A presentation to the Florida Substance Abuse andMental Health Corporation September 9, 2005

1
A presentation to the Florida Substance
Abuse and Mental Health Corporation September
9, 2005
Workforce Development

• Neal A. McGarry
• Executive Director
• Florida Certification Board, Inc.

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Florida Certification Board (FCB)

• Is a private non-profit organization
• Credentials more than 8,904 certified
  professionals statewide
• Was established as an addiction certification
  board in 1983 in Tallahassee
• Is a member of National/International Consortium
  establishing reciprocity in 43 states 17
  countries.

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Multiple Workforce Development Initiatives

• Operates the Southern Coast Addiction Technology
  Transfer Center (SCATTC),
• one of 14 in a national network (since 2002).
• SCATTCs prime purpose is to advance practitioner
  knowledge and expertise in addictions treatment
  and recovery through the provision of continuing
  education and specialized technical assistance.
• Created annual Leadership Institute which has
  been adopted as a national model.

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Multiple Workforce Development Initiatives

• Held a regional conference in February 2005
  Raising the Bar Strengthening Substance Abuse
  Treatment through Workforce Development - to
  bring state teams together to stimulate the
  development of workforce development plans at the
  state level.
• Such an initiative is now underway in Florida.

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Multiple Workforce Development Initiatives
Workforce Development in Substance Abuse
Prevention

• FCB established the Center for Prevention
  Workforce Development in July 2005 funded
  through DCF and SAMHSA
• Will create a comprehensive training system based
  on prevention specialist competencies
• Will host an online Learning Management System
  that can track individual learners and offer
  distance education

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FCB sets standards for

• Addiction Counselors
• Prevention Specialists
• Criminal Justice Practitioners
• Behavioral Health Technicians
• Mental Health Professionals (development stage)

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FCB Applies Recognized Standards

• Uses accepted national/state standards for
  entry-level practice (standards are
  research-based and supported by a
  psychometrically sound Role Delineation Study).
• In some cases certification can be required for
  practice.
• Certification suggests that a person has met a
  set of minimum practice standards.

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FCB Provider Educational System

• FCB currently has 183 approved education
  providers.
• All major Community Colleges/Universities have
  curricula that lead to certification.
• Service providers also offer on-site education to
  employees that helps to obtain/maintain
  certification.
• Private education providers offer significant
  amounts of education.

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FCB Code of Ethics

• All certified personnel must adhere to a code of
  ethics that was developed by the field.
• FCB conducts investigations on all ethical
  allegations and if accusations are founded, FCB
  conducts a full hearing.
• Ethics Committee is made up of certified
  professionals.

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What are some of todays challenges to the
addiction treatment and prevention workforce?
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National Trends Workforce Composition

• Reduced representation of recovering people in
  the field
• Dramatic increase of people formally educated
  trained in addiction counseling (80 BA 49 MA)
• Increased representation of persons trained in
  psychology, social work and counseling
• Feminization of the field (70 of new counselors
  female 68 of clients male)
• Ethnicity mismatch (85 of counselors white 43
  of clients non-white)
• Mulvey, et al. 2003

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Challenges Facing the Workforce

• Among the key issues facing the addiction
  workforce are
• Insufficient workforce/treatment capacity to meet
  demand for services
• The changing profile of those needing services
  (persons with co-occurring mental health
  substance abuse disorders)
• A shift to increased public financing of
  treatment
• Challenges related to the adoption of best
  practices
• Increased utilization of medications in treatment

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Challenges Facing the Workforce

• Among the key issues facing the addiction
  workforce
• are
• A movement toward a recovery management model of
  care
• Provision of treatment and related services in
  non-traditional settings
• Use of performance and patient outcome measures
• Discrimination/stigma associated with addiction.

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Immediate Issues

• Recruitment
• New counselors are needed annually for net staff
  replacement and growth but there are issues that
  need to be addressed in order to attract new
  people for these positions.
• Most people enter the field in mid-30s and often
  as a second career which requires training or
  re-training.
• Retention
• Turnover rates above national average of 11
  ranging from 18.5 - 33 a year (McLellan
  Johnson, et al 2002)
• Counselor salaries and benefits are below other
  similar professions.

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Immediate Issues

• Competency
• Training
• Most training didactic - effective science to
  service transfer requires ongoing skill building
  and clinical supervision
• Agencies cannot get reimbursed for the time
  counselors are being trained.
• Education
• Variation exists in educational programs
  (curricula, degree programs), if they can be
  found
• Low counselor salaries make it difficult for them
  to cover educational costs/loans

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Recruitment and Retention
Perceived Barriers to Entering Substance Abuse
Treatment Field

• Low salary/benefits 38
• Paperwork 27
• Competition from other fields 26
• Large caseloads 25
• Negative notions about addicts 24
• Evening and weekend work hours 20
• Stigma of field 19
• Cost of training 17

• Lack of encouragement 15
• Quality of work environment 15
• Amount of training 15
• Not a real profession 10
• Tx models insensitive to ethnicity/culture 11
• Discrimination 5
• Geographical constraints 4
• No barriers 7
• Source 2002 Florida SA Workforce Survey, SCATTC

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Recruitment and Retention Issues

• Low Counselor Salaries
• 3.6 lt 14,999
• 16.1 15,000-24,999
• 21.6 25,000-29,999
• 14.6 30,000-34,999
• 9.1 35,000-39,999
• 10.7 40,000-49,999
• 14.6 50,000-74,999
• 5.5 gt75,000
• 2.6 refused response
• Source 2002 Florida SA Workforce Survey, SCATTC

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2005 Estimated Salaries by Profession FL Agency
for Workforce Innovation
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SCATTC Agency Director Workforce SurveySalary
Levels (2004)

• Salary
• 15,000-17,999 61
• 18,000-19,999 26.5
• 20,000-23,999 8.8
• 24,000-26,999 2.9
• Salary
• 15,000-17,999 20.6 (6.7)
• 18,000-19,999 41.2 (33.3)
• 20,000-23,999 20.6 (46.7)
• 24,000-26,999 17.6 (10)
• 27,000-29,999 (3.3)

• Entry Level Counselor, no college, no
  certification
• Entry Level Counselor, some college, no
  certification, (lower level certification)

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SCATTC Agency Director Workforce SurveySalary
Levels (2004)

• Salary
• 15,000-17,999 7.5
• 18,000-19,999 10
• 20,000-23,999 50
• 24,000-26,999 30
• 27,000-29,999 2.5
• Salary
• 20,000-23,999 25.7
• 24,000-26,999 48.6
• 27,000-29,999 25.7

• Entry Level, BA, not certified
• Entry Level, BA, certified

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SCATTC Agency Director Workforce SurveySalary
Levels (2004)

• Salary
• 18,000-19,999 2.6
• 20,000-23,999 2.6
• 24,000-26,999 39.5
• 27,000-29,999 23.7
• 30,000-34,000 28.9
• Over 35,000 2.6

• Entry Level Counselor, MA, not certified or
  licensed

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SCATTC Agency Director Workforce SurveySalary
Levels (2004)

• Salary
• 18,000-19,999 2.3
• 20,000-23,999 4.7
• 24,000-26,999 16.3
• 27,000-29,999 20.9
• 30,000-34,000 27.9
• Over 35,000 27.9

• Entry Level Counselor, MA, certified or licensed

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SCATTC Agency Director Workforce Survey

• Qualifications of New Staff
• 40.7 of agency directors reported that up to
  60 of applicants at their agencies were seeking
  their first paid substance abuse treatment
  position.
• Only 9 of agency directors reported that
  applicants were fully qualified to provide
  services upon hire.

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of respondents reporting various ways to
promote the retention of good direct service
staff (top 5 from a list of 17) Source 2002
Florida SA Workforce Survey, SCATTC

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Immediate Actions Needed for Workforce Development

• Recruitment Strategy Student loan forgiveness
  program for persons working in the addiction
  field
• Retention Strategy Increase basic salary levels
  for persons working in the addiction field
• Competency Strategy Add state funding cost
  centers to pay for clinical supervision and to
  pay for persons working in the addiction field to
  attend training.