ALASKA

Identified Problems with the States' Long-Term Care System

• Difficulty recruiting and retaining personal assistance workers, and inadequate staffing in the Division of Senior Services to address recruitment and training.




• Lack of training and technical assistance for providers, personal assistants, and consumers, regarding recent changes to the state's Consumer-Directed Personal Assistance Services (CDPAS) program.

Perceived Strengths

• Newly implemented CDPAS program.




• Recent increases in Medicaid PAS reimbursement rates, which increase the wages and benefits paid to personal assistants thereby facilitating recruitment and retention efforts.




• Commitment by state legislature to fund PAS for both Medicaid and non-Medicaid eligible persons.




• Extensive network of PAS providers throughout the state.

Primary Focus of Grant Activities

• Address personal assistance workforce recruitment and retention problems through existing efforts.




• Educate and train providers, consumers, and personal assistants about the state's new CDPAS program.

Goals, Objectives, and Activities

Overall Goal. To increase knowledge about, and the availability, of consumer-directed personal assistance services statewide.

Goal. Increase training and technical assistance opportunities for personal assistance provider agencies and personal assistants.

Objectives/Activities

• Develop statewide training curricula, standards, and competency testing, for personal assistants working in the agency-based program.




• Increase training opportunities for personal assistants by setting up a network of regional training contractors who will provide training on a routine schedule.

Goal. Increase training and technical assistance opportunities for provider agencies and individuals with disabilities or long-term illness, and, as appropriate, their personal representatives.

Objectives/Activities

• Provide information and training about the new CDPAS program to agencies and consumers.




• Conduct a survey at the end of the second year of the grant to determine how the new program is working for consumers and to identify issues that need to be addressed.

Goal. To increase the recruitment and retention of personal assistants throughout the state.

Objectives/Activities

• Establish a professional association for personal assistants and implement other activities to enhance the image of personal assistants' work.




• Expand the recruitment pool through a number of activities, including those aimed at high school students. These activities are being done through workforce development efforts supported by this grant through contract funding but carried out by the task force of the Alaska Alliance for Direct Service Careers (AADSC).




• Develop and implement retention strategies, including the establishment of a career path.

Key Activities and Products

• Develop a 40-hour personal assistant training curricula, and contract with qualified organizations to provide regional training opportunities using the curricula, as well as smaller course segments on specific topics such as tube feeding.




• Develop a competency exam that will be used statewide as a requirement for personal assistants working in the PAS program.




• Provide technical assistance to providers about the new CDPAS program, to ensure that they incorporate the concepts of dignity, choice and consumer input and control in the provision of services.




• Contribute funds to the Alaska Alliance for Direct Service Careers to implement a plan for recruiting and retaining direct service workers in the disability and aging field, including the establishment of a personal assistant professional association.




• Contract with appropriate agencies to work with individual consumers to address questions that consumers and their personal assistance might have about the new CDPAS program.




• The Division of Senior Services in cooperation with provider agencies and the State Independent Living Council will conduct a comprehensive consumer satisfaction survey to determine how the new changes are working for them and whether changes are needed to improve the delivery of personal assistance services. This initiative will allow consumers opportunities to provide feedback to provider agencies and the Division of Senior Services.




• Develop the capacity to collect and maintain relevant data.




• Conduct formative and summative evaluations.

Consumer Partners

Consumers have been actively involved in the Consumer Task Force, which includes consumers selected by the State Independent Living Council, the Governor's Council on Disabilities and Special Education, and the Alaska Commission on Aging.

Consumer Partners and Consumer Involvement in Planning Activities

The state's starter grant was used to pull together a Consumer Task Force. There were three Consumer Task Force meetings and the discussions at these meetings got progressively more specific about goals and activities as the grant proposal progressed.

Consumer Partners and Consumer Involvement in Implementation Activities

• Consumers will be involved in implementation activities as members of the Personal Assistance Implementation Team, which will monitor the implementation of the new CDPAS program as well as grant activities.




• The Consumer Task Force will coordinate policy development for both of the state's Systems Change grants.

Public Partners

• Alaska Alliance for Direct Service Careers (ADSC).


• Center for Human Development, University of Alaska (CDH).


• Governor's Council on Disabilities and Special Education (GCDSE).

Private Partners and Subcontractors

• State Independent Living Council (SILC).


• Independent Living Centers.


• PAS providers.

Public and Private Partnership Development/Involvement in the Planning Phase

The Governor's Council on Disabilities and Special Education (GCDSE) received the starter grant and used it in part to pull together the Consumer Task force. After the goals and activities were decided on, the proposal was given to the writing team. A number of people wrote the grant: someone from Senior services, the DD Division, and the University. A consumer was also hired to help write the nursing home transition grant.

Public and Private Partnership Development/Involvement in Implementation

A number of public and private partners will be responsible for implementing recruitment and retention efforts. They include the Alaska Alliance for Direct Services Careers, individuals with disabilities and family members, the Division of Senior Services, Alaska Commission on Aging, the Department of Health and Social Services, the Division of Mental Health and Developmental Disabilities, the Advisory Board on Alcoholism and Drug Abuse, the Alaska Mental Health Board, the Division of Employment Security, Alaska Works, and the Division of Public Health.

Existing Partnerships That Will Be Utilized to Leverage or Support Project Activities

The Design Team is responsible for policy recommendations. The Design team sends it policy recommendations to the state's Long-Term Care Implementation Team (LTCIT). The LTCIT oversees all long-term care policies and programs as well as takes input from all the state consumer advocacy boards, including the coordinated Consumer Task Force, the Governor's Council on Disabilities and Special Education, the Alaska Commission on Aging, the Mental Health Board, and the State Independent Living Council.

Oversight/Advisory Committee

• A Consumer Task Force will coordinate policy development for this grant and the state's Nursing Home Transition grant.




• A new PAS Implementation Team will be formed from members of the PAS Design Team that worked on the state's CDPAS program.




• The Personal Assistance Implementation Team will comprise DSS staff, representatives from independent living centers, the state ILC chair, the Center for Human Development Evaluator, PAS providers, and PAS consumers. The Team will meet monthly, and as needed, to monitor the implementation of the PAS program changes and to get progress reports on grant activities.

Formative Learning and Evaluation Activities

• The project will create mechanisms for tracking program goals, objectives and outcomes and incorporating feedback into the project.




• Formative evaluations will be conducted to assess timelines and progress, and to facilitate continuous improvement in project activities.




• The summative evaluation results and findings will be analyzed to determine the impact of the project on creating and sustaining systems change efforts. The summative evaluation will take two forms:




• An annual summary that will discuss project accomplishments and impact on policies, procedures and practices-the extent to which major activities successfully reduce or eliminate barriers, and recommendations for change for the next project year.




• A final comprehensive evaluation report that will look at all the changes to the state PAS programs and make recommendations for further improvements.






• The Center for Human Development at the University of Alaska, Anchorage, will be responsible for the overall evaluation activities.

Evidence of Enduring Change/Sustainability

• Grant activities will build upon and enhance state systems change activities already planned or underway. These activities include the establishment of a CDPAS program; outreach, technical assistance and training for PAS providers, consumers and personal assistants; and interagency recruitment and retention efforts.




• Additional investments in recruitment, training, and retention efforts will increase the availability of services beyond the grant period. Without an adequate supply of PAS workers, it will not be possible to create enduring systems changes.




• Provider training will ensure that consumers in the traditional agency program will have opportunities for increased choice and control.




• Training curricula will be designed to assure their use after the grant ends (e.g., using distance learning, Internet, and Train-the Trainer formats).

Geographic Focus

Statewide.