FAHA 42nd Annual Convention & Exposition July 28, 2005

1

WWorkforceorkforce IInnovationnnovation – –

A Community A Community ResponseResponse

Presented by:Presented by:

Alan D. Sadowsky, PhDAlan D. Sadowsky, PhDInstitute for Geriatric Research & Training. Morse Geriatric Institute for Geriatric Research & Training. Morse Geriatric

CenterCenterExecutive Director, Lola & Saul Kramer Senior Services AgencyExecutive Director, Lola & Saul Kramer Senior Services Agency

on the on the Marilyn and Stanley M. Katz Seniors CampusMarilyn and Stanley M. Katz Seniors Campus

FAHA 42nd Annual Convention & Exposition

2

•Academy of Practical Nursing for Health Occupations

•U.S. Department of Labor•Workforce Alliance, Inc.•Quantum Foundation•Palm Healthcare Foundation•HCA-Columbia and Palms West Hosp.

AcknowledgmentsAcknowledgments

FAHA 42nd Annual Convention & Exposition

3

•HB 1971 (1999-2000) Pilot Project•Mission –research, training and best practices•Support from Deans of all 5 medical schools•Geri-U-online University (GERIU.org)•Surveys and education for the public and dec-makers •Deliverables

Florida’s Teaching Nursing HomeFlorida’s Teaching Nursing Home

FAHA 42nd Annual Convention & Exposition

4

Morse Geriatric Center - History

•280 Bed SNF•Kramer Senior Services Agency•Institute for Geriatric Research & Training 2000: Clinical Dementia Workforce recruitment and retention Nutrition Family expectations Best Practices

• AL/IL added December 2004 (142 beds)

FAHA 42nd Annual Convention & Exposition

5

Background

•Workforce – Who will care for us?•Local, regional, national, int’l issue•Attract workers to field (make viable)•Retain and advance workers•Reduce expensive turnover•Statistics quality of care issues

FAHA 42nd Annual Convention & Exposition

6

P.R.O.M.I.S.E.

•Community demonstration•US Department of Labor•At-risk in targeted areas•Ages 14-24 •Average age = 18

FAHA 42nd Annual Convention & Exposition

7

Selected Characteristics of Population

50% from Belle Glade, Pahokee, South Bay93% female33% live on their own47% are parents (average age 16.7) > 87% are African American> 42% self report history of criminal offense> 33% have immediate family who is an offender> 24% have limited English> 36% report domestic violence> 27% report being victims of sexual offense

FAHA 42nd Annual Convention & Exposition

8

Program Goal

•Find employment for at-risk population•Unintended reality – jobs in health care•Barriers to employment:Child careFinancial aidHousingJob readiness

FAHA 42nd Annual Convention & Exposition

9

Community Partners (selected list)-

•Literacy Coalition •Hispanic Human Resources•Youth Services Council•United Way•Workforce Alliance, Inc.•Boys and Girls Club•Haitian Community Council

FAHA 42nd Annual Convention & Exposition

10

Outcome Measures (selected list)

•Returning to or staying in school….. 75%•Complete skills training …………... 75%•Improve Math and English skills ….

75%•No new criminal justice involvement.

75%

FAHA 42nd Annual Convention & Exposition

11

Program Results N = 103

•96% completed occupational training•80% obtained a job•Math scores increased 1.76 grades from pre to post

test•Reading scores increased 1.4 grades from pre to

post test Recall:

• No previous work history (82%)• History of family violence•24% with limited English•46% were parents (avg. age – 16.7yrs)

FAHA 42nd Annual Convention & Exposition

12

P.R.O.M.I.S.E. Extension

•Disconnect between finding employment – maintaining employment

•Grant ext. (1of 2 sites) based on perf.•New model – Bonus for 6 months

consecutive employment (n=75)•Descriptions/definitions •Eliminate “no call – no show”•100% of those eligible for bonus signed up•All 75 achieve bonus

FAHA 42nd Annual Convention & Exposition

13

Linking People with Careers (LPC)

•Quantum – healthcare conversion trust•Link employment needs of providers with at-

risk population•Expand lessons from P.R.O.M.I.S.E.•Goal 35 enrollees – in 2-year period•Subsequent extension adds 30 enrollees (N=65)•Project coordinator- characteristics

FAHA 42nd Annual Convention & Exposition

14

Program Results

•166 people screened•62 people recruited•55 of 62 (89%) secured employment•39 (63%) still employed•26% found work but unable to maintain•11% “missing”•Contingency fund - a critical component

FAHA 42nd Annual Convention & Exposition

15

•(C.A.R.C.)- Relationship to LPC, PROMISE•Coalition partners in place•Key principles: invest in employees long term commitment

Career Advancement Retention Challenge

FAHA 42nd Annual Convention & Exposition

16

C.A.R.C. Description

•2 years for LPN•Employers to pay tuition, books, uniforms•Potential 100% increase in salary•TANF eligible – local Workforce

involvement •Motivated employers (win-win)

FAHA 42nd Annual Convention & Exposition

17

•Morse Geriatric Center•HCA- JFK and Palms West•Columbia Hospital•Academy of Practical Nursing for Health

Occupations (APNHO)•Literacy Coalition

Partners

FAHA 42nd Annual Convention & Exposition

18

Eligibility Challenges

•Financial•Reading/Math 11th grade level•Difficulty in filling slots•Enormous interest

FAHA 42nd Annual Convention & Exposition

19

•Mentoring•Literacy – expanded to sites•Welfare transition program-workforce•Goals – Outcomes•Work commitment – Morse Geriatric

Center•Experience from other grants – PHF

involvement

Program Components

FAHA 42nd Annual Convention & Exposition

20

Program Outcomes

•38 trainees•26 mentors•Progress in LPN program•CNA certification 27•Satisfaction – employee – employer

FAHA 42nd Annual Convention & Exposition

21

•“…instructors are interested in me…”•“…best part is this will help me be what

I’ve always dreamed of…”•Tutoring was available at different hours•“Thank you – you’ve given me the

confidence to better myself…”

Key Comments

FAHA 42nd Annual Convention & Exposition

22

Program Update

•LPC awarded one final year•Retention bonus now included•Produce training manual•Adopt policies of hiring at-risk when

possible•CARC receives extension (less enrollees)•PROMISE proposed to US Dept. of Labor

to further analyze bonus

FAHA 42nd Annual Convention & Exposition

23

•Substantial obstacles•Contingency $’s are critical•Diversity training essential•Program staff – enrollee bonds – very

strong•Interest is high

Lessons Learned-CARC

FAHA 42nd Annual Convention & Exposition

24

•Mentorship forced•Sense of entitlement can be negative•Commitment with flexibility – keys to

success•Need to broaden the base•CARC – ideal for LTC’s•Tough decisions – some will fail

Lessons Learned……..Part II

FAHA 42nd Annual Convention & Exposition

25

•Facilities must know staff turnover rates•Accept need for long term strategy•Understand the difficult challenge•Look for workers in new places•Be available during crisis•Discipline “silk glove/iron fist”

Policy Implications

FAHA 42nd Annual Convention & Exposition

26

•Advancement motivation-strong•Reduce facility risk – pay on the back end•Establish community linkages-employers,

educators, potential funding sources•Teachers, become more than teachers•Determine time parameters•Invest in human capital- this will take time

Steps to Success