LTC Advisory Council Meeting Summary
Thursday, September 15, 2016
Posted by: Sarah Bass
From Ann Gryphan, Government Policy Solutions
The Wisconsin Department of Health Services is continuing its efforts to implement a statewide dementia system redesign plan, and DHS officials at the DHS Long-Term Advisory Council meeting Tuesday gave an update on the following initiatives:
- Alzheimer’s Family and Caregiver Support Program. DHS got an additional $1 million, also tribal allocations, and made some changes in eligibility – to get those dollars out the doors by July 1. DHS is still working on a developing a statewide caregiver strategy and will soon begin an outreach campaign to reach caregivers, reduce the stigma of caregiving and get them connected to services.
- Crisis training grants. DHS officials said they recently issued a call for dementia crisis training grant applications, have evaluated the responses that came in and will soon be awarding grants that will pay for training for crisis systems. 2015 Wisconsin Act 274 directs the Department of Health Services (DHS) to award $250,000 in grants to counties or regions comprising multiple counties to obtain training for their mobile crisis teams on recognizing and providing services to individuals with dementia. The funding is provided on a one-time basis for state fiscal year 2017.
- Developing a crisis bed proposal. DHS recently brought together stakeholder groups, including law enforcement, nursing homes, managed care organizations and advocates, and has developed an issue paper on this topic that is currently making its way through the department. The issue paper is due to the state legislature by Nov. 1.
Dennis Winters, an economist with the Wisconsin Department of Workforce Development, gave a lengthy presentation about the status of Wisconsin’s workforce, saying the state – and national – labor force are both aging and shrinking and almost all industries are finding it difficult to fill positions. Meanwhile, job growth in the community care and home health industries is on the rise. While the average job growth for all industries in Wisconsin between 2014-2024 is 6.0 percent, continuing care retirement communities and assisted living facilities for the elderly job growth during that period is 54.4 percent, home health care services job growth is 40.9 percent. Meanwhile, nursing assistants and home health aides have a below-average median wage, making it more difficult to attract workers to these jobs. The Wisconsin median wage is $35,110, but the nursing assistant median wage is $26,940 and home health aide $23,110.
What is the solution then to attracting more people to the profession, when it is a job-seeker’s market? Winters acknowledged that is the million-dollar question and suggested looking at outside labor pools.
Winters also said coastal areas of the nation have the advantage of drawing on non-American labor pools, as people migrating to the United States often land in coastal areas. Winters suggested that LTC think globally in attracting workers to the industry. He also said millennial workers are often drawn to quality-of-life issues when making job decisions, such as location, benefits, work-life balance, recreational opportunities, etc. and not just bottom-line dollar wages.
The LTC Advisory Council then broke up into three work groups to brainstorm on possible ways to address the long-term care workforce shortage crisis. Some suggestions were:
- Increasing reimbursement rates to allow higher wages and more benefits for LTC workers.
- Reduction of business costs such as property taxes, licensing, HIPA compliance, regulatory requirements.
- Promoting long-term care jobs via a marketing campaign
- Getting people into the profession, a more coordinated approach among various entities (DWD, DHS, technical colleges, etc.) – including holding a summit to bring all of these entities together.
- Use of media in promoting the benefits of being a frontline caregiver.
- Allow more tasks to be completed by non-RN staff.
- Provide more flexible work time and other benefits to attract millennials, including allowing cooperative workers.
- Bring innovations into the system by looking at what other businesses and industries are doing. Using technology more where appropriate, such as doing things virtually, especially in rural parts of the state. What can we be doing more with technology?
- Create an apprenticeship program for LTC workers.
- Replacing more traditional tasks with things already available in the local economy, such as meal delivery service by a local grocery store instead of paying to bring in someone to cook inside the home.
- Reduce regulatory burdens.
- Need to better understand the workforce and what motivates them. One work group leader said that perhaps there should have been some millennials brought into this discussion to get their perspective and ideas on attracting them into the industry.
- Tapping the labor pool such as retirees who maybe don’t want to be direct caregivers to provide other services.
- Reviewing criminal background check laws.
- Create a professional service corps for LTC workers – and incentivize workers to go into areas of the state facing a profound worker shortage.
In other business, DHS officials reported at Tuesday’s meeting:
- Family Care will expand to the remaining legacy counties in coming months – all counties except Dane County by July 2017, followed by Dane County by Jan. 1, 2018.
- State agency budgets are due to the Wisconsin Department of Administration by Sept. 15. The DHS 2017-19 budget will be a cost-to-continue budget – with no major new expenditures.
- DHS is continuing to work on implementation of: the federal home and community based services rule, the federal managed care rule and also working on a separate initiative to allow tribal members to receive long-term care services through a tribal waiver agency, something that Curtis Cunningham of DHS dubbed“a unique model.”
- DHS continues to expand IRIS consultant agencies (ICAs) and fiscal employer agents (FEAs) – and hopes that by having a choice and competition to attract members it will lead to innovative practices and be more consumer-friendly.
- Three of the managed care organizations are working on a merger. Community Care Connections of Wisconsin (CCCW), ContinuUs and Western Wisconsin Cares (WWC) announced earlier this summer their intent to merge as of January 1, 2017.
- DHS has identified the top five health priorities for Wisconsin. They are: alcohol use; suicide; tobacco use; opioid use; and physical activity and nutrition. In addition, DHS is looking at adverse childhood experiences– such as trauma and abuse – and its causal relationship for many of the five identified health issues.