Monday_ April 8_ 2008

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					                                              Workforce Development Expert Panel Meeting
                                                                        April 7 & 8, 2008
                                                      SAMHSA/CSAT Office, Rockville MD

Dr. Anthony Floyd, University of Washington/Alcohol & Drug Abuse Institute
Dr. Thomas Hilton, National Institute on Drug Abuse
Dr. Robert Hubbard, National Development & Research Institutes, Inc.
Deann Jepson, ATTC National Office
Mary Beth Johnson, ATTC National Office
Dr. Hannah Knudsen, University of Kentucky
Laurie Krom, ATTC National Office
Cathy Nugent, Center for Substance Abuse Treatment
Nancy Roget, Mountain West ATTC
Dr. Michael Shafer, Pacific Southwest ATTC
Dr. Anne Helene Skinstad, Prairielands ATTC (Day 1)
Flo Stein, Department of Health and Human Services (Day 1)
Dr. Jack Stein, Center for Substance Abuse Treatment

Dr. Robert Atanda, Center for Substance Abuse Treatment

Guest Attendees:
Deepa Avula, Center for Substance Abuse Treatment (Day 1)
Deb Trunso, Center for Substance Abuse Treatment (Day 1)

                                Day One – Monday, April 8, 2008

Welcome and Introductions - 8:30 am – 9:00 am
Cathy Nugent opened the meeting by introducing everyone in the room. She also defined the role of the
Workforce Survey Expert Panel as advisory, offering insight and wisdom on how to move the National
Survey forward. CSAT is looking for input on the demographics of the workforce; anticipated workforce
development needs; and common strategies & methodologies to prepare, retain and maintain the

Mary Beth Johnson reviewed who the ATTC Network serves, where the ATTC Regional Centers are
located and the role of the ATTC Network. Ms. Johnson also described the layout of the meeting agenda
and timetable.
(See Welcome PowerPoint slides - Welcome.ppt)

CSAT Vision – 9:00 am – 9:30 am
After the day’s agenda was reviewed, Jack Stein began the meeting thanking everyone for their
participation in this project, and he was glad to have both representation from the research and research
applications side. He talked about the CSAT vision for the national workforce survey and how it should
help describe the workforce. He envisioned this group to have conversations about the target audience;
who will be surveyed; where those surveyed will be working and what data needs to be collected.

Dr. Stein first talked about the term Dr. Wesley Clark is using, Recovery-Oriented Systems of Care, which
is a more strength-based approach and looks at addiction from a more comprehensive perspective. The
substance abuse treatment experience is just one component in an ongoing continuum of care and

                                                Workforce Development Expert Panel Meeting
                                                                          April 7 & 8, 2008
                                                        SAMHSA/CSAT Office, Rockville MD
recovery services and is an integral part of that whole continuum. In addition, the workforce challenges
are multiple and the ROSC approach is a paradigm shift.

Dr. Stein stated, “For purposes of this project, the focus will be on the clinical treatment perspective, in
terms of funding and providing support to the field.” He continued by saying the workforce currently is
in dire straights, at least from our best guesses. There have been quite a lot of snap shot views, including
the extensive work done by the ATTC Network on state workforce surveys and the work by Thomas
McClellan, which surveyed the needs of the treatment system. Dr. McClellan reported there was at least
a 50 percent turnover in counseling staff. Dr. Stein stated, “We’re not sure if this is still true.” There was
also a report/study on the lack of IT conducted a few years ago. One goal of this project is to have some
good benchmarks/foundational milestones in order to get a good grasp of our understanding of the field.

Dr. Stein looked at the US Department of Labor Occupational Outlook Handbook (2008-2009 edition). In
this handbook there is a general category of counselors and a sub-component for substance abuse.
According to this handbook, 635,000 people were identified as counselors and in the substance abuse
category, there were 83,000 behavioral counselors. In addition, in the general counseling category,
between the years 2006 through 2016, they’re expecting to see 21 percent growth and in the substance
abuse counselor category, they’re expecting a 34 percent increase. The Department of Labor’s reasoning
was that more people are seeking treatment and there’s a better attitude toward addiction treatment. Dr.
Stein said CSAT typically talks about 13,000 treatment programs in the country. He also mentioned this
is a field in which we need to be recognized from a strength-based perspective. The US Department of
Labor is identifying substance abuse as an occupation possibility and those who are coming into this field
should recognize there are a lot of opportunities here.

CSAT wants to get a national picture of the workforce. Keeping in mind our limited resources, this
project is for CSAT and the ATTC Network to use and develop our own appropriate training for the
future. This is not a research study. It’s not a large household survey which will answer every question.

While working on the survey, we also need to keep in mind upcoming therapies, such as medication and
behavioral therapies, incorporation of SBIRT, etc. We need to try and answer the following questions:

1. What are the basic demographics (Keeping it to a bare minimum while still remaining useful.)?
2. What are the anticipated training needs around the time this survey comes out (covering 2010-2015)?
3. What strategies & methodologies work best to train and prepare the workforce (Keeping in mind
where technology is going.)?

He further described our target focus, which includes direct or frontline providers and directors in
treatment organizations. These organizations are the 13,000 listed in the SAMHSA Treatment Locator.
They are both publically and privately funded. Most are licensed, but not all.

Jack Stein opened the floor for comments and questions:
        Nancy Roget stated that the SSAs in her region would be very interested in salary information.
     Anne Helene Skinstad requested that we ask questions regarding clinical supervision.
     Aaron Williams recommended making the survey relevant at the state level.

Review of ATTC Survey Activities – 9:30 am – 10 am
Cathy Nugent thanked Jack Stein for his comments and then invited Robert Hubbard to the podium to

                                                   Workforce Development Expert Panel Meeting
                                                                             April 7 & 8, 2008
                                                           SAMHSA/CSAT Office, Rockville MD
present his compiled report on the ATTC Survey activities.
(See Review ATTC Activities PowerPoint slides – Review ATTC Activities.ppt.)

Robert Hubbard made additional comments and posed some questions during his report.
They are as follows:

Dr. Hubbard commented that we need to understand the levels of care within the organization. Patients
and staff float among different roles and treatment organizations. These organizations are linked with
the SAMHSA Treatment Locator. In building the National survey, we need to know how well the sample
represents the frame and get enough data for the sample. We must choose the sampling very carefully.

As for the ATTC workforce surveys, they were extremely variable. The picture of the staff is limited.

Dr. Hubbard also asked a few questions while he was presenting. The following questions were raised:

    1.  Are Agency Directors giving the survey to those who can fill it out?
    2.  Do we need to create a listing of all staff? Response rates would be labor intensive.
    3.  Are there resources already available?
    4.  What competencies are we looking for as a Network?
    5.  People will participate knowing what will happen after the survey. How can we help the
        workforce see this survey as valuable?
    6. Should we consider training needs versus who are the workers?
    7. Perhaps look at these sampling approaches. Can we extract some information from these
    8. How important is state buy-in?
    9. What is the training at the state level?
    10. What is our focus?

He also stated there are good measures out there for treatment but not in recovery. Areas to consider
include demographics, credentials, and job satisfaction.

Overview of the National ATTC Evaluation – 10:00 am – 10:20 am
Next scheduled was Deepa Avula’s overview of the National ATTC Evaluation. She presented the
information by PowerPoint. (See Overview of National ATTC Evaluation PowerPoint slides –
Overview of National ATTC Evaluation.ppt)

After her presentation, there was a 15 minute break.

Workforce Survey Goal – 10:35 am – 11:30 am
Jack Stein spoke about the Workforce Survey Goal. He began by introducing a workforce survey goal
originally stated by the National Association of Social Works (NASW):

         To gather relevant data to support the development of effective workforce policies and strategies to assure
         the availability of adequate numbers of providers prepared to respond to the growing needs of individual’s
         families and communities in need of treatment and recovery services.

                                              Workforce Development Expert Panel Meeting
                                                                        April 7 & 8, 2008
                                                      SAMHSA/CSAT Office, Rockville MD
Dr. Stein solicited comments regarding this goal. There was much discussion among the group and the
following comments and suggestions were noted:

Nancy Roget suggested that the goal needed to mention something about training. The thrust of training
and technical assistance is not embedded there. Cathy Nugent interjected by saying she saw the training
piece embedded by the way the providers are prepared to meet the needs of individual’s families and

Furthermore, Ms. Roget commented she will have less buy-in from SSA’s if CSAT asks what are the
training needs rather than asking questions about where a worker plans to be working in the next 5 years,
what is this person’s academic level, what is their salary status, have they used tobacco, do they have
access to computers and are they using computers at work; or other questions which will give a snapshot
of the workforce. She said there are questions in her workforce survey inquiring about online/internet
use and how familiar an individual is with TAP 21 and TAP 21-A. The findings told her there’s more
work to be done regarding TAP 21-A. She closed by saying her SSAs are interested in seeing any
differences in, for instance Colorado’s workforce compared to Wyoming’s. They’re also interested in
trends such as are these nationwide trends or does this apply only to the east and west coasts? With
these findings, CSAT and the ATTC Network can develop different workforce development activities.

Mike Shafer asked, “What are the critical questions to ask about how do we get them into the field? How
do we keep them in the field? What are the career ladder perspectives/opportunities for them?” He also
said we should keep in mind those topical questions with a policy spin instead of just what are the
training needs, given our limited funds. We should carefully consider the line of questioning. He
mentioned the Arizona Provider Association (APA) Bi-Annual Salary Survey. This is a market adjusted
salary survey done every 2 years. This helps APA see where their pay scale falls relative to their
competitors. Seeing this data has been a huge driver toward recruitment and retention issues. Dr. Shafer
would like to get a better handle on who is actually credentialed and licensed within each state too.

Cathy Nugent added clarification by saying she needs information which will help her (CSAT) write an
ATTC program announcement and RFA, keeping in mind this survey can also be useful to other
audiences. Also, she needs information to answer what does the ATTC Network need to know in order
to identify workforce needs and which strategies should be used.

Hannah Knudsen stated she liked the idea of core competencies which address what we asking the
counselor to do.

Aaron Williams would like to trace the migration of the workforce. He asked if this is something we can
use 5, 10 years from now and actually track the migration of the workforce.

The discussion closed with a group consensus on the following questions
1. What are the demographics of the workforce?

2. What are the anticipated workforce development needs for 2010 – 2015?
3. What are the common strategies & methodologies to prepare, retain and maintain the workforce?

                                                 Workforce Development Expert Panel Meeting
                                                                           April 7 & 8, 2008
                                                         SAMHSA/CSAT Office, Rockville MD
Break-Out Session Discussion – 11:30 am – 12 noon
Following this discussion, Robert Atanda introduced the agenda for the Break Out sessions. He divided
everyone in to three groups to answer each of the above questions. Instructions were given out as to the
process and format of the groups. Then lunch was served.

The I-SATS Data Set Presentation and Discussion – 12:45 pm – 2:30 pm
Subsequently, Robert Atanda presented an overview of the Drug and Alcohol Services Information
System’s (DASIS) Inventory of Substance Abuse Treatment Services (I-SATS) data and National Survey
of Substance Abuse Treatment Services (N-SSATS) survey. He also distributed a handout outlining the
areas of the N-SSATS and what is collected. (see PowerPoint– N-SSATS_2.ppt.)

In addition to the information on the PowerPoint, Dr. Atanda made some additional comments. They are
as follows:

In the I-SATS survey, 80% of the providers are approved. Those not approved are not licensed through
the states.

In comparison, the N-SSATS survey has a 96.5 % response rate and is very labor intensive. With the first
mailing, DASIS receives about a 30% response rate, which is followed by more mailings and telephone
calls. Those that are out of scope (half-way houses, sole practitioners, jails, etc.) are not included in the N-
SSATS survey analysis. On March 31st annually, hospitals are asked how many clients are at their facility.
Eighty percent surveyed are outpatient facilities and 60 percent are private/non-profit, and the facilities
are evenly distributed throughout the Network regions.

After his presentation, Dr. Atanda asked for questions and comments. Mike Shafer wanted to know the
inclusion and exclusion criteria. Dr. Atanda answered by saying we need more clarification from Deb
Trunso regarding the criteria. However, you can get I-SATs information through the state and updates
are made through the state. This is a mail survey with follow-up. Facilities are also searched through the
American Business Index and the American Hospitals Association.

There was discussion on how many provider agencies were in the survey and in which state. To practice
in North Carolina, you have to be registered. Flo Stein mentioned that there is access to this data.
The following numbers were mentioned:
        NC– 537 facilities in the survey.
        DE – 49
        MT – 77
        CA – 2303
        TX – 686
        NY – 1200
        MI – 612
        FL – 1200
        Every other state is under 500.
        CO – 533, inflated number. The rest are assessments and DUI facilities.

The group then asked, “Do we go through agencies or licensing/certification boards and what constitutes
a facility?”

                                                Workforce Development Expert Panel Meeting
                                                                          April 7 & 8, 2008
                                                        SAMHSA/CSAT Office, Rockville MD

Deb Trunso, CSAT staff member responsible for the ISATS and N-SSATS reports, came to the group to
answer questions about the I-SATS data and N-SSATs survey. She said the survey covers specialty
substance abuse units and every site where services are delivered. Within a site there can be more than
one level of care. When asked about the definition of facility, she stated that it is difficult to come up with
a definition of facility that suits every one’s needs. The core most of us can generally agree on, but along
the fringes it can present complications, depending on the objectives.

In addition, Ms. Trunso explained the difference between I-SATs and N-SSATS. I-SATS is a master listing
of facilities and N-SSATS is a survey of the facilities. There was also a question about how agencies
record their numbers. She replied by saying some agencies with multiple locations will “roll up” their
answers and combine their numbers. No effort has been made to have a non-duplicate account of
agencies, especially because this list is always changing.

Bob Hubbard asked if there is an identifier number. Ms. Trunso said it depends on the state whether
there is an identifier number or linked to TEDs. She also stated that the survey is revised once every
three years and there’s an annual census. The response time allocated to do the survey is 35 minutes.

Ms. Trunso quoted the cost of survey at $ 2 million plus $200,000 for maintaining I-SATS. She also
explained the process of the survey. First there is a mailing which yields a response rate of 25 percent.
Then a reminder post card is sent out and there’s a second mailing. Reminder phone calls start after the
second mailing and information is gathered over the phone at this point. It takes about six months to
collect everything and there are approximately 13,000 facilities in the end.

Dr. Stein asked Ms. Trunso if there was any reason why we shouldn’t use the facilities listed in the
survey. She replied that she didn’t see any reason not to use the data. It is continuously updated and has
been successfully used by a number of specialty surveys, CSAT, and OAS, which does the Alcohol &
Drug Services study. She recommended starting with the 80 percent approved facilities in I-SATS. There
are addresses and phone numbers in this survey and each location has an identifier.

Deb Trunso subsequently asked for comments and questions. Some of the group’s input is as follows:

Mary Beth Johnson commented that staff in these facilities could be participating in ATTC activities.

Then Bob Hubbard calculated the cost of an individual survey, which is about $150.00.

Hannah Knudsen was asked how Paul Roman conducts his surveys. She said most of his surveys are
done face-to-face. The agencies give names of counselors. Some, however, choose not to give these
names. Each survey is addressed to the counselor at the agency address.

The groups also discussed the issue of not having a list for every employee. We need to do the survey on
a state or ATTC regional level, otherwise it is not useful. Factors to consider are, 1) Level of analysis,
2) How representative is the survey?, 3) Level of precision. It follows that the survey needs a balance,
given cost constraints.

A 10 minute break was given after this discussion.

                                             Workforce Development Expert Panel Meeting
                                                                       April 7 & 8, 2008
                                                     SAMHSA/CSAT Office, Rockville MD

Refining the Questions Break-out sessions Discussion and Report Outs – 2:40 pm – 4:45 pm
Robert Atanda started by reviewing the group discussion process and questions. Then the Break-out
sessions began. (See Refining the Questions Report-out PowerPoint slides – Refining the

The groups gave input to the leaders who rotated to each group asking for feedback to their assigned
question. You can find these Discussion notes on the Word document labeled Discussion Notes from April

Each leader reported on the discussion and thoughts regarding their assigned question.
Question #1: Led by Nancy Roget
What are the demographics of the workforce?

The following are the compiled comments and questions of the group’s discussion:

        Who are we surveying? Is it a Counselors or Directors survey?
         We need to differentiate between the two.
        We need to describe the frontline staff.
        We need to consider the following demographics:
        Recovery status – Is this the reason why they are entering the field?
        Tobacco usage
        Criminal background – Do they have an arrest record?
        Education level
        Credentialed?/Licensed? – What do you have? Are you looking to be licensed and/or
        What supports do you need to go back to school?
        Degrees do you have? – Other educational goals?
        Age entering field
        Salary questions – annual vs hourly
        Benefits receiving (retirement, health insurance, vacation, sick leave, etc.)
        Benefits you would like to have?
        Tenure
        Part-time or Full time
        Marital status
        Dependents
        Income (total household)
        Where do you plan to be in five years from now?
        Technology questions: Do you have e-mail? Do you or will you have electronic records? Use
         web-based system?
        Telemedicine
        Agency demographics – annual budget/ unfilled positions/ marketing efforts
        1st, 2nd or 3rd career?
        Contract or Employee
        Case load size
        Age
        Primary wage earner or secondary

                                             Workforce Development Expert Panel Meeting
                                                                       April 7 & 8, 2008
                                                     SAMHSA/CSAT Office, Rockville MD
       How many jobs do you have?
       Primary place of employment
       Perception of labor market/other agencies
       Transportation issues:
       Commute? How many hours/miles?
       Where do you live/work? (setting – suburban, urban, or rural?)
       What does recovery mean? (12-step, came from a methadone program, etc.)
       Race
       How many agencies have you worked for?
       Does your agency do anything for those in recovery?

Question #2: Led by Anne Helene Skinstad
What are the anticipated workforce development needs for 2010-2015?

She reported that the group wanted to define the key points. The following is her compiled list:
     We need to define the workforce: clinical directors, line staff and clinical supervisors
     What is the recovery/non-recovery status in terms of education needs?
     Are there needs for further education?
     For people in recovery – What is the training need? How flexible will the agency be if the
        employee wants further education? Is this a reason people leave if they don’t get further
        education? How much education did they initially get?
     There is a need for three types of surveys.
     Clinical Directors may know more about future needs of the workforce.
     Are there HR Directors who oversee future/developmental needs in the workforce?
     Are we/the workforce working with primary care physicians?
     Ask about workload – not just caseload (paperwork, meetings, etc.)
     CEO & Clinical Supervisors take part in sustaining the org. & financially supporting the
        organization. We need to have questions related to this subject.
     Stigma of profession and clients – How does this affect the needs of training/support in the
     Recovery-Oriented area – how does this affect our training needs and for changing perception?
     How do our colleagues feel respected for what they do? Do they feel respected?
     How does this affect the workforce (stigma)
     We need to develop questions for clinical supervisors.
     How much training to clinical supervisors receive?
     How important are clinical supervisors?
     What are the Challenges?
     How to change expectations of caseload?
     How to change expectation for education and how does this impact the feeling of being
     How to measure agreement between the various levels?
     Organizational size? -- How does this impact the support of educational needs, training needs,
        clinical supervision, etc.?
     If the clinical supervisor is also the CEO and HR person, how does this affect workforce needs?
     How do we measure core competencies? (TAP 21 used with performance appraisal) – Could we
        find out how counselors rate in these areas?

                                                Workforce Development Expert Panel Meeting
                                                                          April 7 & 8, 2008
                                                        SAMHSA/CSAT Office, Rockville MD
       Educational background on program directors, those who had business degrees – seemed to
        enhance to use of evidence-based practices. There was greater likelihood that these practices
        would be implemented.

Wrap-up - 4:45 pm – 5:00 pm
The day ended before question #3 could be discussed. The meeting was adjourned for the day and
question #3 was tabled for the following day. Flo Stein and Anne Helene Skinstad left for the airport.

A de-brief meeting with Jack Stein was held afterwards and the most highlighted topic was the lack of
funding available. This came about due to the researchers request for some kind of budget number. This
discussion led to a new proposal, which is presented by Cathy Nugent at the beginning of day two.

                                Day Two – Tuesday, April 9, 2008

Reconvene, Agenda Review and Discussion – 8:30 am – 10:30 am
The Workforce Survey Expert Panel re-convened and Cathy Nugent began the day by thanking the group
for yesterday’s input and discussion. Mary Beth then reviewed the day’s agenda.

There was some initial discussion of how difficult, given the budget constraints, it will be to do a robust
workforce survey.

Cathy Nugent said that the ATTC Network is under-resourced to do a survey of the directors and the
workforce, and we also don’t have a list of the workforce. Per the debrief conversation with Jack Stein
yesterday, it might be possible to do a survey of the directors of treatment agencies electronically, which
would also facilitate the process. Ms. Nugent’s proposal was to do some focus groups with providers.
These groups would allow CSAT to get some qualitative information about maintaining and retaining the
workforce and help inform some questions that would go on a director’s survey. Then we can do a
survey of directors, which seems to be more feasible. The survey would include questions addressing the
universe of people providing frontline treatment and recovery services. Perhaps this would also lay the
groundwork for a researcher to come with a proposal to NIDA to do a larger survey of the workforce.

There were several comments from the group. To begin, Bob Hubbard thought that this seemed to be a
very realistic approach. He said focus groups can help us define the questions. The following are the
comments, questions and suggestions from this discussion:

           Don’t underestimate the work done by part-time and volunteers. Don’t miss this group.
           Ask salary questions. You can get an average salary from a director. What are the HR
            policies? How do you recruit? What are the standards for hiring? What approaches work?
           Include some items that would inform further studies of the providers (with more resources).
           Seems to be a more cost effective approach. Perhaps 1-$2,000 per group for travel and
            incentives and use 3-4 groups per region.
           Get some larger groups to “host” the group instead of trying to find a spot.
           Still have some leg work in identifying directors still to do.

                                     Workforce Development Expert Panel Meeting
                                                               April 7 & 8, 2008
                                             SAMHSA/CSAT Office, Rockville MD
   Probably can get a little bit of individual data, but not much.
   What is the selection criteria/composition of the focus groups and how many per region?
   Where to do the focus groups? Summer Institutes, NAADAC, SAAS
   Need to identify the directors – which ones in an organization will we survey?
   This is a resource issue: follow-up with directors vs focus groups
   Is this a facility survey?
   We need to be clear about our research questions.
   This simplifies the process. Define terms of directors and clarify terminology.
   Much more manageable process/survey.
   This approach would help us define the work force more clearly and it would yield more
    reliable data then we currently have.
   SAMHSA can define the workforce systematically with limited resources.
   There’s a need to bring the scale down given resources.
   Could we use the standard director’s survey we already have?
   Need to explore all our resources (certification, etc.)
   Department of Labor – does a door to door survey. We should look at these resources.
   Directors only survey – define what we mean.
   This focus will cost more for certain regions.
   This may be difficult in some regions than others to do focus groups.
   Target only publically funded facilities getting block grant money.
   Build these groups on already planned trainings, etc.
   Who can answer the salary questions? Is it the directors?
   Directors can download the form and ask others to gather the information.
   Identify items where directors answer only. Highlight these.
   There is concern about the respondent burden.
   Do a facility survey similar to the N-SSATS instead of the Director Survey.
   Identify positions at the facility level. (I-SATS)
   Send out in tandem to N-SSATS survey.
   Conduct focus groups of frontline workers.
   Are phone interviews an option? Maybe a compensated interview?
   This is an opportunity to standardize questions. It cuts down on travel time. Does take some
   Identify Clinical Supervisors leaders to talk to for developing the survey. – Identify key
   Maybe use a combination of focus groups, existing lists, etc. Look at how these things
   Important to sample the domain properly.
   Maybe this is a three part study:
    1. Review/use what is already available.
    2. Focus groups/clinical supervisor interviews
    3. Directors/facilities survey to compliment N-SSATS.
   Make this project smaller and tighter so that we can confidently answer some definitive
   Cathy Nugent stated that the National registry goes way beyond scope of this project. Have
    this project as a separate project.
   Add questions to the N-SSAT survey.
   Need information about facilities in survey.

                                              Workforce Development Expert Panel Meeting
                                                                        April 7 & 8, 2008
                                                      SAMHSA/CSAT Office, Rockville MD
           There is a need to be more grounded or familiar with N-SSATS data and the I-SATS survey.
           OEM clearance until 2010? Is there a different way to piggy back on N-SSATS?
            Suggestion: Review the Research Questions, given this new approach.

There was a fifteen break given after this discussion and then Mike Shafer reported.

Report-Out Continuation – 10:45 am – 11:30 am
Question # 3: Led by Mike Shafer
What are the common strategies & methodologies to prepare, retain and maintain the workforce?
(See Refining the Questions Report-out PowerPoint slides – Refining the Questions.ppt)

The comments and questions he reported are as follows:

           How do we model the movement within the agency?
           Within this loosely bounded system of agencies, there’s potential movement within an
            agency; potential movement between the organizations; and movement in and out of the
            bounded system?
           There are also public and private distinctions. Where do you draw the line between these
           There’s the Substance Abuse workforce vs the Mental Health workforce vs Behavioral Health
            Care Industry workforce which are serving a multitude of agency systems. The question
            becomes - How do we model this system?
           Compensation is not the driver for those to leave the behavioral health field. It is much more
            influenced by Workplace culture. The concepts of procedural justice, distributive justice,
            professional autonomy and professional self efficacy measures seem to be also influential
           Try to tap into not only the frequency and quality of Clinical Supervision but Organizational
            Management, in which Clinical Supervision is just one aspect.
           How can we characterize the workplace culture?
           Aspects of Compensation, Benefits, and Leave policies are critical here.
           Performance Based Rewards. Talked about more privatized agencies such as in Arizona who
            offer rewards on billable hours.
           Simple Recognition (preferred parking)
           Are there interagency opportunities with organizations for bringing in the money or
            providing good quality care? These are all known to be drivers in retention.
           Are there organizational opportunities for advancement?
           Are there opportunities for incentives which are associated with career laddering? Example:
            If I would go back to school or obtain my certification, will this raise my base pay?
           What is the Workforce that we’re studying? We need more clarity.
           We need to ask more questions about the primary client base.
           Ask individuals: Did you work primarily in a substance abuse agency or a mental health
            agency previously? What is the primary composition of your caseload and how does that
            compare to the job you had prior to this one?

         Summary: What does the workforce look like? How are they supported? What is the
           movement of individuals in and between organizations?

                                            Workforce Development Expert Panel Meeting
                                                                      April 7 & 8, 2008
                                                    SAMHSA/CSAT Office, Rockville MD
          Opportunity for Network analysis. What kind of expected behaviors occur? Might be an
           opportunity to pinpoint the kind of trainings are created.
          Professional organization affiliation might be of interest to the field. – Professional
           organizations and provider organizations.
          What is the recovery status?
          What is the treatment approach? Questions related to their philosophy. Is there recovery
           support provided?
          Is there recovery community support for the workforce? Are there policies in place? What
           are your experiences, if you’re in recovery, with recovery support? What might you find?
          What is the level of care agencies are providing?
          Are core functions provided?
          What services are provided? Are there policies for relapse? Are there wellness programs?

Next Steps - 11:30 – 12 noon
Discussion began regarding the next steps towards a National Workforce Survey. Comments are
documented on the Word document labeled Discussion Notes from April 6&7.doc.

Wrap-up – 12 noon – 12:30 pm
Wrap-up comments are also included in the Word document labeled Discussion Notes from April 6&7.doc.

                                         Meeting Adjourned.

Welcome (Welcome.ppt)
Review of ATTC Survey Activities (Review ATTC Survey Activities.ppt)
National ATTC Evaluation (Overview of National ATTC Evaluation.ppt)
Drug and Alcohol Services Information System’s Inventory of SA Treatment Services (N-SSATS_2.ppt)
Flip chart discussion notes (Discussion Notes.doc)
Report Out – PowerPoint document. – (Refining the Questions.ppt)


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