3 Insights from New York’s ‘Workforce Investment Program’

One of my roles at PHI is to promote replicable models for strengthening the direct care workforce at the state level. One outstanding example is New York’s Managed Long Term Care Workforce Investment Program—which will distribute up to $245 million between April 2018 and March 2020 for initiatives designed to “retrain, recruit, and retain healthcare workers in the long-term care sector.”

Through the Workforce Investment Program, the New York State Department of Health has designated 11 workforce training centers as Workforce Investment Organizations (WIO). These WIOs provide a range of recruitment, retraining, and retention initiatives for long-term care staff, particularly direct care workers—fulfilling PHI’s recommendation from nearly a decade ago for the state to create “centers of training excellence.” Medicaid managed long-term care (MLTC) plans can contract with any WIO in their region to offer programs at no cost to long-term care providers, such as home care agencies and nursing homes.

I recently spoke with Jerry Philip, PHI’s VP of Workforce Innovations, about his experiences leading PHI’s WIO. Here are three insights about implementing the WIO training program from that conversation, echoing what I’ve heard from other long-term care providers throughout New York.

State-funded training programs are critically needed.

In New York, as in other states, the long-term care sector is rapidly evolving. Some of the key trends include the transition to Medicaid managed care, the introduction of value-based payment, and the increasing acuity levels among those receiving long-term services and supports.

“WIOs have been really instrumental in helping agencies and workers address these systemic changes and challenges,” Philip reported. “Without programs like this, we know that many providers struggle—on constrained budgets—to provide the training that their workers need.”

For example, as a designated WIO, PHI offers a range of training programs, including: entry-level training for new workers; specialty and advanced role training for incumbent workers; and organizational development training for supervisors and other staff.

Following New York’s example, other states should create and fund statewide training programs that position long-term care providers for success in a shifting landscape.

Quality training programs require sufficient planning time.

When the program launched, newly designated WIOs had little time to secure contracts with MLTC plans and begin implementing new training programs.

“A portion of our first year as a WIO had to be spent doing the initial planning and implementation, so we felt rushed by the end,” said Philip. “We’re seeing a similar challenge again this year.”

States that are developing their own training models should consider funding a planning phase to allow training providers, in partnership with MLTC plans and/or long-term care providers, to identify workforce training needs, create targeted training programs, and develop contracts—all before full implementation begins.

Longer-term funding incentivizes more extensive training programs.

New York’s Workforce Investment Program has only been funded for two years, with funding disbursed through annual payments. While a short-term timeframe may be helpful for initiating and testing a new training program, stakeholders need to know whether and how the program will be sustained over time.

“We’ve seen some hesitancy from potential partners about figuring out a longer-term training strategy because of the single-year funding cycles and uncertainty around funding after March 2020,” said Philip when explaining why many WIOs have, necessarily, taken a short-term approach to creating and implementing new training programs.

Given this funding situation, WIOs and MLTC plans are less likely to embark on multi-year programs, such as training “booster” programs (to help trained workers refresh and enhance their skills over time) or training programs for advanced roles (which require considerable time to design and operationalize). These types of longer-term programs may have a greater impact on preparing the workforce to meet the evolving needs of our long-term care sector.

States that develop similar training programs must identify sustainable funding sources and disburse funding in ways that encourage both short- and longer-term planning. With this approach, training programs are most likely to meet the needs of long-term care providers, workers, and consumers.