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A collaborative model takes on the care gap, part I

March 24, 2008
by John Oberlin
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A group of Michigan providers convened to address their state’s looming care gap and formed the Kent County Health Field Collaborative (HFC).

Michigan’s elderly population is expected to expand during the next 25 years by more than 52%—from 1.2 million to 1.8 million. Its traditional source of new caregivers (women age 25-44) is projected to shrink by more than 10%. Across the LTC industry, the annual turnover rate among entry-level direct-care workers is estimated to be as high as 70%.

In 2004, a number of Michigan providers convened to address their state’s looming care gap and formed the Kent County Health Field Collaborative (HFC). Its first project: a cooperative, flexible, and resourceful program that would directly address the barriers to sustained employment per the individual staffer.

The Opportunity Partnership & Empowerment Network (OPEN) program has been a success and continues to expand its role and coverage area outside of Kent County. During a two-year pilot program, more than 80% of employees utilizing the program maintained their employment. All of these employees were considered at risk of losing their jobs because of inabilities to successfully manage personal challenges and work expectations. Also, two of the five participating employers cut turnover rates in half, while another company reported a drop from an average of 36% to 22%. Among the employers who initially made up the HFC, turnover rates ran as high as 58% before the program.

The program's collaborative structure keeps costs low. Collectively, the provider members, who all share the same problem of staff turnover, pay for one case worker’s salary and any expenses such as supplies and additional project work. Because the HFC is made up of long-term care, acute care, and rehab providers, payments are calculated through a utilization formula.

Each organization predicts what they anticipate access to the services to be and commits that amount to the year’s budget. In 2006-2007—the current year—annual fees ranged from around $1,800 to $14,400. On average, the LTC employers committed to a little more than $5,200 each for the current year.

In the following interview, Carol Helsel, president of HFC and vice-president of human resources at Porter Hills Retirement Communities & Services, and Doug Himmelein, treasurer of HFC and director of human resources at Holland Home, talk with Online Editor John Oberlin about their program.

John Oberlin: How was the OPEN program formed and how did your organizations get involved?

Carol Helsel: Well, we were both involved from the very beginning. There was an organization that had been involved in facilitating discussion, which led to a collaborative model operating in manufacturing (The SOURCE). And their initial thought was that the model could likely be duplicated in healthcare. They saw the program as a potential way to help solve employers’ nursing shortage but then also, in the bigger picture, ensure economic self-sufficiency for the area by helping people be gainfully employed.

JO: What was the program’s initial major goals?

CH: Initially, when we first started talking, we talked around recruitment and retention and saw that we could really come together on the retention side. Because we had long-term care and acute care—we actually had a rehab hospital too—we needed to find something that we could all say was common across the organization. And retention of entry-level employees seems to be that common ground.

And then we drilled down a little further and landed on that revolving-door group of employees who all seem to have personal types of issues that are preventing them from being successful on the job. So in developing that model we really looked at retaining those entry-level employees who didn’t seem to be able to sustain employment—not only within our organizations but really in any organization.

DH: Examples of some of those barriers that might prevent them from coming to work and be retained would be child care and daycare, transportation…it might be a relationship situation in which they are having troubles with their kids, spouse, or boyfriend/girlfriend.

An HFC employer board meeting on March 13, 2008. The collaborative has a board structure, around which members have crafted bylaws around. Each employer has a representative on the board, and there are also partner organizations, such as Goodwill, local colleges, other not-for-profits, and government agencies that contribute. And within that structure there is an executive committee that consists of officer positions. There are also two other committees—a finance committee and a program committee.

JO: So how can the OPEN program help such a personal issue as a boyfriend/girlfriend problem?

CH: We have an OPEN program coordinator. That person is highly skilled in knowing what resources are available in the community and also has a counseling background. So the coordinator would meet with the employee—and it could be that the employee placed a phone call for help or the employer referred the employee—and help to determine what the root cause of the problem is. If it is a relationship issue, for example, they may provide counseling for that or may refer them to some type of a free counseling service.

As another example, if the root cause of the problem is financial, the coordinator will help the employee set up and manage a budget. The program is really geared toward helping that employee in a no-cost way, so the employer can help solve the problem without out-of-pocket money.

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