Demonstration to Improve the Direct Service Community Workforce: An Update

For more information about the projects' hypotheses and interventions, please see the Grantee Profiles.

Arkansas’s Department of Human Services implemented the Direct Service Community Workforce (C-CARE) initiative. Seeking to identify and develop new recruitment strategies, Arkansas has recruited and trained people with disabilities and individuals 55 years and over to become DSWs. They are conducting pre- and post training surveys to test the effectiveness of this strategy and the extent to which these newly trained workers find and maintain employment in the field. Three supervisor workshops have been completed with the curriculum for the final workshop designed in a train-the-trainer format that can be utilized after the grant is over. Arkansas launched a web-based worker registry this month designed to match the needs of in-home consumers with individual personal care providers. A three month media campaign was developed to market the registry statewide. The registry both assists consumers directing their own services to find workers and at the same time provides individuals with potential employment opportunities as personal care providers, available online at: www.dswregistry.ar.gov.

Delaware - Using a values-based approach to recruitment and retention, the University of Delaware implemented several interventions across five participating agencies in the state, including a career lattice, a mentorship program, and a supervisory training program. They are beginning to transition to a train-the-trainer model so that the participating agencies will be able to maintain these programs on their own beyond the grant period. As part of their recruitment interventions, the team created two videos designed to raise awareness about the field and be used as recruitment tools. By depicting the challenges and rewards of the field within a framework of the personal values which guide the direct support professional’s life, viewers are given the unique opportunity to understand, “to connect”, and determine whether the direct support profession is the career for them. Their realistic job preview video won the 2005 Aegis Award, a video industry award, and is available for sale at the Center for Disability Studies at the University of Delaware.

ArcBRIDGES in Gary, Indiana implemented several interventions in their agency, including a cafeteria benefit plan, a career ladder, and a mentorship program. One of their most popular interventions has been the travel reimbursement for workers who travel over ten miles per trip to their work site. With gas prices rising, this extra reimbursement has been very valuable to workers who travel great distances in the work day. Working with a local community college, they developed a certificate program in developmental disabilities in which 37 workers have enrolled. The Indiana Department of Family and Social Services has agreed to support the expansion of this program to nine additional agencies across the state. All together, over 500 workers have participated in one of ArcBRIDGES interventions.

Kentucky – With their DSW grant, Seven Counties Services, Inc. and its primary partner, the Council of Mental Retardation, implemented the Support Providing Employees Association of Kentucky (SPEAK) program with eight other partner agencies. The partnering organizations have worked together to implement several interventions, including a pre-service orientation to potential job candidates – a realistic job preview that occurs before an individual is hired. This intervention has been beneficial to participating agencies by screening out individuals for whom the job would not have been a good match. The SPEAK project was awarded a “Moving Mountains Award” by the National Alliance for Direct Support Professionals in 2007. You can read more about SPEAK on their website at: www.dspspeak.org.

Louisiana - In the first year of their grant, the Volunteers of America tested the impact of training on retention of direct support staff in VOA’s Greater New Orleans location. They were greatly impacted by Hurricane Katrina and realized that this disaster provided a once in a lifetime opportunity to highlight the dedication of direct support workers and the reasons they remain in the field. In the weeks and months following Katrina, many of their direct support staff provided 24-hour assistance to the consumers they served, often living with them under difficult circumstances, helping them rebuild their lives in the city of New Orleans. VOA made a video about the experience of these DSPs entitled “Higher Ground” to tell the first hand stories of staff members who are dedicated to the people with disabilities, who made enormous personal sacrifices to ensure on-going care and who continue to work under extreme pressures as the city strives to recover from this catastrophic disaster. ANCOR, the national trade organization for MRDD providers is working with VOA to distribute these materials as widely as possible, using them to advocate for better wages, benefits and recognition for this valuable workforce. A copy of the report that accompanies the video can be viewed on Volunteers of America’s website at www.voa.org.

Maine – As Maine completes the 4th and final year of its DSW Demonstration Grant, their work has focused on increasing the number of workers with health coverage and enhancing recruitment and retention in participating home health agencies. Recent activities include outreach and support to employers and a restructured Employer of Choice Health and Wellness for Retention Program, which provided a limited number of home health agencies resources to operate a worksite wellness program. The programs are active in six sites and have a high level of direct care worker involvement. Activities have focused on health risk assessment clinics, increasing physical activity and information on nutrition, stress, work-related injury prevention, and health insurance. The state is also working on a pilot demonstration of a state-sponsored incentive for implementing worker retention programs directed to Medicaid/State-funded home care agencies; an exploratory study on the link between workers’ compensation and health insurance coverage and to identify an option for providing workers’ compensation premium discounts for the agencies that enroll in health insurance; and a policy review to identify health coverage options for the business sectors that employs seasonal and part-time workers.

New Mexico – The New Mexico Department of Health Developmental Disabilities Supports Division is testing a Healthcare Reimbursement Arrangement to determine the impact of this type of health coverage on recruitment and retention of direct-service workers. The Health Reimbursement Arrangement project, implemented by the Center for Development and Disability, offers participating direct-service workers an arrangement that combines a limited health insurance product, a prescription discount card, and contributions to a tax-free health reimbursement account. Approximately 200 workers, who were not otherwise insured, have participated across seven agencies.

North Carolina’s “Caregivers are Professionals, Too” program involved four participating agencies in the western part of the state in three interventions: a recognition program, a career ladder/professional development program, and a health benefit that subsidized employee premiums. Through the recognition program, workers were offered cash bonuses for tenure, attendance and anniversaries. Workers have had the opportunity to take professional workshops or study independently through the professional development program. Over 1,500 workers have participated in at least one intervention. The grantee’s evaluators have found that turnover rates have gone down in their participating agencies, and 75 percent of the workers surveyed who received health insurance reported that it had increased their likelihood to stay with their employer.

The grantee in Virginia, the Department of Medical Assistance Services (DMAS), has collaborated with several local organizations to develop targeted recruitment and marketing materials designed to attract new people to the field of direct support. DMAS sub-contracted with the Northern Virginia Skill Source Center to hire a dedicated Job Developer to recruit people into the direct support career path and to date, 25 DSWs have been placed into direct support positions. DMAS also collaborated with the Virginia Geriatric Education Center (VGC) at Virginia Commonwealth University to recruit and train family members and respite providers to enter the direct support field.

The Washington State Demonstration to Improve Direct Service Community Workforce, administered by the Home Care Quality Authority, included several interventions designed to improve staff recruitment and retention outcomes. The grantee piloted Referral and Workforce Resource Centers (RWRC) in four areas of the state, which have now been expanded statewide. The RWRCs provide information to DSWs and prospective workers about the field, offer training and peer mentorship, orientation for new workers, and educate them about the availability of insurance in Washington for qualified individual providers. They also developed an innovative web-based worker registry to match worker skills, training, and abilities with consumer needs and preferences, online at: www.hcqa.wa.gov.