1. State of the Drug and Alcohol Workforce PRO-A Copyright 2015

2. Learning Objectives Summarize the history of the drug and alcohol service system. Summarize the history of the drug and alcohol service system. Identify the issues that led to the workforce crisis. Identify the issues that led to the workforce crisis. Assess the current state of the workforce. Assess the current state of the workforce. Explain what is being done about it. Explain what is being done about it. Discuss what we hope to see in the future. Discuss what we hope to see in the future. PRO-A Copyright 2015

3. Where we came from: The drug and alcohol system was developed in the late 1960s, early 70s through the vision, and advocacy efforts of the early recovery movement. PRO-A Copyright 2015

4. Advocacy & the development of our service system The Hughes Act – 1970 Championed by Senator Harold Hughes of Iowa, an openly recovering alcoholic. Championed by Senator Harold Hughes of Iowa, an openly recovering alcoholic. Provided a comprehensive program to address prevention and treatment of alcohol abuse and alcoholism. Provided a comprehensive program to address prevention and treatment of alcohol abuse and alcoholism. PASSED by ONE VOTE, signed into law on December 31st, 1970. PASSED by ONE VOTE, signed into law on December 31st, 1970. PA Act 63 of 1972 Established our State SCA system and much more Established our State SCA system and much more Only occurred because of the hard work of many recovery advocates. Only occurred because of the hard work of many recovery advocates. Signed into law April 14 th, 1972 Signed into law April 14 th, 1972 PRO-A Copyright 2015

5. There was no drug and alcohol certification in Pennsylvania until 1979. It is estimated that about 75% of the initial workforce was in recovery. The early workforce in PA PRO-A Copyright 2015

6. Two surveys conducted: Two surveys conducted: 1- Counselor survey - 837 responses on barriers, service challenges & workforce concerns. 24% identify that they plan to leave the field within 5 years. 2 – CRS survey - 85 responses - included challenges in developing peer services. PRO-A Workforce Surveys PRO-A Copyright 2015

7. Overview of PRO-A Counselor Survey PRO-A conducted the statewide survey of the counselor workforce in May 2013, with 837 responses. It is the largest such survey ever done in Pennsylvania.  The average counselor is over 50 years old, Caucasian, and female, holding a master's degree, not in recovery, with over 20 years of work experience.  Only 33.3% of those who completed the survey identified themselves as in recovery.  70% of those who identified themselves as in recovery were in recovery for 20 years or longer. PRO-A Copyright 2015

8. 48.2% - are frequently asked to provide unnecessary and personal information about persons they serve that exceed the PCPC. 48.2% - are frequently asked to provide unnecessary and personal information about persons they serve that exceed the PCPC. 53.1% - some to none of their clients are getting the proper level and duration of services from funders. 53.1% - some to none of their clients are getting the proper level and duration of services from funders. 74.6% - clients gets a shorter duration, lower level of care, or that the service they require is not funded or offered. 74.6% - clients gets a shorter duration, lower level of care, or that the service they require is not funded or offered. PRO-A Counselor Survey Selected Findings PRO-A Copyright 2015

9. PA Counselors Leaving the Field Nearly one in four counselors identify that they are leaving the field within five years. PRO-A Copyright 2015

10. The average CRS respondent is a 50 year old, Caucasian male holding a Bachelors degree, in recovery, with 3 to 10 years of work experience. CRS Survey Overview PRO-A Copyright 2015

11.  51.8% were males compared to 35.3% in our counselor survey.  40.5% identified as being other than Caucasian compared to 22.2% in the counselor survey.  Roughly two-thirds of the respondents to the CRS survey identified themselves as in recovery versus one third in the counselor survey.  In relation to the quality and frequency of supervision, a combined total of 22 or 39.3% of the respondents indicated that they did not get supervision as often as they would like, in as good quality as they need, or at all. CRS Survey Selected findings PRO-A Copyright 2015

12. What we learned from our Surveys Workers are being pulled in too many directions / paperwork, etc. Workers are being pulled in too many directions / paperwork, etc. Clients are getting less services than they need. Clients are getting less services than they need. People are leaving our field of service. People are leaving our field of service. PRO-A Copyright 2015

13. The good news… The response to our survey's was fairly robust, and the responses made it clear that the workforce cares deeply for the people we serve and our communities. Also, we believe that our results may hold some hope for the future. Consider that: Lived experience is important - CRS workers were more than three times likely to be in recovery. Lived experience is important - CRS workers were more than three times likely to be in recovery. There is less indication of turnover for CRSs, they are half as likely to be considering leaving the drug and alcohol workforce within the next five years. There is less indication of turnover for CRSs, they are half as likely to be considering leaving the drug and alcohol workforce within the next five years. PRO-A Copyright 2015

14. Progress in the last few years  DDAP has initiated a regulatory review to work towards streamlining regulations while emphasizing care with clinical integrity.  A Workforce group has been formed to look at ways to expand our workforce - PRO-A has been very involved with this group.  Two licensing alerts have come out of this process  New opportunities for persons in recovery  There needs to be more widespread understanding of how these alerts apply at the provider level PRO-A Copyright 2015

15. Certified Associate Addictions Counselors (CAAD) now recognized as Counselors under the Staffing Standards PA Code 704.7 position of Counselor Certified Associate Addictions Counselors (CAAD) now recognized as Counselors under the Staffing Standards PA Code 704.7 position of Counselor What this means is the degree requirement is no longer a requirement for Counselors What this means is the degree requirement is no longer a requirement for Counselors This opens up the pathways for non-degreed persons who meet the PCB / CAAC certification requirements. This opens up the pathways for non-degreed persons who meet the PCB / CAAC certification requirements. Degree Status to meet position of Counselor In Pennsylvania PRO-A Copyright 2015 DDAP Div of Program Lic Alert 02-15

16. Requirements for the CAAC Three years (6000 hours) of employment as an alcohol and drug counselor or supervisor of same within last 7 years. Three years (6000 hours) of employment as an alcohol and drug counselor or supervisor of same within last 7 years. Supervision (300 hours) with a minimum of 10 hours in each domain. Supervision (300 hours) with a minimum of 10 hours in each domain. Pass the IC&RC Examination for Alcohol and Drug Counselors. Pass the IC&RC Examination for Alcohol and Drug Counselors. Signed and dated Code of Ethical Conduct. Signed and dated Code of Ethical Conduct. Signed, dated and notarized Release. Signed, dated and notarized Release. Applicant must either live or work in PA at time of application at least 51% of the time. Applicant must either live or work in PA at time of application at least 51% of the time. Full Application requirements: https://www.pacertboard.org/sites/default/files/applications/PCBCAACApplication_0.pdf https://www.pacertboard.org/sites/default/files/applications/PCBCAACApplication_0.pdf PRO-A Copyright 2015

17. The Supervision of Counselor Assistants Allows an exception be made to the direct observation of a Counselor Assistant from 3 months to a reduced amount, but no less than 1 month under certain circumstances. Exception requests consider if the person: Has 6 months prior employment with direct client contact in a licensed residential setting. Has 6 months prior employment with direct client contact in a licensed residential setting. Has a CRS or minimum of 54 CEUs in specific delineated areas. Has a CRS or minimum of 54 CEUs in specific delineated areas. Must be pursuing promotion to be a Counselor. Must be pursuing promotion to be a Counselor. Assignment of a full case load and change of supervision requirements from Direct Observation to Close Supervision will only occur when the supervisor provides a positive assessment of the base line skills of the Counselor Assistant. DDAP Div of Program Lic Alert 01-15 PRO-A Copyright 2015

18. Career Pathways in the drug and alcohol service system The Pennsylvania Certification Board (PCB) has developed an outline of the general requirements for certification, and requirements to obtain other credentials. While some professionals may choose to stay at a certain level, progression through the ladder can occur with the proper experience, education and examination. Professionals may begin wherever their current experience and education level permit. It can be found here: https://www.pacertboard.org/sites/default/files/PCB_CareerLadder_2015_Revised.pdf PRO-A Copyright 2015

19. PRO-A is dedicated to:  Expanding Drug and Alcohol Recovery Support Services statewide  Strengthen Supervision components across our system  Supporting long term career pathways across the service system  Training system wide on staff engagement, mentoring and retention strategies  Recruiting persons with passion for the work.  Expanding leadership opportunities  Opening up opportunities for advancement through Tuition Reimbursement through Tuition Reimbursement Moving forward – Strengthening our workforce PRO-A Copyright 2015