Bennington
County
School & Workforce Partnership
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I Health and Human Services
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Health and Human Services Occupations in this sector pay well, but there is some variation for specific positions and levels. Across the entire sector, wages are above-average compared to other Vermont industries - but average health care wages are significantly higher than average human services wages 3. In the 1990s, pressure for cost reduction combined with reduction in government spending led to some stagnation in pay levels. However, most recently, wages have been driven up by an overall workforce shortage in this sector. For instance, PMHC reports that earnings of LNAs at Weston Hadden Convalescent Center and Bennington Area Home Health have risen 20% in the past year, and are expected to be driven even higher in the near future.
1) See Graph: "Health and Human Services
Industry as a Percent of Workforce."
Current Workforce Health Care Services One area which is experiencing over-saturation rather than shortage is the field of physical therapy. Arseneau attributes this to changes in the Federal system for reimbursement of Medicare and Medicaid: physical therapy services are not now fully reimbursed, and hospitals have reduced physical therapy staff. Local employers echo state reports that a variety of factors related to employee recruitment and retention lie behind the general shortage of health care workers - escalating growth in number of new openings; high turnover due to wage issues, work loads and job satisfaction levels under managed care systems; likelihood of irregular working hours; job-related injuries, etc 5. Some of these factors are beyond the scope of this Plan, but several have direct relationships to education and training issues. For instance, industry wide there is a high rate of turnover in health care positions and, coupled with the on-going expansion of the health care industry, this makes for an ever-increasing number of positions that need to be filled. Within the nursing field, most of these openings fall at the lower-level positions (e.g., LNA). Partly this is because there is a clear step-by-step career ladder and as positions up the ladder become open the lower-level employees move up and leave vacancies behind them; but also, many who enter as LNAs leave the field altogether after a short period of time. Therefore, health care employers are vocal about the need to recruit and train large numbers of entry-level health care workers for positions such as LNA, patient care assistant (PCA) and home health care aide, and to provide educational opportunities for workers to upgrade their skills and move up the career ladder as openings occur. Many employers provide in-house training as necessary,and regionally, Bennington County has a strong network of education/training opportunities to support the skill development of the health care workforce including but not limited to:
4) "Shortage of Nurses Starting to
Plague Health Care Industry." Vermont Business Magazine, June, 1999.
Another factor relevant to the shortage of health care workers is the overall increase in modern-day career choices for working women. Traditionally, women entering the workforce have been a major source of health care workers, especially in the nursing and home care professions. Nowadays a smaller percentage of women are opting for health care careers. Local health care employers are working to stem this tide by creating closer relationships with area schools and establishing partnerships - through job shadowing, internships, and work experience opportunities - that can interest students in pursuing health care careers. This is viewed as a major recruiting avenue. In addition to the availability of a local workforce, employers are concerned about the quality of those who are available. Beyond technical skills and knowledge, for which ample education/training exists locally (see above listing), health care employers are especially concerned about what are called "soft skills" (flexibility, dependability, willingness to learn, communications skills, teamwork, decision making), about skills in communicating compassion, and about customer relations skills in general. As Phyllis Tarbell of the Dorset Nursing Association puts it, nurses and other professionals providing direct patient care need "excellent people skills." She tends to hire people known to her or her staff. "The kind of person you are is more important than the [technical] skills you have," she says. "You can learn the skills." Several employers state that hiring employees with good "soft skills" results in a staff with staying power. At Orthopedic and Hand Surgery in Bennington, they believe carefully screening and hiring employees with good work ethic, independent thinking, decision-making skills, the ability to listen, and the ability to put information in a larger context has resulted in low staff turnover. Human Services The main factors employers in this sector face are concerns about the skill levels of entry-level employees and the retention of valuable employees. Rudolph Weaver, Director of Human Resources at United Community Services of Bennington County (UCS), which employs a total of 150 individuals to provide counseling and other mental health and substance abuse treatment services to individuals, families and businesses, says that entry-level applicants with no more than a high school diploma often lack a necessary level of reading, writing and effective speaking skills. Although several positions within UCS require only a high school diploma - such as case managers, program managers, respite workers, and group home direct care providers - approximately half of the applicants at this educational level are turned away by UCS, because of skill deficiencies and a poor work ethic. Employees holding post secondary-school degrees are better prepared to be successful in the workplace, Weaver says, and there are adequate numbers of them in the workforce pool. Within the state Department of Social Welfare (DSW) and Department of Social and Rehabilitative Services (SRS), department managers say regular staff training is necessary to remain effective at helping the people they serve. Writing skills are essential, along with computer literacy. Social services staff must be able to synthesize information and present it succinctly in written form to courts, other agencies, etc., says SRS manager Charles Gingo. They must also be able to articulate decisions quickly for individuals who may be unable or unwilling to cooperate. DSW manager Eunice Schlief 's staff have received in-house training in computer skills and team-building. Additional training needs include communication skills and conflict resolution. SRS-employed social workers with a four-year undergraduate degree are eligible for participation in a two-year Masters of Social Work (MSW) program at the University of Vermont (UVM). The program provides full salary while the participant attends school full time, and full tuition, in exchange for a two-year commitment to work for SRS after earning the MSW degree. The state also sponsors a program providing SRS social workers an $800 monthly stipend and pays all the costs to earn a MSW at UVM. 25% of the state's SRS social workers have used one of these options to earn their MSW. The availability of better-educated and trained workers, however, comes with its own challenge for this field. A common problem is retaining these educated people, who find better paying jobs elsewhere, or pursue the earnings opportunities of private practice. The problem is not availability, but affordability, Weaver says. "With more and more services being provided under managed care, more master's degree-level employees will be required," he says. "Wages in the state of Vermont are low overall, and keeping qualified people is often problematic." Some of the state departments face a slightly different issue related to employee retention. Gingo says that his staff has grown because of an increased caseload, but turnover is very low. This means opportunities for advancement in his office are very limited, Gingo said, because employees tend to remain in their positions. Future Workforce Factors driving this growth range from the aging of the baby boomer population to changes in insurance regulations that may cause increases in access to certain services. For instance, Bennington chiropractor Nancy Burns expects a continued steady growth in her client base, partly because medical insurers are now required to cover chiropractic services, and partly because she provides a type of treatment that individuals increasingly seek. For Barber-Thomas, shortened hospital stays, combined with increasing restrictions for admission to nursing homes, are creating the demand for more varied and higher levels of home care. "The push is not to be sick in the hospital," she said. "And this puts a strain on the home care system. I see an expansion of the current home health care agencies." For the health care field, this sector growth will pose the significant challenge of finding a sufficient number of local, adequately skilled, employees. Recognizing this, employers are already committed to establishing stronger partnerships with schools that can serve to recruit more students into the health care field. Related to this, employers such as Barbara Gross of Weston Hadden Convalescent Center are willing to work more closely with schools to encourage them to adopt a focus on "soft skills" as part of their curriculum, which should result in better-prepared entry-level employees for this customer relations intensive sector. Related to the availability of workers, in the health care field employers will need to seek creative solutions to the factors behind high employee turnover. Some agencies are addressing this problem locally. Bennington Health and Rehabilitation Center offers a flexible work schedule, full tuition reimbursement, and subsidized or on-site day care for employees' children. Beyond the fundamental availability of workers, the increased use of technology in many roles in the health care system will result in a growing demand for more technologically skilled workers over-all as well as additional workers within the technology intensive specialties. The increased use of imaging technology in the hospital, for example, will require a larger number of skilled imaging specialists than currently available. Pharmacists are an advanced-skill occupation
expected to change greatly in the near future. RECOMMENDATIONS
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