Field of Work: long-term-care workforce needs in Vermont

Problem Synopsis: Unprecedented vacancies and high turnover among nursing assistants, home health aides and personal care attendants have affected both home- and community-based providers and nursing homes, which have reported annual turnover rates ranging from 40 percent to more than 100 percent. These recruitment and retention problems affect both the quantity and the quality of long-term-care services.

Synopsis of the Work: The Community of Vermont Elders (COVE) was the lead agency for a multi-stakeholder Better Jobs Better Care. Twelve providers participated. Each conducted a workplace assessment to identify its own priorities for direct-care worker recruitment and retention. "That way," says Michelle Champoux, the project's training coordinator, "we made sure we developed both centralized and individualized curricula that addressed the needs expressed by each participating site."

Key Results: The coalition developed three training curricula for direct-care workers: a core training curriculum, called Care Well, designed for personal care attendants; and two specialized trainings, Beyond Basics in Dementia Care and Beyond Basics in Palliative Care, for existing workers.

The 12 participating long-term-care providers received training in leadership development and peer mentoring to support organizational culture change. Half of the sites also received intensive individualized support from project staff.

COVE, which had funding from other sources, and the coalition helped create the Direct-Care Worker Registry Task Force. It also established an annual "Gold Star" awards program in 2006 to recognize home care agencies for improving recruitment and retention practices.