs have enrolled in nursing programs

•Goal: Create partnerships between Colleges & LTC

Outcome 80 CNAs introduced to local undergraduate education and the healthcare pathway

Great Outcomes in Resident Care

& 44 HSL Senior CNAs

Nurses may delegate select responsibilities to the Senior CNAs so their valuable time focuses on RN/LPN role in resident care

Families comment on excellence in care provided to family members

Senior CNAs report increased self-confidence with professional interactions & personal life

Senior CNAs receive “HSL ROCKS” recognition

Senior CNAs empowered to initiate creative activities for residents (movement, art, music, reminiscence, hand massages)

Great Outcomes of College Based

Programs & 80 Senior CNAs

Introduced to local community college and

undergraduate health programs

Increased self-confidence and complete college

application for nursing programs

“Field Trips” - Traveled to each other’s facilities to

learn roles of PT, OT, Speech, Hospice, etc.

Observation of great care provided at other

facilities then brought these new ideas to their

facility

Modifications in the Focus of Care

Geriatric focus modified for CNAs in a Mental

Health Agency - Spring 2016. 10 CNAs

Geriatric focus modified for Medical Assistants in a

Primary Care office - Spring 2016. 8 MAs

Future Endeavor - modify program for CNAs

working in a Pediatric healthcare setting

Future Endeavor - modify program for CNAs in an

Acute Care setting. CNAs complete initial patient

care in a long-term care setting & may need new

focused education for acute care setting.

Implementation at Colleges

Encourage experienced CNAs with leadership

qualities

Nurse educator with long-term care experience

and appreciation of CNA role to teach program

Create collaborations with local LTC facilities to

learn care provided by OT, PT, Speech Therapy,

Skin/Wound, Safe Patient Handling , Palliative &

Hospice, Life Enhancement

Introduction to college’s healthcare careers

Healthcare Program Advisors meet with CNAs

Ongoing Endeavors with the Program

National Certification beyond the initial American

Red Cross Certified Nursing Assistant.

Connected with national certification agencies to

create an advanced level of certification

Program was presented at the Pioneer Network in

August 2016. Program received enthusiastic

response. HSL is in the process sharing program

with other long-term care facilities across the

United States

Thank you for your interest in the Advanced Leadership in Geriatric Care Program for CNAs

CNAs are a valuable member and asset within the healthcare team. This program is the next step in their career ladder and an

excellent initial investment in their professional development.

Contact HSL for more information on implementing the program within your organization

Mary McDougall, DNP, MPH, ANP-BC, Director of Professional Practice & Education

Office: 617.363.8525 MaryMcDougall@HSL.Harvard.edu

Carol S. Kronopolus, MS, RN, Professional Development & Career Development

Office: 617.363.8187 CarolKronopolus@HSL.Harvard.edu

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Options for Creative Streams of Funding: The “SNAP Path to Work” Program Miriam Kaufmann, SNAP Assistant Director, E&T Service,

MA Department of Transitional Assistance

Amy Kershaw, Deputy Assistant Commissioner for Programs (SNAP), MA Department of Transitional Assistance

Special Guest Presentation

SNAP PATH TO WORK PROGRAM

March 17, 2017

Since July 2006, DTA has partnered with the University of

Massachusetts Medical School (UMass) to offer Non-TANF

SNAP participants meaningful opportunities to enhance

employability through SNAP Employment &Training (E&T)

participation.

This collaboration provides an opportunity to create third-party

partnerships with community based organizations, community

colleges and other education and training providers who offer

approved E&T services. Through the program, contracted

partners are able to access federal funds to with which to

continue and supplement existing activities.

Massachusetts’ E&T Program

MA SNAP E&T is now known as the

SNAP Path to Work Program

Massachusetts’ E&T

program was renamed in

October 2016

Project Focus

Training programs that lead to in-

demand jobs with a viable career

pathway in sector industries such

as (but not limited to):

• Construction

• Healthcare

• Hospitality

• Catering/Food industry

• Manufacturing

• Retail

• Information Technology

• Other

SNAP Path to Work Components

Education - educational programs or activities to improve basic s

kills or otherwise improve employability

Skills Training - improves the employability of participants by pro

viding training in a skill or trade, allowing the participant to move

directly into employment

Job Search Training - strives to enhance the job readiness of

participants by providing instruction in job seeking techniques

and increasing motivation and self confidence

Job Search - requires participants to make a predetermined

number of inquiries to prospective employers over a specified

period of time

SNAP Path to Work Components

Job Retention Services - provides support to individuals who have re

ceived E&T services under the SNAP Path to Work program and have

secured employment (for up to 90 days)

Support Services (Participant Reimbursements) - participant

expenses that are reasonable, necessary and directly related to

program participation

• Transportation

• Uniforms/personal safety items

• Training Manuals/Books/Supplies

• Educational/Testing Fees

• Childcare

Co-Enrollment:

Non-Duplication of Services

Training Provider

Wrap around Support Service

DTA/UMass currently contract with 42 E&T providers that

operate quality training or education programs.

As a provider you could be eligible for approximately

50% reimbursement of allowable costs when:

What’s in it for the E&T Provider?

• Serving a client who is

enrolled in the program

through the SNAP E&T

Program; and

• Non federal funds are used to

pay for the client’s

participation.

• SNAP E&T is not a “grant” program, nor is it technically a

“match” program.

• It is a reimbursement program – federal funds reimburse 50%

of allowable E&T expenditures.

• UMass retains 5% of the 50% of SNAP E&T

reimbursement for administration of the program.

Providers receive 95% of the 50%.

Third-Party Partnerships

UMass/DTA contracts with local partners to provide E&T

services

Local partners use non-federal funds to pay for

allowable expenses, and then submit a claim to the State for

reimbursement

Reimbursement back to local partner

Quarter Reimbursement Example

Month 1 Month 2 Month 3

$1500 $1500 $1500

Quarterly Cost of Serving Client: $4,500.00

Reimbursable Amount: $2,250.00

UMASS retains 5% of $2,250: $112.50

Provider payment: $2,137.50

The federal government provides 50%

reimbursements for non-federal spending for:

• Funding for staff required to administer the

program and directly support E&T participants

• Costs for training related to instruction and fees

books, supplies

• Support services including case management

• Additional administrative costs for planning,

implementing and operating the program

• Participant Reimbursements

What expenses qualify for reimbursement?

Potential Funding Sources

• Any non-federal funding

including

• State or local government

funding*

• Private contributions:

foundations or corporate

grants, individual

donations

• Social enterprise revenue

*NOTE: Must ensure

funding sources are not

federal sources within other

grants being utilized

Non-Federal Funding

• State, County, City Funds*

• Private Donations

• Foundation Funds

• Social Venture Revenue

• Community Development Block Grants

(CDBG)

• Tuition Resources (not financial aid or

federal student grants)

• Other State Training Funds*

• SNAP Path to Work Reimbursement

Funding (loses its federal identity once

reimbursed)

*Not already match federally

Funding Source Amount

• Only need enough

matching eligible

funding to fund E&T

participants’ training.

Not for the whole

program.

• Program can serve

some via E&T, some

WIOA and so on.

• Program does not

have to be for SNAP

participants only

Maximize dollars already spent to serve

SNAP recipients

Expand the types of services available and

increase the capacity to serve more individuals

Extremely flexible funding that can cover a wide array of allowable

costs

Create a new funding stream to pay for much

needed participant supports

Benefits of Partnering

B

E

N

E

F

I

T

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SNAP Path to Work Website

www.snappathtowork.org

Questions

Department of Transitional

Assistance

Miriam Kaufmann

SNAP Assistant Director, E&T Service

Miriam.Kaufmann@state.ma.us

(617) 348-5561

Contact

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AHAG

Sub-committees Current state

Future plans

AHAG Strategic Planning

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Status of sub-committees: Curriculum Design and Alignment

▪ Currently working on convening focus groups to hear from employers around the state

▪ Asking questions on readiness of CC grads for jobs in CNA and HHA

▪ Regions so far: Western MA (fall 2016), Cape Cod (Nov 1st, 2016, May meeting TBD), Greater Lowell (April 24th); South coast regions (April 7th); Metro Southwest (TBD April or May)

Future plans:

▪ Update curriculum alignment sheet?

▪ Update state listing of all DCW programs at CC’s?

AHAG Strategic Planning

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Status of sub-committees: Scope and Role Definition

▪ Focused on myths and facts of CNA and LPN roles and scopes of practice

▪ Just began writing a commentary on myths and facts; perspectives; and best practices around this issue

▪ Defining AH direct care workers; roles and expectations

Status of Sub-Committees

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Legislative Outreach and Engagement

▪ Geoff worked with sub-committee to frame language around briefs for updating stakeholders (including legislators) about AHAG and N&AH activities

▪ Temporarily on hold due to key member (James) transitioning to new job

▪ Will start up again

Plans for future:

▪ Will reach out to members to staff up

Status of Sub-Committees

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Nurse Assistant Licensure sub-committee Understand burning issues with DPH training program

certifying process

Set up temporary sub-committee to write up paper on what needs to be done for nurse assistant licensure and pass along to DPH

Questions for discussion Is this practical?

Do we know what the issues are?

What are realistic expectations?

Exploring New Sub-Committees

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Project Plan Sub-Committee Organize projects and other work that are ready for funding

opportunities

Create briefs; project costs

Make connections with philanthropic organizations

Questions for discussion:

Short term?

Is this needed or useful?

Should this be lead by DHE or more local entities?

Exploring New Sub-Committees

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Making the Business Case for the Direct Care Workforce

Reinstate previous sub-committee to make the business case about the direct care workforce

Gather and aggregate data on the labor gap; Costs for businesses; Aging economy; Best practices; Numbers of openings and projected openings

List economic effects of not investing in the Direct Care Workforce (i.e. longer waits for care, reduction of positive health outcomes, increase cost to system, etc.)?

Publish a paper and/or fact sheets and deliver paper to lawmakers and other stakeholders

Questions for discussion:

Has this been done already?

Do agencies (HCA; MA Senior Care; EOEA; Home Care Alliance; etc.) already have this data? Is it duplication of work?

Exploring New Sub-Committees

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Friday, June 9th, 9:30 – 11:30am, 333 South Street Shrewsbury Topic: Looking Back and Measuring Progress

Friday, September 29th, 9:30 – 11:30am, Worcester State University

Friday, December 8th, 9:30 – 11:30am, Worcester State University

Next Meetings

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Thank you sincerely for your time and dedication!!!