CATHY’S Message
Cathy Kinnaman Home and Community Services Director
As we recognize Black History Month this February, I want to take this opportunity to highlight the persistent and alarming health disparities faced by minority groups. Dr. Martin Luther King Jr’s powerful words are especially relevant to the challenges we confront today: “Of all the forms of inequality, injustice in healthcare is the most shocking and inhumane.” These words resonate deeply with our mission at HCS, ALTSA, and DSHS to serve all Washingtonians equitably—especially our most vulnerable populations. Nevertheless, significant health disparities among racial, ethnic, and socio-economically disadvantaged groups remain, demanding urgent attention.
Health disparities among Black Americans are particularly stark, reflecting systemic inequities that cannot be ignored:
• Chronic Diseases: Black Americans face higher rates of chronic diseases such as hypertension (42% vs. 28.7% for White Americans1), heart disease, HIV/AIDS, and asthma in children (12.6% vs. 7.7%1)2. They are 50% more likely to have diabetes and more than twice as likely to die from it than White Americans. 3
• Cancer: Many cancers are more prevalent and deadlier among Black Americans4, who face the highest death rates and shortest survival times.5 Black Americans are 40% more likely to die from breast cancer than their White counterparts, despite similar rates of diagnosis.6
• Maternal and Infant Mortality: Black maternal mortality rates are alarmingly high. In 2021, this rate was 2.6 times higher than that of White Americans.7 Similarly, Black infants have a mortality rate 2.4 times higher than White infants. 3
• Mental Health: Black Americans are 20% more likely to report psychological distress and 50% less likely to receive mental health treatment.2 Only 8.7% accessed mental health services in 2018, compared to 18.6% of White Americans.1
• Healthcare Access: In 2017, 89% of Black Americans had health insurance coverage compared to 93.7% of White Americans, and 12% under 65 were uninsured.1
Addressing these disparities requires confronting structural inequities, expanding access to affordable healthcare, and delivering culturally responsive care. Systemic racism, discriminatory policies, and unconscious bias among healthcare providers all perpetuate these inequities. Washington’s Pro-Equity Anti-Racism plan and the new DSHS mission, vision, and values reflect a commitment to dismantling structural racism and promoting equity for all residents. As the DSHS Office of Equity, Diversity, Access, and Inclusion states, “At DSHS, it is our social responsibility to dismantle structural racism wherever it presents itself in our work, for staff and clients.”
HCS plays an important role in this work. Through programs supporting older adults, long-term care services, and community health initiatives, we have opportunities to make meaningful strides towards equity. By prioritizing culturally competent care, increasing workforce diversity, and addressing social determinants of health, we can drive meaningful change. Let us recommit ourselves to creating systems where every individual, regardless of race, ethnicity, or socio-economic status, can access the care and support they need to thrive.
Together, we can advance equity in health and social services, creating a more just and humane society for all.
With gratitude, Cathy Kinnaman
1 “Health Disparities by Race and Ethnicity.” The Center for American Progress.
2 “Health Disparities Among African-Americans.” Pfizer.
3 “Advancing Better Health Through Better Understanding for Black and African American Communities: Health Literacy, Health Care Access, and Culturally Appropriate Care 2024 Reading List.” U.S. Department of Health and Human Services.
4 “Cancer and African Americans.” U.S. Department of Health and Human Services, Office of Minority Health.
5 “Cancer Facts and Figures for African American/Black People.” The American Cancer Society.
6 “Black Women and Breast Cancer: Why Disparities Persist and How to End Them.” The Breast Cancer Research Foundation.
7 “Maternal Mortality Rates in the United States, 2021.” The Centers for Disease Control and Prevention.
DSHS Region 1
Tami Rucker
Home and Community Services Administrator – Region 1
Adams • Asotin • Benton • Chelan • Columbia • Douglas • Ferry • Franklin • Garfield • Grant • Kittitas • Klickitat • Lincoln • Okanogan • Pend Oreille • Spokane • Stevens • Walla Walla • Whitman • Yakima
Creating Major Impacts Together
2024 was one of the busiest years ever for the Region 1 Nursing Facility Case Management (NFCM) team and we are anticipating 2025 to be even busier! From January thru October 2024 (only 10 months), this amazing team of 24 NFCMs supported 1061 clients transition to their community setting of choice. In 2024, the NFCM team implemented the Complex Transition Pilot, onboarding a new Durable Medical Equipment (DME) specialist, AND the transition of the Expanded Behavior Supports from the Residential Support Waiver (RSW) team to the NFCM team. On November 16, the first ever R1 NFCM Social and Health Program Consultant 4, Chad Wilson, started. Chad joined our team and has been working tireless-
ly on the Expanded Behavior Support (EBS) transition. With consultation, direction, and support, he has restructured the monthly EBS and EBS+ meetings, to focus on identifying client behaviors and successful interventions, with the goal of increasing the number of EBS clients transitioning back into the community. In addition to the EBS program, Chad will be supporting the NFCM team by working with the ever-changing nursing facility staff to educate them on the NFCM’s role in client transitions, to develop and implement LEAN trainings, monitor trends and data tracking, and assist in countless other areas of need. 2025 will be another busy year working together, as a team. We’ve got this! Teamwork makes the dream work! Happy New Year!
DSHS Region 2
Island
Erin Klones Home and Community Services Administrator – Region 2
Snohomish
Making Connections. Strengthening Communities.
As we closed out 2024, Region 2 HCS took a moment to reflect on the progress we made and the challenges we faced. During 2024, Region 2 HCS selected our Word of the Year as “Connection”. Our Word of the Year is both a guiding principle in our daily work and as a core value in the services we provide. Our mission has always been to strengthen the bonds within our communities, connect individuals to the resources they need, and foster a sense of belonging and support among our staff. This past year, we worked tirelessly to deepen those connections and extend our reach to those who need us most.
Throughout the year, we have seen tremendous strides in connecting people to the services and opportunities that empower them to thrive. Our Intake Team processed over 10,000 intakes in 2024 allowing us to connect the citizens of Washington with the services. We implemented new programs like Presumptive Eligibility and Remote Caregiving and continued our hard work in other areas such as decreasing Acute Care Hospital length of stay and transitioning record numbers of clients from Skilled Nursing Facilities. Our in-home teams assessed thousands of clients and navigated the complexities of setting up service amid caregiver shortages. Our State Hospital Discharge and Diversion team worked with behaviorally complex clients to implement appropriate plans of care in a variety of settings. Our Residential Case Management teams continued efforts towards smaller, more equitable caseloads while
adding 400+ clients to the overall caseload numbers.
Our Public Benefits Specialist team saw big changes in 2024. We were able to hire a Deputy Regional Administrator to oversee this program area and ensure the voice of these vital staff and programs is at the forefront of Headquarters and regional decision making. We consolidated into one reporting unit to start the ongoing work of increasing caseload equity throughout the region. Our PBS team managed unprecedented change in 2024 all while providing timely and quality service to our clients.
Other achievements included the opening of a new office in Federal Way, successful Quality Assurance audits for both Social Services and Public Benefits Specialist sides of the house and streamlining staff and processes throughout our Regional Operations & Support Services teams. In 2024, Region 2 HCS also promoted 33 current staff into new roles and ran a success cohort of a new training series called Supervisory Applied Practice.
Our year was not without challenges but taking time to reflect back on our accomplishments was a great reminder of the important and impactful work each member of Region 2 HCS undertook in 2024. As we closed out the year, we voted on our Word of the Year for 2025. Staff selected “Collaboration” as the word to help guide us through 2025. We are looking forward to increased collaboration across program areas, offices and regions…all with an eye towards providing the best service to the people of Region 2.
DSHS Region 3
Kara Sells
Home and Community Services Administrator – Region 3
Clallam • Clark • Cowlitz • Grays Harbor • Jefferson • Kitsap • Lewis • Mason • Pacific • Pierce • Skamania • Thurston • Wahkiakum
Training Units Complete Pilot
In 2023, Region 3 completed a one-year pilot on training units in both Social Services and Financial. This came about because of feedback from staff and a survey on retention. We all know how tough it can be to learn a new job, especially at HCS. These roles are no walk in the park! It was clear that employees wanted more face time with their supervisors to really get the hang of the “on the job” case management stuff.
Supervisors are extremely busy, juggling a million things, mentoring, and providing oversight. So, having a training unit dedicated to new employees during their first year is a game changer. It not only helps with retention but also boosts job performance and sparks innovation. Plus, a training unit creates a culture of sharing and collaboration. New employees can learn from each other’s experiences and skills, making everyone better together.
The best part is everyone gets the same knowledge and stays in the loop with the latest updates and changes. Once the employee meets proficiency, they graduate to their respective unit. When we invest in employee training, it shows we care about their growth and development. This boosts job satisfaction and loyalty, which cuts down on turnover. It’s a no-brainer—well-trained employees are more efficient and productive. They can do their tasks faster and with better accuracy, leading to better outcomes for our clients. We continue to have one Social Services Training Unit but were able to successfully bring on a second Financial Training unit in 2024. While the units for both programs are structured differently, the benefits are the same! Here is some data and feedback we collected regarding this amazing work:
Financial Training Units
• The 2 training supervisors complete the hiring and onboarding. Training is a dual approach utilizing the Social Health Personal Consultant (SHPC) as well as the Training Supervisor.
• 21 Public Benefit Specialists (PBS) have onboarded in the training units and graduated onto their respective teams.
• 18 PBS are currently on the 2 training teams (9 each).
Management Appreciation event in Chehalis (Sept. 2024).
DSHS Region 3
Clallam • Clark • Cowlitz • Grays Harbor • Jefferson • Kitsap • Lewis • Mason • Pacific • Pierce • Skamania • Thurston • Wahkiakum
Conclusion:
– PBS are going into caseloads, on average, right before the 6-month mark, allowing them dedicated time training with the SHPC and Training Supervisor. Once they are trained on married couple applications and have received their trial service evaluation, they graduate and transfer to their respective team.
– New employees really enjoy being on a team with other new employees, learning at the same pace as them. It also allows them to get to connect with others throughout the region.
– The ongoing supervisors are very appreciative of the amount of work this has taken off their plates. Removing the hiring, onboarding and initial training has given them back some much-needed time to focus on their current employees.
Social Services
• Training is a dual approach utilizing the SHPCs as well as the Training Supervisor.
• Total Incoming Trainees: 15 and Number of Graduates: 7
• Average Days to Full Caseload/Rotation: 168 days (6 months vs. 12 months for regular trainees)
• Average Days to Full 1.0 FTE: 178 days (6 months vs. 9-12 months for regular trainees)
• Average Days to Graduation: 281 days (9 months vs. 12 months for regular trainees)
Conclusion:
– The pilot demonstrated strong performance, with high proficiency rates in file reviews and case transfers, contributing to developing skilled and knowledgeable social service staff. The individualized training approach produced competent graduates ready to manage full caseload in a shorter amount of time.
– The training unit received favorable evaluations from participants, trainers, and supervisors, highlighting its effectiveness in supporting both new hires and supervisors.
The onboarding process at HCS is fantastic! I truly appreciate the hard work that has gone into making the training and onboarding process so comfortable and encouraging.
– Public Benefit Specialist
Caregiver Survey Highlights
To better understand the challenges, opportunities, and motivations of those working in caregiving careers, a survey was conducted to gather insights directly from 14,376 caregivers.
This survey sought to explore key themes, including job satisfaction, workplace conditions, training and development needs, and the personal and professional challenges caregivers face everyday. It also examined the factors influencing recruitment and retention and caregivers’ perspectives on career growth opportunities within the industry.
Survey participants included both current and former in-home caregivers. Respondents provided valuable feedback on their experiences, including the rewarding aspects of their roles, such as building meaningful relationships with clients and feeling a sense of purpose. At the same time, they highlighted common challenges, including burnout, low wages, inconsistent schedules, and limited access to training or advancement opportunities.
The survey also identified gaps in recognitions and support for caregivers. Findings underscored the importance of fostering a positive workplace culture, offering competitive compensation, and providing professional development opportunities to retain and attract new caregivers.
Addressing these priorities will improve recruitment and retention of caregivers and positively impact the caregiving workforce.
Click here to read full report.
14,376
Completed Surveys
97% Feel good about the work they are doing 95%
Reported seeing the difference their work makes 91%
Caregivers’ perception client valued and impact of their work
I love caregiving. I have always been someone who loves helping and taking care of people. This job gives me a chance to do that for people.
Wellness
Amy Besel
Senior Organizational Development Administrator
Make Meaningful Change with Habit Stacking
Here is my New Year’s gift to you! Please take 5 minutes to read this article about Habit Stacking. It was written by James Clear, author of the #1 New York Times bestseller, Atomic Habits. I have been using Habit Stacking for the past year and want to share some of the positive impacts I’ve experienced:
• Increased satisfaction and joy
• Increased productivity and follow through
• Better sleeping, eating, and moving
• 65 lb. weight loss
If you want to do something your future self will thank you for, open your calendar right now and create a calendar appointment for yourself for March 12 from 11:00-11:50, copy and paste this link into your calendar appointment, and when the time comes, click the link and scroll down to select the “join” button next to the ALTSA Thrives Connection Café. Come learn about Habit Stacking and leave with a plan to try it for yourself! It's one simple and impactful way to make positive changes for your wellbeing, which matters more than you know.
ALTSA
Photo by Maria Kharitonova Pexels.com
Remote Caregiving
ALTSA in collaboration with Catholic Community Services (CCS) Home Care Agency, rolled out a Remote Caregiving Pilot in 2024. The purpose of the pilot is to increase caregiving options for clients and positively impact recruitment and retention of the caregiving workforce. Remote caregiving uses certified experienced caregivers to provide personal care services, via video technology, for activities of daily living that do not require in-person assistance. For example, Medication reminders is a great way to use remote caregiving and may be done in as little as a 15-minute remote call if this meets a client’s needs!
Remote caregiving is an alternative form of personal care that can be used when an in-person caregiver isn’t available or when a client prefers a remote caregiving experience, and it can also be used in combination with in-person care from an Individual Provider or a home care agency worker. Using this technology increases care
options for clients and benefits the caregiving workforce as it allows older caregivers and those with disabilities the means to enter or remain in their roles as caregivers. ALTSA continues to promote this innovative option to clients to expand their caregiving choices and as a workforce strategy for caregivers.
Keep up to date with remote caregiving processes, tips, and tricks by visiting our NEW Remote Caregiving SharePoint page. Here you’ll find instructions on the referral process, training materials, client success stories, and more!
High School Aide Training Program Adds Schools
In 2024, five new high schools across Washington state began offering the High School Home Care Aide course, a collaboration between the Department of Social and Health Services and the Office of Superintendent of Public Instruction. These schools include New Market Skills Center in Tumwater, Garfield High School and Interagency High School (Seattle School District), Selah High School, and TriTech Skills Center in Kennewick. Since then, a new
program began in Toppenish High School in January and another at Crossroads High School in Granite Falls in February.
The course was designed to prepare students for employment as a Home Care Aide while earning credit toward high school graduation. Using the academic foundation of medical terminology and knowledge of the life sciences, students demonstrate technical skills in real-life caregiving situations. For high school programs, the 90-hour course covers the core foundational knowledge and skills for Health
Science, aligned with National Health Science Standards from the National Consortium for Health Science Education, as well as DSHS requirements.
“We are happy to have added the HCA training to our Professional Medical Careers program,” says Jaimee Dobson, who manages Professional Medical Careers for New Market Skills Center.
“It has allowed us to diversify our medical field pathways offered to our students. The training not only enhances student employability, but also promotes a culture of compassion and support within our school community.”
High School students who participate in the Home Care Aide Training earn high school credits and prepare and take their HCA certification exams (available in English and 12 other languages). With their HCA credentials, they can work in a vital position featuring career growth potential in the expanding health care field with employers across Washington state.
“The HCA program allows students to start their journey into healthcare during high school,” says Danielle DeLuca, Career and Technical Education Program Facilitator for Everett Public Schools. “This amazing opportunity allows them to develop skills and knowledge to earn the HCA certificate, which they can build on as they continue their education. The HCA program provides them a clear pathway, direction and focus as they graduate from high school.”
Visit dshs.wa.gov/hshcatraining for more information on the High School Home Care Aide training program.
March is National Nutrition Month
This March, we celebrate National Nutrition Month and recognize the remarkable service that senior nutrition programs bring to older adults every day across Washington state. The Senior Nutrition Program, funded by the Older Americans Act, has supported older adults across the United States since 1972. The 2025 theme to celebrate the Senior Nutrition Program is A Place at the Table. It recognizes the importance of local nutrition programs and their work to provide meals in communities nationwide. Senior Nutrition Programs promote social connection and food access through community meal sites
Additional resources can be found by visiting:
and home-delivered meal services. More than just a meal, these programs provide a chance to checkin and connect, both with community members as well as to other long-term services and supports that promote health and independence.
Washington state’s Senior Nutrition Program providers serve over 50,000 older adults each year. They provide nourishing meals, connect older adults to other home and community-based services, and promote healthy aging. To find a local Senior Nutrition Program in your area, visit the Washington State Community Living Connections (waclc.org).
Celebrate the Senior Nutrition Program | ACL Administration for Community Living
Washington State Community Living Connections (waclc.org)
Food Assistance for Older Adults (ncoa.org)
Build a Healthy Eating Routine as You Get Older (dietaryguidelines.gov) | Spanish
Senior Nutrition | ACL Administration for Community Living
Senior Farmers Market Nutrition Program | DSHS Senior Farmers Market Nutrition Program (wa.gov)
Basic Food | DSHS (wa.gov)
