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Best Practices in Training the Home and Community-Based Services Workforce

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Title: Best Practices in Training the Home and Community-Based Services Workforce


1
Best Practices in Training the Home and
Community-Based Services Workforce
  • Elyse Perweiler, MPP, RN
  • UMDNJ-School of Osteopathic Medicine
  • Associate Director, New Jersey Geriatric
    Education Center
  • Director New Jersey AHEC Program
  • Strengthening the HCBS Direct Service Workforce
  • May 8-9, 2008
  • Baltimore MD

2
Objectives
  • Discuss the social and policy context for
    training direct service workers (DSWs) to care
    for the elderly
  • Identify best practices for training DSWs in the
    Geriatric Education Center network
  • Describe the role of Community Health Workers
    (CHWs) in minority and underserved communities
  • Identify models for training CHWs through the
    AHEC network

3
What do we know about todays older Americans?
  • Older adults are 12 of our population
  • 26 of physician office visits
  • 35 of all hospital stays
  • 34 of all prescriptions
  • 38 of all emergency medical service responses
  • 90 of all nursing home use
  • Have multiple chronic conditions and experience
    more mental health conditions
  • Over 60 living in the community obtain LTC
    services (e.g., personal care, household chores)
  • 70-80 of care to older adults receiving long
    term care services is provided by direct care
    workers

Institute of Medicine, Retooling for an Aging
America Building the Health Care Workforce,
2008, accessed at http//www.nap.edu/catalog/12089
.html
4
What about the future?
  • Demographic characteristics will differ
  • More health care provided through technology
  • Different expectations and preferences for care
  • Financial realities will change Medicare benefits
  • Greater need for health care services
  • Older adults will become more active partners in
    managing their health

5
Institute of Medicine ReportRecommendations
  • Enhance competence of all individuals in delivery
    of geriatric care
  • Increase recruitment and retention of geriatric
    specialists and caregivers
  • Redesign models of care to increase flexibility
  • Increase state and federal minimum training
    standards for all direct care workers from 75 to
    120 hours
  • Include demonstration of competencies in caring
    for older adults as a certification requirement
  • Provide training to informal caregivers and
    integrate them into the formal health care team

Institute of Medicine, Retooling for an Aging
America Building the Health Care Workforce,
2008, accessed at http//www.nap.edu/catalog/12089
.html
6
Addressing Workforce Issues in Caring for the
Elderly
  • Health care workforce is not sufficient to meet
    needs of the elderly
  • Education of the formal health care workforce
    remains inadequate
  • All health care workers need to be trained to
    care for older adults
  • The reality Majority of care provided to the
    elderly is given by direct service workers or
    informal caregivers
  • Between 2006-2016, personal and home care aides
    will represent the 2nd and 3rd fastest-growing
    occupations
  • Little is done to increase competence of direct
    care workers to care for the elderly

7
Direct Service WorkersStrengthening a Vital Link
  • Focus on improving health care and access to
    minority and underserved communities
  • Establishing key linkages in underserved areas
  • Building a strong network
  • Strengthening the health care team
  • Increasing awareness of the role of Community
    Health Workers (CHWs)

8
Geriatric Education Centers (GECs)
  • 48 GECs
  • Partnerships and collaborations
  • Leveraging funds
  • Support agencies that target paraprofessionals
  • Provide in-service training to nursing homes
  • CE activities and summer institutes
  • Train Direct Service Workers through train the
    trainers models
  • On-line learning and distance education models

9
Best Practices in GECs
  • Minnesota GEC
  • Career Caregiver Leadership Program (CCLP)
  • 6 month education and empowerment program for
    direct care staff
  • Supports system changes and quality of life of
    staff and residents they serve
  • Contact Lisa Edstrom, Ledstrom_at_umn.edu
    Phone (612) 624-3904
  • www.hpm.umn.edu/coa
  • Montana GEC
  • Online Geriatric Education and Certificate
    Program
  • 4 options personal use, CE, 45 hour geriatric
    training certificate, academic credit
  • Contact Montana.GEC_at_umontant.edu Phone
    (866) 506-8432 http//mtgec.umontana.edu

10
Best Practices in GECs
  • Nebraska GEC
  • Interdisciplinary training of nursing home
    providers via delivered over Statewide Telehealth
    Network
  • 6-month curriculum on dementia and mental illness
  • Downloadable Tip Sheets
  • Blog format for Q A
  • Listserv for participating facilities
  • Contact Lisa Bottsford, lbottsfo_at_unmc.edu
    Phone (402) 559-8421
  • New Jersey GEC
  • Train the trainers dementia curriculum for CNAs
    and Home Health Aides
  • 7 modules with variable agendas for full days or
    half-day trainings
  • Utilizes activities, games and audiovisuals to
    reinforce conceptual learning, overcome cultural
    and health literacy barriers
  • Recommended by NJ Dept. of Health Senior
    Services as a model curriculum for dementia
    training in NJ long term care facilities
  • Contact Elyse Perweiler, perweiea_at_umdnj.edu
    Phone (8456) 566-7082

11
Best Practices in GECs
  • Wyoming GEC
  • Foundations of Dementia Care
  • Two 4-day trainings per year (dementia basics,
    meals, communications, pain, behaviors)
  • Scholarships for family caregivers
  • Wyoming Care with Confidence Curriculum
  • 2-day train the trainer workshop for mental
    health professionals to train CNAs in LTC
  • Will conduct 1 to 3 4-hour trainings in their
    regions
  • Contact Jennifer Durer, Coordinator, WyGEC,
    JDurer_at_uwyo.edu Phone (307) 766-3441

12
Best Practices in GECs
  • GEC of Greater Philadelphia (GEC-GP)
  • Teaching and Learning to Care for Caregivers in
    LTC (TLC for LTC) dissemination to direct
    care staff in personal care and adult day health
    agencies serving minority populations
  • Contact Sangeeta Bhojwani, Sangeeta.Bhojwani_at_up
    hs.upenn.edu
  • Phone (215) 573-7293
  • Alaska GEC
  • Collaboration resulted in Trust Training
    Cooperative
  • LTC Apprenticeship Program 3 year pilot project
  • Direct Service Specialist Occupational
    Endorsement
  • Goal create a credentialing program for Alaska
    DSPs that will become the industry standard
  • Contact Sheila Wright, ansjw3_at_uaa.alaska.edu
    Phone (907) 264-6228

13
Area Health Education Centers (AHECs) Building
Best Practice Models in Underserved Communities
  • 54 AHEC Programs, 208 AHEC Centers in 48 states
  • Partner with academic institutions,
    community-based agencies, professional groups,
    state and federal government
  • Leverage funds from other sources
  • Implement competency-based and basic entry level
    core curriculum for Community Health Workers
    (CHWs)
  • Promote CHW leadership
  • Address requirements for certification
  • Support and develop CHW preceptors and placement
    sites

14
Community Health Workers (CHWs) A New Look at
Direct Service Workers
  • Indigenous to and representative of the
    communities they serve
  • Break down language and cultural barriers
  • Have unique skills
  • Known by many names
  • Non-traditional students
  • Not recognized as a profession by the U.S.
    Department of Labor

15
AHEC Best Practice Models
  • Arizona AHEC
  • Community Health Worker National Education
    Collaborative (CHW-NEC)
  • Establish promising practice educational
    program delivery strategies, instructional
    materials/methods, provide technical assistance
  • 6 core Technical Assistance Institutions
  • 15 Adapter Institutions
  • National Advisory Council
  • Expert consultants
  • Evaluator

Contact dproulx_at_u.arizona.edu or www.chw-nec-org
16
AHEC Best Practice Models
  • Gulfcoast South AHEC
  • Community Health Partnership Project
  • Florida AHEC Network Cardiovascular Initiative
    funded by FDOH (2001-2002)
  • 2003 Trained CHWs statewide in CVD prevention
  • Leverages funds and provides stipends and
    incentives
  • CHW Training Model (8-10 hours)
  • Definition, role, rationale, confidentiality,
    adult learning presentation skills, community
    resources, evaluation, data collection, etc.
  • Information on specific health topics (CVD,
    breastfeeding, diabetes) with resources and
    materials
  • Each CHW trained presents at least 2 educational
    programs

Contact Ansley Mora, Community Education
Coordinator, amora_at_health.usf.edu
17
AHEC Best Practice Models
  • DC AHEC
  • Community Health Navigator Project
  • 2005 partnership between a parent advocacy group
    and DC AHEC Program
  • Uses community participatory model of engagement
  • 2006 initial curriculum redesigned and program
    formalized
  • Guides or navigates underserved residents
    through service maze
  • Provides health education and promotion workshops
    and training sessions to improve health outcomes
  • Peer to peer training model (30-32 hr.)
  • Paid a stipend
  • Quarterly in-service training
  • Annual recognition celebration

Contact Kim Bell, Executive Director,
kbell_at_dcahec,org Phone (202) 574-6994
18
AHEC Best Practice Models
  • NJ AHEC
  • NJ Community Health Worker Institute
  • Educational experiences for health professionals
    working with CHWs
  • Pilot projects to show value of CHWs as part of
    the interdisciplinary team
  • Course content on working with/supervising CHWs
  • CHWs as instructors
  • Career development for CHWs
  • Core curriculum to standardize skills and
    competencies
  • Standardized CHW job description for NJ Dept. of
    Labor
  • Establishment of a CHW cluster infrastructure
    to provide training, technical assistance and
    support

Contact Dwyan Monroe, BA, Director, NJ
Community Health Worker Institute,
monroedy_at_umdnj.edu Phone (856)
566-6024
19
Additional Contact Information
  • Elyse Perweiler, MPP, RN
  • Director, NJ AHEC Program
  • Associate Director, NJGEC
  • National Association of Geriatric Education
    Centers (NAGEC) representative
  • perweiea_at_umdnj.edu
  • (856) 566-7082
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