From NC Area Health Education Centers

The Direct Care Worker Credentialing Plan relies on four framework elements:

1. Reliable funding must be made available to invest in the recommended activities.
2. Direct care workers move between settings, specialties, and populations.
3. Existing DCW training curricula and platforms can be leveraged.
4. The solution to the direct care worker crisis is not unilateral. The development and implementation of a certification program will not solve the DCW crisis independently

The Implementation Plan is made up of 6 elements:

1. Implement an umbrella system for credentialing DCWs that incorporates new and existing training options.
2. Adopt common core competencies for all direct care workers.
3. Ensure training is accessible for all workers, including paid training time.
4. Develop infrastructure for the administration and oversight of credentialing.
5. Connect competency attainment with wage and rate differentials.
6. Provide additional wraparound support services to direct care workers.

In terms of benefits, credentialing DCWs in North Carolina would:

1. Enhance recognition of workers’ value by enhancing professional credibility, recognizing achievement, and fostering respect for direct care workers.
2. Support direct care workers by clarifying professional roles and responsibilities, increasing understanding of job expectations, and providing clear pathways for professional advancement.
3. Improve the quality of care by ensuring the attainment of necessary skills and competencies.
4. Allow a mechanism for tracking and coordinating workforce trends, labor statistics, and outcomes related to professional practices.

To further ameliorate the primary concern of a credentialing program being a barrier to workers, we incorporated the following parameters into our plan:

1. Increase training accessibility by ensuring training is available and training time is paid for by employers.
2. Incorporate flexibility by embracing DCW core competencies while allowing for training customization and by creating a mechanism for training to follow the DCW between employer settings as well as across a lifelong learning and professional development continuum via credentials that build upon each other.
3. Ensuring the retention and integration of current DCWs by recognizing existing training accomplishments.

The key factors necessary to support DCW recruitment and retention:

1. Increased wages and benefits
2. Realistic job previews
3. Match between individual skills and the person’s need for support
4. Skilled and supportive supervision
5. Positive organizational culture that fosters respect for DCWs
6. Opportunities for professional advancement
7. Opportunities for self-direction
8. Competency-based training and credentialing
   Successful implementation includes the following objectives:
9. Identify a lead organization (department, outside organization, or other agency) to carry these plans to fruition.
10. Form one or more advisory committees to draw on the knowledge and experience of experts, advocates, and invested partners in the direct care workforce space.
11. Develop implementation resources for employers, including a consultant group and implementation handbook.

Forcina, J., & Collier, C. (2023). Recommendations for HCBS Worker Certification. NC Area Health Education Centers. https://www.ncdhhs.gov/nc-ahec-recommendations-dcw-hcbs-worker-certification/download?attachment.