1 Updated 8/29/16

MASSACHUSETTS DEPARTMENT OF HIGHER EDUCATION ALLIED HEALTH ADVISORY GROUP

STRATEGIC PLAN FOR FY 2017-2018

Issued by:

Massachusetts Department of Higher Education

One Ashburton Place, Room 1401

Boston, Massachusetts 02108

Prepared by:

Geoff Vercauteren, Director, Allied Health Workforce Development

2 Updated 8/29/16

OVERVIEW: The Allied Health Advisory Group performed two strategic planning exercises at its 6/13/16 meeting. Attendees were given 2 worksheets and asked to take some time and complete the questions on them step by step. Sheets were then collected and the data was analyzed. The first part of this report represents the summary of the responses and potential action plans to be taken up by the AHAG. The second section contains the raw data obtained from the respondents and organized roughly by theme. SECTION 1: FINDINGS AND RESULTS – FIRST EXERCISE In the first exercise, members were told that FY17 is looking to be a lean year for the Nursing and Allied Health work. As of this writing, it appears that there will be $200,000 allocated to this work, although that has yet to be confirmed. Members were asked to consider what could be reasonably accomplished with approximately $50,000 in grant dollars (calculated after 50% of dollars going to nursing work and administrative costs factored in). Members were asked first to respond how the money should be given out. Choices were: One $50,000 award? Two $25,000 awards? Other? Should there be a consortium of applicants? The results of the responses were overwhelmingly in favor of a consortium proposal. Results for the sizes of the awards were evenly spread. Next respondents were asked to consider up to 3 priorities the money should be used for. Respondents were also asked to consider the goals of the Allied Health – Direct Care Workforce Plan and the priorities chosen by the AHAG in early 2015. When grouped by themes, alignment of core competencies was by far the most popular with 16 mentions. This includes suggestions for:

Convening groups to define core competencies

Identifying the core competencies to build DCW pathways

Identifying the appropriate duties for each direct care position that represents work being done to, but not over, the highest level of license or certificate

Engaging employer community for codification of competencies and aligning job descriptions and standards of practice

Creating a unified list of competencies These results would contribute to a system that:

Allows DCW to use competencies to progress academically and occupationally via recognized transferable training

Standardize training to better support and sustain staff stability, and

Ultimately lead to true transferability and career laddering (at least within regions). The next most popular theme, with 8 mentions, was developing realistic career and educational pathways for direct care workers. These suggestions include:

Aligning curricula internally and externally and across a wider field (voc schools, universities, training programs, etc.);

Aligning curriculum with employer needs;

Improving articulation between non-credit and for-credit courses, and identifying and mapping the pathways and systems needed to support entry level students to advance along an educational path.

Through these efforts, and the creation of a more standardized system to support entry level students to advance along an educational path, it is hoped that more people will be interested in entering the field, and they will see opportunities for true advancement.

3 Updated 8/29/16

The remaining common themes that were articulated were all tied with a score of 4 mentions each. While not strong showers, there is some value in taking a closer look at them. One of these remaining 3 common themes - the creation of transferrable trainings - has a clear overlap with the core competency and educational/career pathway threads. It would be sensible to include this theme when thinking about the competency and pathway themes. An overlapping idea was for the creation of academic maps with a recognized pathway that is accepted system-wide – or at least regionally – and the creation of formal linkages between non-credit and for credit certificate and degree programs. The second of the 3 remaining themes - increasing career awareness is focused on the continued recruitment of new candidates by expanding interest in DCW jobs across broader community. One suggestion would be to create a website showing all opportunities for education, financial aid, career and education maps, and jobs for DCWs. The last theme is building the business case for the direct care workforce. This effort would be centered around why the DCW is important in this state’s economy, and why the increasing labor shortage needs to be addressed at higher levels. Suggestions on how to begin to tackle this challenge centered around building more regionalized forums and convenings that are focused on the employer voice and offer localized solutions. The entirety of answers, grouped by theme, for this exercise is listed in the appendices. SECTION 2: FINDINGS AND RESULTS – SECOND EXERCISE For the second activity, members were asked to complete was a SWOT analysis in which they considered the strengths, weaknesses, opportunities and threats for the AHAG. Instructions were purposefully vague in order to minimize influence on answers as much as possible. Strengths: Major themes for strengths were:

Membership – Answers included positive comments about the diverse qualities of leadership and education; willingness of members to share resources and how highly motivated and committed the group is to this work

Collective Experience – Answers commended the knowledge, intelligence, history, and workforce development experience around the table, with members having a clear understanding of priorities and focus.

Respect – Respondents felt that members had tremendous respect for each other, respect for different views, and agendas and a commitment to improving and collaborating.

Leadership – Members felt that the group is well-led and well-organized, and is kept on track. Weaknesses: Major themes for weaknesses were:

Employer representation – Members overwhelmingly feel that there needs to be much more employer engagement and representation on the group.

Financial resources – Lack of financial resources is a strongly felt theme through nearly all the sections. Comments focused on needing resources in order to move the agenda and the work forward. Otherwise it is a piecemeal approach that expends great effort to accomplish little.

Missing other representation on group – The employer representation theme was clearly pronounced in the earlier answers, but members also felt that there needed to be representation of other groups as

4 Updated 8/29/16

well. These included more One-Stop Career Centers; WIBs; Health insurance payors, and additional state agencies (DPH; EOLWD; DTA).

Data – Comments highlighted the need for additional data to be shared in order to make better decisions; To determine future need and cost effectiveness of stable workforce, and to quantify the labor market need.

Other comments – There were a few responses that didn’t necessarily fit into a theme, but were good points nonetheless. This included the admittance that although DCW wages are a theme throughout the project, there is a feeling of inability to effect change in wage payments for DCWs, and an inability to effect fundamental change in the home health and long term business model and reimbursement rate.

Opportunities: Themes for this section were wide and varied, and many suggestions mapped to comments mentioned earlier or later in this report (i.e. more data, building career and education pathways, engaging employers, etc.). However, there were a few themes that had some alignment and thus worth noting.

Changing and effecting policy – Respondents felt that there are opportunities for the AHAG to be more influential in being a unified voice to change policies. Acknowledging the fact that DHE and a number of the members of the AHAG are unable to lobby the legislature, there are opportunities for other members to do so on behalf of the work, and to collaborate as a group to craft messaging.

Finding support from legislators – A number of responses advocated for finding a legislative champion or champions in order to effect change at a higher level.

Bringing other agencies together – While the AHAG has a number of state agencies as members, answers indicated that new, different, or additional representatives need to be on the group as well. Suggestions were made for representatives from DPH (nurse assistant licensure); EOLWD; DTA (since DTA issues a number of training vouchers to recipients who often take direct care trainings), and others.

Threats: Major themes for this section were:

Duplication of work – Responses voiced concerns about the possible duplication of efforts that are going on in this space. They also acknowledge the presence of silos and the overlap in efforts that might be going on that could be invisible because of lack of communication.

Conflicting legislative priorities – In line with earlier themes, these responses stated that the DCW issues are competing for attention and funding with other public health and workforce issues going on in the state. Participants admitted that this could lead to a lack of buy-in from key lawmakers.

Financial resources – Takes on same subject matter as mentioned earlier

Other themes – Responses in this section varied, but included many important points worth mentioning, not the least of which was the threat of taking on too much; Taking things on that were beyond our control or ability to influence, and the potential of losing focus of the group.

SECTION THREE: STRATEGIC PLANNING FOR FY17 After analyzing the data from the responses, below are the major actionable themes, some examples of activity happening around the state, and suggestions for further discussion: Theme 1: Core Competency Development:

Currently happening (limited list): o “Scaling Efforts” grant:

Priority 3: Development of Core Competencies o PHCAST “ABC’s” curriculum

5 Updated 8/29/16

o Adoption of competency-based training by some college programs o Collection and comparison of community college C.N.A./HHA curricula o Engaging employer community at a regional level through focus groups for codification of

competencies

Potential opportunities for expansion: o Convene a discussion of community colleges of what it would take to have an aligned curriculum

for C.N.A/HHA and what it would look like o Identify the barriers to adopting an aligned and competency-based curriculum

Discussion: o What more needs to be done in this area? Is it a question of scale and funding for bringing to

scale or something else? o What will it take for the system to move towards an aligned curriculum?

Theme 2: Developing Career and Educational Pathways:

Currently happening (limited list): o Expansion of career lattice designed by UMMS o “Direct Care Worker” grant with Worcester State University giving C.N.A.s an option to return to

school and bridge to college o GPSTEM – guided pathways work o “Scaling Efforts” grant:

Priority 1: Direct Care Worker pathways

Potential opportunities for expansion: o Sharing best practices on career mapping widely across community colleges o Making UMMS career lattice widely available to other stakeholders: Career Centers; Voc Tech

schools; etc. o Aligning curricula internally and externally and across a wider field (voc schools, universities,

training programs, etc.) o Improving articulation between non-credit and for-credit courses, and identifying and mapping

the pathways and systems needed to support entry level students to advance along an educational path.

Looking at best practices and scaling across multiple regions Fertile ground for work to be done through funding

o Continue to work with GPSTEM for alignment of these efforts; partner in efforts where possible to reduce duplication of work.

Discussion: o What more needs to be done in this area? Is it a question of scale and funding for bringing to

scale or something else? o What will success look like in this area?

Theme 3: Career Awareness:

Currently happening (limited list): o Websites describing healthcare careers:

Explore Health Careers.com Mass IntoCareers.org Healthcare Careers.org HCA Council

Potential opportunities for expansion:

6 Updated 8/29/16

o By providing more support in the form of advising and case management, as well as clear career and educational pathways, it is hoped that more people will be interested in entering the field, and they will see opportunities for true advancement.

o Create a short term sub-committee to look into the feasibility for creating a website showing all opportunities for education, financial aid, career and education maps, and jobs for DCWs.

o Conducting an assessment of what’s already out there and how we might be able to leverage it

Questions for discussion o Is another website needed? What would the cost be? What would the content be? How would it

be different? Would it be useful? o What else is happening in this space? o What more needs to happen? o What are other ways to build career awareness? o How can the AHAG facilitate this?

Theme 4: Making the Business Case/Data Collection:

Currently happening (limited list): o EOEA position paper o Mass Senior Care Foundation publications

MA LTC Workforce (2014) Quality Jobs Initiative (2015)

o Homecare Aide Council o PHI o Regional data from WIBs

Potential opportunities for expansion: o 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

State 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.)

Separate by region and combine data from all employer representatives and organized labor

o Publish a paper and/or fact sheets o Deliver paper to lawmakers and other stakeholders o Create a plan for engaging more employers on AHAG

Theme 5: Meeting Structure and Membership:

Currently happening (limited list): o Facilitator is reaching out to more employers and state agencies o Redesigning meeting structure to include more time for open discussions and report-outs

Further opportunities for expansion: o Continue increasing and diversifying membership o Put together plan for getting more OSCCs and WIBs involved with the understanding that OSCCs

are going through upheaval right now with the implementation of WIOA and re-chartering o Identifying leading OSCCs and WIBs who represent best practices in this area. o Increasing legislative connections starting with Legislative Outreach sub-committee o Reach out to EOLWD and ask Jen James if she has a recommendation for representation on AHAG o Reach out to new person at DPH and set up meeting; extend invitation to AHAG o Understand burning issues with DPH training program certifying process

7 Updated 8/29/16

o Set up temporary sub-committee to write up paper on what needs to be done for nurse assistant licensure and pass along to DPH

o Investigate DTA membership as they are a major funder of training vouchers for individuals going into DCW roles

Questions for discussion: o Is this the right time to engage OSCCs given that they are all up for re-chartering and there could

be a dramatic shifting of OSCC operators? o How big should the group be? Should we have a ‘call-in’ option for everyone at every meeting?

What are the pros/cons of doing that? Theme 6: Engaging Legislators and Increasing Financial Support:

Currently happening (limited list): o MAAC efforts for the whole of the N&AH budget o DHE efforts as included in DHE’s overall budget ask o Efforts from AHAG employer representative partners (Homecare Alliance, Mass Senior Home

Care, Homecare Aide Council, etc.) as part of their own campaigns o Legislative Outreach Sub-committee

Further opportunities for expansion: o Use Legislative Sub-committee to identify potential legislators to reach out to o Use data collected from business case work to put together position papers o Figure out how to best tell the story of our work o Revisit the goals of the AH DCW report and produce updates on each

Questions for Discussion o Philanthropic dollars made a huge difference for the nursing work. How do we go about finding

the same? o How should we structure this effort?

8 Updated 8/29/16

APPENDIX I: AHAG PLANNING SESSION ACTIVITY #1 – RESULTS Funding priorities – For FY 2017, the Nursing and Allied Health line item was funded at $200,000. This leaves approximately $50,000 for investment in this work.

Question 1: How should the money be given out? One $50,000 award? Two $25,000 awards? Other? Should there be a consortium?

$50,000 4

2 x $25,000 5

Other 5

Consortium 12

Individual 0

Other 2

Comments from participants:

Consortium is important. I think we need to look at what outcome we can achieve in short term if funding is yearly

School and service provider link?

Curriculum alignment for DCW. Identify needs; align curriculum; get employer buy-in. Maybe hire a consultant to organize.

Focus needs to be policy related; work is happening in most other areas and that seems to be the biggest need right now

Impact statewide that builds towards sustainability beyond the grant

Multiple min-grants to support creativity and exploration of DCW supports and opportunities

Small grants produce limited results

Broken out so some specific regional areas (i.e. Western MA) could work on challenges

Use dollars for convening of employer/industry voices to help inform our work. We continue to struggle with traditional Higher Ed wants vs. anecdotal employer needs. Need better pulse to guide work.

Provide administrative support through the AHAG to ensure the success of the “Scaling Efforts” grant – perhaps $10,000?

Could you give additional dollars to current awardees based on need?

Could it be used for a specific strategy to engage students to consider Allied Health/DCW jobs?

2-3 grants of $15k - $20k would seem more productive. This allows for testing of impact.

One model – provide some seed or match funding to help begin programs. Could something like this be offered to organizations to upskill/train HHA to C.N.A. or C.N.A. to pursue higher career paths?

Question 2: Given this fiscal reality, what should DHE’s funding priorities be? In answering, consider the goals of the DCW plan (on reverse side) and the current priorities being focused on (highlighted).

Increase Career Awareness

PRIORITY PROCESS STAKEHOLDERS OUTCOMES NOTES Build DCW pathways Align curricula to allow

DCWs to progress to other opportunities. Alignment between voc schools, Community Colleges and universities.

Employers, DCWs, Educational Institutions, Labor Unions, Insurers, WIBs

Ladder development; ESOL support; Soft skills training

Non-credit with articulation built in and employer

Employers, Educational Institutions, Labor Unions,

Direct delivery trainings at local facilities

9 Updated 8/29/16

support WIBs

Goal 2: DCW pathways – building relationships with insurers and employers

Frequent small funds and matches from workforce system and/or employers. Seed funding to make and impact in several areas and evaluate success of each pilot project.

Employers; insurance companies; educators; DOL; DHE; EOEA; CNAs; PHCAST; HHAs

vacancy rates; employment rates; turnover rates; insurers to refund following years

Build DCW pathways Identify the pathways: CNAs LPN RN etc.

Students; colleges; workforce; public

Upward mobility

Career pathways - Make many maps so we don’t have to start with a blank sheet of paper

Map DCW pathways both education and occupation; direct care, admin, support, etc. Establish process evaluation design for determining how many people are upwardly mobile. What are the barriers? Collect data at 2-4 test sites

Workers, industry, firms, education

Maps for career counseling; redefinition of career pathway strategy; report to be used to promote value to policymakers and ??

(sylvia)

Career pathways for DCW Develop realistic career pathways

Colleges; CTE Further education

Career awareness/career paths – show that there are feasible career paths toward a more livable wage

Leverage work already done; alignment with employers

OSCCs, training, hospitals, nursing homes, colleges

More people interested in entering field; see it as a true advancement success

Develop support program for disadvantaged students

Assess current service delivery systems and determine gaps of service

Colleges; ABE; ESOL programs; state agencies; EOLWD; OSCCs

A standardized system to support entry level students to advance along an educational path

PATHWAYS = 8

Create recognized transferrable trainings

Employer community key to recognition so finding a meaningful way for them to participate while recognizing that meeting culture is a higher ed culture

Whatever existing regional aggregated voices in healthcare will play

Higher ed creating curriculum informed by more than our own ideas about what a relevant curriculum looks like

Continue expansion of DCW training across all community colleges (consistent curriculum and transferability)

Expand beyond current comm. Colleges; offer train the trainers, TA or implementation strategies

Colleges, labor, employers, WIBs, OSCCs

All community colleges offer entry level DCW training and a career path for additional training/education and career advancement

Create formal linkages between non-credit and for credit certificate and degree programs

ID colleges’ current linkages; ID gaps/barriers to advancement

Colleges; ABE; ESOL programs; career services; non-credit & for credit depts.; EOLWD

Academic maps and a recognized pathway that is accepted statewide

Create a standardized process across community colleges (?? Leanne)

Convene a working group to test process

Students; employers; colleges; OSCCs

50% of students that enter a non-credit program will advance along an academic path

TRANSFERABLE TRAINING = 4

Increase career awareness; build direct care worker pathways with recognized

Pilot grant partnership between employer and educator; Recruitment

Employers; DCWs; Educators; Trainers; DHE *Create project advisory

Boost skills; care for patients; barriers to advancement

10 Updated 8/29/16

transferrable training component to expand interest across broader community

sub-committee

Increase career awareness Identify DCW jobs Ed requirements and salary. In website show all opportunities for education; financial aid; and jobs for DCWs

Education; workforce; government

A resource for the public and DCW stakeholders to identify opportunities in their fields

Increase career awareness Need core competencies to get here, but once that is in place, this would be the next logical step

Colleges, employers, DCWs, unions

Comprehensive and collaborative pathways that are consistent within healthcare organizations

Increase career awareness Pilot statewide core competency curriculum

Colleges; hospitals; LTC; others

Increased Allied Health Workforce in all regions stimulating the economy and resulting in the of dependence on state services/funds

CAREER AWARENESS = 4

Invest in an informational campaign for DCWs

Pull together working group and develop materials

Employers, WIBs, colleges, DOL, EOEA, DHE

Media campaign about why to choose DC jobs

Education campaign about the value of DCWs in healthcare settings

Pull together group, develop materials

Hospitals, managed care, employers, EOEA, EOHHS, DOL, DHE

Education program for managed care

INFORMATIONAL CAMPAIGN ABOUT VALUE OF DCWs = 2

Offer partial scholarships for students

Where the funding for this would come from; state vs. grants?

DCW candidates – particularly those who can’t pay for school

availability of prepared candidates for DCW jobs

Invest in the Development of Core Competencies

PRIORITY PROCESS STAKEHOLDERS OUTCOMES NOTES Align core competencies Convene groups to define

core competencies Employers, DCWs, Educational Institutions, Labor Unions, Insurers

A system that allows DCW opportunities for seamless progression via recognized transferable training

Pilot core competency curriculum and offer statewide

Educational Institutions, Labor Unions, Employers

Seamless pathway for DCWs to use competencies to progress academically and occupationally

Align core competencies Identify each area to highest level of license or certificate

Public; colleges; workforce; students

Identify the core competencies to build DCW pathways

Core competency finalize to sustain direct care worker pathways

Complete ongoing work on this effort

Educational Institutions, Labor Unions, Employers

Standardize training to better support and sustain staff stability

Align competencies around employer need

Employer community key to recognizability so finding a meaningful way for them to participate while recognizing that meeting culture is a higher ed culture

Whatever existing regional aggregated voices in healthcare will play

True transferability and career laddering at least within regions. East/west might remain a useful distinction.

11 Updated 8/29/16

Define core competencies and added competencies needed for career advancement

Assess current curriculum and competencies identified and addressed

Colleges; WIBs; OSCCs; employers; labor

Defined list of core competencies

Core competencies Interview/survey; look at changing how competencies are tested

Red Cross – testing of core competencies

Align core competencies and build consensus

Invest in core competencies Convene regional employers to gather their ideas, concerns, challenges

Employers, job seekers, education, REBs, OSCCs

Develop specific curriculum that aligns with identified needs

Core competencies Convene with employers to align job descriptions and standards of practice

Employers, job seekers, education, REBs, OSCCs

Align job descriptions and employer feedback with academic side of training

Invest in the development of core competencies

Role and scope sub-committee work; then the ‘selling’ of that work

Employers, colleges, DCW Core curriculum would aloe colleges to spend less on curriculum resources; one does it – all benefit

Invest in the development of core competencies

Create regional transferable trainings/certifications

Colleges; hospitals; LTC; others

Increased Allied Health Workforce in all regions stimulating the economy and resulting in the of dependence on state services/funds

Workforce training and education; invest in the development of core competencies

Continue to fund innovative career training models and promote success

AHAG Build a set of educational best practices

Common coursework and competencies between community college programs

All stakeholders come together; review actual curriculum (happened already); build for alignment; identify changes – don’t need to come from DPH

DPH; EOHHS; Executive Office of Community Colleges

Clear set of standards for college programs – so more uniform across state

Developing a scope of practice for DCW

Panel to work on creating a unified list of competencies

Colleges; CTE; OSCCs; Employers

Aligned core competencies

Establish uniform, reasonable, accessible education for direct care ed (already in progress)

Through DHE and HHS funded education

Healthcare hiring agencies; LTC; Home care; Outpatient centers

Uniform education performance expectations for DCWs

DEVELOPMENT OF CORE COMPETENCIES = 16

Change Policy

PRIORITY PROCESS STAKEHOLDERS OUTCOMES NOTES Change policy and improve reimbursement and wages

Research and find experts who understand the current state of wages and reimbursements; identify the best way to improve

Employers, policymakers, government

Improve reimbursement and wages

Change policies Very challenging but very necessary

DCW employers, legislators, community orgs, unions

ways for CNAs could be benefits – cliff related

12 Updated 8/29/16

Change policy; increase reimbursement and wages

Ideas: Make it personal; person who wanted to be a CNA but couldn’t afford to; organizations that can’t hire people; what if it’s you or your partner that needed help?

Legislation; anyone who is caring for an aging relative; LTC; Red Cross

Fear = action; show demand for positions firsthand and the future without them. Scary – especially to baby boomers it will directly impact.

CHANGE POLICIES = 3

Staff a cross-secretariat task force; Convene an education, employer, policy collaborative

EOLWD, EOEA, DTA, DHE, LTSS, WIBs, OSCCs

Unified strategic plan

Cross-secretariat taskforce including DPH, EOEA, DHE

Identify champions with stakes included (aging population)

CROSS SECRETARIAT TASK FORCE = 2

Lobby/advocacy campaign to increase DCW wages

Work with educators and DHE/WIBs to collaborate on this

DCWs; employers; public/private health

job satisfaction; retention; ease recruitment costs; ease overtime costs

Establish minimum wage for DCWs

Influence law-makers; members of the Commonwealth Senate, Reps, Governor

Healthcare hiring agencies for DCW training sites

Attractive wages to recruit and retain workers to direct care jobs

ADVOCACY FOR WAGE INCREASE = 2

Build the Business Case for Investing in the Direct Care Workforce

PRIORITY PROCESS STAKEHOLDERS OUTCOMES NOTES Convene an education, employer and policy collaborative

Identify scope and practice of entry level career ladders

Education; long term care workforce; legislators

Provide a theoretical and practical approach to policy issue

Convene collaborative between workforce, policy and employers

Include regional boards within set areas of state

Workers – especially disenfranchised; employers; moving away from acute care

CONVENE POLICY COLLABORATIVE = 2

Build business case Continue Geoff’s communications; ID leaders; convene to discuss value from their perspectives

Business people across healthcare sectors

Value statement

Build the business case for investing in the direct care workforce

Articulating the business model

Colleges; hospitals; LTC Increased Allied Health Workforce in all regions stimulating the economy and resulting in the of dependence on state services/funds

Build the business case Promote more on the industry side – the focus of this work; regional convenings; tighter relationships with employers

Industry associations; 1199 ; workforce boards; elected officials, EOLWD

Build more awareness and buy-in

13 Updated 8/29/16

Network building; building partnerships; building the business case

Rotating regional forums; inviting colleges, WIBs, employers, healthcare providers

Colleges, employers, WIBs, etc.

Build relationships, strengthen ties between colleges, employers; DHE to achieve common goals

BUILD BUSINESS CASE FOR WORKFORCE = 4

Provide Employer Support

PRIORITY PROCESS STAKEHOLDERS OUTCOMES NOTES Provide employer support Case management model;

supervisor/management training

Employers, employees, potential workforce

retention, employee satisfaction, continuity of care

Offer post placement follow up

Gather data from existing programs: PHCAST, Rapid Response, etc.

Employers, career centers, colleges, WIBs

Best practices around post placement coaching models

POST PLACEMENT FOLLOW UP/CASE MANAGEMENT = 2

Other

PRIORITY PROCESS STAKEHOLDERS OUTCOMES NOTES Opioid awareness training for DCWs

Involve area ER facilities as well as DA office

Hospital/clinics; DA; Legal DCWs would be able to recognize, refer incipient and chronic cases

Match up DCW employers and education sites regionally

Meet regularly/quarterly with area employers

Area employers; DCWs; education; OSCCs

Fill vacancies; enrollment; retention

Diverse population of workforce

Invest in cultural awareness and training

LTC, colleges, CTE DCW who is equipped with the necessary skills to be successful

Measure current outcomes for various DCW training programs to determine best practices by partnerships

Hire educator to assess current status

Colleges, employers, labor, WIBs, OSCCs

Identification of successful models and where scarce dollars should be invested

Create Career Preview Opportunities N/A

14 Updated 8/29/16

APPENDIX II: AHAG PLANNING SESSION ACTIVITY #2 – RESULTS

STRENGTHS LEADERSHIP

15

leadership leadership leadership Geoff - great convener; passionate leadership

committed group and leadership

organized agenda and facilitation

leadership - keeps us on track

organized leadership

committed leadership and support

centralized leadership

leadership could position us as the go to group of leaders in this area

Geoff Coordination / organization of group

organized leadership

MEMBERSHIP AND PARTICIPANT DIVERSITY

19

diversity of membership

diverse qualities of leadership and education

committed group of core attendees so conversation builds overtime

willingness to share resource among participants

diversity and representation of the group

highly motivated and committed group

diversity of participants and knowledge

representation from comm colleges

expertise from all areas

diverse perspectives

regional representation

cross-functional stakeholders' commitment

knowledgeable and diverse group around the table

diverse representation at the table

partnerships between employers and colleges

statewide representation

diversity of membership

COLLECTIVE EXPERIENCE OF GROUP

17

knowledgeable and diverse group around the table

depth of expertise

knowledge base of participants

diversity of experience

clear understanding of priorities and focus

intelligent; lots of experience and history

Expertise / knowledge

different areas of healthcare education

knowledge of participants is comprehensive

educator commitment - post secondary

knowledge and history

experience / knowledge

knowledgeable and diverse group around the table

many group participants have worked collaboratively on this

knowledge of those around the table

experience of members

lots of participants with broad knowledge of WF history and good ideas

15 Updated 8/29/16

COMMITMENT / RESPECT OF MEMBERS

16

respect commitment to improving and collaborating

everyone shows up

able to demonstrate respect

committed individuals

commitment of group

respect across members

camaraderie committed participants

willing to dig deeper

commitment to allied health

committed participants

respect for the issues each of us are facing

commitment to this issue

commitment to the work

all members respect each other and attend mtgs regularly

ALL OTHERS

38

leadership drive to keep group on task

umbrella organizations

informed advocacy

common needs and interests

quarterly meetings very beneficial - great speakers and exchange of ideas

sub-committee work

vision engaging topics and open to different ideas

energy getting closer on defining priorities

subcommittees informed analysis / insight

focus on critical need for healthcare

importance to economy

agenda provided ahead of time

4 mtgs per year shared goals open communication

participants are engaged

WEAKNESSES NEED MORE EMPLOYER AND PAYOR REPRESNTATION

25

need more employer representation on group

decreased level of employers

need for more employers involved

lack of employer perspective

lack of payer participation

employer involvement

need additional employers

business engagement

continued reference to no employers - let trade associations talk

limited employer representation

need more employers to attend

not enough long term care employers at table

need to diversify more

missing employers

missing payers/ins companies

missing some key participants: employers

need more input from other stakeholders

reliance on higher ed systems and structure (i.e. meeting location) when employer voice is required

lack of employer partners

not enough employers

16 Updated 8/29/16

need more employers

need more employers

low employer presence

need payers at table

few employers at table

DATA

11

data to determine future need and cost effectiveness of stable workforce

need for more data

need more data data need more data more data data survey and regional data

data - such as quant. the need; what's the service gap

data

data needs to be shared in order to make better decisions

FINANCIAL RESOURCES

13

lack of funding for projects

resources to implement solutions posed by the group

funding; not enough to expand

resources - need money to pilot projects

limited resources

funding to increase workforce

Budget / funding challenges

lack of $$ need to have more funding

more funding to support the work vs. piecemeal approach

$$ constraints resource constraints

budgetary uncertainties

MISSING OTHER REPRESENTATION ON GROUP

13

participation career center representation

needs to be 'owned' by industry/ EOLWD as well

no connection to legislators

no worker representation

need others from WIBs and career centers, DTA, EOLWD, DPH to hear about changes

missing EOLWD WIB - need engagement

career center management

few other state agencies (DPH) participate

no non-profit community agencies at table

career centers more WIBs and Career Centers

17 Updated 8/29/16

ALL OTHERS

29

inability to effect change in min wage for DCWs

time constraints action plans for various representatives - how can each contribute

marketing promotion of group to get $$ and to get the message out

action is slow Outputs / deliverables are slow

elephant in the room - concern workforce scarcity/turnover will not change w/out fundamental change in the home health and long term business model and reimbursement rates

not enough time for attendees to speak and share updates

meetings don't respect the history that exists in this area

continued asks to support funding where many of us can't do this

limited ability to elicit change

buy-in is limited or not certain

sometimes limitations decrease creativity

time - we need more time to meet to be aggressive

lots of voices may be hard to control

time to share models that are successful now

unclear scope in some areas

not clear what #1 and #2 priorities of group are

success could be articulated more clearly to work as motivator

OPPORTUNITIES CHANGING OR EFFECTING POLICY

12

gather strength among stakeholders to effect min wage change

greater advocacy for health careers training

funding for education of DCWs and tuition assistance

tie in with public health issues to better understand issues

policy discussion about min wage and reimbursement rates

to fund statewide initiatives

to fund urgent areas of concern

mobilize AHAG for awareness and advocacy to increase funding

reignite focus on workforce development issues

the story we need to tell is that we're all aging. Enlightened self interest can fund this work for decades to come

18 Updated 8/29/16

educate administration, employs, ins comp, to better fund DCW

statewide change in direction

FINDING SUPPORT FROM LEGISLATORS

9

influence legislative agenda to bring about change

partnership with elected

champion legislator

involve others who may be able to solve issues

better selling of importance

funding - strength in numbers

advocate not just for $$ but also for collaboration

create 1 voice to be heard loudly

to find a political champion

BRINGING OTHER AGENCIES TOGETHER

9

have DOL at the table

Governor push for secretariats to work together

bring in other state agency representation (DMH, MRC, etc)

state leadership recognition

Sec. Bonner to reach out to others to participate

bring work into public health arena

expand outreach and awareness with other state agencies (DPH)

crossing of DPH/DHE/EOLWD etc.

work more closely with DPH around shared goals

increase of collaboration

OTHER

45

AHAG can become the centerpiece of advisory board for labor, etc.

add narcan training to C.N.A. training

streamline efforts

recruit employers to get involved and invested in the long term

share best practices

sub committee work

strengthen existing programs at colleges

more sharing of best practices

more research and documentation

focus on career pathway programs

change direction for allied health education to make it more seamless

introduce 'hot topics' in MA public health

build pipeline for workers within sector

improve ability to define priority

increase knowledge

evidence to support interventions / strategies

become the go-to group

movement of care to community-based

aging population growth

to analyze needs of workforce

broadening of ideas/sharing

opportunity to gather data

to create difference

tie into hot topics

become the go to group for industry and government on this issue

better networking and collaboration

creating a sense of common purpose and direction

to increase workforce

develop business case for DCW development

capitalize more on building successful projects and strategies

19 Updated 8/29/16

create a campaign to heighten awareness

create a coordinated curriculum so employees can move

define what MA sees as "allied health"

be the "big tent"

create a burning platform - link to opioids or other DPH and EOHHS issues

pilots AHAG could help at state level with CNA certification problems

workforce nationwide recognition

bring more employers to the group

best practices from other states

create data outcome efforts to promote them in all areas

annual plan with clear goals and resources

sub-committees with specific project that equals real outcomes

increase DCW visibility and understanding

THREATS DUPLICATION OF WORK

9

silos silos of varying agencies in the state

territorial protection

duplication replication by other agencies

competing interests

duplication of services/work which then dissipates funding

duplication overlap among agencies' work without communication about our work

CONFLICTING PRIORITIES

6

rising and conflicting federal and state policies and practices

changing priorities

changing priorities

legislative priorities different

lack of buy-in for potential stakeholders

competing priorities

20 Updated 8/29/16

FINANCIAL RESOURCES

14

low funding lack of funding decrease in funding

state budget funding priorities

other agencies seeking same funding dollars

funding challenges

not receiving financial support from administration

no $$$ budget priorities

“Funding” x4 answers

ALL OTHERS

31

apathy/lack of motivated stakeholders

avoid being pigeonholed as elitist/educationist who do not balance budgets

taking on too many things beyond our capability to control; need focus

interest in getting into other allied health careers

scalability legislative support (lack of); wage rates advocacy

need more clear 'products' to keep people coming back

low wages = low interest

place at the table = not priority in state

response to rising healthcare costs

licensing and certification process (with DPH)

need to articulate why DHE called this group together

need to hear from members so they stay engaged

potential for members to become frustrated

potential to change the problem rather than create a solution

turnover of members personnel

focus is larger than DHE and needs cross-sector support

challenges of the workforce - wages, benefits, etc.

can't solve everything; judicious focus

having DHE derail curriculum

big picture - as a society we are all in denial about aging so it's hard to tap into enlightened self-interest when we're in denial about need

higher ed needs employers but we can make it hard for employers to help

rates challenges

not really focused

getting more focused

disbandment of group (lack of funds)

change is not always welcome

no sharing best practices

taking on more than what we can reasonably do

confusion about the role and scope of group