Using Collective Impact to Examine Direct Service Worker Training and Credentialing in North Carolina:...

Area of Science:

• Healthcare Workforce Development
• Public Health Policy
• Social Gerontology

Background:

• North Carolina (NC) employs over 113,000 direct service workers (DSWs) providing essential home- and community-based services (HCBS) to older adults and individuals with disabilities.
• The demand for DSWs in NC is projected to increase by approximately 23,000 new jobs between 2020 and 2030.
• These workers are often under-resourced and inadequately supported, impacting service quality and workforce stability.

Purpose of the Study:

• To conduct a comprehensive landscape analysis of training and credentialing requirements for DSWs in NC's HCBS sector.
• To identify complexities and limitations within the existing training and credentialing systems.
• To develop a crosswalk resource and preliminary recommendations for improving DSW training and credentialing.

Main Methods:

• A Medicaid-funded landscape analysis was performed utilizing the Collective Impact (CI) framework.
• Community engagement involved stakeholders including HCBS providers, licensing entities, advocates, and individuals with lived experience.
• A comprehensive crosswalk of training and credentialing requirements was developed.

Main Results:

• The analysis revealed significant complexity and variability in training and credentialing requirements across different HCBS service delivery models in NC.
• A first-of-its-kind comprehensive crosswalk resource was generated, detailing current requirements.
• Limitations in the existing systems were identified, highlighting areas for improvement.

Conclusions:

• The current training and credentialing landscape for DSWs in NC is complex and presents challenges.
• Community engagement is crucial for understanding and addressing these complexities.
• Preliminary recommendations were developed to enhance the training and credentialing of DSWs, aiming to improve support and service delivery.