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MASON CITY — Improved training for direct care providers is the goal of a state initiative in the face of what has been called a direct care crisis, health care representatives said Thursday in Mason City.

The Iowa CareGivers group predicts 20,000 more direct care providers will be needed by 2020 to care for people in their homes as baby boomers age into the health care system.

The lack of providers is worsened by a turnover rate of 64 percent a year due to inadequate training and lack of recognition for the work they do, group members said.

“I love my job, but we need help,” said Becky Johnson, a certified nursing assistant with Mitchell County Home HealthCare. “We need help right now.”

With a workforce of 75,000, Iowa’s direct care workers represents the state’s largest workforce, said Erin Drinnin, project manager for the Direct Care Workforce Initiative with the Iowa Department of Public Health. “They provide the hands-on support when people most need it.”

But the high turnover rate puts additional pressure on the remaining workers in a job that is already emotionally and physically challenging, she said.

A large part of the problem is inconsistent training and performance standards.

As a certified nursing assistant, Johnson is trained to work with every age group from newborns to the elderly, autistic children to birthing mothers. She can give personal care or help with shopping — whatever is needed.

“More people are choosing to stay home and we’re there to keep them there,” Johnson said.

Not all of Iowa’s direct care givers receive the same level of training as she did, however, and they can be intimidated working in the home, Johnson said.

Niky Lewis of Osage talked about her 60-year-old father, who suffered a stroke several years ago and today receives direct care in Lewis’s home from Mitchell County Home HealthCare.

His CNA assists with his personal care. He also receives assistance from employees from Opportunity Village, who take him out on excursions into the community.

“It allows me to give time to my 10-year-old son,” Lewis said.

Being at home enables her father to interact with his grandson and other members of the family, she said.

In 2005, the Iowa Legislature put in place a Direct Care Worker Advisory Council to launch a Direct Care Workforce Initiative, Drinnin said.

“Addressing turnover was one of their biggest priorities.

“The core of their recommendations is that we should have state standardized training and credentialing.”

Final recommendations were submitted last year.

The IDPH also received a federal grant to plan, implement and test a pilot curriculum based on the recommendations of the council.

Approximately 400 direct care professionals went through the six-hour pilot training course. Virtually all of them reported significant learnings, Drinnin said.

Details about “Prepare to Care: Iowa’s Direct Care and Support Curriculum,” are being shared with direct care and support providers, educators and employers around the state, including North Iowa.

Drinnin observed that high job turnover is costly to employers who must constantly retrain new people.

“I think employers know that if you provide the training, employees will stay,” she said.

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