1. Workforce Development: Recruitment and Retention

2. Today’s Agenda:

3. A Brief Summary I. About the CT LBHS II. Recruitment and Retention III. Evaluation Process IV. Future Directions

4. I. Mission Statement The Connecticut Latino Behavioral Health System (CT LBHS) represents a united effort to expand, enhance, and evaluate a network of treatment services through unique workforce development initiatives created from regional partnerships and tailored to meet the specific behavioral health needs of the adult Latino community.

5. II. Recruitment Where we started:  Fall of 2005: Developing the initial proposal  Winter 2006: Advocating at the state legislature  July 2007: Awarded the first two years of funding How we recruited:  Consensus among hiring agencies for initial job announcement  Local and national search: Professional list-serves & internet-based employment sites 32 APA-accredited pre- and post-doctoral training sites 38 regional colleges and universities 12 state and national professional organizations (i.e., NLPA, LSWO, NASW, CPA)

6. Cont’d Who contacted us:  39 bilingual professionals with varied credentials and training experiences (i.e., LPC, BSW, LCSW, PhD, PsyD, APRN, CASAC, MD) What we screened for:  credentials, experience with Latina/o populations, overall fit based on agency need Results:  10 full-time, 2 part-time clinical positions, % effort of psychiatry time: 3 MSWs, 1 LCSW, 2 Master’s-level substance abuse counselors, 3 Predoctoral fellows, 3 Postdoctoral Fellows Relevant training experiences ranged from international work at UN refugee operations to years of living and working in local New Haven area with Latina/o community

7. Retention Efforts Providing the CT LBHS Training Academy (focus groups; on-site; competency based; CEUs) Supporting additional professional training opportunities (conferences) Renewing annual license fees Serving as qualified site for the NIH & HRSA Loan Repayment Programs Clinical supervision and mentorship Ensuring competitive salaries  National median salary for social workers in outpatient mental health and substance abuse centers: $34,290 (U.S. Dept. of Labor, Occupational Outlook Handbook, 2008-09 Edition)  CT LBHS median salary: $57,000 Hosting monthly meetings with clinicians (familismo) Appointing new clinical faculty to provide supervision to incoming students

8. III. Evaluation Levels Level I: Organizational Level II: Staff Level III: Client Overall Evaluation of Implementation Process

9. Organizational Level Cultural Competency Index (CCI) completed every four months by staff and leadership: Sampling of items:  Management strategy  Community and consumer involvement  Supervision  Direct service support  Linguistically sensitive staff, documents, and materials  Collection of accurate demographics  Evaluation of ongoing cultural competence  Structures and procedures

10. Staff Level Pre- and post-training/consultation evaluation CT LBHS clinician evaluation:  Implementation of treatment (clinician checklist & random tape rating)  Latino cultural constructs  Therapeutic alliance  Clinician satisfaction Client Level Set of instruments to assess treatment outcome at baseline, four months after baseline, and eight months after baseline Instruments assess:  Mental health and substance use disorders (BSI, LDQ, TLFB))  Readiness to change (URICA)  Coping strategies (Brief COPE)  Ethnic experience (SEE)  Latino cultural constructs  Therapeutic alliance (TCS)  Quality of life  Client satisfaction

11. Evaluation of the Implementation Process Focus groups and individual interviews:  Consumers  LBHS leadership  Agency leadership  LBHS clinicians

12. In Summary, our Key Ingredients:  FINDING A COMMITTED, DEDICATED, & SKILLED WORKFORCE  TIMING  CONFIANZA, PERSONALISMO, & RESPETO  CONSENSUS  POSITIVE COMMUNITY RELATIONSHIPS  ADVOCACY & LEGISLATIVE SUPPORT  SHARED RESOURCES  INTELLECTUAL  PHYSICAL  HISTORY OF OUR TRAINING PROGRAM  MENTORSHIP (support system)

13. IV. Future Directions Implementing a consultation model for agency supervisors Ongoing assessment of job satisfaction Addressing issues of sustainability and seeking new funding sources Expanding the training program  Developing practicum placements w/tracks based on professional interests (undergraduate and graduate level) Disseminating information (www.ctlbhs.org, La Visión, & Community Defined Evidence Project )www.ctlbhs.org

14. GRACIAS! manuel.paris@yale.eduanuel.paris@yale.edu michelle.silva@yale.edu luis.aneznava@yale.eduuis.aneznava@yale.edu luis.bedregal@yale.edu