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Welfare-to-Work and other workforce programs offer critical resources that help providers tap into a new source of long term care staff.

When in 1996 Congress and the Clinton administration passed legislation “ending welfare as we know it,” the long term care industry was only beginning to enter the throes of a critical labor shortage. But the legislation designed to trim the nation’s welfare rolls has gained added significance in light of today’s tightening labor market. In conjunction with changes in program rules and national workforce policy, there are many staffing opportunities emerging for long term care providers that shouldn’t be missed.

Under the Personal Responsibility and Work Opportunity Reconciliation Act, large numbers of welfare recipients are required to prepare for and move into the workforce or else forfeit their benefits. At the same time, long term care providers are scrambling to fill numerous frontline positions. But resources for recruitment, assessment, and retention of long term care employees have grown exceedingly scarce due-at least in part-to cutbacks in reimbursement rates.

Such resources, however, are available through the national and state Welfare-to-Work (WTW) programs designed to help welfare recipients’transition into the workforce. Under such programs as Transitional Assistance to Needy Families (TANF), the government will pay for an array of services to recruit and employ former welfare recipients, including costs associated with recruitment, assessment, prevocational and vocational training, certification and testing, mentoring, job coaching, transportation, and child care. And new less restrictive eligibility requirements have dramatically increased the numbers of individuals qualified to participate in WtW programs, which means that more quality people can be recruited for jobs and job training.

In addition to broadening eligibility requirements for WTW programs, the government also has changed the way it helps employers access and train wider-market employees by passing the Workforce Investment Act of 1998 (WIA). Under this act, workforce investment boards (WIBs) combine state and federal funding streams and set new standards of accountability. Unlike the Job Training Partnership Act program it replaced, WIA -- through a series of core, intensive and training services -- has created a truly comprehensive workforce development system with more open access to all, regardless of income.

While some employers who have tried recruiting through WTW and WIA have encountered problems navigating these programs, most agree that WTW initiatives present too great an opportunity to ignore in light of today’s labor crisis. In two recent studies, the following observations emerged regarding WTW hires:
Policy Brief: Putting Welfare Reform to Work on LTC

Published in Provider, October 2000 (Page 79 - Human Resources)
Provider Magazine. The American Health Care Association
Putting Welfare to Work
Michael D. Van Stine, Worforce21
Ninety-four percent of employers that have hired a person on welfare would hire another welfare recipient in the future;
Sixty-five percent of employers surveyed said that welfare recipients have the same or higher retention rates than do employees hired through traditional channels;
Seventy-two percent of employers that have used WtW hires for part-time work would not hesitate to hire welfare recipients for full-time positions;
Business partners have promoted 33 percent of welfare recipients hired;
Sixty-five percent of employers surveyed saw no increase in overall costs as a result of hiring welfare recipients;
Eighty-five percent reported that providing child care and transportation services -- both available through WtW post -employment programs -- improves employee recruitment;
Almost two-thirds found that providing child care and transportation services reduced turnover by 37 to 60 percent;
Fifty-four percent surveyed reported that child care and transportation services reduced employee absenteeism by as much as 20 to 30 percent; and
Forty-nine percent of employers reported that child care and other support services provided by WtW programs had helped boost employee productivity.
Resources Galore

Nationally, total state and federal TANF expenditures for fiscal year 1999 were $22.6 billion, the same as in 1998. However, this level of spending seems to indicate that states are making significant new investments in the program since welfare caseloads in 1999 were in decline, and the associated combined spending on cash assistance was also going down.

Many states help parents get into jobs immediately, prioritizing work with support services over nonproductive cash payments and benefits that duplicate an employer’s benefits package. In fiscal year 1999, states spent $1.8 billion in combined federal and state funds on work activities, an amount equal to 8 percent of total program expenditures and an increase over fiscal year 1999. Cumulative unobligated balances for fiscal years 1997-1999 equal $2.85 billion, or approximately 6 percent of the total $46.8 billion awarded under TANF.

These funds have been carried over and can be accessed for any viable and authorized purpose, including employer-connected programs for recruitment, training, and support services.

The Balanced Budget Act of 1997 also gave states a new funding source to help welfare recipients become employed. The act authorized the U.S. Department of Labor to provide $3 billion in WTW grants to states and communities. These funds were spent on services related to job readiness, job placement, post-employment support, on-the-job training, community service or work experience, short-term wage subsidies, job retention, and supportive services such as child care and transportation. Legislation is currently in progress to extend the time that these programs can operate. Many of the funded programs are designed to train and place employees into the long term care profession.

Accessing WTW Resources

Because WTW and WIA programs vary from state to state, there is no single point of contact for accessing these resources. However, the following suggestions should serve as a good start. Employers may:
Call the facility’s long term care association. Many states are already involved in direct efforts to develop WtW, WIA, and job access programs on behalf of long term care providers.
Identify and cultivate a community-based intermediary as a partner. If a provider is uncertain where to start, the local WIB should have a list of reputable organizations with which they currently contract. A master WIB list can be obtained at the U.S. Department of Labor’s Web site at www. usworkforce.org.
Check out the Workforce Centers of America (WCA) Web site at www.workforce21.net. It is a treasure-trove of resources and links and an opportunity to inquire about customized strategies for long term care providers. WCA is in the process of developing a national alternative recruitment and retention response for the long term care industry with the American Health Care Association.
Providers also may tabulate and access alternative WTW, WIA, and job access resources for successful recruitment and support programs of their own. This is best done by using the services of a reputable intermediary that can help analyze needs by state and locale. Such intermediaries can take the guesswork out of navigating the very complex system of available resources, while helping providers hire more and better-trained and supported employees who stay with them for a longer time.

But now is the time for companies to develop and implement strategies to access these systems, programs, and resources. The need for employees is at a crisis level. The most compelling national WTW opportunities may end when TANF is reauthorized in 2002. And the best way to help ensure this resource after 2002 is to use current programs and surpluses assertively now.

Michael D. Van Stine is president and chief executive officer of Workforce Endeavors, Lansdowne, Pa., a consulting firm that specializes in designing workforce recruitment and retention programs for the long term care industry.