ELEVATING OUR FUTURE WORKFORCE
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Transcript of ELEVATING OUR FUTURE WORKFORCE
ELEVATING OUR FUTURE WORKFORCE
Minnesota Health & Housing Alliance March District Meeting
MEMBERS REPORT BIGGEST CHALLENGES IN 2006-07
• Financial
• Workforce
• Regulatory
• Transformation
Source: 2007 MHHA Member Value Survey
MEMBERS REPORT BIGGEST CHALLENGES IN 2006-07
• Staffing Issues
(especially RN and CNA)
• Recruiting Well-trained Staff
• Retaining Staff
(limited wages and benefits)
Source: 2007 MHHA Member Value Survey
NUMBER OF VACANT FTE POSITIONS IN CARE CENTERS
0.91 1.07
2.53
0.30
4.81
0
1
2
3
4
5
RN LPN C.N.A. Total Total
Source: Long Term Care Imperative 2007 Legislative Survey
ESTIMATED VACANT FTE POSITIONS IN CARE CENTERS
0200400600800
1,0001,2001,4001,6001,8002,000
R.N. L.P.N. C.N.A. DietaryAide
Total
2004 2005 2006
Source: Long Term Care Imperative 2007 Legislative Survey
Source: Minnesota State Demographic Center
PROJECTED POPULATION & WORKFORCE GROWTH
Projected Growth in Workforce
2005-2025
Projected Growth in the Population Age 60 and Over
HEALTHCARE JOBS LEAD MINNESOTA’S FUTURE NEEDS
-10,000 0 10,000 20,000 30,000 40,000 50,000
Agriculture, Forestry, Fishing & Hunting
Utilities
Mining
Manufacturing
Real Estate and Rental and Leasing
Public Administration
Arts, Entertainment, and Recreation
Management of Companies and Enterprises
Wholesale Trade
Information
Finance and Insurance
Other Services, Ex. Public Admin
Construction
Accommodation and Food Services
Educational Services
Retail Trade
Administrative and Waste Services
Professional and Technical Services
Health Care and Social Assistance
Source: DEED, Employment Projections
MINNESOTA HEALTHCARE CAREER TRENDS HISTORY
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
100,000
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Manufacturing Healthcare
PROJECTED GROWTH FOR TOP 15 HEALTHCARE OCCUPATIONS
Source: MN Dept of Employment and Economic Development
0 5,000 10,000 15,000 20,000 25,000 30,000
Registered Nurses
Home Health Aides
Nursing Aides, Orderlies, and Attendants
Licensed Practical and Licensed Vocational Nurses
Medical Assistants
Dental Assistants
Medical and Health Services Managers
Medical and Clinical Laboratory Technicians
Pharmacy Technicians
Healthcare Support Workers, All Other
Pharmacists
Medical Records and Health Information Technicians
Radiologic Technologists and Technicians
Medical and Clinical Laboratory Technologists
Dental Hygienists
Net Job Growth
Replacement Openings
AGING SERVICES
97% 95% 91%
3% 5% 9%
0%
20%
40%
60%
80%
100%
1988 1995 2001
Families Agencies Minnesota Health & Housing Alliance – February 23, 2006Source: Minnesota Department of Human Services
WHO PROVIDES CARE TO OLDER MINNESOTANS
1% drop in family caregiving = $30M in public funds.
13.611.5
9.8
0
3
6
9
12
15
2005 2015 2025
Ratio of women 20-55 to people 85 and over
Minnesota Health & Housing Alliance – February 23, 2005Source: Minnesota State Demographer
RATIO OF CAREGIVERS TO OLDER ADULTS DROPPING
MINNESOTA BOSTS HIGH WORKFORCE PARTICIPATION
NURSING SHORTAGE ONLY EXPECTED TO WORSEN
Current Licensure Average Age
41
42
43
44
45
46
47
RN 44.1 44.7 45.1 45.6 46.0
LPN 42.7 43.5 44.3 44.9 45.1
FY 1998 FY 2000 FY 2002 FY 2004 FY 2006
Source: Minnesota Board of Nursing
A NURSING WORKFORCE APPROACHING RETIREMENT
46
45
NURSING PROGRAMS GROW BUT DEMAND REMAINS HIGH
The Minnesota State Colleges and University System (MNSCU) trains 78% of the state’s new nursing graduates
32 colleges and universities on 53 campuses in 46 communities
MNSCU MISSION TO SUPPORT COMMUNITY NEEDS
Between 2001 and 2005: 74% increasein nursing graduates!
LPNs by 77%RNs by 69%Master’s prepared nurses by 150%
AVERAGE HOURLY RN WAGES HOSPITALS vs CARE CENTERS
$34.80$33.40$31.41
$29.61$27.85
$23.31$22.66$22.58$21.56$20.55$18
$23
$28
$33
$38
2001 2002 2003 2004 2005
Hospital Nursing Home
Source: MN Health Care Cost Information System, Long Term Care Imperative Compensation Survey
Gap=$7.30
Gap=$11.49
Wage Gap Increased 57% in Five Years
AVERAGE HOURLY LPN WAGESHOSPITALS vs. CARE CENTERS
$18.24$17.75
$16.84
$16.29$15.85
$16.60$16.45$16.36$15.65
$15.08
$14
$16
$18
$20
2001 2002 2003 2004 2005
Hospital Nursing Home
Source: MN Health Care Cost Information System, Long Term Care Imperative Compensation Survey
Gap=$1.64Gap = $0.77
Wage Gap Increased 113% in Five Years
AVERAGE HOURLY CNA WAGESHOSPITALS vs. CARE CENTERS
$14.66$14.02
$13.27$12.83
$12.27
$11.19$11.22$11.10$10.83$10.45$10
$11
$12
$13
$14
$15
2001 2002 2003 2004 2005
Hospital Nursing Home
Source: MN Health Care Cost Information System, Long Term Care Imperative Compensation Survey
Gap=$1.82
Gap=$3.47
Wage Gap Increased 91% in Five Years
PERCENT OF CARE CENTERS IN FINANCIAL CRISIS
Source: Imperative Nursing Facility Survey Prepared by LarsonAllen
Legend=<25%
=26%-35%=35%-45%=>45%
East Central 19.4%
Metro 18.6%
Northeast 50.0%
Northwest 35.3%
Southeast 39.2%Southwest 30.0%
West Central 34.6%
(Operating Margin of -5% or worse)
30% of Facilities are in Crisis, 4% Higher
than Last Year
ALMOST 23,000 JOBS AT RISK DUE TO FINANCIAL CRISIS
Jobs at Risk: 5,854
Beds: 13,684
Jobs at Risk: 3,227
Beds: 2,806
Jobs at Risk: 2,387
Beds: 3,000
Jobs at Risk: 2,814
Beds: 4,078 Jobs at Risk: 5,007
Beds: 5,554
Jobs at Risk: 1,311
Beds: 1,615
Jobs at Risk: 2,142
Beds: 4,801
THE INTEREST IS THERE!
• Healthcare careers are the No. 1 choice for students leaving high school (not college-bound), and the third-highest path for those college-bound
• 28% of current Minnesota high school students express interest in health occupations
www.minnesotahosa.org
INNOVATION IS OCCURING
• Share the many changes in Care Centers
• “Culture Change” helps bring focus to our core work and emphasize relationships
• New relationships with and strategies for informal caregivers, volunteers (HCAM) and other non-traditional labor pools is vital
INNOVATION IS OCCURING
• Technology with the potential to revolutionize our missions
• Pioneering design is transforming the spaces we live and work
• Aging Services Careers – new job descriptions, responsibilities, training models, and opportunities for respect
AGING SERVICESWORKFORCE INNOVATION:
MHHA Workforce Solutions Council Drives Association Response
TALENT
WORKFORCE SOLUTIONS COUNCIL
• Advance MHHA’s strategic initiative to “elevate the older adult services workforce of the future”
– Focus on strategies for recruiting and inspiring talent in the field
– Focus on retention strategies and best/promising practices in job satisfaction
– Coordinate efforts with parallel initiatives
CREATING SOLUTIONS
CREATING SOLUTIONS
• Career Exposure and Recruitment
MHHA will explore the promotion of the many careers in older adult services to traditional and prospective employee audiences through a series of outreach initiatives and partnerships
CREATING SOLUTIONS
• Member Skill Building for Talent Retention
MHHA will explore ways to maximize member knowledge through education, issue briefs and launch of an e-community clearinghouse focused on targeted workforce initiatives having the greatest impacts in the field
CREATING SOLUTIONS
• Launch of a New Employee Model
MHHA will lead the creation and expansion of a new older adult services employee in Minnesota, facilitating development of provider knowledge, curriculum design, articulation and instructor agreements with higher education partners
CREATING SOLUTIONS
• Replication of New Training Models
Breaking out of the bottleneck found in traditional higher education avenues, MHHA will explore alternative models for the training of key employee groups, with an emphasis in the field of nursing
CREATING SOLUTIONS
• Career Exposure and Recruitment
• Member Skill Building for Talent Retention
• Launch of a New Employee Model
• Replication of New Training Models
A NEW EMPLOYEE MODEL
CHALLENGES
• Identifying best/ promising practices in the field and emerging care delivery models
• Providing standardization and recognition while allowing for customization
• Developing new curriculum and articulation agreements with higher education
• Identifying resources to lead efforts
HEALTH SUPPORT SPECIALIST (HSS)
• A pathway for organizations to move towards a “universal” worker model
• Designed around a household model with self-lead teams
HEALTH SUPPORT SPECIALIST (HSS)
• Entry-level training program for new frontline workers, taking into account the knowledge and training of existing staff
• Theoretical instruction (386 hrs) combined with on-the-job learning (2500 hrs)
• Customized to unique mission or other training curriculum for each organization
A CLEAR CURRICULUM AND CAREER LADDER
Employment and mentoring with a qualified journey worker from day one
Entry Level
Health Support Specialist
ADVANCING THROUGH THE STEPS
• Medical Terminology
• Dietary Services
(National Serv-Saf Certification)
• Environmental Services
(OSHA 10-hour industry card)
ADVANCING THROUGH THE STEPS
• CPR and First Aid Certificate
• Advanced Dementia Care Certificate
(Alzheimer’s Association)
• Culture Change Certificate
• Certified Nursing Assistant (CNA)
(Facility, Technical or Community College)
ADVANCING THROUGH THE STEPS
• Rehabilitative Aid
(Facility Certificate)
• Certified Medication Aid
(Technical or Community College)
Health Support Specialist Apprentices
Advanced Health Support Specialist
ADVANCING TO “JOURNEY WORKER”
• Completion of all career ladder steps
(Including on the job learning hours)
• Completion of all facility requirements
(Set by each organization)
• Registered Apprenticeship Certificate through Program Sponsor (MHHA)
“The Registered Apprentice program has helped me to broaden my knowledge base to be able to serve our residents better.”
Jennifer Steinkuhler
Health Support Specialist
Brewster Place, KA
HEALTH SUPPORT SPECIALIST (HSS)
HEALTH SUPPORT SPECIALIST (HSS)
• Kansas Registered Apprenticeship program
• Development of curriculum, online distance education, funding sources
• Grant awarded Jan. 1, 2007 to replicate
• Recognized by US Department of Labor
US DEPT. OF LABORU.S. Department of Labor Employment and Training Administration Office of Apprenticeship (OA) Washington, D.C. 20210
Subject: Additional RAIS Code and Occupational Title for Health Support Specialist Occupation Code: 200
Symbols: DSNIP/FJH
Distribution: A-541 Headquarters A-544 All Field Tech A-547 SD+RD+SAC+; Lab.Com
Action: Immediate
PURPOSE: To inform the Office of Apprenticeship (OA), staff of an addition to the Registered Apprenticeship Information System (RAIS) for the coding and recording of a new occupational title for an existing occupation:
Health Support Specialist Existing Title: Home Health Aide O*NET-SOC Code: 31-1011.00 RAIS Code: 1086AA Training Term: 2,500 – 5,000 hrs. Type of Training: Hybrid
The letters “AA” have been added as an extension of the RAIS Code 1086 to identify applications utilizing the new occupational title. The O*NET-SOC Code will remain the same. BACKGROUND: Apprenticeship Program Consultant Michele Boschetto from the Kansas State Apprenticeship Council submitted this occupation. The Health Support Specialist has been recognized to meet Health Care Industry demands for highly-skilled and highly-trained workers. Since the two occupations are similar except for application within the Health Care Industry, O*NET determined it did not qualify for its own separate O*NET-SOC Code. Therefore, OA is awarding a separate RAIS Code extension that would allow for distinction and application by industry. ACTION: Effective immediately, all OA/BAT staff should implement data entry for the “Health Support Specialist” classification into RAIS under Code 1086AA. New program standards and revisions to existing program standards may include incorporation of either occupational title and should utilize the appropriate RAIS Code.
HEALTH SUPPORT SPECIALIST (HSS)
FUNDING SOURCES
• MHHA Foundation
• CBJTG grant through Kansas
• Workforce Investment Act (WIA)
• Pell grants
• Veterans assistance
• Minnesota Scholarship Programs
• Other special funding projects
Patricia Williams began her career in dietary services 13 years ago.
HEALTH SUPPORT SPECIALIST (HSS)
HEALTH SUPPORT SPECIALIST (HSS)
“Brewster Place encouraged me to go into the program to become more involved with resident care.
HEALTH SUPPORT SPECIALIST (HSS)
“It gave me the will to continue my education – put the learning bug in me.”
HEALTH SUPPORT SPECIALIST (HSS)
“I plan to work toward an LPN degree next. I look forward to coming in each day.”
Patricia WilliamsHealth Support SpecialistBrewster Place, KA
THE BENEFITS
• Reduces barriers to employment through provider-based classroom instruction
• Increases loyalty, self-esteem, wages, college credits, and incentive to remain in aging services
MHHA ACTIVITY
• Applying to the Department of Labor Registered Apprenticeship Unit to be the sponsoring organization in Minnesota
• Initiating education and partnership building with provider organizations and higher education stakeholders
• Application for grant funds to further develop, launch and sustain program
Tiara Weber has graduated from the program and is now a Health Support Specialist. She is pictured with therapy dog Sissy.
HEALTH SUPPORT SPECIALIST (HSS)
HEALTH SUPPORT SPECIALIST (HSS)
HEALTH SUPPORT SPECIALIST (HSS)
NEW TRAINING MODELS
“Long-Term Care Connection”
A Customized LTC LPN Program Developed by
Good Shepherd Community
CHALLENGES
• Shortage of licensed and qualified staff• Increasing nurse retirements• Competition with hospital wages• 24/7 staffing schedules (holidays/weekends)• Lack of graduates with LTC focus• Required nurse/resident ratios• Financial costs of training• Lack of evening programs
EDUCATION BARRIERS
• Lack of clinical space
• Lack of qualified faculty
• Lack of classroom space
• Lack of resources to start-up and maintain
GOOD SHEPHERD REALITY
• High use of pool staff
• High staff turnover
• Few recruitment options for LPNs
• Limited career ladder opportunities
• Long waiting lists for traditional students
• No options for non-traditional students
• Funding — but no where to spend it
LTC LPN PROGRAM
In 2001, Good Shepherd Community launched a customized LPN program in partnership with St. Cloud Technical College
LTC LPN PROGRAM
• Facility served as primary clinical site and also created classroom and lab space
• Evening classes and accelerated learning methodology incorporated
LTC LPN PROGRAM
• St. Cloud Technical College provided customized curriculum
• Nursing Facility Scholarship Program funding was utilized
• Results: Increased staff retention, creation of career ladders, increased LPN pool in region, increased quality of care, improved staff morale, loyalty
LTC LPN PROGRAM
• Enrollment now available to 25 long-term care settings in Central Minnesota
• Three classes – over 60 caregivers – have received their LPN degrees to date
• Classes provided a focus on the LTC LPN and increase number of available staff in the region
MHHA ACTIVITY
The MHHA Board of Directors authorized staff to proceed with planning for expansion and replication of the LTC LPN program developed by Good Shepherd Community and St. Cloud College
REPLICATION
• Identify communities with need, promise
• Identify providers with potential classroom and lab space
• Secure funding for necessary investments
• Coordinate with MNSCU for curriculum, adoption of adjunct instructors/faculty
• Disseminate best practices from Good Shepherd experience i.e. scheduling, etc.