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WORK FORCE DEVELOPMENT

WORK FORCE DEVELOPMENT. DEVELOPING AND ENHANCING THE WORKFORCE FOR CHEMICAL DEPENDENCY TREATMENT Robin Roberts David Jefferson. AGENDA. Status of the workforce Competencies Training Current challenges DASA updates Legislation Consideration for the future. OBJECTIVES .

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WORK FORCE DEVELOPMENT

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  1. WORK FORCE DEVELOPMENT DEVELOPING AND ENHANCING THE WORKFORCE FOR CHEMICAL DEPENDENCY TREATMENT Robin Roberts David Jefferson

  2. AGENDA • Status of the workforce • Competencies • Training • Current challenges • DASA updates • Legislation • Consideration for the future

  3. OBJECTIVES • What skills and competencies do you need to prepare yourself for the future? • How does this information affect you?

  4. WHAT IS WFD? • Webster does defines 1: the workers engaged in a specific activity or enterprise <the factory's workforce> 2: the number of workers potentially assignable for any purpose <the nation's workforce> de·vel·op·ment • Lawrence M. Anthony, EdD, LICDC University of Cincinnati 1: An integrated process requiring participation and cooperation of several employment related institutions whose goal is to help develop and maintain a viable workforce.

  5. WHAT IS THE NUMBER ONE PUBLIC HEALTH ISSUE? • Addiction, U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMSHA) 2002 Report • 19 million Americans need treatment • 25% are able to access treatment • 50% of those in treatment do not complete • The way services are delivered is a barrier to both access and retention • CESAR FAX: Annapolis Coalition on Behavioral Health Workforce SAMSHA Report: Critical Workforce Shortage, Narrow Focus on White Adults, Dissatisfaction Among Persons In Recovery, Inadequate and Irrelevant Training.

  6. WORKFORCE DEVELOPMENT MISSION • Pride • Pay • Professionalism

  7. WHAT ARE THE MAIN WORKFORCE ISSUES? • Recruitment • Retention • Education and Training

  8. SHORTAGE OF CDP’S ? • Directors said: • 40% their agency are understaffed • There is a vacancy rate of 1.10 FTE per agency • 54% of shortages are budget related • 46% stated they would still be understaffed if all budgeted positions were filled • 49% reported an average of 1.92 FTE planned hires • CDP’s account for 79% of all planned hires • Agencies employ on average 10- 11 treatment staff • On average, agencies have 3- 5 CDPT’s for every 10 clinicians. • Substance abuse professionals will increase Nationally by 33% over the next decade, (U.S. Department of Labor)

  9. WHAT IS THE NUMBER OF CDP’S NEEDED IN WA STATE? • Currently there are 2,562 active Chemical Dependency Professionals and 906 expired or otherwise loss of credentials in the state of Washington. • Directors said; 280 additional CDP’s are needed. Note: This does not include the 10% (256 CDP’s) who indicated that they plan on leaving the field soon. • The potential of an additional loss of 10% (256) in a worst case scenario could result in 536 CDP’s positions not filled. • The effect of Treatment Expansion further increases the need for CDP’s given an expected 5% to 10% increase in patients caseload each year.

  10. CDP’S NEEDED

  11. AGING OUT OF THE WORKFORCE • 70% of directors and 37% of clinicians are 50 years old or older • 15% of clinicians are in their 60’s • 27% of directors are 60 years old

  12. AGENCY LEVEL TURNOVER • 2002 turnover rate was 22% • 2005 turnover rate was 23% • 61% of clinicians leave for another agency, • 49% of clinicians leave for another allied field • Two factors appear to be statistically significant predictors of turnover: • (1) years experience of the director (more experience, less turnover) • (2) clinical supervision (more frequent clinical supervision, more turnover) • Most turnover in the state is agency to agency turnover • Nationally the turnover rate is approximately 11%

  13. REASONS FOR DIRECTOR TURNOVER • Director and clinician report: • better salary, • better work opportunities (within the field) • burnout • Directors leave category: • level of job satisfaction is the lone significant predictor for membership in the changer category • Recovery status and second career status • Directors not in recovery and CD treatment is a second career are more likely to be considering (with high or definite probability) leaving the field • A statistically significant larger proportion of clinicians at agencies with 2 or fewer staff report their likelihood of changing agencies is “not at all” clinicians may find working in smaller agencies less stressful.

  14. RETENTION

  15. RETENTION STRATEGIES • Increase salaries • Provide raises for increased education and training programs completed • Reducing paperwork • Creating incentive for personal growth and advancement • Flexible schedules • Hiring the best person in the first place (use of structured interviews, team interviews, writing & demonstration exercises, etc)

  16. CHALLENGES AND CROSS-CUTTING ISSUES OF THE TREATMENT WORKFORCE

  17. COMPETENCY OR?

  18. Work Force Environment • SAMHSA Center for Substance Abuse Research Report 6-18-2007 said, “Substance abuse and mental health care environments ‘Toxic” for persons in recovery and those working in the field.” • A critical workforce shortage • A narrow focus on Urban White Adults • Dissatisfaction among persons in recovery • Inadequate and irrelevant training • http://www.samhsa.gov/workforce/annapolis/workforceactionplan.pdf

  19. COMPETENCY • “...a measurable human capability that is required for effective performance…” • “…comprised of knowledge, a single skill or ability, a personal characteristic, or a cluster of two or more of these…” • “…are the building blocks of work performance…” -- Marrelli et al

  20. COMPETENCY • Education • Standards • Training

  21. COMPETENCY • Challenges: • Variation and a lack of standardization in educational programs (curricula, degree programs) • Difficulty in transferring credits • DOH has to act as registrar for all applicants • NAADAC certification for all Community College CD programs • Special populations needs. • Statewide Adolescent Grant Stakeholders support the implementation of adolescent competencies and a voluntary credential. • Need more specialized training for older adults, ethnic minorities, criminal justice and other special populations.

  22. COMPETENCY • Training • Use of evidence-based practices • Outcome measurement • New medications • Addiction treatment (primary health care, allied health professions)

  23. CROSS-CUTTING ISSUES • Stigma • Noncompetitive compensation

  24. STIGMA • Some negative perception associated with substance abuse professionals • Difficulty in recruitment and retention • Addiction professionals considered lower status than other professionals • Reluctance to enter the field • Contributes to noncompetitive salaries • Misconceptions about treatment, and the qualifications of a clinician

  25. COMPENSATION • Low Salaries • In 2002, average salaries in low $30,000s • Majority of counselors (61%) earned between $15,000 and $34,000 • Majority of agency directors (68%) had salaries ranging from $40,000 - $75,000 • In 2005 67% of clinicians made less than $35,000 a yr. (88% less than $45,000) • In 2005 69% of clinicians report being the primary wage earner for their family • Factors associated with higher salaries: • graduate degrees • certification • years in the field

  26. COMPENSATION • Inadequate health care coverage among professional staff • 30% had no medical coverage • 40% no dental coverage • 55% not covered for substance use or mental health services (Counselor, 2004)

  27. WFD POSITION UPDATES DASA DIRECTOR’S • CDPT classification law, did not pass. DASA is proposing to revive the bill to include a separate category in DOH for CDPT’s and limiting the number of years that a person can be a CDPT. • Promote Substantial Equivalency: WA Accepts, • Alabama-Masters level addiction professional (MLAP) • Arizona-Substance Abuse Counselor (SAC) • Idaho-Advanced CADC • Oregon-CADCII & CADCIII • Continue collaboration with key partners, CDP Advisory Board, DOH, NCCDE, NAADAC, Tribes, and other State Agencies such as DOC. • New link on DASA WFD web page • CDP and CDPT certification information • Application process readiness • Course work description and criminal background checks • Research and updates on WFD. • Support the “National Certification” of Colleges • Early information to prospective CDP students • CDP recruitment brochure

  28. TREATMENT STAFF • Chemical Dependency Professional (CDP) means a person certified by the Washington State Department of Health (DOH) Health Professions Quality Assurance Office • Chemical Dependency Professional Trainees (CDPT’s) means a person assigned a trainee position by an administrator of a state of Washington certified chemical dependency service agency • CDPT’s are required to be registered as a counselor or have a current license issued by the DOH

  29. HOW DO I BECOME A CDPT? • There are five basic steps to becoming a CDPT listed below. For more detailed instructions obtain a Registered Counselor Application Packet or contact the Department of Health (D.O.H.). 1. Submit a completed application for Registered Counselor along with your personal explanation and documentation of any “yes” answers to the personal data questions; 2. Complete four (4) hours of AIDS/HIV training; 3. Submit the $40.00 application fee to the DOH; 4. Verify other credentials held in this or in other states even if credential is not currently active; 5. Receive your CDPT credentials!

  30. WHAT ARE THE BASIC STEPS TO BECOMING A CDP? • There are five basic steps to becoming a CDP. For more detailed instructions, on the web go tohttps://fortress.wa.gov/doh/hpqa1/hps7/Chemical_Dependency/default.htm for a Chemical Dependency Professional License Application Packet or contact the Department of Health (D.O.H.) at (360) 236–4700 1. Register with the D.O.H. as a registered counselor/CDPT. Call the D.O.H. Application Packet Line at (360) 236-4700 and press option 1 to request an application. Leave your name and address and a packet will be automatically sent to you. 2. Complete the Chemical Dependency college course work and the supervised (2,500-AA, 1,500-BA, 1,000-Graduate Level) internship hours. 3. Submit the application with a fee of $40 to D.O.H. 4. Submit an application to D.O.H. for "Chemical Dependency Professional" status with a $100 application fee and a $125 initial certification fee, both non-refundable. 5. Take and pass the written examination.

  31. Proposed CDPT Legislation • Submitted by Chemical Dependency Professionals SubgroupChemical Dependency Professional TraineesJuly 2006 to the Governor’s office for review the following: • Revise RCW 18.205 - Chemical Dependency Professionals, to create a new RC certificate aligned with CDP certification. The new credential might be RC-CDP Trainee or CDP Trainee. • An RC-CDP Trainee must attest annually, after receiving a certificate, to actively pursue the educational requirements per WAC 246-811-030 to become a CDP. • Should CDP Trainees demonstrate certain core competencies before providing specific counseling services to patients? Yes but that has not been defined yet. • Should they take an exam? While a state exam for RC-CDP Trainee is not required, the RC-CDP Trainee is required to take and pass a number of exams in core competency counseling areas while completing the education requirements to become a CDP. • How should they be supervised? CDP Trainees are supervised under the authority of DOH WAC 246-811 and DASA WAC 388-805. WAC 246-811 describes supervisor qualifications while WAC 388-805 describes elements of supervision. • Should there be an interim permit for those intending to become licensed or certified? Yes The new RC–CDP Trainee certificate should be time limited, e.g., five – six years, at which time the RC-CDP Trainee will be expected to complete his/her education, training, and experience to become a CDP.

  32. KEY THEMES

  33. KEY THEMES • Compensation, Competitive Salaries and Benefits • Aging out of the workforce • Integrated strategic planning by key entities • Improve clinical supervision • Training for clinical and recovery support supervisors • Investigate loan forgiveness and repayment programs • Develop career paths and establish national core competencies • Develop leadership and management initiatives • Provide support related to relapse in the workforce • Provide education on addiction treatment within other disciplines • Standardize Education CDP programs in the state • Recommend that all CDP programs in the state become NADDAC certified.

  34. THE FUTURE

  35. ARE YOU BE READY FOR THE FUTURE? • Preparing for integrated treatment of Co-Occurring Disorders • Preparing for working with other special populations • Expertise in Evidenced Based Program, Practices and Implementation • Connecting to the systems that further WFD • Have the leadership skills needed in a changing work world • Have the clinical supervision skills to adequately supervise those in training and those with advanced skills

  36. Work Force Development Resources • NFATTC Workforce Development Survey Report 2006 (PDF) • DASA Workforce Development Presentation 2007 (PPT) • Annapolis Coalition: History of Planning Process and Overview of WFD Plan (PPT) • Annapolis Coalition: A Thousand Voices – National Action Plan on Behavioral Health WFD (PDF) • Annapolis Coalition: A Framework for Discussion – Action Plan for Behavioral Health WFD (PDF) • Department of Health Chemical Dependency Forum Results (Word) • Department of Health Chemical Dependency Advisory Board Minutes ( • NAADAC Workforce Development Presentation (PPT) • SAMSHA Substance Abuse Workforce Development Environment Scan (PDF) • Ohio Workforce Development Article (PDF) • DASA Training and Workforce Development Website link http://www1.dshs.wa.gov/dasa/services/training/training.shtml

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