1. ELEVATING OUR FUTURE WORKFORCE
Minnesota Health & Housing Alliance March District Meeting

2. MEMBERS REPORT BIGGEST CHALLENGES IN 2006-07
Financial
Workforce
Regulatory
Transformation
Trends have been consistent 2006 and 2007
Workforce bumped Regulatory in 2006
Source: 2007 MHHA Member Value Survey

3. MEMBERS REPORT BIGGEST CHALLENGES IN 2006-07
Staffing Issues
(especially RN and CNA)
Recruiting Well-trained Staff
Retaining Staff
(limited wages and benefits)
Trends have been consistent 2006 and 2007
Workforce bumped Regulatory in 2006
Source: 2007 MHHA Member Value Survey

4. NUMBER OF VACANT FTE POSITIONS IN CARE CENTERS
Source: Long Term Care Imperative 2007 Legislative Survey

5. ESTIMATED VACANT FTE POSITIONS IN CARE CENTERS
Source: Long Term Care Imperative 2007 Legislative Survey

6. PROJECTED POPULATION & WORKFORCE GROWTH
Projected Growth in Workforce
Projected Growth in the Population Age 60 and Over
Future prospects for older adult service providers will include 1) increasing labor shortage as the economy emerges from the shadow of recession, 2) increasing wage pressures for skilled workers in the greater marketplace, 3) new technologies that may improve productivity, 4) greater availability of customized training allowing us to “grow our own” and 5) the many challenges from the growing diversity in the workplace.
Source: Minnesota State Demographic Center

7. HEALTHCARE JOBS LEAD MINNESOTA’S FUTURE NEEDS
Demand for health care jobs remains the leading growth area in Minnesota, with 51,900 jobs being added in the past six years and the highest demand for RNs, home health aides, nursing aides, and LPNs projected into the future.
Source: DEED, Employment Projections

8. MINNESOTA HEALTHCARE CAREER TRENDS HISTORY

9. PROJECTED GROWTH FOR TOP 15 HEALTHCARE OCCUPATIONS
AGING SERVICES
Source: MN Dept of Employment and Economic Development

10. WHO PROVIDES CARE TO OLDER MINNESOTANS
1% drop in family caregiving = $30M in public funds.
Minnesota Health & Housing Alliance – February 23, 2006
Source: Minnesota Department of Human Services

11. RATIO OF CAREGIVERS TO OLDER ADULTS DROPPING
Ratio of women to people 85 and over
Minnesota Health & Housing Alliance – February 23, 2005
Source: Minnesota State Demographer

12. MINNESOTA BOSTS HIGH WORKFORCE PARTICIPATION
Labor force participation fluctuates based on larger trends, such as state and national economic growth, technology, or retirement rates. In general it is high in Minnesota, with growth opportunities limited to underutilized labor pools, including immigrants, the disabled, retirees and the underemployed.

13. NURSING SHORTAGE ONLY EXPECTED TO WORSEN

14. A NURSING WORKFORCE APPROACHING RETIREMENT46 45
We’re all getting older. The average age of Minnesota nurses continues to rise. In 2006 the median age of RNs is 47 and LPNs is 46. We’ve just seen the start of this wave of current nursing leaders leaving the field.
Source: Minnesota Board of Nursing

15. 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 campuses in 46 communities
Given increasing enrollment numbers, new nursing programs continue to expand around the state. While there are currently 26 programs approved for practical nursing, 18 for professional (AD), and 15 programs for professional baccalaureates in Minnesota, this isn’t enough to meet demand. Scholarship opportunities, immigration, healthy work environments and the boarder state registry are also challenges in keeping an adequate supply of well-trained nurses.
Minnesota State Colleges and Universities (MnSCU) serves 369,000 students each year (educating 78% of all new nursing graduates) across 35 colleges and universities in 48 cities. Their strategic plan includes goals to increase access and opportunity in the pipeline as well as to develop new partnerships for high quality programs that serve the regional needs.

16. 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%
Given increasing enrollment numbers, new nursing programs continue to expand around the state. While there are currently 26 programs approved for practical nursing, 18 for professional (AD), and 15 programs for professional baccalaureates in Minnesota, this isn’t enough to meet demand. Scholarship opportunities, immigration, healthy work environments and the boarder state registry are also challenges in keeping an adequate supply of well-trained nurses.
Minnesota State Colleges and Universities (MnSCU) serves 369,000 students each year (educating 78% of all new nursing graduates) across 35 colleges and universities in 48 cities. Their strategic plan includes goals to increase access and opportunity in the pipeline as well as to develop new partnerships for high quality programs that serve the regional needs.

17. AVERAGE HOURLY RN WAGES HOSPITALS vs CARE CENTERS
Wage Gap Increased 57% in Five Years
Gap=$11.49
Gap=$7.30
Source: MN Health Care Cost Information System, Long Term Care Imperative Compensation Survey

18. AVERAGE HOURLY LPN WAGES HOSPITALS vs. CARE CENTERS
Wage Gap Increased 113% in Five Years
Gap = $0.77
Gap=$1.64
Source: MN Health Care Cost Information System, Long Term Care Imperative Compensation Survey

19. AVERAGE HOURLY CNA WAGES HOSPITALS vs. CARE CENTERS
Wage Gap Increased 91% in Five Years
Gap=$3.47
Gap=$1.82
Source: MN Health Care Cost Information System, Long Term Care Imperative Compensation Survey

20. PERCENT OF CARE CENTERS IN FINANCIAL CRISIS
(Operating Margin of -5% or worse)
Northwest 35.3%
Northeast 50.0%
East Central 19.4%
West Central 34.6%
Legend
=<25%
=26%-35%
=35%-45%
Metro 18.6%
=>45%
30% of Facilities are in Crisis, 4% Higher than Last Year
Southwest 30.0%
Southeast 39.2%
Source: Imperative Nursing Facility Survey Prepared by LarsonAllen

21. ALMOST 23,000 JOBS AT RISK DUE TO FINANCIAL CRISIS
Beds: 2,806
Jobs at Risk: 1,311
Beds: 1,615
Jobs at Risk: 2,142
Beds: 4,801
Jobs at Risk: 2,387
Beds: 3,000
Jobs at Risk: 5,854
Beds: 13,684
Jobs at Risk: 2,814
Beds: 4,078
Jobs at Risk: 5,007
Beds: 5,554

22. 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

23. 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

24. 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

25. AGING SERVICES WORKFORCE INNOVATION:
MHHA Workforce Solutions Council Drives Association Response

26. TALENT Talent – the theme for our first day at the Institute;
Talent – the acknowledged core to carrying out our missions each and every day; and
Talent – the people we are lucky enough to have sitting around our Workforce Solutions Council.

27. 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
MHHA Board formed the Workforce Solutions Council – setting forward a charter to:
Coordinate efforts with parallel initiatives
Focus on retention strategies and best/promising practices in the area of job satisfaction and training
Creation of a focused work plan identifying four solution-focused areas of activity

28. CREATING SOLUTIONS

29. 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

30. 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

31. 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

32. 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

33. CREATING SOLUTIONS Career Exposure and Recruitment
Member Skill Building for Talent Retention
Launch of a New Employee Model
Replication of New Training Models

34. A NEW EMPLOYEE MODEL
When the MHHA Board held it’s retreat in 2006 there was a good degree of interest in the concept behind creating a new model of worker.
At the same time, Association initiatives around culture change continued to grow – and many of the people in the room were braving new ground creating new models

35. 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

36. HEALTH SUPPORT SPECIALIST (HSS)
A pathway for organizations to move towards a “universal” worker model
Designed around a household model with self-lead teams

37. 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

38. A CLEAR CURRICULUM AND CAREER LADDER
Health Support Specialist
Employment and mentoring with a qualified journey worker from day one
Entry Level

39. ADVANCING THROUGH THE STEPS
Medical Terminology
Dietary Services
(National Serv-Saf Certification)
Environmental Services
(OSHA 10-hour industry card)

40. 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)

41. ADVANCING THROUGH THE STEPS
Rehabilitative Aid
(Facility Certificate)
Certified Medication Aid
(Technical or Community College)
Health Support Specialist Apprentices
Advanced Health Support Specialist

42. 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)
Home Health Aid Certificate
(Technical or Community College)
Activity Director Certificate
Social Services Designee

43. 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

44. 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

45. US DEPT. OF LABOR

46. HEALTH SUPPORT SPECIALIST (HSS)

47. FUNDING SOURCES MHHA Foundation CBJTG grant through Kansas
Workforce Investment Act (WIA)
Pell grants
Veterans assistance
Minnesota Scholarship Programs
Other special funding projects

48. HEALTH SUPPORT SPECIALIST (HSS)
Patricia Williams began her career in dietary services 13 years ago.

49. HEALTH SUPPORT SPECIALIST (HSS)
“Brewster Place encouraged me to go into the program to become more involved with resident care.

50. HEALTH SUPPORT SPECIALIST (HSS)
“It gave me the will to continue my education – put the learning bug in me.”

51. 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

52. 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

53. 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

54. 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.

55. HEALTH SUPPORT SPECIALIST (HSS)

56. HEALTH SUPPORT SPECIALIST (HSS)

58. “Long-Term Care Connection”
NEW TRAINING MODELS
“Long-Term Care Connection”
A Customized LTC LPN Program Developed by
Good Shepherd Community

59. 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

60. EDUCATION BARRIERS Lack of clinical space Lack of qualified faculty
Lack of classroom space
Lack of resources to start-up and maintain

61. 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

62. LTC LPN PROGRAM
In 2001, Good Shepherd Community launched a customized LPN program in partnership with St. Cloud Technical College

63. LTC LPN PROGRAM
Facility served as primary clinical site and also created classroom and lab space
Evening classes and accelerated learning methodology incorporated

64. 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

65. 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

66. 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

67. 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.

68. FOR FURTHER INFORMATION
Adam Suomala
Manager of Member Relations