MHSA Workforce Education & Training MHSA Workforce Education - - PowerPoint PPT Presentation

MHSA Workforce Education & Training MHSA Workforce Education & Training (WET) (WET)

County of San Diego Mental Health Services

MHSA MHSA – – WET Fundamental Concepts WET Fundamental Concepts

• includes

includes clients and family members clients and family members, , and and Counties work with their communities to Counties work with their communities to implement education implement education and training and training that contributes to developing and maintaining a that contributes to developing and maintaining a workforce workforce which which

• client

client-

• and family

and family-

• driven,

driven,

• is capable of providing

is capable of providing culturally competent culturally competent, ,

• integrated,

integrated,

• wellness and recovery/resiliency oriented

wellness and recovery/resiliency oriented services services within a collaborative environment.

Five WET Funding Categories Five WET Funding Categories

1.

• 1. Workforce Staffing Support

Workforce Staffing Support

for planning, administering, supporting and for planning, administering, supporting and evaluating the workforce programs and trainings evaluating the workforce programs and trainings

• 2. Training and Technical Assistance
• 2. Training and Technical Assistance

for events and activities to assist the public mental for events and activities to assist the public mental health workforce in improving delivery of services health workforce in improving delivery of services consistent with the MHSA consistent with the MHSA-

• WET fundamental

WET fundamental concepts concepts

$17.3 million (over 10 years) for programs & activities in 5 funding categories:

WET Funding Categories WET Funding Categories

5 5.

. Financial Incentive Programs

Financial Incentive Programs

for stipends, scholarships and loan assumption programs to for stipends, scholarships and loan assumption programs to recruit and retain public mental health employees recruit and retain public mental health employees

• 3. Mental Health Career Pathway Programs
• 3. Mental Health Career Pathway Programs

for educational, training and counseling programs designed for educational, training and counseling programs designed to recruit and prepare individuals for public mental health to recruit and prepare individuals for public mental health careers careers

• 4. Residency and Internship Programs
• 4. Residency and Internship Programs

for addressing identified shortages in the licensed, direct for addressing identified shortages in the licensed, direct service provider positions service provider positions

WET Planning Overview WET Planning Overview

2007 2008 2009 April May June July August Sept October November December January February March April May June July August Sept October November December January February March April Early Implementation Planning Developed WET Implementation Request X X X X Wet Implementation Request Submitted Wet Implementation Request Approved Needs Assessment Data Collection Contract With Consultant For Needs Assessment Consultant & County Research/Analyses Focus Groups Conducted Targeted Electronic Surveys Conducted Phase I Key Informant Interviews Conducted Phase II Key Informant Interviews Conducted Workforce And Education Training Plan Development Needs Assessment Presented For Comment Solicited WET Recommendations From Community Convened WET Workgroup Cross Threading Group Makes Prioritization Recommendations Workforce And Education Training Plan Submission 30-Day Public Comment Period Mental Health Board/Public Hearing Submit Plan To California State Department Of Mental Health

WET Planning Data WET Planning Data

Counties are required to propose programs Counties are required to propose programs and activities that address the County and activities that address the County’ ’s s workforce development, education and workforce development, education and training needs identified through a training needs identified through a Needs Assessment Needs Assessment. .

Workforce Needs Assessment Workforce Needs Assessment

A standardized A standardized baseline set of workforce data baseline set of workforce data summarizing summarizing personnel shortages and needs of ethnic/racial and culturally personnel shortages and needs of ethnic/racial and culturally underrepresented populations by indicating: underrepresented populations by indicating:

– – Current staffing patterns Current staffing patterns – – Hard Hard-

• to

to-

• fill positions

fill positions – – Current ethnic/racial composition and language Current ethnic/racial composition and language capacity capacity – – Additional staffing requirements Additional staffing requirements

Workforce Needs Assessment Workforce Needs Assessment Stakeholder Participation Stakeholder Participation

• 25 Focus Groups

25 Focus Groups – – 229 individuals 229 individuals

– – Providers, Consumers, Education, Training, Community, Providers, Consumers, Education, Training, Community, Councils, HHSA Councils, HHSA

• 25 Key Informant Interviews

25 Key Informant Interviews

– – Community, consumer, family and current mental health Community, consumer, family and current mental health providers providers

• 3 Targeted Surveys

3 Targeted Surveys – – 80 respondents 80 respondents

– – Consumer and family members, program managers, and Consumer and family members, program managers, and direct mental health service providers direct mental health service providers

2007 2008 2009 April May June July August Sept October November December January February March April May June July August Sept October November December January February March Needs Assessment Data Collection Contract With Consultant For Needs Assessment Consultant & County Research/Analyses Focus Groups Conducted Targeted Electronic Surveys Conducted Phase I Key Informant Interviews Conducted Phase II Key Informant Interviews Conducted

WET Needs Assessment WET Needs Assessment Data Collection Data Collection

• Step 1 – Gather information for Needs Assessment from stakeholders

Completed

December 2008 January 2009 February 2009 March 2009 Needs Assessment Presented For Comment Solicited WET Recommendations From Community Convened WET Workgroup

WET Plan Development WET Plan Development

• Step 2 – Share Needs Assessment findings with stakeholder

representatives to generate WET programming ideas

• Step 3 – Convene WET work group including subject matter experts
• nvene WET work group including subject matter experts

to craft WET programming recommendations using ideas from Needs to craft WET programming recommendations using ideas from Needs Assessment, stakeholder representatives, consumers/family member Assessment, stakeholder representatives, consumers/family members s Completed Completed

REVIEW OF REVIEW OF NEEDS ASSESSMENT NEEDS ASSESSMENT KEY FINDINGS KEY FINDINGS

Current Workforce Current Workforce

Type Type

• 3491 individuals, 2001

full time equivalent (FTE) positions – 22% County Staff – 75% Contracted Staff - community based

• rganizations (CBO)

– 3% fee-for-service providers (FFS)

Mental Health Workforce by Type

2001 FTE

75% 22% 3%

Contract (CBO) County Employee Fee for Service

Current Workforce Current Workforce

Classifications Classifications

5 major job classifications highest concentrations are:

• 39% Licensed Direct
• 24% Unlicensed Direct
• 20% Support Staff

39% 24% 20% 12% 5%

Licensed Direct Unlicensed Direct Support Management/Super Other

Current Workforce Ethnicity Current Workforce Ethnicity

59% 19% 8% 9% 1% 4% White Latino African American Asian Native American Other

43% 30% 13% 5% 1% 8% White Latino African American Asian Native American Other

Workforce by Ethnicity Consumers by Ethnicity Workforce by Ethnicity Consumers by Ethnicity

Current Workforce Current Workforce

Language Language

• 4 San Diego County threshold languages: Spanish,

Vietnamese, Tagalog, Arabic

• Requirement for bilingual staff was one of the top

reasons for the continued vacancy of direct service staff positions

• Spanish continues to be the most sought after

language in the mental health workforce

• Other linguistic needs identified: Chaldean,

Hmong, Cambodian, Laotian as well as for immigrant populations from East Africa, many of who speak Somali and Swahili.

Current Workforce Current Workforce

Consumers & Family Members Consumers & Family Members

• 82 people / 52 FTE designated

consumer/family positions

• Consumer/family positions

– Peer-to-Peer programs, – Clubhouses – Full Service Partnerships (FSP)

• There is a high level of

ethnic diversity in the consumer positions (64%)

36% 32% 24% 1% 3% 4%

White/Caucasian Hispanic/Latino African American/Black Asian/Pacific Islander Native American Multirace or Other

Shortages by Classification Shortages by Classification

Licensed Positions Licensed Positions

• MFT/including MFT

MFT/including MFT interns interns

• MSW /including interns

MSW /including interns

• LCSW

LCSW

• Bilingual Therapist

Bilingual Therapist – –

• utpatient services
• utpatient services
• Psychiatrist (all)

Psychiatrist (all) – –General General – –Child/adolescent Child/adolescent – –Geriatric Geriatric

• Psychologist

Psychologist-

• Licensed

Licensed Clinical Clinical

• Nurse (all)

Nurse (all) – – Clinical Specialist Clinical Specialist – – Licensed Vocational Licensed Vocational – – Registered Registered – – Psychiatric/Family Psychiatric/Family Practitioner Practitioner

Shortages by Classification Shortages by Classification Unlicensed Positions Unlicensed Positions

• Mental Health

Mental Health Rehabilitation Specialist Rehabilitation Specialist

• Case Managers (CBO

Case Managers (CBO

• nly)
• nly)
• Consumer/Family

Consumer/Family Members (CBO only) Members (CBO only)

• Other Unlicensed:

Other Unlicensed:

– – Coordinator/Specialist Coordinator/Specialist – – Program Aid/Assistant/Representative Program Aid/Assistant/Representative – – Child Development Counselor, Child Child Development Counselor, Child Care Worker Care Worker – – Chemical Dependency Counselor Chemical Dependency Counselor – – Milieu Specialist Milieu Specialist – – Student Interns (BA/AA, High school) Student Interns (BA/AA, High school) – – Volunteers/Interns Volunteers/Interns – – Mental Health Worker/Asst/Case Mental Health Worker/Asst/Case Worker/Specialist/Counselor Worker/Specialist/Counselor – – Program Specialist Program Specialist – – Emergency Response Team Worker Emergency Response Team Worker – – Awake Overnight Counselor Awake Overnight Counselor – – Legal Support Staff (Conservator) Legal Support Staff (Conservator)

Shortages by Classification Shortages by Classification Management Positions Management Positions

• Chief Executive Officer (CBO)

Chief Executive Officer (CBO)

• Other Manager/Supervisor

Other Manager/Supervisor

• Licensed Managers/Supervising Clinicians

Licensed Managers/Supervising Clinicians

Shortages by Classification Shortages by Classification

Support Positions Support Positions

• Clerical/Secretary

Clerical/Secretary

• Administrative Assistant

Administrative Assistant

Challenges in Attracting & Hiring Challenges in Attracting & Hiring

• Competing with higher salaries in other MH

Competing with higher salaries in other MH sectors (nonpublic) sectors (nonpublic)

• High cost of living in San Diego

High cost of living in San Diego

• Intense competition for bilingual staff

Intense competition for bilingual staff

• Perceived low status of mental health careers

Perceived low status of mental health careers

• Under

Under-

• representation of diverse cultural groups

representation of diverse cultural groups in higher education in higher education

• Educational pathways are not clearly defined

Educational pathways are not clearly defined

Challenges to Retaining Staff Challenges to Retaining Staff

• Limited opportunities for advancement

Limited opportunities for advancement

• Salaries below community compensation

Salaries below community compensation

• Limited time for supervisors to mentor

Limited time for supervisors to mentor

• Productivity based too much on billing

Productivity based too much on billing

• High level of stress & burnout

High level of stress & burnout

• Difficulty in retaining interns that often move to

Difficulty in retaining interns that often move to private practices or hospitals once licensure is private practices or hospitals once licensure is attained attained

STRATEGIES STRATEGIES

Strategies Strategies

Consumers and Family Member Focus Consumers and Family Member Focus

• Restructure delivery system models to deliver an integrated

Restructure delivery system models to deliver an integrated approach approach

• Identify training and clear professional ladders/ promotional

Identify training and clear professional ladders/ promotional

• pportunities
• pportunities
• Incorporate workforce opportunities for consumer and families

Incorporate workforce opportunities for consumer and families beyond entry level or paraprofessional positions beyond entry level or paraprofessional positions

• Make provisions for adequate supervision & support

Make provisions for adequate supervision & support

• Create opportunities for consumer awareness and education

Create opportunities for consumer awareness and education regarding working in the system and the potential impact on regarding working in the system and the potential impact on finances and benefits (e.g. SSI, Section 8, taxes, etc.) finances and benefits (e.g. SSI, Section 8, taxes, etc.)

Strategies Strategies

by Position Classifications by Position Classifications

• Define and target most critical position

Define and target most critical position classifications classifications

• Determine strategies based upon where

Determine strategies based upon where partnerships within specific position classifications partnerships within specific position classifications exist exist

• Identify the opportunities to create pipelines in

Identify the opportunities to create pipelines in these areas these areas

Strategies Strategies

Create Opportunities for Pathways into Public Create Opportunities for Pathways into Public Mental Health Careers Mental Health Careers

• Start young: career exposure for the emerging

Start young: career exposure for the emerging workforce workforce

• Develop

Develop “ “current worker current worker” ” pathways for a pathways for a “ “grow grow

• ur own
• ur own”

” approach approach

• Strengthen connections at the post

Strengthen connections at the post-

• secondary

secondary level to educate and inform about public mental level to educate and inform about public mental health careers health careers

Strategies Strategies

Retaining Staff Retaining Staff

• Create a public mental health system culture that

Create a public mental health system culture that values and invests in the future of its workforce values and invests in the future of its workforce

• Create clear opportunities for advancement, pay

Create clear opportunities for advancement, pay increases, mentoring by supervisors, and further increases, mentoring by supervisors, and further education to promote/enhance cultural competency education to promote/enhance cultural competency

• Address expectations of the work with respect to

Address expectations of the work with respect to the balance of time spent on billing, documentation the balance of time spent on billing, documentation and paperwork requirements versus direct services and paperwork requirements versus direct services

WET Plan Development & Submission WET Plan Development & Submission -

• Next Steps

Next Steps

• Step 4 –

– Cross threading group prioritizes WET program Cross threading group prioritizes WET program recommendations followed by 30 day comment period recommendations followed by 30 day comment period

December 2008 January 2009 February 2009 March 2009 April 2009 Convened WET Workgroup Cross Threading Group Makes Prioritization Recommendations Workforce And Education Training Plan Submission 30-Day Public Comment Period Mental Health Board/Public Hearing Submit Plan To California State Department Of Mental Health

• Step 5 –

– Mental Health Board/Public Hearing Mental Health Board/Public Hearing

• Step 6 –

– Submission to State Department of Mental Health Submission to State Department of Mental Health

And now And now… …

The WET programming initiatives, ideas and The WET programming initiatives, ideas and activities the activities the CrossThreading CrossThreading Work Group is Work Group is considering for prioritization. considering for prioritization.

For more information on WET see the Network of For more information on WET see the Network of Care website: Care website: www.sandiego.networkofcare.org www.sandiego.networkofcare.org