Ep:21: NY Trade Organization Launches Caregiver Mentorship Program to Help Reduce 90-Day Turnover

Miriam Allred (00:05):

Welcome to Vision | The Care Leaders’ Podcast. I’m Miriam Allred with Activated Insights. My guest today is Kathy Febraio the President of New York State Health Care Providers, a trade association representing home care, home health, and other health care organizations in the state of New York. Before we get started and talk about the pilot program, we want to hear a little bit about your background with the association during your presidency with the association and even a little bit about your background before you started with NYSActivated Insights. So tell us more about yourself.

Kathy Febraio (00:37):

Okay, great. I’m Kathy Febraio, I’m the President and CEO of the New York State Association of Healthcare Providers. I’ve been here for almost two years now. And prior to that, I’ve worked in associations for over 20 years primarily in leadership positions and primarily in healthcare, so representing different sectors within the healthcare system over all of those years. It’s been a wonderful transition to come in and work in the home and community-based care sector. It has a lot of relevance to other associations I’ve worked with, but, you know, I think what I enjoy is that there is so much contact directly with the patient. And so much time time spent with the patient as opposed to so much of the healthcare system where the, you know, you’re providing care as quick glee and ease as efficiently as possible. But you never get, you don’t get to develop that wonderful relationship that happens in home care.

Miriam Allred (01:53):

Absolutely. Remind me how long you’ve been with the, your current association in New York?

Kathy Febraio (01:59):

I’m coming up on two years in January. And it’s been a very interesting ride you know, getting to know home care and, but at the same time pulling in the relevant information from past positions and understand, or do you understand health insurance, you understand Medicaid, et cetera, which is a big, big benefit in coming into the new to a new industry. But you know, it all ties together. Well, healthcare is undergoing a lot of training and it’s not entirely different here in home care than it is in other sectors.

Miriam Allred (02:41):

Well, this is the industry to be in right now that we find ourselves the way things are going. You know, I just feel grateful to be in this industry and to see this rapid change, you know, I think it’s fantastic and it’s exciting as stressful as it can be at times, let’s jump into this pilot program, tell about really what it is, what was the initial problem or the need that you’re trying to solve. And why did you go with a mentorship pilot program to carry this out?

Kathy Febraio (03:10):

Well, clearly in this industry, there are workforce issues. It is a workforce that does not always get the respect that it needs for the work that they do. They are the front line and they are in very stressful situations and they’re very much on their own and needing to make independent choices and decisions in someone’s home and in the state of New York. The first year I was here with Activated Insights, they were holding a series of planning sessions on the long-term care sector, the challenges that they’re facing, the changes that are going to need to happen in order for it to remain a viable and sustainable and prepare for the aging population that we’re all going to experience in the next 10 to 20 years. So through those conversations, it became very apparent that the, you know, retaining a stable workforce is critical to have those services ready and available for patients.

Kathy Febraio (04:26):

And, you know, during one of the sessions where we spoke specifically about the workforce issues, we had some folks come from the governor’s office to speak about workforce initiatives, that the state was going to be address thing. They were going to be offering some funding for projects and programs that could address workforce issues. And as part of that day, we, they had a panel discussion from a wide variety of experts on what different types of policies and programs could improve and impact the workforce in a long-term care, but very specifically home care. So one of those ideas and concepts that they were talking about was mentorship and how, you know, research has shown that it makes a difference in whether or not someone will remain in a in a job or position. So that really intrigued me. You know, we all along our careers have had mentors that have made a difference and have made or career choices and, and helped us advance in our careers. And so I thought, you know, this would be a wonderful way to address this issue. Not only would you be making an impact on the workforce retention, but on the workforce itself on the individuals that are providing this care would have some support that they’ve probably never experienced in their career otherwise

Miriam Allred (06:11):

I appreciate you giving that context. We know that turnover is such an issue in the industry, and it’s interesting to hear and see how at the state level, every state is approaching it in slightly different ways. And I think that a mentorship, pilot program, a great way to implement, you know, program into insight change and try something new. So I think that’s great. So appreciate you sharing that backstory. So let’s talk about the program itself, you know, you’ve built out the idea over the past year, the program has been launched for about four months. So tell me a little bit about how things really got going. How did you secure the funding? Talk to me about those initial steps to really get the program up and running.

Kathy Febraio (06:53):

Well, once I left that meeting, I just decided to do some research. I, I assumed there probably meant to be mentorship programs out there and available that I could either model or I could take different aspects of different mentor programs and put them together in order for it to be pertinent to home care and pertinent to what is happening in New York state. And I did find quite a bit of information. I also reached out to some of my very own members who already had mentorship programs and ask them about, you know, what worked well, what were the challenges, what would you have done differently? And then, you know, the, over the course of, probably about four or five months, I put together a lot of information and pulled together a a recommendation of a program outline and then began to pursue funding.

Kathy Febraio (07:53):

And some of the funding that’s available in New York were through the economic development panels in each County of the state. And in addition, there were some funding at the state level, but you had to start with your local economic development group. And, you know, that was a bit challenging because those folks are typically working on you know, putting in new buildings, attracting major employers and have a very different perspective on what economic development dollars should do. So by through my network of connections, I also came across someone who worked for what is called a workforce investment organization or a wheel. And these are entities that the state of New York created several years ago and sent, gave funding to address long-term care recruitment and retention issues. And I found that we made, we had a wonderful connection. They’re called the Iroquois healthcare association, and they really understand long-term care and they understand home care. So we talked, we found that it was a great fit and they were able to provide funding for a one-year pilot program. And I just so grateful that I had a partner that understood our industry, and I wasn’t going to be working with a group of people who were used to working on building buildings. So they’ve been a wonderful resource as we’ve unveiled this and implemented this and have been able to give some advice behind the scenes on, on things we could do or things we should be thinking about and addressing,

Miriam Allred (09:49):

I didn’t run this by you beforehand, but would you be willing to share what that funding looks like? Just kind of a ballpark amount, a one-year program like this?

Kathy Febraio (09:58):

We were given just under $500,000 and what that will cover are actually two pilot programs. We’re doing one in New York city, and we’re doing one in what we call upstate New York. So we’ve got the capital of New York, the Albany area, we, and we have two rural locations, one up near the Canadian border and one out in a more central New York. And what we wanted to do was not only implement the program at these what turns out to be six agencies, but we wanted to be able to compare and contrast what would happen in a major city and a major metropolitan area versus a suburban and rural area. So that was really at the encouragement of the funder. So it was, you know, what turned out where it was proposed as a New York city pilot soon became two pilots. And it’s been, it’s been wonderful to do the comparisons. There are many things that are very similar, and then there are some things that are just very different. The availability of workforce is a challenge in both areas, but in a different way.

Miriam Allred (11:22):

So give me a little, let’s talk about the program more specifically, you know, who’s involved, you kind of mentioned the three upstate three downstate or in the city. Talk to me a little bit more about who’s involved. What’s the timeline, what are the desired outcomes, you know, kind of break down what the program is actually looking like.

Kathy Febraio (11:38):

So the pilot is funded for one year and for nine months of that year, there’s going to be active mentoring occurring in the agencies. There was a period of setup a time and after it closes, there’ll be an analysis and white papers written to report what happened has occurred. And so I am working with Activated Insights as the market research function for this pilot. I wanted to be able to implement this program and provide research to support our findings. We wanted to prove our theory that mentorship would have an impact on retention and turnover rates. And we’ve also been able to measure satis job satisfaction, likelihood to recommend the agency either to a patient or to another potential employee. And I also contracted with someone who could provide training so that the mentors who are experienced caregivers at these agencies will be given some direction on how to become a mentor.

Kathy Febraio (12:57):

How do you act in this capacity? You’re not someone’s friend, you’re also not someone’s supervisor. So what is a mentor and how do you make that relationship work? So we provided two half days of training for those experienced caregivers who chose to be mentors. And we space those about 30 to 45 days apart so that they would get training before they started mentoring. And then they would get additional training after they had been mentoring for about a month or so. And then at that training, they could talk about specific issues or challenges. They came across in it and help to get them addressed and help them to determine, you know, how can I move forward as a better mentor now that I know what it really is really truly like. So, Oh, each mentor is working with a new hire for a period of 90 days.

Kathy Febraio (13:59):

And we know that that’s the most critical time to make sure an aide is comfortable in their job in order to get them to stay. We, you home care pulse has done a lot of research around that and certainly identified that as the most critical time to get an aid comfortable on in the program. So then we measure at 30, 60, 90 day intervals to check their satisfaction levels with their job. We do this and compare this against those that were not given a mentor upon hire so that we can compare those sets of statistics. And we are already beginning to see, you know, just four months in of active mentoring that it does make a difference. So we’re seeing changes in turnover rates, which is wonderful. And on top of that, we’re learning of specific stories and that really make you understand the, the difference you’re making to these people’s lives.

Kathy Febraio (15:10):

Not they’re not just a number, but that they are experiencing stressful situations and they have a mentor that is helping them through it. Which has been phenomenal addition. It’s also opening up a communication channel between the individual that’s out there in the home, out there in the field with the agencies corporate office. You know, communication is key in any situation, but it’s extremely challenging when you’re managing a field staff. And this has proven a way to bring back information to management that may have been missed in the past. So that’s something our agencies are very happy to have learned. Some have changed some of their onboarding techniques and activities in order to better incorporate that new hire into the agency. So we’re seeing positive things already in this short period of time, and it’s very exciting.

Miriam Allred (16:19):

I’m glad you hit on that communication piece. I’ve had the opportunity to read quite a bit of feedback, both from the caregivers and the mentors from the surveys and communication time and time, again comes up in the comments in that the caregivers are grateful to have that mentor there, to act as that liaison in that communication piece. And that’s been so crucial. I’ve also loved reading the mentors feedback at home care pulse. We talk a lot about career ladders and these caregivers that have stepped up to become mentors. They’re so grateful and excited and really looking forward to this new role in mentoring other caregivers. So I think even just the role of the mentor is so pivotal and also just so fulfilling for these caregivers to have something to look forward to or to grow into. And I think that’s been such a neat finding so far.

Kathy Febraio (17:10):

Oh, I agree with you. It, it is. And it makes them feel, feel more valued as an employee. Not only am I providing wonderful care to my patients, I now can provide a pathway for my colleagues and have them a love and appreciate the job as much as the mentor to us.

Miriam Allred (17:31):

Absolutely. So you’ve mentioned a few outcomes that we’re already seeing just four months into the program. Tell me, what would you ideally like to see maybe some statistics or numbers if everything went according to plan and we really saw the most desired, what would that look like?

Kathy Febraio (17:52):

Well, I think that would look like we would see a significant shift in the retention rates of those AIDS by being mentored. And then we hope to be able to translate that into a return on investment for these agencies, that the amount of money that they’re saving on recruiting constantly recruiting new employees is decreased. And therefore the funding they’re spending on managing a mentorship program is well worth the investment and giving them not only the anecdotal stories of why they should do this, but the business stories of why they should do this. And ultimately we do hope that we will be able to take our information and not only convince other agencies to take on a mentorship program, but we’re hoping that we will seek out additional funding to help support implementing the program, whether that be through state funds or other nonprofits. We’re not sure yet, but ultimately I think that’s the goal is that we will be able to leverage what we learn and expand the program into more and more agencies.

Miriam Allred (19:18):

I appreciate what you said about the cost of turnover. There’s sometimes feels like there’s this disconnect between, you know, retention and turnover, but then the actual cost that it’s costing your agency, the cost of turnover, we kind of shove that from the rooftops, your home care pulses, the costs of losing one caregiver, you know, for most agencies ranges between $1,800 and $2,000 per caregiver lost. And when you break that down or map that out for a year at an agency, it’s a lot of money. And so finding whatever there’d be a mentorship program or whatever it is at your agency to reduce that turnover, especially in the 90 days is absolutely crucial. So I’m glad that you hit on that, that ROI. There really is ROI directly attached to caregiver retention. So that is so important kind of in closing here, I’d like to hear, you know, some things that you’ve learned in your role in this program that you could share with other organizations or even agency owners that are undertaking or planning a special project like this, you’ve really spearheaded. This I’d love to hear what you’ve learned and what recommendations you have for others looking to implement or carry out a project like this.

Kathy Febraio (20:33):

Well, I would, I would certainly recommend it to keep an open mind. We’ve learned things along the way we’ve made changes and we’ve made adjustments to the program. As we learned more and as I spoke earlier, he agencies have made changes to their processes and procedures as they’ve learned more information. So I think if you’re flexible, adaptable, and willing to learn from this experience, it will be, it will benefit everyone. And you’d be surprised at, you know, some of the smallest changes can make the biggest impact. So I would strongly recommend any agency to seriously consider a mentorship program. I think it really speaks to what value you place on your workforce by giving them a program such as this, that feeds their soul. It really helps them to enjoy their job that much better. They know that you value them and certainly the families and the patients already do, and they will see a change, I believe in their caretakers you know, attitudes in the home. And that is what this is all about.

Miriam Allred (21:55):

Well, Kathy, I appreciate you taking the time to share a little bit about this program. It’s been really exciting for us here at Activated Insights to be a part of it. As we get the feedback back every single month, it’s exciting to see what the caregivers and what the mentors are saying. And I think there’s a lot left to uncover over the next few months. So really appreciate being a part of it.

Kathy Febraio (22:17):

I just want to say thank you for, for letting me come on and speak about the program it’s near and dear to my heart. And I greatly appreciate the support and role you play in, in this program, because again, you understand home care and I’m surrounded by people who are in this program for all the right reasons to make the difference to the workforce and greatly.

Miriam Allred (22:50):

Thanks for listening to this episode of vision. If you’d like to learn more about Activated Insights, and how we help individual agencies reduce caregiver turnover, and increase retention, visit our website homecarepulse.com. Thanks again and we’ll see you next time!