ELEVATING OUR
FUTURE WORKFORCE
Minnesota Health & Housing Alliance
March District Meeting
MEMBERS REPORT BIGGEST
CHALLENGES IN 2006-07
• Financial
• Workforce
• Regulatory
• Transformation
Source: 2007 MHHA Member Value Survey
MEMBERS REPORT BIGGEST
CHALLENGES IN 2006-07
• Staffing Issues
(especially RN and CNA)
• Recruiting Well-trained Staff
• Retaining Staff
(limited wages and benefits)
Source: 2007 MHHA Member Value Survey
NUMBER OF VACANT FTE
POSITIONS IN CARE CENTERS
5
4.81
4
3
2.53
2
0.91
1.07
1
0.30
0
RN
LPN
C.N.A.
Total
Total
Source: Long Term Care Imperative 2007 Legislative Survey
ESTIMATED VACANT FTE
POSITIONS IN CARE CENTERS
2,000
1,800
1,600
1,400
1,200
1,000
800
600
400
200
0
R.N.
L.P.N.
2004
C.N.A.
2005
Dietary
Aide
Total
2006
Source: Long Term Care Imperative 2007 Legislative Survey
PROJECTED POPULATION
& WORKFORCE GROWTH
Projected Growth in Workforce
Projected Growth in the Population
Age 60 and Over
20052025
Source: Minnesota State Demographic Center
HEALTHCARE JOBS LEAD
MINNESOTA’S FUTURE NEEDS
Health Care and Social Assistance
Professional and Technical Services
Administrative and Waste Services
Retail Trade
Educational Services
Accommodation and Food Services
Construction
Other Services, Ex. Public Admin
Finance and Insurance
Information
Wholesale Trade
Management of Companies and Enterprises
Arts, Entertainment, and Recreation
Public Administration
Real Estate and Rental and Leasing
Manufacturing
Mining
Utilities
Agriculture, Forestry, Fishing & Hunting
-10,000
0
10,000
20,000
30,000
40,000
50,000
Source: DEED, Employment Projections
MINNESOTA HEALTHCARE
CAREER TRENDS HISTORY
100,000
90,000
80,000
70,000
60,000
50,000
40,000
30,000
20,000
10,000
0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Manufacturing
Healthcare
PROJECTED GROWTH FOR TOP
15 HEALTHCARE OCCUPATIONS
Dental Hygienists
Medical and Clinical Laboratory Technologists
Radiologic Technologists and Technicians
Medical Records and Health Information Technicians
Pharmacists
Healthcare Support Workers, All Other
Pharmacy Technicians
Medical and Clinical Laboratory Technicians
Net Job Growth
Medical and Health Services Managers
Replacement Openings
Dental Assistants
Medical Assistants
Licensed Practical and Licensed Vocational Nurses
Nursing Aides, Orderlies, and Attendants
AGING
SERVICES
Home Health Aides
Registered Nurses
0
5,000 10,000 15,000 20,000 25,000 30,000
Source: MN Dept of Employment and Economic Development
WHO PROVIDES CARE TO
OLDER MINNESOTANS
1% drop in family caregiving = $30M in public funds.
100%
3%
9%
5%
80%
60%
97%
95%
91%
1988
1995
2001
40%
20%
0%
Families
Agencies
Source:&Minnesota
Human Services
Minnesota Health
HousingDepartment
Alliance – of
February
23, 2006
RATIO OF CAREGIVERS TO
OLDER ADULTS DROPPING
Ratio of women 20-55 to people 85 and over
15
13.6
11.5
12
9.8
9
6
3
0
2005
2015
2025
Source: Minnesota
Demographer
Minnesota Health & Housing
AllianceState
– February
23, 2005
MINNESOTA BOSTS HIGH
WORKFORCE PARTICIPATION
NURSING SHORTAGE ONLY
EXPECTED TO WORSEN
A NURSING WORKFORCE
APPROACHING RETIREMENT
Current Licensure Average Age
47
46
45
46
45
44
43
42
41
RN
LPN
FY 1998
FY 2000
FY 2002
FY 2004
FY 2006
44.1
42.7
44.7
43.5
45.1
44.3
45.6
44.9
46.0
45.1
Source: Minnesota Board of Nursing
NURSING PROGRAMS GROW
BUT DEMAND REMAINS HIGH
The Minnesota
State Colleges
and University
System (MNSCU)
trains 78% of the
state’s new
nursing graduates
32 colleges and
universities on
53 campuses in
46 communities
MNSCU MISSION TO SUPPORT
COMMUNITY NEEDS
Between 2001 and
2005: 74% increase
in nursing graduates!
LPNs by 77%
RNs by 69%
Master’s prepared
nurses by 150%
AVERAGE HOURLY RN WAGES
HOSPITALS vs CARE CENTERS
$38
Wage Gap Increased 57% in Five Years
$34.80
$31.41
$33
$33.40
$29.61
$27.85
Gap=$11.49
$28
Gap=$7.30
$23
$20.55
$21.56
2001
2002
$22.58
$22.66
$23.31
2004
2005
$18
Hospital
2003
Nursing Home
Source: MN Health Care Cost Information System, Long Term Care Imperative Compensation Survey
AVERAGE HOURLY LPN WAGES
HOSPITALS vs. CARE CENTERS
$20
Wage Gap Increased 113% in Five Years
$18.24
$17.75
$18
Gap = $0.77
$15.85
$16.84
Gap=$1.64
$16.29
$16
$16.36
$15.65
$16.45
$16.60
2004
2005
$15.08
$14
2001
2002
Hospital
2003
Nursing Home
Source: MN Health Care Cost Information System, Long Term Care Imperative Compensation Survey
AVERAGE HOURLY CNA WAGES
HOSPITALS vs. CARE CENTERS
Wage Gap Increased 91% in Five Years
$15
$14.02
$14
$12.83
$13
$13.27
$14.66
Gap=$3.47
$12.27
$12
Gap=$1.82
$11
$10
$10.45
2001
$10.83
2002
Hospital
$11.10
2003
$11.22
$11.19
2004
2005
Nursing Home
Source: MN Health Care Cost Information System, Long Term Care Imperative Compensation Survey
PERCENT OF CARE CENTERS
IN FINANCIAL CRISIS
(Operating Margin of -5% or worse)
Northwest 35.3%
Northeast 50.0%
West Central 34.6%
East Central 19.4%
Legend
=<25%
Metro 18.6%
Southwest 30.0%
Southeast 39.2%
=26%-35%
=35%-45%
=>45%
30% of Facilities are
in Crisis, 4% Higher
than Last Year
Source: Imperative Nursing Facility Survey
Prepared by LarsonAllen
ALMOST 23,000 JOBS AT RISK
DUE TO FINANCIAL CRISIS
Jobs at Risk:
1,311
Jobs at Risk:
3,227
Beds: 2,806
Beds: 1,615
Jobs at
Risk: 2,387
Jobs at Risk:
2,142
Beds: 4,801
Beds: 3,000
Jobs at
Risk: 5,854
Jobs at Risk:
2,814
Beds: 4,078
Beds: 13,684
Jobs at Risk: 5,007
Beds: 5,554
THE INTEREST IS THERE!
• Healthcare careers are the No. 1 choice
for students leaving high school (not
college-bound), and the third-highest path
for those college-bound
• 28% of current Minnesota
high school students
express interest in
health occupations
www.minnesotahosa.org
INNOVATION IS OCCURING
• Share the many changes in Care Centers
• “Culture Change” helps bring focus to our
core work and emphasize relationships
• New relationships with and strategies for
informal caregivers, volunteers (HCAM)
and other non-traditional labor pools is vital
INNOVATION IS OCCURING
• Technology with the potential to
revolutionize our missions
• Pioneering design is transforming the
spaces we live and work
• Aging Services Careers – new job
descriptions, responsibilities, training
models, and opportunities for respect
AGING SERVICES
WORKFORCE INNOVATION:
MHHA Workforce Solutions Council
Drives Association Response
TALENT
WORKFORCE
SOLUTIONS COUNCIL
• Advance MHHA’s strategic initiative to
“elevate the older adult services
workforce of the future”
– Focus on strategies for recruiting and
inspiring talent in the field
– Focus on retention strategies and
best/promising practices in job satisfaction
– Coordinate efforts with parallel initiatives
CREATING SOLUTIONS
CREATING SOLUTIONS
• Career Exposure and Recruitment
MHHA will explore the promotion of the
many careers in older adult services to
traditional and prospective employee
audiences through a series of outreach
initiatives and partnerships
CREATING SOLUTIONS
• Member Skill Building for Talent
Retention
MHHA will explore ways to maximize
member knowledge through education,
issue briefs and launch of an e-community
clearinghouse focused on targeted
workforce initiatives having the greatest
impacts in the field
CREATING SOLUTIONS
• Launch of a New Employee Model
MHHA will lead the creation and
expansion of a new older adult services
employee in Minnesota, facilitating
development of provider knowledge,
curriculum design, articulation and
instructor agreements with higher
education partners
CREATING SOLUTIONS
• Replication of New Training Models
Breaking out of the bottleneck found in
traditional higher education avenues,
MHHA will explore alternative models for
the training of key employee groups, with
an emphasis in the field of nursing
CREATING SOLUTIONS
• Career Exposure and Recruitment
• Member Skill Building for Talent Retention
• Launch of a New Employee Model
• Replication of New Training Models
A NEW EMPLOYEE MODEL
CHALLENGES
• Identifying best/ promising practices in the
field and emerging care delivery models
• Providing standardization and recognition
while allowing for customization
• Developing new curriculum and articulation
agreements with higher education
• Identifying resources to lead efforts
HEALTH SUPPORT
SPECIALIST (HSS)
• A pathway for
organizations to move
towards a “universal”
worker model
• Designed around a
household model
with self-lead teams
HEALTH SUPPORT
SPECIALIST (HSS)
• Entry-level training program for new
frontline workers, taking into account the
knowledge and training of existing staff
• Theoretical instruction (386 hrs) combined
with on-the-job learning (2500 hrs)
• Customized to unique mission or other
training curriculum for each organization
A CLEAR CURRICULUM
AND CAREER LADDER
Health
Support
Specialist
Employment
and mentoring
with a qualified
journey worker
from day one
Entry
Level
ADVANCING THROUGH
THE STEPS
• Medical Terminology
• Dietary Services
(National Serv-Saf Certification)
• Environmental Services
(OSHA 10-hour industry card)
ADVANCING THROUGH
THE STEPS
• CPR and First Aid Certificate
• Advanced Dementia Care Certificate
(Alzheimer’s Association)
• Culture Change Certificate
• Certified Nursing Assistant (CNA)
(Facility, Technical or Community College)
ADVANCING THROUGH
THE STEPS
• Rehabilitative Aid
(Facility Certificate)
• Certified Medication Aid
(Technical or Community College)
Health Support Specialist Apprentices
Advanced Health Support Specialist
ADVANCING TO
“JOURNEY WORKER”
• Completion of all career ladder steps
(Including on the job learning hours)
• Completion of all facility requirements
(Set by each organization)
• Registered Apprenticeship Certificate
through Program Sponsor (MHHA)
HEALTH SUPPORT
SPECIALIST (HSS)
“The Registered Apprentice
program has helped me to
broaden my knowledge
base to be able to serve
our residents better.”
Jennifer Steinkuhler
Health Support Specialist
Brewster Place, KA
HEALTH SUPPORT
SPECIALIST (HSS)
• Kansas Registered Apprenticeship program
• Development of curriculum, online distance
education, funding sources
• Grant awarded Jan. 1, 2007 to replicate
• Recognized by US Department of Labor
US DEPT. OF LABOR
U.S. Department of Labor
Employment and Training
Administration
Office of Apprenticeship
(OA)
Washington, D.C. 20210
Symbols: DSNIP/FJH
Distribution:
A-541 Headquarters
A-544 All Field Tech
A-547 SD+RD+SAC+;
Lab.Com
Subject: Additional RAIS
Code and Occupational Title
for Health Support Specialist
Occupation
Code: 200
Action: Immediate
PURPOSE: To inform the Office of Apprenticeship (OA), staff of an addition to the
Registered Apprenticeship Information System (RAIS) for the coding and recording of a
new occupational title for an existing occupation:
Health Support Specialist
Existing Title: Home Health Aide
O*NET-SOC Code: 31-1011.00
RAIS Code: 1086AA
Training Term: 2,500 – 5,000 hrs.
Type of Training: Hybrid
The letters “AA” have been added as an extension of the RAIS Code 1086 to identify
applications utilizing the new occupational title. The O*NET-SOC Code will remain the
same.
BACKGROUND: Apprenticeship Program Consultant Michele Boschetto from the
Kansas State Apprenticeship Council submitted this occupation. The Health Support
Specialist has been recognized to meet Health Care Industry demands for highlyskilled and highly-trained workers.
Since the two occupations are similar except for application within the Health Care
Industry, O*NET determined it did not qualify for its own separate O*NET-SOC Code.
Therefore, OA is awarding a separate RAIS Code extension that would allow for
distinction and application by industry.
ACTION: Effective immediately, all OA/BAT staff should implement data entry for the
“Health Support Specialist” classification into RAIS under Code 1086AA. New program
standards and revisions to existing program standards may include incorporation of
either occupational title and should utilize the appropriate RAIS Code.
HEALTH SUPPORT
SPECIALIST (HSS)
FUNDING SOURCES
•
•
•
•
•
•
•
MHHA Foundation
CBJTG grant through Kansas
Workforce Investment Act (WIA)
Pell grants
Veterans assistance
Minnesota Scholarship Programs
Other special funding projects
HEALTH SUPPORT
SPECIALIST (HSS)
Patricia Williams began
her career in dietary
services 13 years ago.
HEALTH SUPPORT
SPECIALIST (HSS)
“Brewster Place
encouraged me to go
into the program to
become more involved
with resident care.
HEALTH SUPPORT
SPECIALIST (HSS)
“It gave me the will to
continue my education
– put the learning bug
in me.”
HEALTH SUPPORT
SPECIALIST (HSS)
“I plan to work toward
an LPN degree next.
I look forward to
coming in each day.”
Patricia Williams
Health Support Specialist
Brewster Place, KA
THE BENEFITS
• Reduces barriers to
employment through
provider-based
classroom instruction
• Increases loyalty,
self-esteem, wages,
college credits, and
incentive to remain
in aging services
MHHA ACTIVITY
• Applying to the Department of Labor
Registered Apprenticeship Unit to be the
sponsoring organization in Minnesota
• Initiating education and partnership
building with provider organizations
and higher education stakeholders
• Application for grant funds to further
develop, launch and sustain program
HEALTH SUPPORT
SPECIALIST (HSS)
Tiara Weber has
graduated from the
program and is now a
Health Support
Specialist. She is
pictured with therapy
dog Sissy.
HEALTH SUPPORT
SPECIALIST (HSS)
HEALTH SUPPORT
SPECIALIST (HSS)
NEW TRAINING MODELS
“Long-Term Care Connection”
A Customized LTC LPN Program
Developed by
Good Shepherd Community
CHALLENGES
•
•
•
•
•
•
•
•
Shortage of licensed and qualified staff
Increasing nurse retirements
Competition with hospital wages
24/7 staffing schedules (holidays/weekends)
Lack of graduates with LTC focus
Required nurse/resident ratios
Financial costs of training
Lack of evening programs
EDUCATION BARRIERS
• Lack of clinical space
• Lack of qualified faculty
• Lack of classroom space
• Lack of resources to
start-up and maintain
GOOD SHEPHERD
REALITY
•
•
•
•
•
•
•
High use of pool staff
High staff turnover
Few recruitment options for LPNs
Limited career ladder opportunities
Long waiting lists for traditional students
No options for non-traditional students
Funding — but no where to spend it
LTC LPN PROGRAM
In 2001, Good Shepherd Community
launched a customized LPN program in
partnership
with St. Cloud
Technical
College
LTC LPN PROGRAM
• Facility served as primary clinical site and
also created classroom and lab space
• Evening
classes and
accelerated
learning
methodology
incorporated
LTC LPN PROGRAM
• St. Cloud Technical College provided
customized curriculum
• Nursing Facility Scholarship Program
funding was utilized
• Results: Increased staff retention, creation
of career ladders, increased LPN pool in
region, increased quality of care, improved
staff morale, loyalty
LTC LPN PROGRAM
• Enrollment now available to 25 long-term
care settings in Central Minnesota
• Three classes – over 60 caregivers – have
received their LPN degrees to date
• Classes provided a focus on the LTC LPN
and increase number of available staff in
the region
MHHA ACTIVITY
The MHHA Board of
Directors authorized
staff to proceed with
planning for
expansion and
replication of the LTC
LPN program
developed by Good
Shepherd Community
and St. Cloud College
REPLICATION
• Identify communities with need, promise
• Identify providers with potential classroom
and lab space
• Secure funding for necessary investments
• Coordinate with MNSCU for curriculum,
adoption of adjunct instructors/faculty
• Disseminate best practices from Good
Shepherd experience i.e. scheduling, etc.
FOR FURTHER
INFORMATION
Adam Suomala
Manager of Member Relations
asuomala@mhha.com
651-603-3530