BRING & KEEP OUR KIDS HOME
KATHY CRAFTDHSS, THE TRUST & UA
JUNE 15, 2009
Community systems of care
Informal Community
Support
Self-HelpPrimary Prevention
MentoringEtc.
Crisis &Assessme
nt
Entry&
Exit
7 daysRehabilitation
Outreach
Group Homes
Day Programs Residential
7 days/weekOutreachin acute
short term
Community
Based Treatment
Services
Primary CareSpecialty Care
OutpatientCare Mgmt.
Psychosocial
Rehab
Formal
Community
Support
Acute Need for Care
Recovery
Inpatient
24 HourTotal Care
Community Rehabilitatio
nServices
ACTPartial Hosp.
Etc.
Formal System Natural Support & Care
DEFINING THE WORKFORCE
WIDE RANGE OF DISCIPLINES (PSYCHIATRY, PSYCHOLOGY,
SOCIAL WORK, NURSING) PROVIDERS (PSYCHOLOGISTS,
COUNSELORS, PSYCHIATRIC NURSES) PROFESSIONAL LEVELS
(PARAPROFESSIONALS TO GRADUATE LEVEL)
SERVICES (TREATMENT, PREVENTION, RECOVERY)
FINDINGS FROM THE ANNAPOLIS COALITION REPORT WORKFORCE CRISIS WITH SPECIALITY POPULATIONS (GERIATRICS,
CHILDREN, RURAL, SUBSTANCE ABUSE, PERSONS OF COLOR) DISSATISFACTION AMONG PERSONS IN RECOVERY & FAMILIES EMPLOYER DISSATISFACTION WITH THE PRE-SERVICE EDUCATION OF
PROFESSIONALS MULTIPLE SILOS & ABSENCE OF COORDINATION NARROW FOCUS ON URBAN, WHITE ADULTS NEED BETTER DATA & TOOLS PROPENSITY TO DO WHAT IS AFFORDABLE, NOT WHAT IS EFFECTIVE DELAY: SCIENCE TO SERVICE POCKETS OF WORKFORCE INNOVATION: DIFFICULT TO SUSTAIN &
DISSEMINATE
SOURCE: ANNAPOLIS COALITION NATIONAL STRATEGIC PLAN FOR BEHAVIORAL HEALTH WORKFORCE
DEVLEOPMENT
National Framework – Goals
Broadening the concept of workforce1. Significantly expand the role of individuals in
recovery, and their families when appropriate, to participate in, ultimately direct or accept responsibility for their own care, provide care and supports to others, and educate the workforce.
2. Expand the role and capacity of communities to effectively identify their needs and promote behavioral health and wellness.
National Framework - Goals
Strengthening the workforce3. Implement systemic recruitment and
retention strategies at the federal, state, and local levels.
4. Increase the relevance, effectiveness, and accessibility of training and education.
5. Actively foster leadership development among all segments of the workforce.
National Framework - Goals
Structures to support the workforce6. Enhance the infrastructure available to
support and coordinate workforce development efforts.
7. Implement a national research and evaluation agenda on behavioral health workforce development.
WHAT WE KNOW FOR SURE
RURAL PROFESSIONALS SHORTAGE RATES UNCHANGED FOR PAST FIVE DECADES
MANY PUBLIC BH SYSTEMS AVERAGE 30% STAFF VACANCY
AVERAGE TIME TO RECRUIT PSYCHIATRIST TO RURAL PRACTICE IS 32 MONTHS; INCREASES WITH SOLO PRACTICES
PROVIDERS WITH CMHC TRAINING & PRACTICE MORE LIKELY TO BE RETAINED IN CMHC PRACTICE
CHILDREN DE-SELECT CAREERS BY THE 4TH GRADE!
INADEQUATE SUPERVISION IS A MAJOR RETENTION FACTOR…EMPLOYEES LEAVE SUPERVISORS NOT JOBS!
Behavioral health workforce – grow your own strategy logic model
- Popu
lati
on o
f Fo
cus
+
Increase knowledge of behavioral health
Exchange knowledge about behavioral health careers
Provide accessible behavioral health training
Applied trainingopportunities
Job
sssss
ssss
sss
ss
s
ALASKA LEADS THE WAY AND HAS IT ALL GOING…. STATEWIDE TV, RADIO, & PRINT PSA’S
THAT EDUCATE ABOUT BEHAVIORAL HEALTH ISSUES AND THE WORTH OF RELATED JOBS-PROFESSIONALS
PIPELINE INITIATIVES FOCUSED ON INCREASING THE INTEREST OF SCHOOL-AGE YOUTH IN BEHAVIORAL HEALTH CAREERS
THINK ABOUT MENTAL HEALTH FIRST AID
AND THEN SOME….
THRESHOLD JOBS TO CAREERS: APPRENTICESHIP PARTNERSHIPS (LABOR) COMPETENCY WORKGROUP RURAL HUMAN SERVICE PROGRAM ROBERT WOOD JOHNSON (RWJ) JOB BASED
LEARNING PILOT
NOT FINISHED YET
HIGHER EDUCATION PARTNERSHIPS RURAL HUMAN SERVICE PROGRAM ARTICULATED ACADEMIC LADDER BEHAVIORAL HEALTH ALLIANCE DISTANCE DELIVERED SOCIAL WORK
DEGREES ALASKA RURAL BEHAVIORAL HEALTH
TRAINING ACADEMY DOCTORAL PROGRAM IN
COMMUNITY/CLINICAL PSYCHOLOGY WITH RURAL & INDIGENOUS PEOPLE FOCUS
AND FINALLY…
DEVELOPMENT OF APA ACCREDITED INTERNSHIP CONSORTIUM FOCUSED ON ALASKA PRACTICE
EMERGING PSYCHIATRIC RESIDENCY AND CHILD PSYCHIATRY FELLOWSHIPS WITH UW FOCUSED ON ALASKA
CROSS UNIVERSITY/CROSS DISCIPLINE FACULTY TRAINING IN CHILDREN’S SYSTEM OF CARE TO PROMOTE INTERDISCIPLINARY CURRICULUM CHANGE
LAST BUT NOT LEAST
STATE LOAN REPAYMENT PROGRAM HOUSING STIPEND PROGRAM TRAINING COOPERATIVE & LEARNING
MANAGEMENT SYSTEMS STATEWIDE CONFERENCE STATEWIDE BEHAVIORAL HEALTH
STRATEGIC PLAN
ALASKA STATE VISION
BY 2015, BENEFICIARIES OF THE ALASKA MENTAL
HEALTH TRUST AUTHORITY SHALL HAVE ACCESS TO
A CAPABLE, CULTURALLY COMPETENT WORKFORCE
TO SUPPORT THEIR COMMUNITIES AND FAMILIES
ACROSS THE LIFESPAN
ALASKA STATEWIDE INFLUENCES ADMINISTRATIVE/EXECUTIVE ORDER 234 HEALTH CARE STRATEGIC PLANNING COUNCIL ALASKA HEALTH CARE COMMISSION DEPARTMENT OF LABOR & ECONOMIC
DEVELOPMENT – ALASKA WORKFORCE INVESTMENT BOARD
DEPARTMENT OF EDUCATION & EARLY DEVELOPMENT
AGIA – ALASKA GAS INDUCEMENT ACT ASHNHA – ALASKA STATE HOSPITAL & NURSING
ASSOCIATION PRIMARY CARE COUNCIL ASHPIN – ALASKA SMALL HOSPITAL PERFORMANCE
IMPROVEMENT NETWORK
SETTING THE CONTEXT – KEY POINTS HEALTH CARE IS BIG BUSINESS SHORTAGES ARE WIDESPREAD AND EXPENSIVE ITINERANTS ARE A COST TO EMPLOYERS, AND
A DRAIN TO OUR LOCAL ECONOMIES COLLABORATIONS ARE HAPPENING SOLUTIONS MUST BE RESOURCED AT EVERY
LEVEL 26,500 PEOPLE (8%) OF ALASKA’S
WORKFORCE ARE IN HEALTH CARE CONTINUUM RANGES FROM OJT TO PH.D. SHORTAGES EXIST IN ALL 119 OCCUPATIONS
SETTING THE CONTEXT – KEY ITINERANT PROVIDERS MEAN DOLLARS LOST
TO EMPLOYERS, AND RESOURCES NOT INVESTED IN LOCAL ECONOMIES
IN 2005, WE KNOW: 80 HOSPITALS/THOs/MENTAL HEALTH CENTERS
SPENT OVER $11 MILLION IN RECRUITMENT, $13 MILLION IN ITINERANTS ($24 TOTAL) IN 16 OCCUPATIONS
FMH SPENT OVER $640.0 IN RECRUITMENT AND $920 IN ITINERANTS
FMH HAS SAVED AT LEAST $1.5 MILLION IN NURSE RECRUITING SINCE LOCAL TRAINING STARTED
ALASKA LARGE HEALTH PROVIDERS PROVIDENCE HEALTH SYSTEM – ALASKA’S
LARGEST EMPLOYER SINCE 2001 FIVE OF THE TOP 20 EMPLOYERS ARE
HEALTHCARE; 24 OF TOP 100 EMPLOYERS ARE IN HEALTH AND
SOCIAL SERVICES HEALTH TOPPED $5 BILLION IN 2005, 1/3 THE
VALUE OF NORTH SLOPE OIL EXPORTS THAT YEAR
1-3 ALASKA DOL RESEARCH & ANALYSIS
4 DATA FROM INSTITUTE FOR SOCIAL & ECONOMIC RESEARCH, UAA
UNIVERSITY OF ALASKA HEALTH PROGRAMS MORE THAN 70 PROGRAMS STATEWIDE IN ALLIED &
BH, EMERGENCY SERVICES, HEALTH MANAGEMENT, MEDICAL OFFICE, NURSING, PRIMARY CARE, PUBLIC HEALTH…
OVER 4000 STUDENTS AT ALL LEVELS (TRAININGS TO DOCTORATES) IN MORE THAN 250 LOCATIONS; ABOUT 1200 PROGRAM AND DEGREE COMPLETERS PER YEAR
FROM AY01-AY08, 68% MORE HEALTH STUDENTS AND 66% MORE COMPLETERS
USING A VARIETY OF EDUCATIONAL MODALITIES WORKING ON MAINTAINING GAINS AS WELL AS
ENHANCING HEALTH PROFESSIONAL OFFERINGS (PA,OT, PT, PHARMACY)
DEVELOPING HEALTH SCIENCES CAMPUS AT UAA, IMPROVING OTHER FACILITIES ACROSS THE STATE
2007 Vacancy Study FindingsOccupation Group #
VacanciesVacancy Rates
Mean/Longest Vacancy/months
Physicians 226 11.7% 18 months
Registered Nurses 439 8% 2 years
Behavioral Health 1033 13.9% 17 months
Allied Health 434 7.9% 11 months
Dentists 71 10.3% 19 months
Pharmacists 98 23.7% 15 months
Therapists (PT, OT, ST, SLP)
234 15-30% 2 years
Other occupations 994
TOTAL 3529
Workforce DevelopmentFocus Area Infrastructure
Workforce Development Coordinator Steering Committee
Recruitment and Retention Subcommittee
Training and Education Subcommittee Policy Meetings
WICHE – Western Interstate Commission on Higher Education Credentialing and Quality Standards –
with the Annapolis Coalition Ph.D. Clinical Internship Focus Area Evaluation
HEALTH WORKFORCE DEVELOPMENT FOCUS AREA INFRASTRUCTURE
DHSS, UA & The Trust – shared institutional position Primary point of contact and liaison Provide direction and guidance Ensure successful accomplishment of
project and initiative goals and interim benchmarks
Ensure proper stewardship of public dollars and accountability for investments made; and,
Assist in charting new health workforce development and career building directions
WORKFORCE DEVELOPMENT FOCUS AREA
Concentrates on increasing the volume, caliber, and geographic breadth of professionals serving Trust beneficiaries in long-term care, developmental disabilities, and behavioral health.
An initiative of this breadth requires strong partners and a stable flow of resources.
HEALTH WORKFORCE DEVELOPMENT FOCUS AREA
Recruitment and Retention Loan Repayment Wages & Benefits Alaska Alliance for Direct Care Services Cash Stipends Psychiatric Residency “Grow Your Own” – Area Health
Education Center (AHEC) Vacancy Study Marketing
Workforce Development Focus Area
Training and Education Trust Training Cooperative/Learning
Management System & Geriatric Training Alaska Rural Behavioral Health Training
Academy Children’s Mental Health Credential & Quality Standards Disability Justice BTKH – Bring the Kids Home Peer Support Brain Injury Training Distance MSW Program Expansion Ph.D. Clinical Internship UAA/UAF Human Services Children’s Residential