Better Jobs, Better Care

Better Jobs, Better Care/NOVA Update: March, 2006

New Organizational Vision Award Program Continues to Advance

Two kick-off events were held in the fall of 2005 for the approximately 60 pilot participant agencies in North Carolina’s program to establish the New Organizational Vision Award (NOVA) as a voluntary, raise-the-bar culture change program. More than 170 persons attended these events which served to congratulate the pilot projects for their willingness to assist the Partner Team with testing and refining the NC NOVA model, provide the pilots an overview of the application, review and determination process for NC NOVA special licensure designation, and answer any questions the pilot sites have as they begin implementing NC NOVA criteria.

FORLTC Board Member and Public Policy Committee Chair John Young, who represents FORLTC on the NC NOVA Partner Team, spoke at the Raleigh kick-off event. He congratulated the pilots on their willingness to participate and emphasized what a positive development it is to be part of a program intended to improve direct care jobs and care settings through an incentive-based program which rewards providers for meeting higher standards.

The Partner Team will seek to have legislation passed during the upcoming session of the General Assembly to establish NC NOVA as a voluntary statewide program beginning in 2007. Next steps for the Partner Team include determining how to measure program impact and developing educational materials for consumers, family caregivers, providers, policymakers and others. In addition, the Partner Team will be making plans to support providers interested in seeking NC NOVA designation through a variety of training initiatives.

For more information on the development of this innovative “Better Jobs, Better Care” initiative, please see the remainder of this section.

Better Jobs, Better Care Update: July, 2005

Pilot Phase Progresses for BJBC/NOVA

North Carolina’s Better Jobs, Better Care Partner Team, including FORLTC Board Member John Young, has now selected 60 organizations around the state for the pilot phase of this innovative program. Each hopes to be among the first to obtain the North Carolina New Organizational Vision Award, or NC NOVA, next year.

The Partner Team depended primarily upon the professional organizations within its membership to choose the 20 nursing facilities, 20 adult care homes and 20 home care agencies that are now participating in the pilot. These team members are the Association for Home and Hospice Care of North Carolina; NC Assisted Living Association; N.C. Association, Long-Term Care Facilities; N.C. Association, Non-Profit Homes for the Aging; and N.C. Health Care Facilities Association. We are delighted to recognize them here.

Medical Review of North Carolina will manage the application, review and determination process. Each pilot site may submit an application when it is ready. The deadline for the first batch of completed applications for the two-year special licensure designation is May, 2006.

All 60 of the selected pilot entities have received the Pilot Project Informational Manual specifying the criteria for NC NOVA designation and are working to institute the necessary organizational change initiatives. State-Approved Coaching Supervision Trainers selected to help them include two members of FORLTC’s Education and Outreach Committee, Teepa Snow of the Alzheimer’s Association and Sandy Spillman of the N.C. Assisted Living Association.

The pilot phase of the program is scheduled to continue through August, 2006. We look forward to recognizing all successful applicants when they are named. Please refer to the other article in this section for background information on the philosophy and strategy involved in BJBC/NOVA, which so clearly reflects the FORLTC mission “to promote the highest quality of life for those who cannot live independently, and for those who care for them.”

Better Jobs, Better Care -- FOR Support

In North Carolina, approximately 80,000 adults must depend on others for basic care. In nursing homes, 80-90 percent of this care is typically provided by nursing assistants/aides who have little training and earn just slightly over the minimum wage. Even the best of them are stressed by the demands of their jobs, and many must work additional jobs just to get by.

Home care and assisted living workers face similar challenges. Consequently, it’s not surprising that in 2001, turnover rates for direct care workers in North Carolina averaged 50% in home care, 102% in nursing homes, and 113% in adult care homes. Can anything be done to address this issue and thereby positively impact the care our loved ones receive?

Here at Friends of Residents in Long Term Care (FORLTC) we believe the answer is “yes.” We have for some time been actively involved in efforts to improve jobs for direct care workers and reduce turnover through a program known as “Better Jobs, Better Care (BJBC)” which is developing a voluntary special licensure designation for home care agencies, adult care homes and nursing facilities.

FORLTC representatives have offered their expertise for more than a year to formulate BJBC for North Carolina, one of only five states selected for this effort, which is funded by the Robert Wood Johnson Foundation and Atlantic Philanthropies. The Partner Team we participate in is currently involved in selecting 20 home care agencies, 20 adult care homes and 20 nursing homes throughout the state to pilot this innovative program.

The 60 pilot entities will test out the practices the Partner Team has researched and codified to positively affect the recruitment, retention and job satisfaction of direct care workers. As currently proposed, BJBC will assign the following values to items designated as “domains”: Supportive Workplaces, 45%; Balanced Workloads, 25%; Training, 20%; and Career Opportunities, 10%.

Under each of the categories, the Partner Team has created detailed standards to be met in order for the special license designation known as NOVA (New Organizational Vision Award) to be granted. For instance, the program sets out specifications for orientation, training and peer mentoring for all new direct care staff that have been demonstrated to improve retention, job satisfaction, and the quality of the care these front line employees provide.

The BJBC elements we are helping to develop and implement dynamically reflect our top priorities, featured in our mission statement, of doing everything we can “to promote the highest quality of life for those who cannot live independently, and for those who care for them.” FORLTC is confident that simply publicizing these standards will help raise the bar for long term care, creating a win-win situation for residents and long term care workers, as well as providing recognition for the pilot entities and encouraging others to implement the BJBC specifications.

FORLTC is committed to continuing to support and develop this innovative program, working together with the North Carolina Foundation for Advanced Health Programs and other agencies towards full implementation in 2007. For more information on the BJBC initiative, please continue to watch this space for updates. You may also want to visit http://www.dhhs.state.nc.us/ltc/ltcwf.htm on the web for more details.