Allied Health Advisory Group

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

Introductions Welcome Please say your Name Title Organization 2

Updates from DHE 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 3

Learning and Sharing Job Fair 2.0 in Lowell January 26 th, 2017 Patricia Yu, Director of Policy and Research, MA Executive Office of Elder Affairs Discussion: What regions should be targeted next? Willing partners? 4

Leanne Winchester, Project Director, Massachusetts AHEC Interim Report on the Scaling Efforts to Advance the Direct Care Workforce grant (Part II) 5

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

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 State Partners Executive Office of Elder Affairs Massachusetts Department of Public Health Executive Office of Labor and Workforce Development

8 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

Timeline 9

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

12 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

Questions, Comments, other Considerations 13

Leanne Winchester, MS RN Project Director Direct Care Workforce Development EOHHS/ELD/UMMS MassAHEC One Ashburton Place, 5 th floor Boston, MA 02108 (617) 573-1823 Leanne.Winchester@state.ma.us 14

Special Guest Presentation The Advanced Leadership in Geriatric Care Program for Certified Nurse Assistants Carol Kronopolus, Professional Development & Career Development Coordinator, Hebrew Senior Life 15

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

Special Guest Presentation 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 31

SNAP PATH TO WORK PROGRAM March 17, 2017

Massachusetts E&T Program 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.

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 indemand 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

What s in it for the E&T Provider? 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: 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.

Third-Party Partnerships 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/DTA contracts with local partners to provide E&T services Local partners use nonfederal funds to pay for allowable expenses, and then submit a claim to the State for reimbursement Reimbursement back to local partner UMass retains 5% of the 50% of SNAP E&T reimbursement for administration of the program. Providers receive 95% of the 50%.

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

What expenses qualify for reimbursement? 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

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

Benefits of Partnering 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 B E N E F I T S

SNAP Path to Work Website www.snappathtowork.org

Questions Contact Department of Transitional Assistance Miriam Kaufmann SNAP Assistant Director, E&T Service Miriam.Kaufmann@state.ma.us (617) 348-5561

AHAG Strategic Planning AHAG Sub-committees Current state Future plans 49

AHAG Strategic Planning 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 1 st, 2016, May meeting TBD), Greater Lowell (April 24 th ); South coast regions (April 7 th ); Metro Southwest (TBD April or May) Future plans: Update curriculum alignment sheet? Update state listing of all DCW programs at CC s? 50

Status of Sub-Committees 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 51

Status of Sub-Committees 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 52

Exploring New Sub-Committees 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? 53

Exploring New Sub-Committees 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? 54

Exploring New Sub-Committees 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? 55

Next Meetings Friday, June 9 th, 9:30 11:30am, 333 South Street Shrewsbury Topic: Looking Back and Measuring Progress Friday, September 29 th, 9:30 11:30am, Worcester State University Friday, December 8 th, 9:30 11:30am, Worcester State University 56

Thank you sincerely for your time and dedication!!! 57