By Geralyn Magan
A North Carolina initiative to bolster the direct care workforce is drawing attention 20 years after its launch during the Better Jobs Better Care demonstration.
A 20-year-old project that is well known to the LeadingAge LTSS Center @UMass Boston found itself in the spotlight last fall when the National Academy for State Health Policy (NASHP) decided to highlight promising practices to address the current workforce crisis.
During NASHP’s September conference, representatives of several states shared the creative ways in which they are addressing a variety of challenges that direct care professionals face. Among those creative initiatives was the North Carolina New Organizational Vision Award (NC NOVA), a voluntary licensure program designed to improve direct care jobs in the state’s nursing homes, adult care homes, and home care agencies.
NC NOVA and BJBC
NC NOVA was developed as part of the national Better Jobs Better Care (BJBC) demonstration program funded jointly by the Robert Wood Johnson Foundation and The Atlantic Philanthropies. The Institute for the Future of Aging Services—now known as the LeadingAge LTSS Center @UMass Boston—served as the national program office for the four-year, $15.5 million initiative, which ran from 2002 to 2006.
BJBC’s goal was to “reduce the high vacancy and turnover rates of direct care workers and improve workforce quality through both policy and practice changes,” according to Robyn Stone, co-director of the LTSS Center and principal investigator for the BJBC initiative.
Five state-based coalitions—in North Carolina, Vermont, Pennsylvania, Iowa, and Oregon—participated in the BJBC demonstration.
The North Carolina Foundation for Advanced Health Programs, a BJBC grantee, convened a partner team in 2003 to develop NC NOVA. The North Carolina Senate established NC NOVA as a statewide program effective January 1, 2007.
CRITERIA AND EXPECTATIONS
NC NOVA consists of a uniform set of criteria and expectations addressing factors known to affect the recruitment, retention, and job satisfaction of direct care professionals. Home care, adult care homes, and nursing homes that are judged to meet those criteria and expectations receive a special licensure designation from the state’s Division of Health Service Regulation.
NC NOVA standards span four major areas:
- Supportive workplaces.
- Training.
- Career development.
- Balanced workloads.
The NC NOVA designation is issued as a separate license document sent to the provider in addition to the provider’s operating license. Well-Spring, a LeadingAge member in Greensboro, NC, was the first recipient of the NC NOVA licensure designation.
EARLY OUTCOMES AND LASTING LESSONS
In 2008, annual average turnover rates for NC NOVA adult care homes and nursing homes were between 61% and 89% lower than the aggregate statewide rates for these settings, according to a 2010 article in the North Carolina Medical Journal. In addition, average annual turnover data for NC NOVA home care agencies were 12% lower than average statewide data for home care agencies. The special license issued by the state “provides creditability for employers, workers, consumers, and the general public,” according to authors Susan Harmuth and Thomas R. Konrad.
“The message we are learning from NC NOVA is that you need to have a longer vision for how a new initiative will be implemented and used,” says Stone. “A lot of the work around the NC NOVA program was developed during the Better Jobs Better Care demonstration. The seeds were planted then. But now, given our current workforce crisis, NC NOVA is being brought out as a good tool for moving workforce development forward and recognizing providers that are doing a great job as employers of choice.”