NC-PHCAST – The Community College Connection Margaret Roberton, NC Community Colleges Kathy Turner, NC Division of Health Service Regulation

Statistics and Projections In the next 20 years the number of persons 65 and older will almost double from 1.3 million to 2.3 million In the next 20 years the number of persons 65 and older will almost double from 1.3 million to 2.3 million North Carolina is 10th nationally in size of total population, we are 9th in those 60 and older. North Carolina is 10th nationally in size of total population, we are 9th in those 60 and older. By 2025, 86 of the NC’s 100 counties are projected to have more people over age 60 than age 17 and under By 2025, 86 of the NC’s 100 counties are projected to have more people over age 60 than age 17 and under

Statistics and Projections In 2025, one in four North Carolinians will be 60 and older In 2025, one in four North Carolinians will be 60 and older Over the next two decades, the age group will be the fastest growing of those ages 65 and older Over the next two decades, the age group will be the fastest growing of those ages 65 and older The number age 85 and older will grow fastest beginning in 2030,when the oldest of our 2.4 million baby boomers near their 85 birthday The number age 85 and older will grow fastest beginning in 2030,when the oldest of our 2.4 million baby boomers near their 85 birthday

Demographics Status of North Carolinians 65 and older: Status of North Carolinians 65 and older: Living alone 29% Living alone 29% Veterans 22% Veterans 22% Have a disability 38% Have a disability 38% Median household income 27% Median household income 27% Income below poverty level 10% ($10,778) Income below poverty level 10% ($10,778) Income is between % Income is between % of the federal poverty level 25% of the federal poverty level 25%

NC currently has more than 17,000 older adults with Alzheimer’s or other types of dementia most of whom are being cared for at home or by family and friends. By 2030, the total number is projected to rise to nearly 300,000. NC currently has more than 17,000 older adults with Alzheimer’s or other types of dementia most of whom are being cared for at home or by family and friends. By 2030, the total number is projected to rise to nearly 300,000. For those age 75 and older, 13% live below the federal poverty level and 30% live at or between % of the FPL For those age 75 and older, 13% live below the federal poverty level and 30% live at or between % of the FPL Statistics and Projections

Key Concepts of NC PHCAST Builds on prior Direct Care Worker Initiatives Builds on prior Direct Care Worker Initiatives Creates 4-phased framework for training and competency to better prepare new and incumbent workers Creates 4-phased framework for training and competency to better prepare new and incumbent workers Training Venues: Training Venues: Community Colleges Community Colleges High Schools High Schools Increasing demand for direct care workers Increasing demand for direct care workers Personal Care Aides and Home Care Aides are the fastest growing occupations Personal Care Aides and Home Care Aides are the fastest growing occupations Plus, Nurse Aides are in the top 11 jobs in terms of largest job growth Plus, Nurse Aides are in the top 11 jobs in terms of largest job growth Trained, competent workers are essential to quality care Trained, competent workers are essential to quality care Create a “Gold Standard” for minimum training Create a “Gold Standard” for minimum training

Overview of NC’s 4-Phase Approach Phase I – Introduction to Direct Care Work Phase I – Introduction to Direct Care Work Phase II – Direct Care Basics (pre-Nurse Aide level) Phase II – Direct Care Basics (pre-Nurse Aide level) Phase III – Nurse Aide I Phase III – Nurse Aide I Phase IV – Advanced NA training/competency Phase IV – Advanced NA training/competency Home Care Nurse Aide Home Care Nurse Aide Geriatric Nurse Aide Geriatric Nurse Aide Medication Aide Medication Aide Option for in-service use across settings Option for in-service use across settings

Community College Phase IPhase IIPhase III Phase IV Asheville-Buncombe * Central Carolina *** Central Piedmont * Coastal Carolina *** Forsyth Technical * Mitchell *** Roanoke-Chowan ** Sandhills *** Southeastern *** Stanley *** Tri-County *** Wake Technical *** Community College Pilot Sites Includes both pilot years Excludes Halifax CC & Cape Fear CC/Elder House

499 Pilot Participants Phase I – 203 Phase I – 203 Phase II – 262 Phase II – 262 Phase III - 57 Phase III - 57 Phase IV – 160 Phase IV – 160

Key Impacts Better matching/redirecting of prospective workers to job-more focused recruitment Better matching/redirecting of prospective workers to job-more focused recruitment Competency based – certificate or credential at each phase Competency based – certificate or credential at each phase New and incumbent workers can enter at various points New and incumbent workers can enter at various points Expands state recognized career path options; supports workers; responds to employer need Expands state recognized career path options; supports workers; responds to employer need Enhanced career paths, employability and responds to employer need (4-phase approach – specialties) Enhanced career paths, employability and responds to employer need (4-phase approach – specialties) Integration with other training & QI initiatives Integration with other training & QI initiatives Builds on prior direct care initiatives in NC Builds on prior direct care initiatives in NC Removes some barriers to training Removes some barriers to training

Phase I- Sample Comments (student) This course has started me on the path to reaching my career goals. (88% agree) This course has started me on the path to reaching my career goals. (88% agree) I know about career options that I did not know about before the completing this course. (95% agree) I know about career options that I did not know about before the completing this course. (95% agree) This course has put me further along in reaching my education goals. (89% agree) This course has put me further along in reaching my education goals. (89% agree) I am considering career options that I was not considering before the course. (95% agree) I am considering career options that I was not considering before the course. (95% agree) This course has made me more satisfied with my direct care job than I was before. (89% agree) This course has made me more satisfied with my direct care job than I was before. (89% agree) This course has made me a better direct care worker. This course has made me a better direct care worker. (94% agree) I would recommend this course to my coworkers. I would recommend this course to my coworkers. (94% agree) N = 18

Phase IV- Sample Comments (student) This course has started me on the path to reaching my career goals. (100% agree) This course has started me on the path to reaching my career goals. (100% agree) I know about career options that I did not know about before the completing this course. (93% agree) I know about career options that I did not know about before the completing this course. (93% agree) This course has put me further along in reaching my education goals. (89% agree) This course has put me further along in reaching my education goals. (89% agree) I am considering career options that I was not considering before the course. (72% agree) I am considering career options that I was not considering before the course. (72% agree) This course has made me more satisfied with my direct care job than I was before. (92% agree) This course has made me more satisfied with my direct care job than I was before. (92% agree) This course has made me a better direct care worker. This course has made me a better direct care worker. (100% agree) (100% agree) I would recommend this course to my coworkers. I would recommend this course to my coworkers. (96% agree)N=29

Research Questions for Graduates/Instructors/Employers 1. What were the barriers to effective PHCAST implementation? 2. In what ways did partners leverage resources to implement and/or sustain the training program in local communities? 3. What aspects of the PHCAST curriculum were the most valuable to each stakeholder group (e.g., students, educators, employers)?

Barriers Administrators: Marketing and Recruiting Administrators: Marketing and Recruiting Instructors: Scripted curricula, content redundancy, instructor guide book Instructors: Scripted curricula, content redundancy, instructor guide bookResources Goodwill Goodwill Public Housing Authority Public Housing Authority CCRC CCRC

What aspects of the PHCAST curriculum were the most valuable? Students – problem solving, adapting to difficult situations, understanding grief and dementia, applying person-centered care Students – problem solving, adapting to difficult situations, understanding grief and dementia, applying person-centered care Instructors – seeing students get jobs, new alliances within our school Instructors – seeing students get jobs, new alliances within our school Employers – reports were more pertinent, client compliments increased, (documentation) Employers – reports were more pertinent, client compliments increased, (documentation)

2010 – 2013, What’s Next? Implementation Phase Curricula Curricula Evaluation Evaluation Test banks Test banks Other Other

Human Resource Development Governance SBCC Code – HRD Program Continuation SBCC Code – HRD Program Continuation Each college shall operate a Human Resources Development (HRD) program to provide assessment services, employability training, and career development counseling to unemployed and underemployed individuals. FTE shall be generated from HRD programs. Each college shall provide HRD instruction and support necessary for unemployed and dislocated workers to be served within the college service areas. Each college shall operate a Human Resources Development (HRD) program to provide assessment services, employability training, and career development counseling to unemployed and underemployed individuals. FTE shall be generated from HRD programs. Each college shall provide HRD instruction and support necessary for unemployed and dislocated workers to be served within the college service areas. Vision and Mission Statement Vision and Mission Statement HRD is a dynamic and vital workforce development program with proven economic, social, and educational success. The purpose of the HRD program is to educate and train unemployed and underemployed individuals for success in the workplace.

HRD Program Goals Provide program outreach and student recruitment activities to targeted populations Provide program outreach and student recruitment activities to targeted populations Assist students in accessing meaningful training and/or employment opportunities Assist students in accessing meaningful training and/or employment opportunities Enhance and develop the student’s employability skills Enhance and develop the student’s employability skills Develop and promote the student’s ability to move towards economic self-sufficiency Develop and promote the student’s ability to move towards economic self-sufficiency

Human Resources Development Core Services Core Services Skill assessment services Skill assessment services Employability skills training Employability skills training Career development counseling Career development counseling Target Groups Target Groups Unemployed adults Unemployed adults Underemployed adults Underemployed adults Core Components Core Components Assessment of an individual’s assets and limitations Development of a positive self-concept employability skills communication skills problem-solving skills Awareness of the impact of Information Technology in the workplace 1D SBCCC Program Classifications

HRD Fee Waiver Guidelines Eligibility Requirements Eligibility Requirements HRD courses are not free… Fees are waived HRD courses are not free… Fees are waived Waiver is based on the individual’s income Waiver is based on the individual’s income Unemployed Unemployed Underemployed* Underemployed* Notification of pending lay-off Notification of pending lay-off

HRD Eligibility For HRD purposes, underemployed is defined as individuals… For HRD purposes, underemployed is defined as individuals… working and is eligible for the Federal Earned Income Tax Credit (FEIT); or working and is eligible for the Federal Earned Income Tax Credit (FEIT); or working and earning wages at or below two hundred percent (200%) of the federal poverty guidelines. working and earning wages at or below two hundred percent (200%) of the federal poverty guidelines.

Assessment Assessment Ability to appropriately identify individuals prepared to enter healthcare fields Ability to appropriately identify individuals prepared to enter healthcare fields Introduce occupational requirements to maximize success of students progressing into Nurse Aide I Introduce occupational requirements to maximize success of students progressing into Nurse Aide I Introduce workplace realities of personal/home care environments vs. residential/institutional settings Introduce workplace realities of personal/home care environments vs. residential/institutional settings Outline pathway alternatives for health care fields Outline pathway alternatives for health care fields Personal Home Care Aide Personal Home Care Aide Recognized & standardized curriculum Recognized & standardized curriculum PHCAST Needs Aligned to HRD Core Services

Employability Skills Employability Skills Concepts contextualized for healthcare field Concepts contextualized for healthcare field Communication, listening skills, teamwork, and time/stress management Communication, listening skills, teamwork, and time/stress management Career Development Career Development Ability to problem solve independently Ability to problem solve independently Decision-making and management skills Decision-making and management skills

Specific HRD PHCAST Courses Phase I – Introduction to Direct Care Work Phase I – Introduction to Direct Care Work (Focus on job readiness skills, literacy, numeracy, keyboarding, and realistic job previewing) Career Exploration Career Exploration Self-Assessment Self-Assessment General soft skill requirements General soft skill requirements CPR (lay person) CPR (lay person)

Specific HRD PHCAST Courses Phase II – Direct Care Basics Phase II – Direct Care Basics (Focus on non-nurse aide personal care tasks and soft skill development; 3) expanded nurse aide (NA-1) skills) (Focus on non-nurse aide personal care tasks and soft skill development; 3) expanded nurse aide (NA-1) skills) Introduction to base skills Introduction to base skills Introduction to functional concepts within role Introduction to functional concepts within role Enhanced soft skills training Enhanced soft skills training Career counseling Career counseling

Importance of PHCAST to Employers & Personal Care Clients Growing need for Continuum of Care Growing need for Continuum of Care Rising cost of care & shortage of trained workers Rising cost of care & shortage of trained workers Greater efficiency in healthcare delivery (lowering cost while improving delivery) Greater efficiency in healthcare delivery (lowering cost while improving delivery) Promote quality care for increasing numbers of older adults and persons with disabilities Promote quality care for increasing numbers of older adults and persons with disabilities

Recruitment / Marketing: Getting Their Attention Program Outreach Program Outreach External Agencies External Agencies Internal Resources Internal Resources Community Community

Program Outreach Program Outreach External Agencies External Agencies JobLink Career Centers JobLink Career Centers Division of Workforce Solutions (ESC) Division of Workforce Solutions (ESC) Social Services Social Services US Committee for Refugees and Immigrants US Committee for Refugees and Immigrants Shelters Shelters National Guard/Family Employee Assistant Center National Guard/Family Employee Assistant Center Community-based Organizations Community-based Organizations Recruitment / Marketing: Getting Their Attention

Program Outreach Program Outreach Internal Resources Internal Resources HRD classes HRD classes Introduction to Healthcare Occupations Introduction to Healthcare Occupations HRD Strategies for Success HRD Strategies for Success CE Healthcare classes CE Healthcare classes Back-to-Work intake sessions Back-to-Work intake sessions Basic Skills Plus Basic Skills Plus Recruitment / Marketing: Getting Their Attention

Program Outreach Program Outreach Community Community Flyers and brochures Flyers and brochures College catalogues College catalogues College website College website Social Media Social Media Past HRD students (Phase I and Phase II) Past HRD students (Phase I and Phase II) Current and Past NA I students (Phase IV) Current and Past NA I students (Phase IV) Local home care facilities Local home care facilities Recruitment / Marketing: Getting Their Attention

Recruitment / Marketing: Challenges Communication of value Communication of value Home care agencies Home care agencies Benefit of contextualized training Benefit of contextualized training Benefit of advanced standardized training (Phase IV) Benefit of advanced standardized training (Phase IV) Participants Participants Benefit of credential for hiring Benefit of credential for hiring Benefit of commitment to entire pathway Benefit of commitment to entire pathway Program schedule/mix Program schedule/mix

Audience Experiences

Want to Know More? Margaret Roberton Kathy Turner