Ability Beyond Disability’s P2E Program Using CDS Has 63 Graduates – and All 63 DSPs Are Still There

It is not everyday that you have an employee run up and give you a hug because they got into a training program, but at Ability Beyond Disability we are getting used to just that! Since beginning our Pathways to Excellence program in May of 2008, hugging has been on the rise.

Maybe that is because Pathways to Excellence (P2E) is more than your typical training program -- it is a career path that engages employees in our organization’s vision. At Ability Beyond Disability in Bethel, CT., we have a 55-year history of providing support to individuals with disabilities. But equally as important is our dynamic vision for the future -- Vision 2013. It is a vision of growth, creative solutions, and new possibilities for providing support to twice as many individuals with developmental and neurological disabilities in Connecticut and New York. Each year, we serve approximately 1,300 individuals through community-based residential, vocational, behavioral, nursing and rehabilitation services.

Anyone in our field knows the direct support staff story – low pay, lack of training, lack of recognition, and lack of career growth and advancement. Ability Beyond Disability employs 715 direct support staff, and have been challenged by annual turnover rates ranging from 30 to 35 percent. We knew something had to change if we were going to grow to meet the increasing support needs of those in our communities. We did a lot of research, and found the College of Direct Support (CDS) to be the leader in direct support training and best practices.

We have put a lot of new workforce ideas and best practices in place over the past few years, but nothing compares to the success we have seen in the past year since implementing our P2E program, with CDS as its core curriculum.

We began P2E, a career path program for our direct support workforce, with two goals -- to advance the skills, knowledge and ability of our direct support workforce, and at the same time provide promotional opportunities and financial rewards. The program was designed by a focus group of direct support staff and frontline supervisors from across the organization. Before we could start, we needed the approval and support, both in spirit and financially, from our entire organization. It soon became clear the program had overwhelming support! Our focus group became our initial pilot group and began in May 2008. All 17 participants graduated in November 2008 and P2E has been rolling ever since.

Here’s how it works. The first phase of the P2E Program is the Direct Support Professional (DSP) training program. Prospective participants self-select into the program and are required to complete an application, including a brief statement of what they wish to gain from the program and future career goals. Criteria for the program includes having worked in direct support with us for at least one year, compliance with all required trainings and certifications, no disciplinary actions within the past 12 months, and a letter of support from their supervisor. We run the program similar to college semesters, with a specific application period and a three-hour “kick-off” to orient participants to the program.

Ability Beyond Disability's Graduates and Staff

Participants must complete about 120 hours of online CDS lessons over a five-month period. Monthly group meetings are held to discuss a pre-selected course andparticipants are responsible for a written reflection of the course being discussed and to share what they have learned. Most participants have expressed the positive impact the CDS courses have on them, including sparking new ideas to provide better support, and viewing themselves as professionals, excited by the career possibilities that lie ahead as a result.

Recognition is a crucial element. We make sure we recognize the successful completion of the DSP program, not only internally, but with the greater community so that they may understand the importance of direct support. Let’s face it -- did any of us have a high school guidance counselor tell us about a career in direct support? Upon completion, graduates are promoted to a new title of DSP, which comes complete with a 50-cent hourly pay increase and a graduation ceremony. Graduates invite their co-workers, family, friends and those they support. The crowd rises to their feet and they file in to the now infamous chant “D – S – P! D – S – P!” They are presented a framed certificate along with a completion bonus of $1,000 by members of our Board of Directors and senior leadership. Photos and a press release are sent to each participant’s hometown paper in an effort to share their achievements with their neighbors and friends.

The next step in the P2E program is still in development. It includes specialty certifications with their own 40-hour training programs combining classroom and CDS courses not completed as part of the first step of the program. The specialty certifications are designed to assist our organization with our Vision 2013 goals.

Our organization has made a tremendous investment in our direct support workforce. To date, we have had 63 graduates, amounting to $63,000 in bonuses alone. In addition, we have 45 current participants in the program, and a waiting list of qualified applicants eager to start. This is a large investment, but with an equal if not larger return. In the past year we have seen a decline in our turnover rate – from 30% to 21%. We realize that the poor economy helps us retain employees, but also realize that it is how we treat people now, when the economy is poor, that will help us retain them when things improve.

Since beginning the P2E program in May 2008 we have had NO turnover among participants. All 63 graduates are still working here, eagerly awaiting the development of the specialty training programs. For each employee we retain, we save money on recruiting and on-boarding costs such as background checks and training. Each employee retained means the individuals we support know and recognize the person working with them each day, and it means that his or her family member recognizes the staff member working with their loved one. Can you put a price on that? As the credit card commercial says – PRICELESS. The success of P2E has shown us that by investing in our employees, they are, in turn, investing in a career with us.

“Our greatest asset is our workforce, and therefore, I can’t think of a better investment than our Pathways to Excellence program. It is a win-win for all. Our staff have the opportunity to develop professionally, and the people we serve benefit from having consistent and highly qualified staff,” said Thomas H. Fanning, President/CEO, Ability Beyond Disability

It makes one proud to work for a company that has a vision, especially in the tough economic climate that we all find ourselves faced with, and prouder still that our organization recognizes the importance of the direct support workforce who make the support we provided yesterday, today, and tomorrow possible. Oh, and of course, I love the hugs!

Written by Kristine Foss, Workforce Planning & Development Administrator at Ability Beyond Disability in Bethel, CT. You may reach her at 203.826.3066 or via email at kfoss@abilitybeyonddisability.org.

2008 Direct Support Professionals Wage Study

The 2008 Direct Support Professionals Wage Study, which was conducted in partnership between ANCOR and the Mosaic Collaborative for Disabilities Public Policy and Practice, imparts a sobering view of a national healthcare workforce in crisis.

Direct Support Professionals (DSP) provide “hands on” daily supports, training and habilitative services to persons with developmental and physical disabilities. Analysis of survey results compared wages among DSPs employed by private providers with those who work for state-run programs.

The national average starting wage for private provider DSPs in community programs is $8.53 per hour, comparedto the average starting wage of $12.13 for state-employed DSPs – representing a 42 percent difference. Annualized, the average entry wage for a private provider DSP falls just short of the federal poverty level as the private DSP entry wage is $17,744 compared to the federal baseline (for a family of three) at $17,600.

“The wage disparity among private and public DSPs is startling,” said Renee Pietrangelo, CEO of ANCOR. “As demand for the supports provided by DSPs grows exponentially, low wages will prevent private providers from attracting and retaining a qualified workforce.”

The Bureau of Labor Statistics projects a 49 percent increase in the number of direct care positions that will be needed between 2006 and 2016. This problem is compounded by the fact that the workforce is almost entirely funded by the Medicaid program.

The CDS Story at Alternative Community Training: Turnover is down, 'Increase in Positive Culture for Agency'

Alternative Community Training, Inc. (ACT) has been a human services provider for persons with disabilities in Columbia, MO, since 1975, initially providing educational services to students in a private school setting. Today, predominantly an adult-service provider, ACT supports more than 300 persons with disabilities in the following Programs: Community Living, Community Employment, Community Integration and ACT Works. The College of Direct Support (CDS) has been utilized in Missouri and at ACT as a pilot program since November 2005 -- and the results for this agency have been amazing!

The Missouri College of Direct Support currently has about 35 agencies throughout the state participating in the pilot, which will continue though June 2009. The agency administrators in the state have convened on a monthly basis to annotate curriculum, complete a thorough overview of each course and to make recommendations regarding how CDS courses could replace current statewide requirements for training. The administrators group, along with the Statewide Steering Committee, has been the driving force behind the level of success associated with using the CDS.

ACT has offered CDS on a completely voluntary basis. If learners are interested in completing courses, they seek out the agency’s CDS administrator to get started with classes. ACT does offer incentives for completing courses. Learners who provide direct support can receive a total stipend of $700 in bonus money. This includes $350 after completing a set of six prescribed courses and the on-the-job training checklists that the CDS offers. The learners and their supervisors then have the option to choose “elective courses” from the remaining seven courses needed to complete state certification requirements for Missouri. Once the on-the-job training checklists are reviewed with learners, they are eligible for the second stipend of $350. The learners also receive a $0.25 hourly rate increase and a title change, to Direct Support Professional (DSP).

Ed Ricciotti, who recently began a position as a Frontline Supervisor after working as a DSP for 12 years states, “The CDS courses assisted me to become a better DSP and now I am able to use this as a frame of reference when I am training and supervising our DSPs.”
Employees complete surveys to provide feedback regarding the validity of the courses completed. This survey data is maintained on a statewide basis and has assisted the Missouri Division of Developmental Disabilities to have credible data supporting the use of CDS statewide. The state is currently looking into funding options that would sustain this program into the future.

Employees from ACT have given rave reviews regarding the CDS content. Employees feel better prepared for their daily responsibilities after completing these courses. Employees who support persons with behavior challenges feel more confident when dealing with challenging situations. Employees have a realistic picture of the vital role they play in the lives of persons supported. ACT’s mentor and CDS graduate Emma Landry, notes, “The CDS classes that I took were very user friendly. I enjoyed listening to the stories of real individuals and their staff members and felt like they helped me to fully understand what was being taught to me. I can honestly say that I gained a great deal of knowledge, understanding, and awareness from taking the CDS courses. I feel that I can now better support the individuals in our program and I feel that I can be a better advocate for them.”

ACT recognizes all learners who have achieved this status at ACT employee events (our annual retreat, holiday party, employee appreciation days, etc.) The learners receive a framed certificate from the State of Missouri recognizing the completion of the required curriculum. This certificate is portable across the state, so retraining would not need to occur if a DSP relocates to a different part of Missouri. ACT also provides CDS graduates with a CDS tote bag filled with items/goodies to assist the DSP in doing their job. Learners are recognized in ACT’s quarterly newsletters. ACT believes that celebrating these accomplishments is an integral part of the delivery and success of this curriculum.

ACT also offers an incentive to Frontline Supervisors and Managers, which includes a $500 bonus for completing 13 courses in the DSP curriculum and four courses in the College of Frontline Supervision and Management (CFSM). Again, learners complete these courses and reviews the on-the-job training component prior to receiving bonus monies.

Carrie Griffith, Manager of ACT’s Community Living program and a CDS graduate said: “The CDS has become a valuable resource for our organization. Even though I had experience in the field, going through the coursework (both the direct-care portion as well as the frontline supervision) taught me new information as well as helping me to refresh on important points. As a manager, the On-the-Job Training Assessments for each course were a great opportunity to touch base with my staff, to have the type of discussions that you don’t typically have in the hustle and bustle of the work week. The OJT Training Assessments served as a springboard to several conversations about where we are as an agency and where we are going. The CDS experience is a reminder that what we do is important and we need to keep learning so that our practices don’t become stagnant. The DSPs who have completed the courses typically are contributing more ideas and have renewed enthusiasm for the profession.”

The response from other ACT employees has been phenomenal! There are currently 148 learners from ACT utilizing the CDS. This includes consumers, direct care employees, supervisors, managers, administrative support staff -- and even our Chief Executive Officer, Mark Hassemer. Mark notes, “We are very encouraged by the early results of making CDS training available to our Direct Support Professionals. People are increasing their skill level, which results in more effective and efficient services. Staff retention has been enhanced, critically important in today’s environment. The direct support positions are just perceived differently since we started the CDS training; people are on a career track and receive a portable certification.

ACT’s Training and Development Committee recently revised the agency’s New Hire orientation to include employees completing the CDS Safety course as part of their new-hire training with ACT. This introduction to CDS has sparked an interest in many employees to continue with courses and gain the wealth of knowledge this training program offers. ACT’s Training and Development Committee is currently working on new-hire training for supervisors and plans to include the new course from the CFSM -- “Becoming a Supervisor.”

Retention statistics for the agency for the past two years have shown that the implementation of the CDS and making it available to ACT employees has “raised the bar” for delivering quality services for consumers supported in ACT’s programs. Retention statistics from calendar year 2006 showed a 43% turnover rate. In 2007 that dropped to a 23% turnover rate. The CDS was a contributing factor in the 20% decrease in turnover. ACT has seen an increase in a positive culture for the agency. The level of professionalism has increased as a result of this curriculum being available to employees. Employees understand that they are not just providing supervision to persons with disabilities; they are facilitating support for persons served to be included in their community.

Michelle Saunders is the CDS Administrator for ACT and can be contacted via email at michelle4act@socket.net or by calling Alternative Community Training at 573-474-9446. If you are interested in more about the services Alternative Community Training provides, please go to their website: www.actservices.org

Open Your Eyes-Sean Delaney

Many of you have probably already seen this video, but it is worth repeating here. Sean Delaney won the Music and Comedy category in The DSP TV Online contest "You Need to Know Me" sponsored by ANCOR. For more information about ANCOR, click here.

Thank You-Andrea McMurray

Andrea McMurray won an honorable mention in The DSP TV Online contest "You Need to Know Me" sponsored by ANCOR. For more information about ANCOR, click here.

Maroon and Gold by Greg Devorce

Greg Devorce won the Self-Advocate category in The DSP TV Online contest "You Need to Know Me" sponsored by ANCOR. For more information about ANCOR, click here. Greg's song is dedicated to his job coach.

Eugene-Eugene Miller

Eugene Miller won the healthy living category in The DSP TV Online contest "You Need to Know Me" sponsored by ANCOR. For more information about ANCOR, click here.

Hear Us Out-Chad Ek

Chad Ek won the Reality category in The DSP TV Online contest "You Need to Know Me" sponsored by ANCOR. For more information about ANCOR, click here.

Where's my Lasagna?

October 6th-10th is Mental Illness Awareness Week. As this week is upon us I’d like you to think about the people you know with chronic and/or serious mental illnesses. People who sometimes fall away, are hospitalized, or have to leave work or school due to mental illness. People who because of their illnesses sometimes cannot get by without significant, on-going help from family caregivers. I also want you to think about those family caregivers whose lives and energy are devoted to keeping loved ones safe and helping the person to managing the illness.

I want you to think how you have handled the “news” that someone has a mental illness, and especially if that person had to be hospitalized or “found out” they were ill after being arrested. These are very stressful times for the family and the person. They are akin to when someone suffers a major heart attack, gets into a car accident, or goes into a diabetic coma. But what is often strikingly different is how the rest of us respond when it’s mental illness and not physical illness.

How many of you have organized an office pool to send flowers and a card saying “Hope you are feeling better soon!” after hearing someone has been hospitalized for a mental illness? How many of you have done this when a person goes in for other types of medical emergencies?

When it’s mental illness how many of you have called the person or family members and asked “How is it going? What can I do for you?” How many of you have offered to come walk the dog, bring dinner, or spend time with the person who is ill so they and the family caregiver can both get a break? How often do you ask a person or their caregiver after the initial crisis: “How’s it going now? What’s the prognosis? What treatment options are you using? What’s been most helpful to you? Are there things that I could do that would be helpful to you now?”

It’s not uncommon in the face of long term disability and chronic illness for some friends to drop away and for life to change. But how we react when we first find out is a clear sign of the ongoing prejudice and ignorance about mental illness. I met a woman in a family education course run by the National Alliance for Mental Illness (NAMI). She said to the group: “Hospitalizing my son (for bipolar disorder) was the worst, most heartbreaking thing I had ever been through. When I got home I called my Mom and said ‘Where’s my lasagna?’ (The traditional family dish for comforting people in the face of illness). No one seemed to notice at all.” Her experiences were echoed by everyone in the group and I hear them again and again in support groups. Where are my friends? Where is my family? Why are we being rejected, ignored, or treated with suspicion? Why is no one talking about this?

This year during Mental Illness Awareness week, I’d just like you to take some time to ask yourself why.

This post is courtesy of Susan O'Nell