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HCS Highlights - Winter 2022

Page 1

HCS Highlights WINTER 2022

HAPPY NEW YEAR!


CONTENTS 04

BEA’S MESSAGE

06

REGIONAL UPDATES

10

STRATEGIC OBJECTIVE 2.1

11

EDI & THE ANNUAL REVIEW

12

WELLNESS: RESOURCES FOR CAREGIVERS

13

MEDICAID TRANSFORMATION

15

MEDICAID TRANSFORMATION CLIENT STORIES

16

HCS TEAM SPOTLIGHT


BEA’S MESSAGE Happy New Year! Although we ushered in 2022 with a new COVID-19 variant that is causing another surge in cases, I am finding myself feeling hopeful for the months ahead. Even as the pandemic continues, we are developing and improving our policies to serve clients while keeping our employees, providers and the people we serve safe. Beyond our immediate work with COVID, we also have a number of projects and programs on the horizon that we can look forward to in the coming year.

Bea Rector Director, Home and Community Services

In 2021, the legislature passed House Bill 1411, which sought to decrease employment barriers and expand healthcare workforce eligibility by examining the crimes that disqualify an individual from performing personal care. The current automatic, lifelong disqualification, while created to protect vulnerable adults, is often unfair and limits clients’ ability to receive paid care from friends or loved ones of their choosing. Under legislative direction, ALTSA has established a workgroup to develop recommendations for a process to determine whether, when and how a trusted individual can be hired by a client if they have a disqualifying conviction. By allowing some individuals who have disqualifying crimes to perform paid care, we would be able to promote client choice, mitigate workforce shortages and support families in providing care, while also addressing some inequities in our criminal justice system that disproportionately impact people of color. We also learned at the end of 2021 that our 1115 waiver one-year extension got approved so we can continue offering our MAC, TSOA, Supported Employment and Supportive Housing programs through calendar year 2022. This is important to continuing to support individuals in their own homes, to achieve recovery and wellness and to participate in meaningful daily activities and community integration. The Health Care Authority will also be submitting an application for a full five-year renewal, which would start in 2023 and we are working with them on that submittal. You can read more about the extension on page 13 of this issue. In February, we’re also looking forward to the first phase of the Consumer Directed Employer (CDE) implementation. This project began all the way back in 2018, when DSHS partnered with a private entity, Consumer Direct of Washington, that would become the Consumer Directed Employer. They will serve as the employer for Washington’s individual providers, shifting the IP employment-related activities to the CDE. This will help DSHS realize the goal of targeting case management expertise to focus less on administrative tasks and more on the clinical needs of clients. We also have a full legislative session ahead of us. In preparation for the implementation of Washington’s Consumer Directed Employer, we have submitted some request legislation, House Bill 1777/Senate Bill 5529, which would expand the definition of a personal aide to include someone who may be under contract


with DSHS or may be an employee of a Consumer Directed Employer. This is essential to ensuring choice for individuals with functional impairments who self-direct health related tasks to their Individual Providers. A second piece of request legislation would allow tribes to administer long-term services and supports in a similar capacity as DSHS for individuals within the regional authority of the tribe. As the demand for Medicaid long-term services and supports continues to grow, so does our need to expand access and cultural competence. Expansion of these statutes would help increase access to culturally competent services for tribal members while giving tribes the autonomy to administer services to individuals within their regional authority. The legislature will also be considering changes to WA Cares, a long-term care insurance benefit for eligible workers. Our WA Cares team in HCS will continue to prioritize supporting a successful implementation of the WA Cares program and working closely with the authorizing environment and stakeholders through the coming session. This session, the legislature will also be passing a supplemental budget. In December, Bill Moss sent out a great summary of the ALTSA-related items in the Governor’s proposed budget, but I wanted to highlight one exciting item that, if funded by the legislature, would impact our HCS staff. The governor has proposed $18.9 million to reduce the number of cases per HCS and AAA case manager to 75. This would not only contribute to better outcomes for our clients and reduce the need for expensive institutional stays, but it would benefit employee well-being and reduce burnout. We’re still early in the budget process, but it’s a positive first step toward recognition of the important work performed by our social workers and case managers. We also recognize the workload needs to be addressed in other parts of our division, but felt that it is important to take a phased approach to the funding request. I know with COVID we often feel like it’s one step forward and three steps back. But we’ve learned a lot through this process and we’re going to use all that we’ve learned as we move into 2022. We have a lot of exciting work on the horizon and I look forward to a year of positive steps forward.

In Case You Missed It: Gratitude In recent regional staff road shows we asked HCS staff to think back on the past year and share expressions of gratitude. We want to share those with you and hope that it will bring a smile and provide an opportunity for personal reflection as well. Thank you, Kim Leslie, for putting these expressions of gratitude together. • • •

Region 1 Gratitude Region 2 Gratitude Region 3 Gratitude


REGIONAL UPDATES REGION 1

This is the perfect time of year for giving to those less fortunate than ourselves and to organizations that support specific needy populations or communities. Our official kick-off for the 2021 Combined Fund Drive campaign began October 4. The 2021 CFD theme is, “UNITY with the COMMUNITY!” Region 1 Home and Community Services, in collaboration with Adult Protective Services, has several staff who volunteer to coordinate activities around the region. This team is led by Pakou Lee. Thank you, Pakou, for your Leadership!

Tami Rucker Region 1 Administrator

Beginning in early November, the Combined Fund Drive team highlighted a charity each Friday to provide opportunities for staff to learn more about the various charities within our communities. In honor of Veteran’s holiday, they highlighted the Veterans Community Response Charity. They have initiated a few fun activities, one being “Gratitude E-Grams.” APS and HCS staff who have veteran co-workers they want to thank for their service could send an E-Gram to that person with a cost of $1 each. This fundraising event was set up to support the following organizations and went through Dec. 10:

JDRF International, Washington-Northwest Chapter, Charity Code: 1482728

Purpose: To accelerate life-changing breakthroughs to cure, prevent and treat Type 1 Diabetes and its complications. JDRF is the leading global organization focused on T1D research and is committed to funding the development of new therapies and treatments to keep people with T1D healthier, longer, until a cure is found.

Salvation Army - Benton/Franklin Counties, Charity Code: 0316172

Purpose: The Salvation Army was founded in 1865 by William Booth. It is a nonprofit organization organized for the purpose of engaging in and otherwise promoting charitable. Religious, educational, missionary, philanthropic and similar work.

Veterans Community Response, Charity Code: 1482763

Purpose: VCR is a non-profit comprised of firefighters, veterans and therapists who work to support combat veterans in their post-war readjustment. This group helps combat veterans develop the skills to overcome their physical, mental and spiritual wounds and move into productive and satisfying postcombat lives.


Vanessa Behan Crisis Nursey, Charity code: 0315409

Purpose: Crisis nursery/primary level abuse prevention. Provides immediate short-term respite care for children between birth and age six who are at risk of abuse and neglect when their families are in crisis. Offer parent support and education towards the goal of a consistent, positive relationship with their children. Offer basic needs such as diapers and formula.

Second Harvest, Charity Code: 0316374

Purpose: Second Harvest Inland Northwest is a non-profit corporation which provides food and related commodities to people in need throughout the inland northwest.

Blessings Under The Bridge, Charity Code: 1482213

Purpose: Through God’s truth, we endeavor to reach, bless, and offer unconditional love to the homeless and less fortunate by restoring hope, purpose, and dignity to the hearts and lives of those lost on the streets of our community and the communities around the world. Additional activities are being planned at this time that will give all staff the opportunity to participate and give to a charity that is important to them. Everyone’s contribution matters. I am honored to see the commitment and excitement of our team members around Region 1, knowing this project will make a difference in the lives of many! Thank you all for your participation in the 2021 Combined Fund Drive and for the work you do to transform lives!


REGIONAL UPDATES REGION 2

Sonya Sanders Region 2 Administrator

Like other regions, Region 2 staff continue to work hard and give their best efforts in staying strong and committed to the agency’s work. It has not been easy these last 21 months, especially with the Governor’s mandate. Losing staff, regardless of the reason, is not easy for a unit/agency. Many staff and managers have dealt with strong emotions and are grieving due to the mandate and loss of staff. We continue to work with clients from Western State Hospital. The WSH unit staff have been going out to WSH to assess and transition clients. We have been making great strides in placing those clients in the community. For the month of October 2021, Region 2 transitioned 11 clients from WSH and diverted 14 clients from local psychiatric facilities. Great job and not easy feat. We have created a new PBS unit in Bellingham. This is a benefit for the clients that lives in that area. PBS caseload throughout the region will be slightly lowered with the addition of three new PBS. For years in Holgate, we used to have staff “Trick or Treat” management. We would do a costume and cubicle contests, have snacks and treats throughout the office. Staff really enjoyed this activity. This year, we had a virtual contest and while I miss seeing everyone engaged in this workplace activity, I appreciate those who participated online. It was nice to see pictures of staff, their children and their pets dressed in Halloween costumes. As this year comes to a close, I want to thank all the Region 2 employees who continue to show up and show out for the clients of Washington State. Happy New Year!

REGION 3

You Are Welcome Here You are welcome here! You are valued and appreciated here. This is something we should all feel when we enter our workplaces (in person or remotely). Inclusion is a value that both ALTSA and HCS Region 3 hold and strive to achieve in actionable ways every day. Creating a culture where everyone feels a sense of belonging and inclusion has been one of my main goals since I started as a Regional Administrator in 2019.

Debbie Willis Region 3 Administrator

Given our new remote work environment it is even more important to make a conscious effort to reach out to each other and especially our newer employees to make them feel welcomed and included. During COVID times, I have often wondered how our new employees feel entering a workplace where they have not had the opportunity to meet their supervisor and co-workers in person. Do they feel part of the team? Do they feel included and have the social connections that help form strong teams?


As part of my effort to get to know our new employees, the Deputy Regional Administrator, Kara Sells, and I hold a meet-and-greet for new employees where we share information about ourselves and learn about them as well. The meetings are very positive, and we usually get great feedback about how welcomed they feel by their supervisors and teammates. After our last meet and greet, I reached out and asked them if they would share examples of how co-workers and supervisors have supported them and reached out to them as new employees. Here is some of their feedback: • My direct supervisor was out on leave when I started and Paulette was amazing at making me feel really welcomed! She coordinated job shadows for me in my first weeks to connect me with the people that I would be working with in many different areas of the division, from financial, social work, and administrative hearings. In a time when we are all working remotely and building those connections can be very difficult, Paulette did a lot to facilitate building those connections so that I would have people I can reach out to for help as I learn this new position. It has also been really impactful for me feeling like I am part of this team. • I feel such a strong sense of teamwork in my unit in Tacoma. When one person is behind, everyone will jump in and do what they can to help our team member! You can feel it from the top down and I am so grateful to be a part of this team! • My first day at HCS I was welcomed by emails from my team members telling me they hoped that I had an amazing first day and to not hesitate to reach out if I had any questions or needed any help. I felt welcomed and part of the team from the start, like I had been here for a while. • From day one my supervisor Anna and my team has supported me, encouraged me, and helped me to grow as a colleague and as a person. Because of my supervisor and the type of team she helps cultivate and grow, my whole team has helped me to grow in this first month alone whether they know it or not. With the openness and inclusion, I have been able to stretch myself and have been more bold and autonomous than I ever have in a job, reaching out and communicating versus being the silent observer in the corner. The words of encouragement, validation, support, and openness has been invaluable to this career shift and helping me grow professionally and personally. It is refreshing to have a supervisor and team who emphasize selfcare and taking care of yourself because as the saying goes you can’t pour from an empty cup. • All my teammates have reached out – both on and off camera, to welcome me, offer help and encouragement. My supervisor, Brandi, is marvelous, and an incredible leader; she encourages, is resourceful, shows me how to do things, reaches out daily, has set up many opportunities for shadowing and trainings. More importantly, she keeps reminding me how important I am to this team and how grateful they are to have me – she makes me feel honored and valued. • We meet every morning to staff the day and offer help and encouragement to each other – that daily connection helps; fun, gifs, laughter and sharing joy is fostered and encouraged. Co-workers have randomly messaged to offer assistance, and they’re open to my requests for help – even though I know they’re swamped, they always make time for me. • After reading this feedback, I know we are on the right track! I encourage you all to continue to reach out to our new employees to help them feel welcomed and included. We were all “new” at one point and I bet we each can still remember the one person who truly helped us and made a difference for us. Continue to be the one who made the difference and the one who didn’t hesitate to make someone feel welcomed here.


STRATEGIC OBJECTIVE 2.1:

ADDRESSING WORKFORCE CHALLENGES Washington, like the rest of the country, is facing a workforce crisis. Currently, more than 1 million Washingtonians are over the age of 65. That population is expected to reach 1.5 million by 2025. An estimated 70 percent of those individuals will need long-term services and supports in their lifetime. To meet the needs of individuals with disabilities and older adults, we need to recruit and retain a well-trained workforce of direct care professionals across all our settings, including skilled nursing facilities, assisted living facilities, adult family homes and in-home care. Long-term services and supports has a long history of workforce shortages and high turnover rates driven by low wages and benefits, poor job quality and a lack of recognition for the value of the work performed and the demonstrated competencies gained in the field. Although we have one of the highest direct care worker average wages in the nation, Washington’s minimum wage increases annually and the gap between the hourly wage received by direct care workers and the minimum wage is shrinking. In addition to our aging population, there are a number of other factors contributing to the need to develop effective workforce strategies to

increase the number of individuals entering and staying in the direct care workforce. Our new WA Cares Fund, a long-term care public insurance model, will significantly expand access to needed long-term care, further increasing the demand for services, and a high number of the long-term care workforce will be nearing retirement age within the next 15-20 years. ALTSA and HCS are taking a leading role in addressing the long-term care worker shortage. With that in mind, we developed a new strategic objective to address the shortage and improve recruitment and retention of home care aides and certified nursing assistants. Strategic Objective 2.1 is to build the long-term care workforce to meet the needs of clients while creating resources to retain a high-quality longterm care workforce. We plan to do this through a multifaceted approach that includes increasing the number of high schools, skill centers and other educational programs offering home care aide certification training, by designing and deploying resources to increase retention, and to increase the visibility of the direct care workforce by educating workforce boards, centers and health care providers about this work.


EQUITY, DIVERSITY & INCLUSION

EDI QUESTION ON THE ANNUAL REVIEW As we complete our annual reviews this year, many of you probably noticed that there was a new question on the annual review related to equity, diversity and inclusion. This was a question for you and your supervisor to complete together, with the goal of educating and facilitating understanding on issues related to all forms of oppression. As part of DSHS’s Truth, Social Justice and Dismantling Racism three-year plan, DSHS decided to add a level of accountability to each employee’s annual performance review. Too often in EDI programs, there is a larger focus on activities that only have a small impact. The goal with adding this question to performance reviews is to help foster some of the long-overdue conversations that need to happen between management and staff. By including this new question on this year’s performance review, our expectation is that we all begin the conversation about how each one of us can participate in DSHS’s progress toward becoming an anti-racist, equitable, transformative organization. To do that, we must first understand what that means on a systems level. Each one of us will have a different goal in this area. You might be reading a book or participating in an activity, or you might be exploring new concepts or attending a listening session. To further help staff understand what exactly

this means, ALTSA will be offering resources to help everyone understand what exactly it means to be anti-racist. EDI principles have to do with every aspect of our jobs. Our main goal is to create an environment of mutual respect, equity and acceptance of the people we serve and with whom we serve. By incorporating this question in everyone’s annual review, we all have an opportunity to think about how we can make DSHS a better organization.

EDI Question For the next evaluation cycle, how can the employee participate in DSHS’ progress towards becoming an anti-racist, equitable, transformative organization (examples of participation include, but not limited to attending a listening session, working on one of the action steps in the Truth to Action Initiative, engaging in a book club pertaining to the relevant subject and participating in a training, conference, or other related learning opportunity relevant to the topic)?


WELLNESS

5 RESOURCES FOR FAMILY CAREGIVERS This fall, we celebrated National Family Caregiver Month, an annual reminder that our paid and unpaid family caregivers are the backbone of our long-term care system. Being a caregiver can place a significant burden on those providing the care. Fortunately, there are a number of resources to assist those of us who are caring for a loved one. If you’re a caregiver for someone you love, or if you know someone who is, here are some useful resources. • Caregiver Support Programs: A variety of caregiver support programs and services are available to those of us who care for friends or family members. If you are a caregiver looking for support, visit the Washington Community Living Connections website or call 1-855-567-0252. • Caregiver Support Groups: Support groups can connect you with others who are providing care for loved ones. These can be safe places to share your feelings, compare notes and offer thoughts and ideas. The Caregiver Support Groups page on

the ALTSA website has more details. • Dementia Road Map: Hundreds of thousands of family members across Washington are caring for a person with memory loss or dementia. The Dementia Road Map: A Guide for Family and Care Partners provides information, tips and resources for the journey. You can view a PDF of the roadmap, which includes instructions for ordering physical copies, on the ALTSA website. • Kinship Caregiver Programs: If you’re raising the child of another family member or friend, you are a kinship caregiver. Supports such as the Kinship Navigators program and support groups area available to you. Visit the ALTSA Kinship Care webpage for more details. • Dementia Legal Planning Toolkit: The new Dementia Legal Planning toolkit helps individuals with memory loss and their family members and caregivers to plan for the future. You can download a PDF of the toolkit on the Washington Law Help website.


HCA GRANTED EXTENSION TO MEDICAID TRANSFORMATION The Health Care Authority (HCA) will be requesting a five-year extension to its Medicaid Transformation Project, which includes some of ALTSA’s long-term services and supports and supportive housing and supported employment programs. We are actively partnering with HCA to develop the renewal application which will be submitted in 2022. Under Section 1115 of the Social Security Act, the Centers for Medicare and Medicaid can approve budget-neutral pilot projects intended to better serve Medicaid populations. For the last five years, ALTSA, in partnership with the Health Care Authority, has been participating in Medicaid Transformation Project, a Section 1115 demonstration project. The Medicaid Transformation Project consists of five initiatives, two of which involve ALTSA. Initiative 2, Supporting Older Adults and Family Caregivers, includes the Medicaid Alternative Care (MAC) and Tailored Supports for Older Adults (TSOA) programs. Initiative 3, Foundational Community Supports, includes our Supported Employment and Supportive Housing programs. Washington has requested a one-year extension to the waiver, which would extend the program through 2022. We are confident this extension will be approved by CMS. Washington will also request a five-year renewal, which would extend the program from January 2023 to December 2027. The renewal request also proposes four new enhancements to our long-term services and supports. These are:

• Presumptive eligibility: This provides individuals applying for home- and community-based longterm services and supports with immediate access to essential services, prior to a final financial determination and a full functional eligibility assessment. This reduces Medicaid institutional bias and helps address acute care hospital capacity issues. Through April 2021, nearly 10,000 individuals who have accessed TSOA using presumptive eligibility. Only 1.4% were found to be financially ineligible. • Guardianship: This provides compensation for guardians who provide decision-making support during times of transition, where a guardian might be necessary to provide informed consent for transition and medical care purposes. • Rental subsidies: This assists clients transitioning from institutional settings to community settings, enabling them to receive cost-effective in-home services while waiting for a permanent subsidy opportunity. • Coordinated personal care: This implements a more efficient service model that allows flexibility in the scheduling and delivery of personal care services to clients living in proximity to one another. To read more about Washington’s Medicaid Transformation Project, visit the Health Care Authority webpage.


MEDICAID TRANSFORMATION PROJECT

The Medicaid Transformation Project is a five-year Section 1115 Medicaid demonstration waiver project that is made up of five initiatives to improve our state’s Medicaid programs and services. ALTSA is involved in two of those initiatives.

INITIATIVE 2:

Supporting Older Adults and Family Caregivers Medicaid Alternative Care (MAC) and Tailored Supports for Older Adults (TSOA) are services and supports tailored to meet the needs of individuals so that they can remain in their own homes with the support of personal assistance or a family caregiver. Modeled after the Family Caregiver Support Program, MAC and TSOA offer services such as: • Specialized equipment and supplies such as incontinence supplies and durable medical equipment • Training and education for family caregivers • Caregiver assistance such as respite care • Health maintenance and therapy programs such as massage and exercise programs • Personal assistance such as in-home care, homedelivered meals and nurse delegation (TSOA only)

INITIATIVE 3:

Foundational Community Supports (FCS) Foundational Community Supports provides supportive housing and supported employment services to Washington’s most vulnerable Medicaid enrollees. Supported Employment helps individuals with employment assessments, outreach to employers, connections with community resources, assistance with job applications, education and coaching to help clients stay in their jobs, and other supports. Supportive Housing helps individuals with housing assessments, outreach to landlords, connections with community resources, assistance with housing applications, education and coaching to help clients resolve disputes, and other supports.


MEDICAID TRANSFORMATION

CLIENT STORIES Supportive Housing

Gerald* was 71 years old when he was admitted to a Skilled Nursing Facility to recover from wounds. He admitted that he did not have a stable living environment to safely discharge to and stressed that he had outstanding needs for housing and caregiving services. He also had a history of recurrent infections, likely due to past living situations, and had serious fluctuations in his physical and mental health functioning. Gerald entered the SNF with a host of healthcare issues, including amputations, chronic heart and lung issues, high blood pressure and diabetes. He had limited income and very few external supports. But Ondrenesha “Nesha” Wright, FCS Supportive Housing provider staff at Validus Consulting, met virtually with Gerald, engaging in active listening and working to determine the housing and other supports that he needed. She helped him complete his ALTSA “Bridge” housing subsidy paperwork. Once the housing voucher had been issued, Nesha found an apartment that would accept the voucher – and be suitable for someone with long-term care needs who was in a wheelchair. “It took some time” to find him housing, Nesha explained. “The client began feeling increasingly frustrated, especially when the facility went into lockdown due to COVID. He threatened to leave the

Supported Employment

Kyle,* age 29, had never worked before but said he wanted to “give it a try.” He approached a Foundational Community Supports Supported Employment Services specialist at his residential facility in Spokane, where the employment specialist was meeting with another client. Kyle has epileptic seizures and his family was worried he might injure himself if he had a seizure while working. They were not supportive of his attempts to get a job, but Kyle was undaunted. After only a few weeks of working on job readiness skills and applying for several employers of his choice, Kyle was invited to interview at Albertson’s, which was a 10-minute walk from his residence. Kyle had been diligently practicing his interview skills and was nervous because he’d never interviewed before. He and his employment specialist worked on some

SNF many times, and at certain steps we felt like he was going to blow.” But using her skills in motivational interviewing, Nesha was able to help the client understand that he was assured a safer discharge if he continued to reside in the facility until his independent housing could be established. “Everything seemed more challenging because of COVID, even getting a copy of his Social Security Benefit Award letter,” Nesha stated. When an apartment approved his application, Nesha guided the apartment managers in understanding how the housing subsidy worked, including assisting with paperwork and coordinating the unit’s Housing Quality Standards inspection, a requirement for ALTSA’s subsidy so that our subsidy clients are housed in safe and healthy apartments. And when Gerald moved into his new apartment in Thurston County, Nesha added, “He was over the moon, just so excited. He was extremely grateful, especially for the transitional items we got for him so that he could remain safe and healthy in his new housing.” But the work isn’t over yet – indeed, it has just begun. “I’ll continue to help him integrate into the community, as he’s requested,” Nesha said. “I’ll be checking in with him regularly and offering resources and information. I’ll continue to call him in order to make sure he’s overcoming any new barriers he finds as he settles in to his new life.”

techniques to reduce his anxiety. Kyle’s employment specialist accompanied him to the interview. “He answered questions like a pro,” his employment specialist said. Afterward, Kyle said he was very comfortable at his interview and that the Albertson’s staff seemed very kind and friendly. The next day, Kyle was hired and invited to come in to complete paperwork. He was elated. His first few days of work, he trained on computer tasks, janitorial tasks, bagging and merchandise returns. He is interested in training to be a cashier next. Kyle says that he loves his job and feels like he has gained a new family at Albertson’s. Given his success at his new job, Kyle’s own family now recognizes his capacity to work successfully.


HCS TEAM SPOTLIGHT Caregiver Training, Policy & Oversight

Washington is home to more than 100,000 paid long-term care workers who provide essential care to clients across all our settings, from their own homes to adult family homes, assisted living facilities and nursing homes. The Training, Communications, Development & Workforce Development (TCDWD) Unit within HCS is responsible for all the curriculum and policy related to the training of direct caregivers in Washington state regardless of fund source. This includes developing training solutions, supporting learning management systems and managing core training programs for case managers. “We coalesce around the ALTSA mission and care deeply about the work we do and why we do it,” said Michael Sheehan, Training Development & Learning Management Unit Manager, of his team. “We treat one another with respect, we share our knowledge freely, we are quick to ask each other for support, just as we are quick to support others. We are good people doing quality work for the benefit of our clients and partners.”

This work includes developing instructor-led training materials, instructional videos, eLearning and hybrid solutions. TCDQ is responsible for developing and managing the basic training required by caregivers seeking Home Care Aide certification. They also produce population-specific training around mental health, dementia, traumatic brain injury and diabetes. They manage and develop eLearning for CareLearn WA and the learning management system (LMS) for caregivers and help support the Washington State Learning Center (the LMS used by internal staff). “We support those who work directly (and indirectly) with clients by nurturing the skills they require to provide person-centered care,” Michael said. “The better we do our job, the better prepared our workforce is to transform lives.” Looking ahead, the team is considering their training development projects for 2022. Those might include Tribal respite training, substance abuse, caregiver harassment, extreme weather and person-centered training.


TCDWD is also responsible for developing rules and policy regarding direct-caregiver training. The training, oversight and policy team is responsible for ensuring the quality of long-term care worker training by reviewing and approving instructors and curriculum to meet our state requirements as well as DSHS standards and policies. Like it did to many other aspects of ALTSA’s work, the COVID-19 pandemic interrupted regular caregiver training significantly. When the pandemic began, current and prospective long-term care workers couldn’t access in-person trainings. The state legislature suspended training requirements so that individuals and facilities could continue retaining and hiring direct caregivers. TCDQ responded by expanding and adapting rules to allow for more virtual trainings and many in-person training sites have re-opened with strict COVID protocols. However, the state now has a backlog of workers who will need to complete the training that the legislature put on hold. Establishing a single deadline would result in a significant strain on the training system. The team addressed the problem by developing a cohort system, which bases training deadlines on the dates of a caregiver’s hiring or rehiring. The state will also be crediting caregivers with 12 hours of DSHS-approved continuing education credit for the emergent and intensive on-the-job training all direct-care workers had to complete on topics such as proper use of PPE and quarantine protocols. “In the three and a half years I’ve worked in this unit, I’ve been so impressed with the amount of education, knowledge, experience and dedication people have for serving our clients and customers,” said Adora Brouillard, Training Unit Manager for TCDWD. “During the pandemic, our team has worked countless hours, volunteered to help other teams, assembled face mask kits and have provided creative solutions to ensure training can continue for long term care workers, who in turn, can continue to provide services to our clients. I’m extremely proud, humbled and grateful for the often unseen contribution and commitment of everyone on the team.

Long-term care worker training requirements were suspended at the beginning of the COVID-19 pandemic. Now that training is available both virtually and in-person with COVID protocols in place, workers will be required to complete training and certification as follows. Training Completion Deadlines Worker hired or rehired during the time frame of:

Must be certified as a home care aide no later than:

8/17/2019 to 9/30/2020 4/30/2022 10/1/2020 to 4/30/2021 6/30/2022 5/1/2021 to 3/31/2022 8/31/2022 After 3/31/2022 Standard training requirement Certification Completion Deadlines Worker hired or rehired during the time frame of:

Must be certified as a home care aide no later than:

8/17/2019 to 9/30/2020 10/1/2020 to 4/30/2021 5/1/2021 to 3/31/2022

7/19/2022 9/18/2022 11/19/2022

After 3/31/2022

Based on hire date


Big Chief Mountain & Hollywood Bowl, Stevens Pass

Do you have a story tip? Want to submit a photo of Washington’s scenery? SEND THEM TO MEGHAN.ERKKINEN@DSHS.WA.GOV!


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