12 Recruiting and Retaining the Next Generation

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Recruiting and Retaining the Next Generation of Human Service Workers

rtc.umn.edu/dsp



14.8%

20.2%

27.3%34.3%

40.5%

48.

0%

10%

20%

30%

40%

50%

60%

Total U.S.Employment

LicensedPractical Nurses

RegisteredNurses

Nursing Aides Personal CareAttendants

HomeAi

U.S. Demand for Workers Projections[2002 – 2012]

Source: Occupational Employment Projections February 2004, U.S. Bureau of labor Statistics .



Wages Matter Wyoming 2002 Wage Initiative:

Investment $7.6 million state; $14.7 million federal

But… Wages aren’t the only thing



Recruitment and Retention InterventionStrategies

• Finding and Welcoming New Employees – Recruitment and marketing

• Marketing Toolkit• Inside recruitment sources• Marketing campaigns

– Selection and hiring• Structured interviews• Realistic Job Previews

– Orientation and Socialization• Competency-based training and career paths

– College of Direct Support

– Mentoring programs – Apprenticeship and credentialing



Recruitment and Retention InterventionStrategies

• Improving organizational management practices – Professionalizing DSP roles (NADSP) – Creating a culture of respect and empowerment – Team building – Participatory management

– Recognition Programs• Enhancing the skills of frontline supervisors

– Core Competencies – College of Frontline Supervision and Management

• Systemic solutions – Wage and benefit campaigns

– Statewide workforce initiatives – Improve quality improvement efforts – Core competencies for DSPs



Niche GroupMarketing

• Gen X and Y’rs• Faith communities

• Retirees• Students• Displaced workers• Stay at home

parents



Realistic Job Previews

Present non-distortedinformation

to job applicantsabout the joband the organization

before a job offer hasbeen made



WA: Referral and Workforce ResourceCenters – Expanding the Universe of Workers

• Funding Source: CMS Direct Service Workforce Demonstration Grant• Interventions:

– Online worker referral registry matching consumers to available individual providers (1,800 individual providers wereregistered by Feb 2006 and 676 referrals had been provided)

– Provides resources to consumers about how to hire, interview and supervise individual providers – Realistic job preview info for individual providers including web site, self-assessment and video – Peer mentoring for individual providers – Professional development for individual providers – Insurance for individual providers

• Under the Home Care Quality Authority – www.hcqa.wa.gov

• Serves consumers receiving in-home services and the independent providers they directly hire in four regions

http://www.hcqa.wa.gov/





CMS Real Choice Systems Change Grants

• 20 states• First awarded in 2001• Designed to improve recruitment in

retention of direct support workers inboth health and human services

• Recruitment efforts – public awareness campaigns, – job fairs, – worker registries, – back up systems or nontraditional

populations;• Training and career ladders

– pre-service training,

– specialized skill training, – training delivery strategies, – career ladders;

• Extrinsic reward efforts – wages, – health benefits, – access to loans;

• Culture changes – worker associations, – caregiver support groups, – improved work environments, – consumer directed programs;

• Systems administration and planningefforts – data development, –

state policy changes – job profiling.



• Strategies – Workforce plan – Trained 522 supervisors – Interventions

• RJP video shown to 491DSPs – KSDSP org started – College of Direct Support

for 371 DSPs – Piloted apprenticeship

model – Targeting Marketing

• Results – DSP turnover reduced

from 58% to 49% – FLS turnover reduced

from 23% to 16% – Early turnover reducedfrom 48% to 41%



National Training Institute for FrontlineSupervisors and Technical Assistance

Project – Comprehensive Approaches

Participants• 5 States and 8 Organizations• 17 Trainers Trained in 2 Train the

Trainer Intensives

Supervisor Training• 590 Attended RRD Training• 317 Learners Completed 3,075

CFSM Lessons Online• 238 Attended Other TrainingDSP Training• 101 Trained using CDS• 222 Got Revised Training

Other Intervention Examples• 2090 Saw RJP• 552 Got Revised Interview• 505 Welcomed in a New Way

• 85 Participated in a Mentoringprogram• 320 Promoted• 382 Participated in NADSP

Project funded by the National Institutes onDisability and Rehabilitation ResearchH133G030058



DSP Turnover 2003 to 2006 NTIFFS Pa rticipa

0%

10%

20%

30%

40%

50%

60%

70%

80%

A B C D E F A verage

T u r n o v e r

DSP Turnover Reduced an Average of 18%in 2.5 Years: NTIFFS



Measuring Outcomes: Pennsylvania 2005Collecting and Monitoring Information

36%39%

14%

5%

17%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Turnover % left w/in 6 months Vacancy Rate

P e r c e n

tDSP

FLS

42% in 1999 PA legislative



Direct Service Workforce DemonstrationGrants (CMS)

• Awarded in 2003 and 2004,• 10 states

– Delaware, – Louisiana, – Maine, – New Mexico, – North Carolina, – Arizona, – Indiana, – Kentucky, – Virginia and – Washington state

• Designed to reduce in DSP vacanciesand turnover rates in health andhuman services.

• Interventions: – providing access to health care

benefits, – realistic job previews, – orientation and socialization

programs, – enhanced training or education

programs, – peer mentoring programs, – marketing and recruitment

campaigns, – worker registries, – recognition programs



Direct Service Workforce DemonstrationGrants (CMS): SPEAK – Improve hiring practices

0%

10%

20%

30%

40%

50%

60%

70%

2004 2005 2006

T u r n o v e r

R a t e s

• Interventions: – Pre-service orientation – Realistic job previews

– Orientation andsocialization withmentors

– Enhanced training andeducation

– Recognition

www.dspspeak.org



National Alliance for Direct SupportProfessionals (NADSP) – Identity and Image

The NADSP promotes thedevelopment of a highly competenthuman services workforce whichsupports individuals in achieving their life goals.

Resources include: – NADSP Membership – NADSP Web site – NADSP Credentialing Program – Code of Ethics

– Frontline Initiative – Moving Mountains Awards

www.nadsp.org



National DSPCredential Program

• On July 1, 2006, a nationalcredentialing program for DSPswas launched by the NADSP. – Industry driven and VOLUNTARY – Establishes national patterns for work-

based learning and related instruction – Based on nationally validated

competencies (knowledge, skills, andattitudes), the NADSP Code of Ethicsand DSP Professionalism

– Affordable, flexible, portable, andnationally recognized

– Verification process to confirm DSPcertification status



Direct Support WorkforceResources

• The Lewin Group (Medicaid)*www.lewin.com

• Paraprofessional Healthcare Institute (long-term care)*www.paraprofessional.org

• Research and Training Center on Community Living, University of Minnesota(community supports for people with disabilities)*

http://rtc.umn.edu/dsp • The Westchester Consulting Group (personal assistance)*

www.westchesterconsulting.com • Institute for the Future of Aging Services (aging)*

www.futureofaging.org• Annapolis Coalition on Behavioral Health Workforce (SAMSA)

http://www.annapoliscoalition.org

• Cornerstone for Kids (children) http://www.cornerstones4kids.org

www.dswresourcecenter.org

http://www.lewin.com/

http://www.paraprofessional.org/

http://rtc.umn.edu/dsp

http://www.westchesterconsulting.com/

http://www.futureofaging.org/

http://www.annapoliscoalition.org/

http://www.cornerstones4kids.org/

http://www.dswresourcecenter.org/

http://www.dswresourcecenter.org/

http://www.cornerstones4kids.org/

http://www.annapoliscoalition.org/

http://www.futureofaging.org/

http://www.westchesterconsulting.com/

http://rtc.umn.edu/dsp

http://www.paraprofessional.org/

http://www.lewin.com/



Small Steps Can Make a BigDifference…

Source: US Department of Health and Human Services January 2006

Figure 5. Demand for DSP Recruits to Meet Projected Demand forLTSS , 2005-2020 at Current 50% Turnover and with Annual

Reductions by 2% (50% in 2005, 48% in 2006, 46% in 2007, etc.)to 30%

0

200,000

400,000

600,000

800,000

1,000,000

2 0 0 5

2 0 0 7

2 0 0 9

2 0 1 1

2 0 1 3

2 0 1 5

2 0 1 7

2 0 1 9

Year

D S P s R e c r u

i t e d At constant 50%turnover

At 2% annualreductions to 30%

Ad l S i & C i i i



Adult Services & Community Living -workforce development research and

practice



Contact Information

Sheryl Larson, Ph.D. Research Director 612.624.6024 [email protected]

Research and Training Center on Community LivingInstitute on Community Integration (UCEDD)

University of Minnesota, Twin Cities214b Pattee Hall, 150 Pillsbury Drive SE

Minneapolis, MN 55455

mailto:[email protected]

mailto:[email protected]

12 Recruiting and Retaining the Next Generation

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