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1、DEVELOPING AND ENHANCING THE WORKFORCE FOR CHEMICAL DEPENDENCY TREATMENT Robin Roberts David JeffersonWORK FORCE DEVELOPMENT1AGENDAStatus of the workforceCompetenciesTrainingCurrent challenges DASA updatesLegislationConsideration for the future2OBJECTIVESWhat skills and competencies do you need to p

2、repare yourself for the future?How does this information affect you?3WHAT IS WFD?Webster does defines 1: the workers engaged in a specific activity or enterprise 2: the number of workers potentially assignable for any purpose developmentLawrence M. Anthony, EdD, LICDC University of Cincinnati 1: An

3、integrated process requiring participation and cooperation of several employment related institutions whose goal is to help develop and maintain a viable workforce.4WHAT IS THE NUMBER ONE PUBLIC HEALTH ISSUE?Addiction, U.S. Department of Health and Human Services, Substance Abuse and Mental Health S

4、ervices Administration (SAMSHA) 2002 Report19 million Americans need treatment25% are able to access treatment 50% of those in treatment do not completeThe way services are delivered is a barrier to both access and retentionCESAR FAX: Annapolis Coalition on Behavioral Health Workforce SAMSHA Report:

5、 Critical Workforce Shortage, Narrow Focus on White Adults, Dissatisfaction Among Persons In Recovery, Inadequate and Irrelevant Training. 5WORKFORCE DEVELOPMENT MISSIONPridePayProfessionalism6WHAT ARE THE MAIN WORKFORCE ISSUES?Recruitment Retention Education and Training7SHORTAGE OF CDPS ?Directors

6、 said:40% their agency are understaffed There is a vacancy rate of 1.10 FTE per agency54% of shortages are budget related46% stated they would still be understaffed if all budgeted positions were filled49% reported an average of 1.92 FTE planned hiresCDPs account for 79% of all planned hires Agencie

7、s employ on average 10- 11 treatment staffOn average, agencies have 3- 5 CDPTs for every 10 clinicians. Substance abuse professionals will increase Nationally by 33% over the next decade, (U.S. Department of Labor)8WHAT IS THE NUMBER OF CDPS NEEDED IN WA STATE?Currently there are 2,562 active Chemic

8、al Dependency Professionals and 906 expired or otherwise loss of credentials in the state of Washington.Directors said; 280 additional CDPs are needed. Note: This does not include the 10% (256 CDPs) who indicated that they plan on leaving the field soon.The potential of an additional loss of 10% (25

9、6) in a worst case scenario could result in 536 CDPs positions not filled. The effect of Treatment Expansion further increases the need for CDPs given an expected 5% to 10% increase in patients caseload each year.91011CDPS NEEDED12AGING OUT OF THE WORKFORCE70% of directors and 37% of clinicians are

10、50 years old or older 15% of clinicians are in their 60s27% of directors are 60 years old13AGENCY LEVEL TURNOVER2002 turnover rate was 22%2005 turnover rate was 23%61% of clinicians leave for another agency, 49% of clinicians leave for another allied fieldTwo factors appear to be statistically signi

11、ficant predictors of turnover: (1) years experience of the director (more experience, less turnover) (2) clinical supervision (more frequent clinical supervision, more turnover)Most turnover in the state is agency to agency turnover Nationally the turnover rate is approximately 11%14REASONS FOR DIRE

12、CTOR TURNOVERDirector and clinician report:better salary, better work opportunities (within the field) burnout Directors leave category: level of job satisfaction is the lone significant predictor for membership in the changer category Recovery status and second career statusDirectors not in recover

13、y and CD treatment is a second career are more likely to be considering (with high or definite probability) leaving the fieldA statistically significant larger proportion of clinicians at agencies with 2 or fewer staff report their likelihood of changing agencies is “not at all” clinicians may find

14、working in smaller agencies less stressful. 15RETENTION16RETENTION STRATEGIESIncrease salariesProvide raises for increased education and training programs completedReducing paperworkCreating incentive for personal growth and advancement Flexible schedulesHiring the best person in the first place (us

15、e of structured interviews, team interviews, writing & demonstration exercises, etc)17CHALLENGES AND CROSS-CUTTING ISSUES OF THE TREATMENT WORKFORCE18COMPETENCY OR?19Work Force EnvironmentSAMHSA Center for Substance Abuse Research Report 6-18-2007 said, “Substance abuse and mental health care enviro

16、nments Toxic” for persons in recovery and those working in the field.”A critical workforce shortageA narrow focus on Urban White AdultsDissatisfaction among persons in recoveryInadequate and irrelevant training 20COMPETENCY“.a measurable human capability that is required for effective performance”“c

17、omprised of knowledge, a single skill or ability, a personal characteristic, or a cluster of two or more of these”“are the building blocks of work performance”- Marrelli et al 21COMPETENCYEducation StandardsTraining22COMPETENCYChallenges:Variation and a lack of standardization in educational program

18、s (curricula, degree programs) Difficulty in transferring credits DOH has to act as registrar for all applicantsNAADAC certification for all Community College CD programsSpecial populations needs. Statewide Adolescent Grant Stakeholders support the implementation of adolescent competencies and a vol

19、untary credential.Need more specialized training for older adults, ethnic minorities, criminal justice and other special populations.23COMPETENCYTraining Use of evidence-based practicesOutcome measurementNew medicationsAddiction treatment (primary health care, allied health professions)24CROSS-CUTTI

20、NG ISSUESStigmaNoncompetitive compensation25STIGMASome negative perception associated with substance abuse professionalsDifficulty in recruitment and retentionAddiction professionals considered lower status than other professionalsReluctance to enter the fieldContributes to noncompetitive salariesMi

21、sconceptions about treatment, and the qualifications of a clinician26COMPENSATION Low Salaries In 2002, average salaries in low $30,000s Majority of counselors (61%) earned between $15,000 and $34,000 Majority of agency directors (68%) had salaries ranging from $40,000 - $75,000In 2005 67% of clinic

22、ians made less than $35,000 a yr. (88% less than $45,000)In 2005 69% of clinicians report being the primary wage earner for their familyFactors associated with higher salaries: graduate degreescertificationyears in the field 27COMPENSATIONInadequate health care coverage among professional staff30% h

23、ad no medical coverage40% no dental coverage55% not covered for substance use or mental health services(Counselor, 2004)28WFD POSITION UPDATES DASA DIRECTORSCDPT classification law, did not pass. DASA is proposing to revive the bill to include a separate category in DOH for CDPTs and limiting the nu

24、mber of years that a person can be a CDPT.Promote Substantial Equivalency: WA Accepts, Alabama-Masters level addiction professional (MLAP) Arizona-Substance Abuse Counselor (SAC) Idaho-Advanced CADC Oregon-CADCII & CADCIII Continue collaboration with key partners, CDP Advisory Board, DOH, NCCDE, NAA

25、DAC, Tribes, and other State Agencies such as DOC. New link on DASA WFD web pageCDP and CDPT certification informationApplication process readiness Course work description and criminal background checksResearch and updates on WFD.Support the “National Certification” of CollegesEarly information to p

26、rospective CDP studentsCDP recruitment brochure29TREATMENT STAFFChemical Dependency Professional (CDP) means a person certified by the Washington State Department of Health (DOH) Health Professions Quality Assurance OfficeChemical Dependency Professional Trainees (CDPTs) means a person assigned a tr

27、ainee position by an administrator of a state of Washington certified chemical dependency service agency CDPTs are required to be registered as a counselor or have a current license issued by the DOH30HOW DO I BECOME A CDPT?There are five basic steps to becoming a CDPT listed below. For more detaile

28、d instructions obtain a Registered Counselor Application Packet or contact the Department of Health (D.O.H.). 1. Submit a completed application for Registered Counselor along with your personal explanation and documentation of any “yes” answers to the personal data questions;2. Complete four (4) hou

29、rs of AIDS/HIV training;3. Submit the $40.00 application fee to the DOH;4. Verify other credentials held in this or in other states even if credential is not currently active;5. Receive your CDPT credentials!31WHAT ARE THE BASIC STEPS TO BECOMING A CDP?There are five basic steps to becoming a CDP. F

30、or more detailed instructions, on the web go to for a Chemical Dependency Professional License Application Packet or contact the Department of Health (D.O.H.) at (360) 23647001. Register with the D.O.H. as a registered counselor/CDPT. Call the D.O.H. Application Packet Line at (360) 236-4700 and pre

31、ss option 1 to request an application. Leave your name and address and a packet will be automatically sent to you.2. Complete the Chemical Dependency college course work and the supervised (2,500-AA, 1,500-BA, 1,000-Graduate Level) internship hours.3. Submit the application with a fee of $40 to D.O.

32、H.4. Submit an application to D.O.H. for Chemical Dependency Professional status with a $100 application fee and a $125 initial certification fee, both non-refundable.5. Take and pass the written examination.32Proposed CDPT LegislationSubmitted by Chemical Dependency Professionals SubgroupChemical D

33、ependency Professional TraineesJuly 2006 to the Governors office for review the following:Revise RCW 18.205 - Chemical Dependency Professionals, to create a new RC certificate aligned with CDP certification. The new credential might be RC-CDP Trainee or CDP Trainee. An RC-CDP Trainee must attest ann

34、ually, after receiving a certificate, to actively pursue the educational requirements per WAC 246-811-030 to become a CDP. Should CDP Trainees demonstrate certain core competencies before providing specific counseling services to patients? Yes but that has not been defined yet. Should they take an e

35、xam? While a state exam for RC-CDP Trainee is not required, the RC-CDP Trainee is required to take and pass a number of exams in core competency counseling areas while completing the education requirements to become a CDP.How should they be supervised? CDP Trainees are supervised under the authority

36、 of DOH WAC 246-811 and DASA WAC 388-805. WAC 246-811 describes supervisor qualifications while WAC 388-805 describes elements of supervision. Should there be an interim permit for those intending to become licensed or certified? Yes The new RCCDP Trainee certificate should be time limited, e.g., fi

37、ve six years, at which time the RC-CDP Trainee will be expected to complete his/her education, training, and experience to become a CDP. 33KEY THEMES34KEY THEMESCompensation, Competitive Salaries and BenefitsAging out of the workforceIntegrated strategic planning by key entitiesImprove clinical supervision Training for clinical and recovery support supervisors Investigate loan forgiveness and repayment programsDevelop career paths and establish national core competenciesDevelop leadership and management initiativesProvide support related to relapse in the workforceProvide education on addicti