Kelly Parsons and Amy Persell Director of Customer Experience and Managing Director of Training Adult Education Advisory Council April 9, 2019

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Kelly Parsons and Amy Persell Director of Customer Experience and Managing Director of Training Adult Education Advisory Council April 9, 2019

HCAs are an Integral Part of the Healthcare Workforce

Who are caregivers? Our Workforce 2019 SEIU 775 Benefits Group; For internal use only. 3

Who are caregivers? Understanding Who We Serve 2019 SEIU 775 Benefits Group; For internal use only. 4

Who are caregivers? Motivation for Caregiving Substantial Motivators for becoming a paid caregiver include: desire for employment, having a friend or family in need of care or already providing informal care and might as well get paid. 2019 SEIU 775 Benefits Group; For internal use only. 5

How we serve Caregivers

$ $

How we serve caregivers 1,262 classes/series offered. 964,963 total training hours. 22,916 of people covered by HBT in 2018. 3,522 of new enrollees in 2018. 80,000 + participants. 9,000+ users 900+ job matches. *As of 12/18

Overview Health Low Premiums for HCAs ($25/month includes Medical, Dental Hearing, Rx, Hearing and Behavioral Health Coverage. Testing, piloting and creating innovative programs and interventions to improve the health and safety of caregivers. This includes a safety show program, and behavioral health innovations including mindfulness and online text based coaching. All caregivers have access to an EAP and text based coaching. $10 copay/$0 in network copay for behavioral health. Low eligibility to qualify (80 hours per month, average worker works 100+ hours per month) Partner with carriers to provide population-based, integrated care- Kaiser, Willamette, Delta, Aetna and SaveRx Emphasis on primary care 79% of members are paneled to a PCP. 2019 SEIU 775 Benefits Group; For internal use only.

Overview Retirement Effective date was 3/1/2016 A defined contribution profit sharing plan solely funded by employer contributions: $0.23/qualifying hour from July 2015 - June 2017 $0.25/qualifying hour from July 2017 - June 2018 $0.50/qualifying hour from July 2018 - June 2019 $0.65/qualifying hour from July 2019 - June 2020 $0.80/qualifying hour from July 2020 - June 2021 First plan participants vested and can request a retirement benefit as of March of 2019 2019 SEIU 775 Benefits Group; For internal use only. *As of 12/18

Overview Carina Carina connects verified home care aides with Medicaid and state funded clients. Services include technology platform, marketing and customer service. Allows caregivers to find clients who need care and helps clients find care. Users can include information on types of care previously provided and any specialty training a caregiver may have. 2019 SEIU 775 Benefits Group; For internal use only. *As of 12/18

How we serve caregivers Unified Caregiver Experience 8,182 Caregivers 50 Employers (calls per month) 1,589 Caregivers Recruited 126 Statewide Events 2019 SEIU 775 Benefits Group; For internal use only. 12

How we serve caregivers Equity & Inclusion 49 languages supported overall (MRC, language line, interpreters). 16,898 interpretation hours provided YTD. 171,419 words localized YTD. 2019 SEIU 775 Benefits Group; For internal use only. 13

Preparing for Tomorrow

Coming Care Crisis Demographic Shifts Every 8 seconds, an American turns 65. 52,000 caregivers currently working in Washington. By 2030, Washington will need 76,000 caregivers. 15

National Labor Market Perspective Direct Care Workers: Largest Occupational Group in the US by 2020 Source: PHInational.org, Occupational Projections for Direct-Care Workers 2012-2022 16

DSHS Projections Demographic Shifts 45,000 caregivers currently working in Washington. By 2030, Washington will need 76,000 caregivers. 2019 SEIU 775 Benefits Group; For internal use only. 17

Washington State Labor Market Perspective Where are long term care workers? Source: DSHS ALTSA, October 2018 2019 SEIU 775 Benefits Group; For internal use only. 18

Turnover Churn Let s Talk Turnover 2019 SEIU 775 Benefits Group; For internal use only. *Based on estimated increases in the number of Medicaid consumers using HCA services as individual providers, through home care agencies, and in adult family homes and boarding homes. 19

DSHS LTSS Projections Workforce Projections Long-Term Services and Support: 6% of Washington state s operating budget in 2018. 12% of Washington state s operating in 2030. $6 Billion 2019 SEIU 775 Benefits Group; For internal use only. 20

Areas We Would Love to Partner Workforce Development Recruitment Workforce Stability Professionalization and opportunities for advancement Job Quality Growth 2019 SEIU 775 Benefits Group; For internal use only. 21

Training Benefits 2019 SEIU 775 Benefits Group; For internal use only. 22

Training Partnership By the numbers Train in 39 cities, across 28 counties Provided training to more than 45K caregivers Offered over 962K training hours Nation s largest organization for home care workforce training and development Washington s second-largest learning organization Training offered in 13 languages Over 1,000 class cohorts planned for this year Approximately 50 23

Training Partnership Onboarding Process 24

Training Partnership Training Benefit Courses (hours) Required Orientation & Safety (5 hours) Required Basic Training 70 Basic Training 30 Basic Training 9 Parent Provider (7 hours) Required DOH Exam Certification not required Required & Optional Nurse Delegation (12 hours) Optional Required & Optional Advanced Training (70 hours) Continuing Education (12 hours a year) https://www.myseiubenefits.org/training/training-schedules/ 25

Training Partnership Orientation and Safety Role of the HCA Consumer Rights and Communication Emergency Preparedness Infection Control Accident Prevention 26

Training Partnership Basic Training 70 The purpose of the Basic Training Curriculum (BTv3) is to assist the Home Care Aide (HCA) to integrate the skills that he or she has learned during basic training to specific conditions that may be encountered when working with a client. The Basic Training curriculum is based on the required knowledge and skills outlined for basic HCA training in WAC 388-112-0055. The WAC defines the following core knowledge and skills. The HCA will be able to: Understand and use effective interpersonal and problem-solving skills with the client, family members, and other care team members. Take appropriate action to promote and protect client rights, dignity, and independence. Take appropriate action to promote and protect the health and safety of the client and the HCA. Correctly perform required personal care tasks while incorporating client preferences, maintaining the client s privacy and dignity, and creating opportunities that encourage client independence. Adhere to basic job standards and expectations. 27

Training Partnership Training Calendar Basic Training 70 28

Training Partnership Permanent Training Locations Port Angeles Everett Lynnwood Bremerton Seattle Des Moines, Kirkland Kent, Tukwila Tacoma Aberdeen Lakewood Olympia, Tumwater Chehalis Spokane Longview Vancouver Richland 29

Training Partnership Training Portal 30

Training Partnership Competency Based Curriculum Curriculum development starts with Skill Gap Design Research: Curriculum that emphasizes outcomes of a learning process. Learner-centered and adaptive to learners' changing needs. Focus on real-world need discovered through qualitative research with HCAs. Designed to be meaningful and relevant to real world scenarios and tasks. Seeks to improve quality of care, client safety, learner and job satisfaction, and job retention. 31

Training Partnership Curriculum Development Curriculum development starts with Skill Gap Design Research Focus on HCA Point of View Real world, goal oriented scenarios Actual jobs to be done How clients and HCAs move through scenarios and independently problem solve Competencies and skills as they appear in the real world Three Paths Competency Development Model Literature Review Existing Data & Insights HCA Direct, Generative Target Develop competencies on time/at pace while ensuring we are matching skills required in the realworld. 32

Training Partnership Peer Mentor Program Overview Program Launch, Sept 2016 3 FTE, 1 Program Staff Current Initiatives Data Driven Predictive Intervention Instructor & Self Referral Apprenticeship Support Failed Exam / Retake Support Individual Providers 63% of all mentees are IPs 2018 Service Snapshot 1,759 served 6.668 services provided 33

Training Partnership Peer Mentor Support Strategies Reduce Cognitive Overload Early On Clarity through guided support. Just-in-time communications. Prioritization and proactive planning. Orientation and Safety Novice Caregiving Registering Preparing Attend Basic Training Increase Confidence Through Additional Practice Study support outside of class. Guided role play and practice. Reduce Anxiety by Making the Unfamiliar, Familiar Reduce Cognitive Overload Early Reduce Anxiety by Making the Unfamiliar, Familiar Increase Confidence Through Additional Practice Study tips and strategies to practice at home. Guided walk through of training and test day. 34

Training Partnership Peer Mentor 35

Training Partnership Language Supports Translators provided for those not in a language class and for American Sign Language Basic Training 70 English Arabic Chinese Korean Russian Somali Spanish Vietnamese Basic Training 30 English Chinese Korean Russian Spanish Vietnamese In Person Led Continuing Education English Lao Arabic Russian Cambodian Somali Chinese Spanish Korean Tagalog Vietnamese 36

Training Partnership Continuing Education Sample of online CE titles Accident Prevention Client use of marijuana in home care Consumer Directed Care for common medical conditions: stroke Dementia and personal care Food allergies and sensitivities Historical perspectives on the treatment of people with disabilities Improving time management skills Positive behavior support for young consumers with developmental disabilities Understanding basic medical terminology 37

Training Partnership Continuing Education In Person Led Courses April 2019 Post-Surgical Care Opioids and Client Use of Marijuana in Home Care Medication Assistance Supporting a Client with Hearing Loss Managing Compassion Fatigue 38

Training Partnership Advanced Home Care Aide FY19 Q2 39

Training Partnership Advanced Home Care Aide Upon successful completion of the course, learners should be able to: Provide person-centered care. Use the ADAPT problem solving method. Practice motivational interviewing techniques to collaborate with a client. Recognize opportunities to forestall escalation and employ appropriate techniques when caring for escalated clients. Use the appropriate treatment and care plans in providing in-scope care for a client. Monitor and report changes in a client s physical and/or mental health status. Collaborate with a client to ensure that medication is appropriately managed in accordance with treatment and/or care plan(s). Promote health literacy and empower a client to be engaged and at the center of their own health. Collaborate with a client in organizing care activities. 40

Training Partnership Supplemental Benefits Exempt Certification Benefit HCAs without a BT70 requirement may take the course, obtain certification, and earn wage differential Continuing Education for Uncertified Caregivers HCAs without a CE requirement may take CE courses Nurse Delegation as Continuing Education HCAs without a Nurse Delegation requirement may take the course to fulfill CE requirement and be eligible for additional employment opportunities 41

Training Partnership Future Plans Basic Training version IV Revisions to Advanced Home Care Aide Advanced HCA class access Basic Training access to remote areas Peer Mentor program growth 42

Training Partnership College Engagement Credit for Prior Learning Highline College Articulation Orientation & Safety, Basic Training 70, Advanced Home Care Aide 145 hours Department of Labor recognized apprenticeship enrollment 43

Together the future is bright

Thank you Kelly Parsons kelly.parsons@myseiubenefits.org Amy Persell amy.persell@myseiubenefits.org 45