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Application for the Use of Civil Money Penalty Funds

Date of application: 5/04/2018

Idaho Caregiver Career Project

Submitted by:

Idaho Health Care Association Foundation

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Background

1. Submitted by: Robert Vande Merwe, Chair- Idaho Health Care Association Foundation

Mailing Address: 1524 W. Cayuse Creek

Physical Address: Meridian, ID 83646

Phone: 208.343.9735

Tax Identification Number: 82-033-1516

Email: robert@idhca.org

Signature: Project Originator

2. Primary Contact of the Project: Robert Vande Merwe

3. Background of applicant (organization’s/individual’s history, capabilities, website, etc.):

Qualifications. Describe how your organization is qualified to carry out this proposal.

The board of the Idaho Health Care Association Foundation are long term care providers and advocates

that are uniquely qualified to bring all stakeholders together to achieve the purposes of this proposal

and increase the numbers of CNAs available to SNFs in Idaho. Idaho Department of Health and Welfare

and the Idaho Department of Labor are also supportive of this grant and will be a key to its success.

The various partners involved have established relationships in the facilities, communities and the

Idaho workforce arena to be able to collaborate with all involved to orchestrate such a program. The

collective partnership allows many avenues of outreach and skillsets to reach our objective.

4. Have other funding sources been applied for and/or granted for this proposal or project?

Yes

No

5. Are you a certified nursing home?

Yes

No

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Project Details

6. Project Title: Idaho Caregiver Career Project

7. Summary of the Project and its Purpose: list

a) the problem or gap this project is aiming to address,

b) goals and/or objectives, and

c) a plan to implement the project to include a timeline. Keep in mind that CMP funds shall

only be used for activities that benefit or protect nursing home residents.

Summary and Purpose: SNFs in Idaho are not finding an adequate supply of competent CNAs to meet

the demand. A common problem is that potential CNAs must go through 120 hours of training- time

which is not reimbursed by the facility if the CNA chooses to work for a SNF. This proposal seeks to

eliminate some of the obstacles SNFs are having in finding applicants for these positions. The obvious

solutions are:

1. Increase the supply of potential CNAs

2. Decrease the turnover of CNAs who work at SNFs.

We hope to show that by using CMP funds we can make a difference in the number of qualified CNAs

available to work in Idaho SNFs and reduce CNA turnover in these facilities.

a. According to a survey conducted by the Idaho Health Care Association Foundation, eighty-seven

[87%] percent of the facilities responding have CNA vacancies, are currently hiring CNAs and have

had open CNA positions for some time. It is believed that Idaho needs approximately 1600 CNAs to

meet the needs of residents in SNFs.

According to the American Health Care Association, the turnover rate of nursing assistants in Idaho

nursing facilities is over 75% annually. This means that Idaho SNFs likely need to replace up to 1200

nursing assistants annually. This data identifies the critical need for caregivers in Idaho’s skilled nursing

facilities. Although there are many CNA courses throughout Idaho taught by the community colleges,

the vast majority of those students never work in a SNF after becoming certified. The primary reason

many students take a CNA course is that it will help them obtain admission to a nursing program.

Idaho facilities cannot meet the needs of residents in their care without a sufficient number of

competent caregivers. Many caregivers are being asked to work overtime to compensate for the

critical shortage of caregivers in Idaho. CNAs are not at their best when continuously asked to work

overtime.

Many facilities simply recruit CNAs from other facilities with higher wages or sign-on bonus’.

Recirculating the same number of caregivers does not address the workforce shortage. The Idaho

Health Care Association Foundation together with stakeholders and partners, proposes to use Civil

Monetary Penalty (CMP) funds to establish a program that encourages individuals to choose caregiver

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careers. By recruiting 500 new caregivers to the profession, we seek to make a difference in the lives

of residents in Idaho SNFs.

b. The goals of this project are:

i. Encourage individuals to enter caregiver careers;

ii. To improve the hiring practices, orientation, training & caregiver

empowerment that is provided by facilities;

iii. Help maintain a sufficient number of competent caregivers to meet the needs of

residents in Idaho SNFs; and

iv. Reduce caregiver turnover.

Implementing best practices to strengthen the interview/selection process, providing adequate

orientation & on-going training, creating a supportive work environment, and empowering the

caregiver have been shown to reduce turnover and increase the competency of caregivers thereby

decreasing the number of new caregivers that must be trained each year.

c. This project intends to increase the availability of a stable & qualified direct care workforce in skilled

nursing facilities in the following methods and timeframes:

Plan Timeline

Survey facilities:

• Facility Name

• Contact person

• CNA turnover

• Current CNA openings

Do you hire NAs? If so, do you use the apprenticeship model?

• How many more students could each program accept?

Pre-grant

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Survey participating facilities:

• What best practices have you implemented in your interview/selection

process?

• What was the quality of orientation they received by the SNF?

• What percentage started working for the SNF prior to graduation? Prior

to starting class?

• How did students hear about/decide on becoming a CNA?

• How many graduates from CNA programs immediately work for SNFs?

• How long do they stay at a SNF?

• What is the job satisfaction of CNAs in SNFs?

• What is the image of the profession among all CNA graduates?

• What is the image of the profession among those who immediately work

for SNFs?

Post grant-approval

The nursing home community (including resident and/or family councils and

direct care staff) will be involved through interviews of residents and families

to help identify the admirable qualities of the best CNA, for use in

interviewing, hiring & training.

Months 0 - 2 Develop policies, procedures, application forms, student enrollment

documentation, and a process to govern the Idaho Caregiver Career

Program.

Develop a marketing, referral, & recruitment plan to include website and

social media presence in an effort to increase the number of people entering

the profession.

Offer nurse assistant training & testing at no cost to the student. This would include:

• an equipment & uniform allowance; and

• payment to the student, of wages while in class.

Months 3 - 24

A $500 retention bonus paid to nursing assistant, by the facility, after working

for six months (1040 hours) at a participating skilled nursing facility. Months 9 - 24

Incentivize facilities by IDOL-Apprenticeshipidaho program, for eligible CNA

registered apprentice that completes a Department of Labor “approved”

register apprenticeship (See addendum).

Plan Timeline

Encourage a Mentoring Program for seasoned CNAs desiring a mentor status

in their facility. Months 3 - 24

Formal recognition and celebration of career caregivers at facility level and

state association level.

Annual IHCA

Conventions in July

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An ongoing effort by facilities to recognize excellent caregivers:

• recognition program;

• competitive wages;

• competitive benefits.

Months 3 - 24

Promote the use of apprenticeships to help caregiver’s career growth. Months 3 - 24

Mid-grant monitoring (re-direction if necessary) Month 12 - 14

Evaluate results of CNA training, certification, & retention Months 18 - 24

Submit final report at end of grant period

MARKETING AND RECRUITMENT

The Foundation and partners will develop a marketing and recruitment campaign via a website and

social media efforts to encourage individuals to enter the profession of nursing assistant in SNFs which

will include:

• A social media campaign to promote the program in communities throughout the state,

• Help connect potential CNAs with community colleges who offer the training,

• Help connect potential CNAs with SNFs in their area,

• Idaho’s Community Colleges and Workforce Training Centers will disseminate information to

current and potential students,

• Department of Labor will promote the program to all stakeholders, and

• Apprenticeship for direct care staff

SKILLED NURSING FACILITIES - See flowchart in addendum.

1. Skilled nursing facilities desiring to participate in this project would submit to the Project

Manager the “Request to Participate in Idaho Caregiver Career Program” form. (see form in

addendum)

2. A media campaign to attract individuals to the caregiver profession would refer the individual

to a website. At the website, upon entering their zip code, they would be provided a link to the

participating skilled nursing facilities in their geographic area.

3. The individual would complete an employment application.

4. Once hired by a participating facility, the facility would enroll the individual into a nurse aid

certification training course.

5. The nursing home would submit an “Initial Application of Intent to Request Grant Monies” to

the Project Manager. (see form in addendum)

6. Nursing facilities will be encouraged to start the employee in an “approved” apprenticeship

program, as appropriate.

7. Once all requirements are met the facility will submit a “Request for Reimbursement” with all

required supporting documentation to the Project Manager. (see form in addendum)

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8. On a quarterly basis the Project Manager will submit a funding request to the Department of H

& W for reimbursement for the costs approved in this grant proposal.

Payments to the participating SNF will be contingent upon receipt of the requisite information:

Copy of student/new hire Orientation Checklist.

Proof of Enrollment / Tuition paid in full.

Student attests to receiving the necessary uniform & equipment required by the college.

Student attests to receiving payment of wages while taking nurse aide course.

Copy of the Certificate of Completion from college.

Verification nurse aide has been added to CNA Registry.

Nurse aide attests to facility support of progressing up apprenticeship ladder &/or mentorship

program.

Proof nursing assistant has worked 1040 and was paid a $500 retention bonus by the facility.

8. Describe how this project will directly benefit nursing home residents.

In order to sustain quality of life, quality of care & improve resident, family and staff satisfaction, a

competent & stable direct care workforce is a necessity. Insufficient numbers of CNAs certainly

increases the workload of each caregiver and does not allow them to provide resident-centered,

quality care for individual residents. This program will:

INCREASE THE NUMBER OF COMPETENT CNAs available to work in skilled nursing facilities;

which in turn allows for:

The ability for a facility to cover all shifts with their own staff with limited overtime.

Overworked staff and the use of agency staff decrease the quality of care at facilities

Consistent assignments…caregivers get to know their residents better and can

anticipate their needs.

PROVIDE TRAINING TO AN ENTRY-LEVEL WORKFORCE and an opportunity for jobs in long

term care.

DECREASE CAREGIVER TURNOVER which results in:

Caregivers less likely to be overworked covering shifts.

Enhanced caregiver moral & workplace satisfaction.

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Increased quality of life & quality of care for the residents.

ENCOURAGE A FORMAL MENTORING PROGRAM which results in:

Increasing the probability of a successful entry-level caregiver.

Reduction of an immediate loss of the new hire & loss of the seasoned caregiver.

PROMOTE IMPLEMENTATION OF AN APPRENTICESHIP MODEL which:

Improves CNA competency & greater depth of skills & specialty skills.

Unique/Innovative. This proposal is unique and innovative and will increase the quality of

care/quality of life of the residents in Idaho SNFs.

A similar CMP funded project was approved by CMS for Wisconsin.

The entire country is experiencing a shortage of direct health care staff. Several projects are

bringing together the state’s health department, local community colleges and workforce

training centers, the state’s department of labor, the state’s health care association, the state’s

hospital association and the state’s skilled nursing facilities to collaboratively address the

workforce shortage.

The data shows that facilities are operating without enough caregivers. They are coping by

employing a variety of temporary measures. None are lasting solutions to the problem and all

lower the quality of care. An increase in the number of caregivers, a decrease in caregiver

turnover and an increase in workplace satisfaction all lead to an increased quality of care.

Idaho borders two states (Washington & Oregon) with minimum wage requirements much

higher than the minimum wage required by federal law. The Idaho facilities near the borders

of these states face a particularly difficult time finding and keeping caregivers.

Fifty-six [56%] percent of the facilities responding to the IHCA survey are limiting admissions or

are not expanding their capacity directly related to the difficulty in finding adequate supply of

competent caregivers. These decisions ultimately reduce the access for seniors.

Offering opportunities for career growth such as a formal “Mentoring” training for seasoned

CNAs in participating facilities enriches the training & orientation of the student, contributes to

a positive start for the student, and rewards & boosts the self-esteem of the seasoned caregiver

to continuing in their caregiver role thus reducing turnover.

An innovative aspect of our project is that it will help fund both the CNA courses and the wages

of employees while they are in class. (See note in bullet 13.) The vast majority of those who

take the CNA course in Idaho do so for reasons other than to work as a CNA in a SNF (apply to

nursing school etc.) Most potential CNAs cannot go without an income for 3 to 4 weeks while

they are in class. The purpose of our grant is to financially enable SNFs to pay for more CNA

courses and even pay for the caregiver’s wages for the time they spend in class. The grant will

reimburse the facility a portion of the CNA class at the time of graduation. But the grant will

only reimburse the facility for a portion of the wages paid to CNAs after they have been

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employed by the facility for 1040 hours. The facility will have an even greater incentive to retain

new CNAs. The Idaho Department of Labor will provide more financial incentives for CNA

retention and progression.

9. List any physical items that will be deliverables as a result of funding this project (e.g., electronics,

training materials, curricula).

IHCAF educational opportunities will share best practices to help facilities improve

interview/selection & orientation of new CNAs as well as practices designed to reduce caregiver

turnover.

10. List how the project’s performance will be monitored or evaluated to include specific metrics.

These metrics shall be submitted as part of the completion of the project or as frequently as

required by the State or territorial agency.

Results Measurements. Specific measures will be met by the end of the program:

o Reduce CNA vacancy rates by 20%.

o Reduce CNA turnover by 5%.

o A growth in the use of best practices in orientation & training provided to new CNAs at SNF,

by 20%.

o Increase CNA job satisfaction by 10%.

All pre-post measurements will be obtained by the program coordinator

Each facility will use their own measurement tool and will be compared before and after.

o Increase the use of the apprenticeship model in SNFs. This will lead to increased wages,

promotions and career growth.

Documentation of Results. Information from the results of this grant will be obtained and

evaluated. The IHCA Foundation, with the assistance of IDOL, IHCA and IDHW will conduct a

comprehensive evaluation of this project. The evaluation will include pre-post data.

Expected Outcomes. As a result of this grant we expect that five hundred (500) new individuals

will enter the CNA profession over the next two (2) years. An apprenticeship model will help them

grow and develop in the profession.

The expected timeline is as follows:

Train 50 caregivers by month #6 of the grant

Train a total of 125 caregivers by month # 12 of the grant

Train a total of 250 caregivers by month #18 of the grant

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Train a total of 500 caregivers by month #24 of the grant

Facilities will learn how to better recruit, retain and advance CNAs.

Each participating facility will report quarterly their CNA vacancy rate and their CNA

turnover rate to the program coordinator.

11. Are there potential risks or barriers associated with implementing this project, and if so, what is

your plan to address these concerns?

There is a plan for a mid-point evaluation & redirection, if needed, of the project. The following items

will be formally monitored throughout the project to ensure they don’t negatively impact or stall the

project:

A potential barrier to the project would be a lack of applicants to the program. In addition to

social media marketing, we will brainstorm and implement other “out-of-the-box” strategies. If

necessary, we will ask facilities to implement sign-on bonuses to attract applicants.

Colleges finding enough instructors to teach additional CNA courses. The colleges would recruit,

orient & employ additional instructors. If necessary, we will encourage our facilities to offer up

qualified RNs to be employed part-time by the colleges to be online instructors of CNA classes.

Facilities having enough LPN or RN mentors to for NAs to accomplish their clinical hours. The

facilities would need to institute a bonus to those LPNs and RNs willing to take on additional

duties to help NAs accomplish their clinical training. We would encourage the colleges to

employ clinical instructors. If necessary, the IHCA Foundation will consider incentivizing facility

staff to become CNA instructors & clinical mentors.

12. If applicable, list any other entities (e.g., individuals, organizations, associations, facilities, etc.)

that will be partnering with the applicant on this project, whether or not the entity will be

receiving funding (and how much funding), and what specific deliverables the entity is

responsible for.

Consumer and Other Stakeholder Involvement.

Stakeholders: Receiving funds? Specific

deliverables?

Idaho H & W, Bureau of Facility Standards Forward Funds to

IHCA Foundation

Idaho Health Care Association Foundation (IHCAF) Forward funds to

facilities

Idaho Career & Technical Education

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Community Colleges & Workforce Training Centers

o North Idaho College

o Lewis & Clark State College

o College of Western Idaho

o College of Southern Idaho

o Eastern Idaho Technical College

o Idaho State University

The Idaho Department of Labor (IDOL)

Idaho Health Care Association (IHCA)

Idaho Hospital Association (IHA)

Idaho’s skilled nursing facilities (SNFs)

Idaho Alzheimer’s Planning Group

Idaho Office on Aging

Boise State Center for the Study of Aging

AARP Idaho

Qualis Health

CNAs in SNFs

In addition to extensive consultation with the stakeholders above, the program evaluator will interview

residents and families to help identify the admirable qualities of the best CNAs. These interviews will

guide the program and will be shared with CNAs during their training.

13. Specify the amount requested for the entire project. If it is a three-year project and requires

$25,000 per year, then enter $75,000 in the second entry. If you are requesting $25,000 for a one-

year project, then enter $25,000 in both entries.

Please include an Excel spreadsheet with line items and costs of these items. Costs should be as

detailed as possible. For example, travel should include the purpose, location, mileage rate,

flight, and hotel costs. Personnel should include an hourly rate. Include a tab for each year of the

project. Please include a description of costs and any non-CMP funds received for this project.

Excel spreadsheet (under attachments)

• Total Amount Requested: $ 513,500

• Total non-CMP funds received for this project: $1,477,500

Funding. Up to 500 students will be recruited, trained and retained through this program. Nursing

facilities will reimburse the community colleges and workforce training centers the cost of training

and testing. The program will reimburse the facility a portion of the NATCEP costs as well as wages

paid while the students were in class. An enormous obstacle in obtaining CNA training is the lack

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of income for the students for time spent in class. The cost of CNA courses is also prohibitive for

facilities. Some but not all of these costs are paid for by Medicaid. To participate in the grant,

facilities must agree to pay the wages of students during their CNA training. The grant will

reimburse facilities costs that are not reimbursed by Medicaid- if they are able to retain new CNAs

for at least 6 months. The facilities will be forced to take a risk and put forth more money to help

train new CNAs. There will be a new huge financial incentive for them to reduce turnover.

CMP Budget

*39% of student wages while in class $254,000

*39% of the cost of CNA classes $229,500 Ɨ Social Media PR/recruitment campaign designed by foundation partners: $ 10,000 Ɨ Program coordinator for coordination and program evaluation $ 20,000

Total $513,500

Idaho Partner Budget

IDOL Apprenticeships Grants 50 students if available and if qualified $ 150,000

Wage increases to those who complete apprenticeships $1,040,000

Facility $500 bonuses after 6 months / 1040 hours from date of “enrollment” $ 250,000

Google Grant $ 10,000

IHCA Foundation payment to coordinator for program administration/evaluation $ 20,000

Total $1,477,500

Total Budget $1,991,000

Time/Assets. What time or assets will your organization contribute to this project?

• The Foundation board chair will contribute to the administration and oversight of the

program at no labor charge. Estimate 80+ hours for a total of $4000.

Awards. Are those assets contingent upon receiving this award?

• no

Contribution. What level of contribution (cash or in-kind) will your organization be making to this

proposal?

• The Idaho Health Care Association Foundation will donate $20,000 to assist in the

development, administration and evaluation of the program. This donation plus the CMP

grant funds will pay for a project manager.

• The Idaho Health Care Association Foundation collects donations with annual dues from the

skilled nursing facilities that are specifically solicited for the Caregiver project.

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• The Department of Education plus each of the community colleges will provide in-kind

contributions towards this program.

• Each of the partners of the grant will contribute time and effort in the social media campaign

to find potential CNAs.

• Google Analytics awarded the Foundation a $10,000 in-kind grant. This grant will help in the

social media/marketing aspects of the program.

Involved organizations. Organizations that will contribute funds through this project and are

expected to execute and bear responsibility for components of this project include:

• Idaho Health Care Association Foundation,

• Idaho Department of Health and Welfare,

• Idaho Skilled Nursing Facilities approved by the program,

• Idaho’s Community Colleges and Workforce Training Centers, and

• Idaho Department of Labor

Facilities who participate in the program will attend classes offered by Qualis Health (Idaho’s Quality

Improvement Organization), IHCA, iCARE (Idaho’s Culture Change Organization) or other

organizations and make a commitment to:

• Reduce caregiver turnover,

• Embrace culture change / person-centered care, including consistent assignment,

• Complete the Facility Assessment & Caregiver Assessment

• Elevate the profession of caregiver in the facility,

• Develop more flexible scheduling,

• Help improve employee satisfaction, and

• Provide educational and growth opportunities via tuition reimbursement or

apprenticeships.

Non-supplanting. Provide a description of the manner in which the program will not supplant

existing responsibilities of participating facilities to meet the existing Medicaid/Medicare

requirements or other statutory or regulatory requirements.

• This proposal does not supplant any responsibilities of participating facilities to meet

Medicare/Medicaid requirements. Nursing facilities are required to provide adequate staff

to meet the care needs of residents. This program is intended to increase the number of

individuals available to work as CNA’s in Idaho SNFs, to promote the virtues of working as a

CNA in a SNF and to help improve the career advancement of those who enter the caregiving

career. A 45 year low in the Idaho unemployment rate is the reality for many SNFs. This

grant will help them meet their statutory requirements in a way that without a collaborative

effort, they would be unable to provide care with the adequate number of CNAs.

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*Note: In Idaho, a CNA course consists of least 120 hours (88 hours of classroom training and 32 hours

of clinical experience). The grant will help pay for the wages of students while they are in class at

$10.85 per hour if the facility retains the employee for at least 6 months. Reimbursements will be

made only for expenses which will not be reimbursed later by Medicaid. According to the Idaho

Department of Labor, in May 2017 the statewide entry wage for nursing assistants was $10.40 per

hour. We believe that this entry wage has already increased by 4% but have no firm data. Our budget

assumes that the entry wage will have increased by at least 4% by the midpoint of the grant in 2019

($10.85). The out of pocket costs of CNA training from the largest program in Idaho (College of Western

Idaho) is at a minimum $1200 which includes: fees, books, exams and supplies. The student’s expenses

can be much higher depending on other basic supplies and immunizations which may be needed. The

grant will also help pay for the out of pocket expenses related to CNA courses if the facility retains the

employee for at least 6 months. Reimbursements will be made only for expenses not reimbursed later,

by Medicaid.

The Nurse Aide Training and Competency Evaluation Program (NATCEP) helps reimburse a SNF the

costs associated with training and testing of CNAs who work at each facility. After the facility submits

a cost report, the Idaho Medicaid program reimburses each facility the Medicaid portion of their

approved costs for CNA training and testing. In Idaho, 61% of patient days are paid for by Medicaid. If

a facility’s average occupancy in a period was 61% Medicaid, Medicaid would reimburse the facility

61% of the costs associated with training and testing CNAs employed by that facility via the next cost

setting calculation. The CMP funds utilized in this program will reimburse the facility for the costs NOT

reimbursed by the Medicaid program. Therefore, this program will reimburse a participating facility

approximately 39% of the costs of training and testing CNAs in addition to approximately 39% of the

wages paid to students while they are in class. Each facility will submit their ratio of Medicaid patient

days, to total days- in the prior year. The program will reimburse each facility the proportion of costs

not reimbursed by Medicaid. Each facility will record this revenue in their cost reports and will ensure

that all Medicaid reimbursement regulations are followed.

Ɨ Note: A Social Media/PR Coordinator will work for just 6 hours per week at $16 per hour. They will

be teaching, encouraging, coordinating and monitoring the social media efforts of involved

organizations. We believe that word of mouth and social media will be the most effective method of

finding potential CNAs. This person will spend 6 hours per week on various social media platforms

helping the project partners reach potential CNAs. In addition, the partner organizations will spend

many more hours per week publicizing the opportunities in SNFs. We believe that the 6 hours per

week will be crucial to coordinate all of the social media efforts and to find candidates in this era of

historically low unemployment. A program coordinator/evaluator will work for 18 hours per week at

$16 per hour for the two years of the grant. It will be critical to ensure that no grant funds are paid to

facilities for expenses that will be reimbursed eventually by Medicaid. The coordinator will need to

track each facility, their Medicaid utilization rate, each new potential CNA, their employer and their

longevity, all requested reimbursements, employee turnover rates at each facility as well as orientation

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practices and job satisfaction at each facility. This person will be able to demonstrate the success of

the grant using CMP funds.

Payments to the participating SNF will be contingent upon receipt of the requisite information:

Copy of student/new hire Orientation Checklist.

Proof of Enrollment / Tuition paid in full.

14. Please list the time period of the project.

• Number of Years: Two (2) years

• Specific Dates Proposed for the Project: as soon as possible

15. Please indicate which category this project should be considered.

Culture Change (e.g., "Culture change" is the common name given to the national movement

for the transformation of older adult services, based on person-directed values and practices

where the voices of elders and those working with them are considered and respected.)

Resident or Family Council

Direct Improvements to Quality of Care Consumer Information (e.g., information that is

directly useful to nursing home residents and their representatives to become knowledgeable

about their rights, nursing home care processes, and other information useful to a resident)

Transition Preparation for a Nursing Home Resident

Training

Other, please specify.

Attestation Statement

CMP funds have been provided for the express purpose of enhancing quality of care and quality of

life in nursing homes certified to participate in Title 18 and Title 19 of the Social Security Act. Failure

to use CMP funds solely for certified nursing homes and for the intended purpose of the project

proposal is prohibited by federal law. Failure to use the CMP funds as specified will result in denial

of future grant applications and referral to the appropriate entity for Medicare/Medicaid fraud and

program integrity. By signing below, you are confirming that everything stated in this application is

truthful and are aware of the allowed uses of CMP funds.

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Name of the Responsible Applicant:

Robert Vande Merwe, Idaho Health Care Association Foundation

robert@idhca.org 208-343-9735

Fax: 208-342-6891

Signature of the Responsible Applicant:

Date of Signature: 5/2/2018

Addendum & Attachments

Describe how the outcomes of the project will be sustained after the CMP funding has ended.

Whereas the root-cause of CNA turnover appears to be attributed in part to poor interview/selection

process, poor morale, & inadequate orientation/training. It is anticipated the participating facilities

will institute “best practices” in the areas of recruitment, selection, & retention (to include orientation,

continued training, empowerment, mentoring and recognition, etc.) that will result in a decrease in

turnover and increased CNA morale. So long as the facilities continue to implement “best practices”

the perception of a career as a caregiver in long term care will be a positive one.

Apprenticeship Funds available through the Idaho Department of Labor:

Through its WIOA Adult, Dislocated Worker, and Youth training programs, and the ApprenticeshipIdaho grant

from the US Department of Labor, the Department is supporting Registered Apprenticeship opportunities that

connect job seekers to career pathways and provide an innovative workforce solution for high growth industries,

including health care. In support of IDHW’s Certified Nursing Assistant project, the Department anticipates a

statewide capacity to provide $2500 for a minimum of 50 individuals to offset employer training costs when

placed in an apprenticeship program registered with the US Department of Labor’s Office of Apprenticeship.

Additional support services, such as uniforms or supplies, when required for job placement, will be available to

assist apprentices in job acquisition. The Department’s support is contingent upon the ongoing availability of

federal funds and continued federal authorization of program activities.

Offset of employer training costs = $2500

Support services for apprentice: = $500

Total match per apprentice: = $3000

Total ($3000 x 50 apprentices) = $150,000

The specific apprenticeship ladders and associated raises are developed by each facility and approved by the

Idaho Department of Labor. Steps in the caregiver career ladder could include:

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• Caregiver

• CNA

• Dementia Specialist

• Restorative Specialist

• Psychiatric Specialist

• Person-directed Care

• Mentor

ATTACHMENTS:

• Pre-grant Survey Data

• Idaho Caregiver Career Project Flow Chart

• Request to Participate in Idaho Caregiver Career Project (form)

• Initial Application of Intent to Request Grant Monies (form)

• Request for Reimbursement (form)

• Budget sheet -revised