2017 Healthcare Report

Building the

HEALTH CARE WORKFORCE

From the Ground Up

A Workforce Development Strategy for the Health Care Sector in Waterloo Wellington Dufferin Building The Health Care Workforce From The Ground Up

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The Workforce Planning Board of Waterloo Wellington Dufferin (Planning Board) is one of twenty-six Planning Boards across the Province of Ontario. Our mandate is to act in partnership with all sectors of our community including Business, Labour, Education/Trainers and Community Representatives to collaboratively develop solutions to address labour market needs. The Workforce Planning Board serves all of Waterloo Region, Wellington County and Dufferin County.

The Workforce Planning Board of Waterloo Wellington Dufferin would like to thank our partner, Conestoga College, Institute of Advanced Technology & Learning and the Waterloo Wellington Local Health Integration Network for their support as well as all of the people who took part in this project.

This report was compiled by Carol Simpson, Executive Director, Workforce Planning Board of Waterloo Wellington Dufferin

This project is funded in part by the Government of Canada and the Government of Ontario

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A Workforce Development Strategy for the Health Care Sector in Waterloo Wellington Dufferin

CONTENTS EXECUTIVE SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 The Project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 A Profile of the Health Care Sector in Waterloo Wellington Dufferin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Quick Facts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Health Care Businesses by Number of Employees . 6

RECOMMENDATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Health Care Employment Data . . . . . . . . . . . . . . . . . . . 6

Health Care Jobs by industry Sub-sector . . . . . . . . . 7

Recruitment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Health Care Occupations with Older Workers . . . . . 8

Retention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Health Care Employment by National Occupational Classification (NOC) . . . . . . . . . . . . . . . 8

Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Local Training examples at the entry to mid-skill level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Training Updates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Challenges & Opportunities . . . . . . . . . . . . . . . . . . . . . . . 10

The view from the inside...

What we heard from employers and workers. . . . . 10

The view from the outside...

What we heard from jobseekers and employment service providers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

THE PERSONAL SUPPORT WORKER DILEMMA . . . . . 13

Unstructured Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Re-engagement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 ACTION PLAN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Unstructured Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Recruitment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Retention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Re-engagement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 PARTICIPATING ORGANIZATIONS . . . . . . . . . . . . . . . . 23

Focus Group Participants . . . . . . . . . . . . . . . . . . . . . . 23

APPENDIX A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

Health Care Employer Survey Input . . . . . . . . . . . . . . 24

APPENDIX B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

Top Jobs by Number of On-line Postings by National Occupation Classification (NOC) . . . . . . . . 29

APPENDIX C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

Partnership Agreements . . . . . . . . . . . . . . . . . . . . . . . . . 31

Building The Health Care Workforce From The Ground Up

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This report contains a number of recommendations aimed at addressing opportunities and challenges identified

EXECUTIVE SUMMARY This report contains the findings of a project to develop a Workforce Development Strategy for the Health Care Sector in Waterloo Wellington Dufferin.

This project was a partnership between the Workforce Planning Board of Waterloo Wellington Dufferin and Conestoga College Institute of Training & Learning with support from the Waterloo Wellington Local Health Integration Network and funded by the Ministry of Advanced Education and Skills Development (MAESD).

A key goal is to support unemployed and employed workers who are having difficulty accessing employerrecognized skills training and support employment and advancement opportunities.

The Health Care sector is one of the largest employment sectors in the region and looks after a population of over 830,000 people. In 2016 there were 4,300 businesses in the sector and over 2,000 of these businesses reported having employees. Employment data shows that over 32,000 people were working in the sector in 2016 and there is significant ongoing demand for new workers.

Workforce development opportunities and challenges facing the local health care sector are diverse and numerous. Lack of applicants, legislative requirements, training standards, working conditions and pay disparity are all impacting the sector’s ability to maintain and improve the level of service to clients.

In total over 40 organizations and almost 100 people participated in consultations, interviews and focus groups with jobseekers, youth, current and former employees to share their issues and understanding, or lack thereof, of opportunities and challenges within the sector.

There is obvious frustration with both legislative and training requirements which many felt was limiting their ability to fully meet the needs of their patients/clients.

The goal of this project was to identify specific actions to address key industry issues and partners who would be willing to support the implementation of these actions moving forward. In order to be able to develop strategies to impact occupations that are currently in high, if not

critical, demand, the project is mainly focussed on entry to mid-level occupations where training requirements are 2 years or less in total.

Growth in the number of businesses in the sector, particularly in home care, is significantly impacting the requirement for more Personal Support Workers however the occupation is rife with disparity in working conditions, wages and advancement opportunities. Lack of standardized entry level training is confusing to both employers and potential jobseekers as some currently available training options are recognized by some but not others. Occupations where one would anticipate there should be growing employment opportunities as the population ages, e.g. recreational therapy type occupations, are provided with a variety of training options but few employment opportunities for grads.

Five Streams of focus areas were identified with some overlap in needs under each: • Unstructured Industry

• Recruitment

• Retention

• Training

• Re-engagement Partnership Agreements have been signed by the following organizations who have agreed to lend their support to future discussions with MAESD regarding the implementation of the actions included in this report.

These initial partners include Conestoga College ITAL, Care Partners, Therapeutic Recreation Ontario, Schlegel Villages Inc., Bayshore Home Care Solutions and the Ontario Personal Support Workers Association.

Building The Health Care Workforce From The Ground Up

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THE PROJECT Introduction The Workforce Planning Board of Waterloo Wellington Dufferin (Planning Board) has long recognized that significant challenges and opportunities are facing the local health care sector. In June 2017, the Planning Board had an opportunity to submit a proposal to the Ministry of Advanced Education and Skills Development (MAESD) to develop a new workforce strategic plan specifically for the local health care sector in Waterloo Wellington Dufferin under their Sector Specific Partnerships Grant (SPPG). This project has Conestoga College, Institute of Advanced Learning as its key partner.

Starting in late August 2017, this initiative, completed in November 2017, has resulted in an action plan which will provide guidance and direction to Ontario’s provincial government regarding how best to support investment in local health care workforce development priorities in the immediate future. The project was conducted internally by expert Planning Board staff.

Based on the need to build capacity at the entry to mid-level skilled workforce, this project focussed mainly on occupations which can provide access to employment opportunities to jobseekers in the shortest possible timeframes. In this case from a minimum of eight weeks to a maximum of two years.

Methodology Over the project period, the Planning Board reached out to hear from local health care providers both large and small and across all aspects of service delivery.

This evidence-based plan needed to incorporate the input from as many providers as possible in order to support potential future MAESD investment to address the sector’s workforce challenges and opportunities.

In total over 40 organizations and almost 100 people participated in consultations, interviews and focus groups with jobseekers, youth, current and former employees to share their issues and understanding, or lack thereof, of opportunities and challenges within the sector.

The Planning Board used a number of different methods to gather input. These included the following: Surveys A survey was implemented to gather data from local health care providers. In total, there were 18 organizations who responded representing almost 10,000 workers. Although not part of the actual project itself, in January 2017, the Planning Board conducted its annual workforce survey. This provided input from an additional 28 health care respondents regarding workforce challenges and opportunities.

These respondents represented approximately 4,500 additional workers. Since the results were only a few months old, these findings also provided a valuable data source to the project.

Focus Groups Three focus groups were held with jobseekers and potential workers from Employment Ontario service providers.

One focus group was held with health care faculty.

One focus group was held with health care workers/ Personal Support Workers.

Interviews Seven lengthy interviews were held with multiple representatives from training institutions, health care facilities and provincial organizations representing health care workers.

Industry Consultations Three industry consultations with health care providers were held one each in Waterloo, Wellington and Dufferin counties.

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A Workforce Development Strategy for the Health Care Sector in Waterloo Wellington Dufferin

A PROFILE OF THE HEALTH CARE SECTOR IN WATERLOO WELLINGTON DUFFERIN Population Population Growth 2014-2016 2014

2016

Growth

Dufferin

60,729

61,429

700

Waterloo

538,473

548,018

9,545

Wellington

220,928

223,869

2,941

Total

820,130

833,316

13,186

Largest Age Cohort Growth 2014-2016 Dufferin

70-74 yrs

19%

Waterloo

65-69 yrs

9%

85+ yrs

11%

65-74 yrs

9%

Wellington Waterloo Wellington Dufferin Source: EMSI

Quick Facts • From 2014 to 2016 there was an increase of 7% in the number of health care workers in the Waterloo Wellington Dufferin region with over 32,000 people employed in the sector in the region.

• From 2014 to 2016, the highest percentage of job growth is focussed in sectors offering many types of entry to mid-level opportunities. These are medical and diagnostic laboratories, home health care services and other ambulatory health care services. Average wages in these sectors range from $34,496 to $49,578.

• With the highest growth in 65-74 year olds, the number of home health and other residential care centred businesses rose significantly during the same period from 206 to 240. There was also significant growth in the size of these businesses

• e.g. in 2014 there were only 6 businesses reporting 100-199 employees but in 2016 that had grown to 9 businesses. The demand for home care services and additional employees to meet those growing needs will only continue to grow as more seniors want to remain in their own homes for longer.

• In order to look at where potential employment opportunities are likely being created, it is important to understand which occupations have the oldest workers. Over 28% of all managers in health care were aged 55 or over in 2011 while 25% of medical laboratory technicians, 22% of medical administrative assistants, 20% of home support workers, 18% of nurse aides, etc., and 16% of receptionists also fell into that older worker category. It is likely fair to say that many workers represented here have already retired or are likely to be retiring very shortly.

Building The Health Care Workforce From The Ground Up

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Health Care Businesses by Number of Employees Total with employees 621 - Ambulatory health care services 622 - Hospitals 623 - Nursing and residential care facilities

1-4

5-9

10-19

2049

5099

100199

200499

500 +

1,758

1,150

380

154

52

6

11

3

2

19

6

0

1

0

1

1

3

7

289

18

65

101

50

31

15

9

0

Source: Statistics Canada, Canadian Business Patterns, June 2017

As of June 2017, there were a total of 2,066 businesses with employees servicing the local health care sector in the Waterloo Wellington Dufferin region. There were another 2,224 businesses with no employees i.e. they were owner operated or used contract employees.

Think if all of these businesses hired just one worker in 2017.

Other people will want to remain in their homes longer and, as a result, we are seeing significant growth in small private home care and long term care enterprises.

As these new companies ramp up the demand for workers will continue to grow.

According to Statistics Canada there were over 32,000 people employed in the health care sector in the region.

The population is aging and more people are living longer. Some will eventually be required to live in a non-home setting such as long term care facilities or palliative care where they can receive the necessary level of care that their situation requires. This is fuelling employment growth across the region as existing facilities expand or new facilities are being built to meet demand.

Health Care Employment Data Census Division Name

2014 Jobs

2016 Jobs

Waterloo

19,918

21,315

1,397

7%

$44,545

Wellington

8,302

8,714

412

5%

$43,214

Dufferin

2014 - 2016 Change

2014 - 2016 % Change

Avg. Wages Per Job

1,936

2,338

402

21%

$45,653

30,156

32,367

2,211

7%

$44,267

Source: EMSI

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A Workforce Development Strategy for the Health Care Sector in Waterloo Wellington Dufferin

Health Care Jobs by Industry Sub-sector NAICS

Description

2014 Jobs

2015 Jobs

2016 Jobs

6211

2014 - 2016 Change

2014 - 2016 % Change

Avg. Wages Per Job

Offices of physicians

2,073

2,187

2,334

261

13%

6212

Offices of dentists

2,230

2,421

2,484

254

11%

$44,787

6213

Offices of other health practitioners

1,813

1,656

1,842

29

2%

$35,507

6214

Out-patient care centres

1,355

1,494

1,535

180

13%

$55,230

6215

Medical and diagnostic laboratories

318

363

431

113

36%

$46,370

6216

Home health care services

1,735

2,171

2,186

451

26%

$34,496

6219

Other ambulatory health care services

146

175

215

69

47%

$49,578

6221

General medical and surgical hospitals

8,383

8,561

8,836

453

5%

$58,783

6222

Psychiatric and substance abuse hospitals

372

356

371

(1)

(0%)

$55,114

6223

Specialty (except psychiatric and substance abuse) hospitals

<10

<10

<10

Insf. Data

Insf. Data

Insf. Data

6231

Nursing care facilities

5,492

5,402

5,700

208

4%

$30,627

6232

Residential developmental handicap, mental health and substance abuse facilities

2,495

2,512

2,429

(66)

(3%)

$32,657

6233

Community care facilities for the elderly

2,132

2,373

2,545

413

19%

$33,404

6239

Other residential care facilities

1,602

1,558

1,452

(150)

(9%)

$32,761

30,156

31,236

32,367

2,211

7%

$44,267

$59,365

Source: EMSI

Building The Health Care Workforce From The Ground Up

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Health Care Occupations with Older Workers Occupations with workers over age 55 in 2011

% of all workers in occupation

0311

Managers in health care

28.3%

3112

General practitioners and family physicians

25.6%

3212 Medical laboratory technicians and pathologistsâ&#x20AC;&#x2122; assistants

24.6%

4151

24.5%

Psychologists

1243 Medical administrative assistants

22.1%

3012 Registered nurses and registered psychiatric nurses

21.7%

4412 Home support workers, housekeepers and related occupations

20.2%

3413 Nurse aides, orderlies and patient service associates

18.0%

3142 Physiotherapists

17.9%

3111

Specialist physicians

17.7%

1414

Receptionists

16.2%

3233 Licensed practical nurses

16.1%

4165 Health policy researchers, consultants and program officers

15.4%

Source: NHS 2011

Health Care Employment by National Occupational Classification (NOC) NOC

Description

2015 Jobs

2017 Jobs

0311

Managers in health care

596

506

(90)

(15%)

$45.00

1243

Medical administrative assistants

454

696

242

53%

$21.20

1252

Health information management occupations

56

30

(26)

(46%)

$22.91

1414

Receptionists

3,736

3,579

(157)

(4%)

$17.50

3011

Nursing co-ordinators and supervisors

311

287

(24)

(8%)

$36.18

3012

Registered nurses and registered psychiatric nurses

6,168

5,718

(450)

(7%)

$34.94

3111

Specialist physicians

83

122

39

47%

$32.57

3112

General practitioners and family physicians

200

247

47

24%

$32.62

3113

Dentists

30

35

5

17%

$43.80

3121

Optometrists

12

<10

Insf. Data

Insf. Data

Insf. Data

3122

Chiropractors

20

<10

Insf. Data

Insf. Data

Insf. Data

3124

Allied primary health practitioners

142

80

(62)

(44%)

$40.67

3125

Other professional occupations in health diagnosing and treating

36

10

(26)

(72%)

Insf. Data

3131

Pharmacists

593

570

(23)

(4%)

$46.64

3132

Dietitians and nutritionists

130

107

(23)

(18%)

$36.03

3141

Audiologists and speech-language pathologists

239

307

68

28%

$37.49

3142

Physiotherapists

268

356

88

33%

$35.43

3143

Occupational therapists

113

207

94

83%

$36.14

3144

Other professional occupations in therapy and assessment

226

186

(40)

(18%)

$26.03

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2015 - 2017 Change

2015 - 2017 % Change

A Workforce Development Strategy for the Health Care Sector in Waterloo Wellington Dufferin

2016 Avg. Hourly Wages

NOC

Description

2015 Jobs

2017 Jobs

3211

Medical laboratory technologists

3212

2015 - 2017 Change

2015 - 2017 % Change

2016 Avg. Hourly Wages

211

365

154

73%

$35.19

Medical laboratory technicians and pathologistsâ&#x20AC;&#x2122; assistants

296

476

180

61%

$25.79

3214

Respiratory therapists, clinical perfusionists and cardiopulmonary technologists

147

236

89

61%

$38.01

3215

Medical radiation technologists

142

249

107

75%

$37.16

3216

Medical sonographers

35

75

40

114%

$36.44

3217

Cardiology technologists and electrophysiological diagnostic technologists, n.e.c.

67

92

25

37%

$29.33

3219

Other medical technologists and technicians (except dental health)

619

887

268

43%

$21.71

3221

Denturists

0

0

0

0%

$0.00

3222

Dental hygienists and dental therapists

534

419

(115)

(22%)

$37.01

3223

Dental technologists, technicians and laboratory assistants

88

60

(28)

(32%)

$25.77

3231

Opticians

104

142

38

37%

$23.78

3232

Practitioners of natural healing

14

16

2

14%

$28.00

3233

Licensed practical nurses

1,288

1,457

169

13%

$27.72

3234 Paramedical occupations

579

459

(120)

(21%)

$35.66

3236

Massage therapists

264

208

(56)

(21%)

$22.03

3237

Other technical occupations in therapy and assessment

23

57

34

148%

$23.32

3411

Dental assistants

3413

Nurse aides, orderlies and patient service associates

3414

540

526

(14)

(3%)

$20.05

5,556

6,510

954

17%

$19.66

Other assisting occupations in support of health services

701

638

(63)

(9%)

$19.01

4151

Psychologists

133

71

(62)

(47%)

$40.92

4152

Social workers

1,192

1,600

408

34%

$33.05

4165

Health policy researchers, consultants and program officers

452

414

(38)

(8%)

$33.04

4412

Home support workers, housekeepers and related occupations

1,265

1,224

(41)

(3%)

$16.07

27,660

29,236

1,576

6%

$26.98

Average Source: EMSI

Building The Health Care Workforce From The Ground Up

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Local Training examples at the entry to mid-skill level Entry/mid-level training and upgrading available locally includes, but is not limited to, the following occupations and modules: • Community Service Worker • Developmental Service Worker

Training Updates • The demand for Medical Office Administrator has been significant over the past 2-3 years and the two year program at Conestoga College is now supplemented by a 24 week program which is similar in length to that of the private career colleges in order to meet demand.

• Conestoga College has recently developed an 8-week Pre-PSW program which is currently being piloted with a large employer in the sector which allows for bridging into the College’s PSW program.

• Intra-Oral Dental Assistant • Massage Therapy • Medical Lab Assistant/Technician • Medical Office Administrator • Personal Support Worker • Pharmacy Assistant • Paramedic • Respiratory Therapy • Occupational and Physiotherapy Assistant • Enhanced professional Practice Gerontology • Practical Nursing • Hearing Instrument Specialist

CHALLENGES & OPPORTUNITIES Based on the need to build capacity at the entry to mid-level skilled workforce, this project focussed mainly on occupations which can provide access to employment opportunities to jobseekers in the shortest possible timeframes. In this case from a minimum of eight weeks to a maximum of two years. There are a multitude of jobs being created at these levels in the Waterloo Wellington Dufferin region.

The view from the inside...

What we heard from employers and workers.

October Survey: 100% of businesses had hard-to-fill positions.

It is clear from the employer feedback that different employers consider these positions at different skill levels.

Top 5 Hard-to-Fill Entry-level Positions 1.

Personal Support Worker

2. Registered Nurse 3. Food Services Worker

Businesses have difficulty hiring

Top 5 Hard-to-Fill Mid-Level Positions 1.

Personal Support Worker

2. Registered Practical Nurse 3. Food Services Worker

Most difficult to fill: PSWs, RPNs and food service workers

4. Cook 5. Human Resources/Admin Assistant In the Home Health Care sector the geographies of care can be large and can create travel restrictions for some entering the sector. Also, those providing beginning and end of day care may have extensive travel time to and from patient location to their home. In some cases caregivers may travel up to an hour to provide only an hour of care. (A total of 3 hours of worker time to service 1 hour of care) There are issues with scope of practice e.g. using Developmental Support Workers (DSW) vs. Personal Support Workers (PSW). There may be opportunities to develop alternative support staff roles. Many felt that a review of legislation might be beneficial to the industry however that was not unanimous across all sectors.

4. Care giver/Home maker 5. Administrative Assistant 10

A Workforce Development Strategy for the Health Care Sector in Waterloo Wellington Dufferin

Technology in the field is creating challenges for some staff. In some environments, seniority-based promotions mean that those next in line may not have the technical skills required to be successful. In other cases, workers are unable to keep up with technological change and need time for training and learning these new skills. There are a variety of record maintenance and communication tools used across the industry meaning that workers who are moving around are in need of retraining to these new systems.

The face of the health care workforce is changing and diversity training could benefit many workplaces.

Cultural awareness could create opportunities to better align hiring and on-boarding practices and provide supportive working relationships, increasing retention rates. This could also support targeted marketing of training and employment opportunities to newcomers to the region.

Immigration to the region could provide a stream of new workers but could also provide entrepreneurial opportunities for newcomers to serve the needs of ethnic groups at home and in their own language e.g. Arabic, Mandarin, etc. This could provide access to employment and provide these workers with opportunities to advance their English language skills over time in order to gain new skills and have eventual employment mobility both within and outside the industry.

It was noted that a number of nursing students work as supportive workers while in school. Providing targeted entry level training opportunities for non-medical postsecondary students could provide valuable additional worker hours at peak times such as evening, weekends and over the summer months similar to lifeguard or other certifications available to support student employment.

Many health care related training programs are still filling up but year over year there are fewer applications despite increased demand from the industry. 76% of survey respondents indicated they felt there was a gap in available training.

Training Available – October Survey • 82% feel that there is available training adequate to the meet the needs of existing employees • 59% feel that there is currently available training adequate to the meet There are significant the needs of new employees training gaps, especially • 41% feel that there is currently available training adequate to the meet the needs of future employees

related to new and future employees

• 76% of businesses feel there is a GAP in available training

Students need to be made more aware of the types of opportunities available within the health care sector.

In 2014, it was reported that only 4% of high school graduates were going into post-secondary health care programs. Health and Wellness Specialist High Skills Major programs get many high school students interested in options like therapist/technician e.g. recreational therapy. Many local health care employers report a desire to hire these types of positions but also report having no budget to be able to provide these services to their clients/patients. Enrolment in these programs is up but few jobs are actually being created.

Building The Health Care Workforce From The Ground Up

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The view from the outside...

What we heard from jobseekers and employment service providers.

Three focus groups were held for current Employment Ontario clients who are unemployed jobseekers.

Participants were asked to name 5 entry/mid-level occupations within the sector but most were unable to identify more than 3 or 4. Those most often referred to were Registered Nurse, Lab Technician, Personal Support Worker and Orderlies. It is clear that these unemployed workers are not considering employment in the health care sector as they are unaware of the scope of local opportunities for accessing entry level training/jobs. They believe that there are few if any jobs available at the base entry level requiring little or no training and little opportunity for advancement for those jobs which are available.

When asked why they were no longer seeking employment in the sector, several former health care workers in their early-mid thirties (therapists) reported that they had not felt â&#x20AC;&#x153;valuedâ&#x20AC;? by their clients or their colleagues. They said that some of their friends in the sector had already left. Although they had invested significant time training for these occupations they felt they could do better elsewhere.

The health care sector is not a first choice for many younger people. The majority of those interested were in the 25-44 or 44+ age ranges.

255 clients assisted by Employment Ontario Service providers in Waterloo Wellington Dufferin reported coming from employment in the health care sector.

Only 62 were reported as going back to employment in the sector in WWD. We are not sure what happened to the remainder but it is likely that they moved to other employment opportunities and away from health care.

Several focus group participants reported that they had not taken advantage of Second Career training opportunities as they believed that there would be no jobs available at the end of the training. E.g. Current high demand for medical office assistant, dental assistant, lab assistant jobs, etc. were all misunderstood by jobseekers. At least 2 participants indicated that, had they been supplied with the labour market information provided during the course of the focus group discussion, and had they been made aware of the local employment opportunities available, then they would have applied to Second Career and would now have been employed and not still looking for work.

Personal Support Worker (PSW) was not high on the list of jobs of choice as it was considered by many to be a minimum wage level job with no upgrading opportunities. There were a couple of people who were considering PSW as a career and had applied to Conestoga College. They indicated that their goal was to eventually become a Registered Practical Nurse (RPN).

12

A Workforce Development Strategy for the Health Care Sector in Waterloo Wellington Dufferin

THE PERSONAL SUPPORT WORKER DILEMMA The Personal Support Worker (PSW) situation in Ontario is dire in many parts of Ontario however in Waterloo Wellington Dufferin it is nothing if not critical.

Every participant in this project whether an employer, PSW, co-workers, associations, etc. recognizes and clearly stated that there needs to be something done now to significantly increase the supply of new workers and retain existing workers if we are to be able to meet current and future demand.

Here are just a sample of some of the comments that have been heard on numerous occasions: • Hard for older PSWs to keep pace • Many facing burnout • Growing workplace injuries

With multiple access points, varying levels of recognition of training, a dictionary of job titles and disparity across wage and working situations, it is not really surprising that the occupation is in crisis.

In order to understand how the industry can take advantage of potential opportunities, we first have to understand why the situation is the way it is currently.

The graphic below shows where some of these bottlenecks are happening most often and where there are barriers to movement either across or up to new and higher paying opportunities over time in the same or different sectors.

• Working beyond capacity • Impact to service delivery quality • Different pay for similar work • Meeting the complex/diverse needs of patients • Split shifts vs. full time hours • Lack of new worker supply • Competition both within sectors (e.g. Home Care) and between sectors (Long term care vs. hospitals) • Reputation/lack of value

Building The Health Care Workforce From The Ground Up

13

To some employers utilizing uncertified low skilled workers with very basic training to help support PSWs in the workplace would be beneficial however others did not feel that this approach or the use of partial training would suit their needs. In Waterloo Wellington Dufferin there are three formal routes to PSW employment. These are Adult Education, Private Trainers/Private Career College, and Ontario Community Colleges. There are always a few exceptions to the rule but, in general, recognition of this training and career paths are as indicated below.

People choosing to take training to become a PSW are often completely unaware of the limitations their choice of training will place on their future career options. We learned that oftentimes the adult education option is their only choice from a financial perspective. Many assume that the private trainer option is similar to the College certification, only quicker. The career does not appear to be being pushed by employment service providers as a viable option for Second Career training.

If a base minimum standard could be identified it would allow workers the opportunity to select which career path they wish to aspire to. Those wishing to remain at the basic level would be employable at basic entry level working conditions and wages. Modular training would enable those wishing to proceed to more advanced opportunities to access required upgrading or specialized modules e.g. dementia, hospital settings, etc. This would give both employer and employee more mobility and advancement options and increase the pool of potential employees. Although the goal would be to create a larger pool of PSWs, recognition of a base minimum standard as prior learning could provide increasing mobility options to meet the need for higher skill level occupations such as RPN/RN and supervisory/management positions. These positions are ranked immediately below PSW in the hard to fill jobs categories.

Adult Education

Private Trainer / Private Career College

Ontario Community College

Training

Free programs available through school board.

Certificate tuition program

Diploma tuition program

Employment Access

•H ighly valued by job seekers who have limited education and economic support as a way to access employment.

•T raining viewed by some employers as non-comparable to College level programs.

•A lthough many state they do not need this “top tier” of gold standard training credential, the certification is certainly valued and recognized by all employers.

• I t is a path that is also highly valued by some employers such as in-home care but not acceptable to others.

• I n most cases there is little or no access to career path advancement.

•L imited opportunities to move into more highly paid options e.g. hospital.

•T here is no recognition of training equivalency to career paths such as RPN.

•M any candidates enter the industry at this level with a view to career paths in RPN and eventually RN. •T his is generally the candidate who is highly prized as a potential for specialized and advanced positions e.g. in palliative care, dementia wards, etc.

Mobility

Minimal within PSW

Limited within PSW

Unlimited within PSW with access to RPN and RN

Wage

Generally low

Low to mid-range

Mid to high

14

A Workforce Development Strategy for the Health Care Sector in Waterloo Wellington Dufferin

RECOMMENDATIONS Over the course of the project it became clear that all of the recommendations fell under five action categories.

These are: • Unstructured Industry

• Recruitment

• Retention

• Training

• Re-engagement

Some recommendations cover more than one of these categories and so will be listed under what is considered to be the main category.

Unstructured Industry Identified Needs: • Address existing barriers and bottlenecks within the system which are impacting low-mid level workers both existing and new e.g. multiple access points to training, pay disparity and mobility factors • Provide necessary coordination and implementation support to local health care workforce development activities in order to enhance local collaboration across the local industry

RECOMMENDATION 1: Establish and provide staff support to a Local Health Care Employment Task Force.

If the health care sector is to be successful in implementing the actions brought forward in this plan it will be necessary to support and enhance local collaboration through the establishment of a Local Employment Task Force. This group would initially consist of key partners who have self-identified during the course of this project. Key partners currently include Conestoga College, Bayshore Home Care Solutions, Schlegel Villages Inc. and Ontario Personal Support Workers Association. This would require the support of a 3rd party Project Manager with focus on leading implementation of activities.

The role of the Local Health Care Employment Task Force would be to: • Monitor implementation of the Strategic Plan • Provide leadership and direction to staff and working groups on initiatives • Identify resources and other potential activities • Advocate for PSW National Occupation Classification (NOC) review

Building The Health Care Workforce From The Ground Up

15

RECOMMENDATION 2: Identify acceptable training requirements for each industry sector and streamline PSW training standards to support entry to, and advancement within, the occupation at mutually agreed upon levels e.g. Entry level PSW, PSW 1, PSW 2 Specialized PSW. Key stakeholders in the health care sector, including employers, unions, associations, and educators should be supported to form a working group to develop an acceptable model and training standard for entry level PSW. The goal would be to map out pathways which will provide increased opportunities for training/ upgrading/retention through the development of modular training. Recognizing that not all businesses will be able to hire at the minimum requirement, the development of this type of base training will enable those who can to hire at that level while still providing the worker with opportunities for advancement both cross sector and inter-sector. This will enable lower skilled workers, workers from non-traditional labour pools and those with no financial capacity to fund training to access employment, get experience and learn what their path is to mobility in the sector. These workers then are no longer stuck at the bottom of the pipeline. Those with higher skills can directly access employment at a higher level based on their educational achievements and financial capacity and find employment with businesses requiring that higher minimum standard.

Although the focus is to increase the pool of potential PSW workers, this type of modular training could provide opportunities for the following: • professional development credits • equal funding for equal positions • additional RPN/RN training routes For the purposes of this report, we are referring to Ontario College level PSW certification as the “gold standard” simply because it is generally recognized and accepted as the most universally accepted PSW training level by local employers, although not always required by many employers. By saying this we are not inferring that other training entry points are offering inferior training, rather we are recognizing that, although other entry points may be able to provide entry level employment, if they are to be able to provide consistent advancement opportunities, there will be areas of curriculum identified that may require augmentation through additional hours of training via modular training.

By working backwards from the “Gold Standard – College level curriculum”, each section of curriculum available in other entry level training programs should be evaluated and equated with the gold standard to determine the level of recognition and any gaps or upgrading requirements. E.g. An enhanced training module might be required to bring part of the curriculum offered at the base level to match or be equivalent to the gold standard. These types of modules could be taken at any time and offered by trainers/employers e.g. through continuing education at a college or delivered as on the job training. Once completed, each additional module would then be signed off on the PSW’s training record. This record would be held by both the employer and any PSW registering body e.g. The Ontario PSW Association or any other regulatory body which may be established. Once the required modules have been completed, the worker can then be recognized as equivalent to entering the occupation at the next level and can apply for positions at that higher level.

Number of modules are for example only 16

A Workforce Development Strategy for the Health Care Sector in Waterloo Wellington Dufferin

Recruitment Identified Needs: • Increase the available pool of PSWs to meet the urgent and immediate employer demand for workers • Enhance the image of the sector, specifically highlight entry-mid-level employment opportunities • Encourage more students to consider employment opportunities within the health care industry • Enhance entry level training and employment opportunities RECOMMENDATION 3: Partner with local school boards to review Specialist High Skills Major (SHSM) – Health & Wellness program to offer information on local entry and mid-level in-demand health care occupations Currently program appears to be more geared to wellness programming. SHSM needs to focus more on entry to mid-level level health care occupations and front-line care opportunities. Many students leaving high schools are opting for programs such as recreational therapy type positions where opportunities would appear to be growing and in demand however there are lots of grads but few jobs. Businesses would like to hire these types of workers but there is little funding available. If the SHSM program can focus on where the jobs are actually being created it might create more interest in the industry.

RECOMMENDATION 4: Partner with Employment Ontario (EO) and other agencies including Local Immigration Partnerships to build the pipeline to health care employment for youth, new Canadians, refugees, aboriginals, francophones, etc.

Provide ongoing Labour Market Information to EO and other agencies staff and clients to better understand where current health care employment entry points are and how to access them. E.g. update existing but outdated health care careers CD, workshops, presentations, etc. Local marketing of opportunities through videos/bus campaigns to direct potential workers to agencies which can then direct them to training/employment opportunities.

RECOMMENDATION 5: Propose a review of the National Occupation Classification (NOC) covering Personal Support Workers and advocate for a new and separate NOC for the occupation.

It is hard to understand demand for workers in the sector since there are so many differing job titles and job descriptions creating confusion as to whether they actually require a PSW or not and at what level.

Creating a separate NOC for PSW would encourage more people to consider the career and more easily support marketing of job opportunities across the sector.

Retention Identified Needs: • Address burnout • Flexible scheduling to provide maximum opportunities for staff coverage • Financial support for on the job training • Highlight the value of workers both internally and externally RECOMMENDATION 6: Identify and review existing flexible staffing models for PSW and potentially other occupations. Develop a Pilot Employer Consortium to look at the potential for flexible scheduling and employee sharing.

Some local employers are looking at implementing staffing models where workers identify how many hours they wish to work and when and are scheduled accordingly into shifts using flexible scheduling.

Many current staff are experiencing burnout as they try to cover extended shifts while others are only able to garner a few hours of work here and there. A pilot model could be tested to use not only flexible scheduling by employers but also across employers forming a worker supply pool which can be directed by hours wanted by staff and geographic location, e.g. neighbourhood model for home care where PSW will be allocated clients closest to their geographic home base. This would engage workers to potentially work additional hours by creating full time work or they can pick hours they want to work. Workers can plug themselves in and could potentially be hired by a third party/shared/paid. Perhaps there is an opportunity to support language training here also.

Building The Health Care Workforce From The Ground Up

17

Training

Re-engagement

Identified Needs:

Identified Needs:

• Develop creative ways to provide alternate support staff roles

• Encourage those who have left the industry to reconsider

• Keep up with technological change

• Promotion of planning work externally

• Cultural awareness in the workplace • Address declining enrolment • Financial support for on-boarding new hires RECOMMENDATION 7: Investigate the potential and development of common applications to meet the technological needs of the local sector.

Conduct a study to look at types of technology used to record patient care both onsite and remotely and use of technology out in the field. Perhaps there is a common application which could be used so people can move between facilities/sectors without the need for retraining. There may be an opportunity for a possible Private-Public-Partnership with local high-tech businesses. Basic training should also be developed or provided for the use of communication devices such as cell phones and tablets.

RECOMMENDATION 8: Develop and implement short term training for supportive care workers to meet the immediate need of some local employers.

This type of programming will meet the immediate needs of some but not all employers for basic entry level workers and so this type of programming should be developed in tandem with the proposed establishment of base PSW entry level standards.

This will ensure that those taking this type of training will not be stuck at this level and will have mobility options should they desire to upgrade to PSW. At this level there will need to be infrastructure developed to support in-home practicum opportunities. There may be additional potential for non-health related students to take this type of training in order to access evening, weekend and summer employment.

RECOMMENDATION 9: Ministry of Advanced Education and Skills Development (MAESD) take a greater role in promoting this type of planning work being done in communities both to the communities and to other related ministries.

Resources should be made available to promote this type of planning work to the broader community to negate any duplication of effort either within the community or within other ministries. E.g. Resources to market the study recommendations and gain support for implementation plan or promoting how training makes a difference to lives of people in the community.

Also advise Ministry of Health that this work is being undertaken to minimize duplication of efforts and gain support and additional resources for implementation e.g. pilot models.

Employment Ontario (EO) agencies should be directed to support implementation activities as part of their work plan by MAESD in order to ensure that clients are not missing out on potential entry/mid-level opportunities.

RECOMMENDATION 10: Promote the Health Care Sector to former workers Upon the completion of the PSW training alignment initiative, embark on an aggressive marketing campaign to re-engage former disgruntled workers and highlight newly created advancement opportunities.

This type of short term training could provide employment opportunities to those in non-traditional labour pools e.g. refugees.

Support employer access to financial training subsidies through Canada Ontario Job Grant (COJG).

18

A Workforce Development Strategy for the Health Care Sector in Waterloo Wellington Dufferin

ACTION PLAN UNSTRUCTURED INDUSTRY Key Activities

Start Time-frame

Anticipated Completion

Lead/Co-Leads

ACTION 1: Establish Local Health Care Employment Task Force (LHCETF) 1.1 I dentify who the members of the Short term Task Force should be to ensure 0-3 months representation of industry, labour, education and Employment Service providers.

On-going

WPBWWD

12 â&#x20AC;&#x201C; 18 months

WPBWWD, LHCTEF

1.2 Establish the roles and responsibilities of the Task Force 1.3 H ire a Project Manager to coordinate Task Force activities 1.4 O nce in place, Task Force to review Action Plan and fine tune priorities based on available resources 1.5 Task Force/Staff Coordinator to advocate for PSW NOC review 1.6 M arket Health Care Sector employment opportunities ACTION 2: PSW Mapping and Alignment Project 2.1 D etermine the organizations that need to contribute to and agree on a new PSW training structure

Short term 3-6 month

2.2 C reate a working group with leadership from the LHCETF 2.3 Identify minimum employer standards/requirements 2.4 Map existing training and employment routes 2.5 D evelop and implement acceptable model and training for PSW 2.6 Promotion of available training e.g.

COJG and Second Career.

Building The Health Care Workforce From The Ground Up

19

RECRUITMENT Key Activities

Start Time-frame

Anticipated Completion

Lead/Co-Leads

ACTION 3: Promotion of Entry to Mid-Level Careers in Health Care 3.1 I dentify organizations/institutions who host career fairs to seek opportunities for collaboration

Short term 0-3 months

On-going

WPBWWD

12-18 months

LHCETF

3.2 H ost various careers fairs across the region to promote current opportunities 3.3 I dentify gaps in available career resources and update existing but outdated career materials 3.4 Marketing of opportunities to Employment Ontario agencies, other agencies, second career clients, and potential workers through presentations, workshops, etc.

3.5 D evelop local industry branding for use across the region ACTION 4: Review SHSM Health and Wellness Curriculum 4.1 S trengthen focus on entry to mid level Health Care occupations and front-line care opportunities

Medium term 6-12 months

4.2 P rovide additional experiential learning opportunities for Health Care SHSM students through tours, volunteer opportunities and co-op opportunities.

20

A Workforce Development Strategy for the Health Care Sector in Waterloo Wellington Dufferin

RETENTION Key Activities

Start Time-frame

Anticipated Completion

Lead/Co-Leads

ACTION 5: Employer PSW Consortium Pilot Project 5.1 Review existing staffing models 5.2 R eview best practices, investigate flexible scheduling options including technology/apps, scheduling, location

Medium term 6-12 months

12-18 months

WPBWWD, LHCTEF

5.3 I dentify key pilot employer participants ACTION 6: Develop a Mental Health and Wellbeing Strategy for Health Care workers 6.1 C onduct an environmental scan of current best practices

Medium term 6-12 months

12 months

WPBWWD, LHCTEF

Medium term 6-12 months

On-going

WPBWWD, LHCTEF

6.2 I dentify key elements 6.3 Develop a strategy ACTION 7: Employee appreciation campaign 7.1 D etermine what would most make Health Care workers feel valued 7.2 C reate messages, posters videos and media to show appreciation for workers in the Sector

Building The Health Care Workforce From The Ground Up

21

TRAINING Key Activities

Start Time-frame

Anticipated Completion

Lead/Co-Leads

ACTION 8: Develop a technology training plan 8.1 Review existing on-site and remote communication devices and technology used across the region

Medium term 6-12 months

6-12 months

8.2 I dentify potential new application 8.3 Incorporate literacy and computer use upgrading into training modules

WPBWWD, LHCTEF Potential partners: Ontario Community Colleges and Private Career Colleges

8.4 Develop and implement a shared training model ACTION 9: Develop and deliver cultural awareness and diversity training 9.1 C onduct an environmental scan of current best practices in cultural awareness and diversity training

Medium term 6-12 months

12 months

WPBWWD, LHCTEF

On-going

Conestoga College

9.2 I dentify key elements 9.3 Develop a strategy ACTION 10: Expand supportive worker training program 10.1 R eview infrastructure for offering inhome practicum

Short term 0-3 months

10.2 Identify employers willing to upgrade workers hired at this level 10.3 P romote program to EO and other agencies assisting clients in nontraditional labour pools

RE-ENGAGEMENT Key Activities

Time-frame

Anticipated Completion

Lead/Co-Leads

ACTION 11: Develop a marketing campaign for former Health Care workers 11.1 U pon completion of Action 2, develop marketing material and promote to EO service providers.

22

Long term

A Workforce Development Strategy for the Health Care Sector in Waterloo Wellington Dufferin

PARTICIPATING ORGANIZATIONS Agilec

Mavencare

Arbour Family Medical Centre

Medix College

Avalon Care Centre

Nurse Next Door

Bayshore Home Health

Paramed

Bethsaida Retirement Home

Parents for Community Living

Care Partners

Peace of Mind Care

CBI Home Health

PSW Ontario

City of Kitchener

Schlegel Villages

Closing The Gap

Seniors for Seniors

Community Care Concepts

St. Joseph’s Health Centre

Conestoga College

St. Louis Adult Learning Centre

Dufferin Oaks

St. Luke’s Place

East Wellington Community Services

Sunbeam Centre

Georgian College

Therapeutic Recreation Ontario

Guelph General Hospital

Traverse Independence

Guelph Independent Living

Tri-County Mennonite Homes

Home Instead Senior Care

Upper Grand District School Board

Immigration Partnership Waterloo

Wellington Terrace LTC

Independent Living Centre of Waterloo Region

Therapeutic Recreation Ontario

Jarlette Health Services

Secord Trails Care Community

Focus Group Participants (37) Waterloo – 18 Wellington- 4 Dufferin – 15

Building The Health Care Workforce From The Ground Up

23

APPENDIX A HEALTH CARE EMPLOYER INPUT On-line Survey – October 2017 EmployerOne - January 2017 October 2017 – 18 Respondents, 9,915 workers represented January 2017 – 28 Respondents, 4,376 workers represented

Types of Employment

Separations October Survey: 94% of businesses had separations in the last year Total Separations last year = 1,788 73% of dismissals were entry-level positions • 82% of all separations were quits

High number of quits

• 15% of all separations were dismissals • 3% of all separations were retirements Separations - October Survey

January Survey: 59% of businesses had separations in the last year Total Separations last year = 343 • 78% of separations were quits

24

A Workforce Development Strategy for the Health Care Sector in Waterloo Wellington Dufferin

Hires October Survey: 100% of businesses hired last year Total hires last year = 1,776 â&#x20AC;˘ 78% of hires were entry-level positions â&#x20AC;˘ 72% of hires were part time

Entry-level and part time positions are in demand

January Survey: 82% of businesses hired last year

Positions Hired Last Year October Survey

January Survey

Position

Number

Personal Support Workers

666

Personal Care Attendant

120

Registered Practical Nurse

62

Caregiver

Position

Number

Personal Support Workers

152

Health Professionals (Nurses/Paramedics)

90 31

50

Registered Nurse / Registered Practical Nurse

Community Living Aide

40

Support Coordinator

15

Attendant Services Workers

25

Food Service Worker

8

Food Service Worker

17

Cook, Dietary Aides

7

Assistant Support Provider - Direct Support Professional

10

Administration

4

Medical Receptionist

4

Home Makers

10

Executive Director / Administrator

3 3

Nutrition Services Worker

6

Developmental Services Workers

5

Maintenance, Lifestyles and Food Service Manager

Terrace Aide

5

Mental Health Clinician

3

Administrative Positions

4

Community Youth Worker

2

Registered Nurse Manager

4

Occupational Therapist

2

Medical Receptionist

3

Physiotherapy Assistant

2

Client Service Coordinator

2

Pretesting

2

Community Facilitator

2

Clinical assistant

1

Senior Support Provider - Manager

2

1

Clerical

1

Communications and Program Coordination

Community Engagement Coordinator

1

Customer Service Coordinator

1

Community Support Worker

1

Dental Assistant

1

Direct Funding Coordinator

1

Dental Receptionist

1

Director of Client Services

1

Director of Admissions

1

Manager, Community Support Services

1

Health Links Manager

1

Outreach Worker

1

Optometric assistant

1

Summer student

1

Physician Assistant

1

Total

1,041

Total

Building The Health Care Workforce From The Ground Up

337

25

Skills and Certifications Sought

Hard to Fill Positions

October Survey

October Survey:

Top 5 Hard Skills

100% of businesses had hard to fill positions

1.

Ability to read

Very basic skills are in demand

2. Ability to write

Top 5 Hard to Fill Entry-level Positions

3. Ability to use computer

1.

4. Ability to use software

2. Registered Nurse

5. Case management/charting

3. Food Services Worker

Personal Support Worker

4. Care giver/Home maker

Top 5 Soft Skills 1.

Businesses have difficulty hiring

5. Administrative Assistant

Team work

2. Conflict resolution

Top 5 Hard to Fill Mid-Level Positions

3. Customer Service

1.

4. Problem solving

2. Registered Practical Nurse

5. Time management

3. Food Services Worker

Top 5 Certifications 1.

Personal Support Worker Certificate

2. Registration in Nursing (RPN or RN)

Personal Support Worker

Most difficult to fill: PSWs, RPNs and food service workers

4. Cook PSW Certificate most mentioned certification needed

5. Human Resources/Admin Assistant Top Hard to Fill Highly-Skilled Positions

3. Food Service Worker Certificate

• Registered Practical Nurse

4. Medical Office Administration

• Director of Client Services

5. Social Worker

• Maintenance Manager

Recruitment

Reasons Jobs Were Hard to Fill - October Survey

Locally – 100% Employers do not get enough applicants with qualifications applying for positions

Regionally – 28% Provincially – 6% Nationally – 6% • Only 2% used a paid recruitment agency • 17% used immigration services

Findings consistent with January Survey

26

A Workforce Development Strategy for the Health Care Sector in Waterloo Wellington Dufferin

Anticipated Hires October Survey: 89% plan to hire in the next year (a total of 628 positions).

Employers plan to hire to fill vacancy and expansion needs

Reasons for Hires Positions

Total Hires

Retirements

Fill a Vacancy

Expansion

Other

Managers in health care

5

25%

50%

0%

25%

Medical administrative assistants

9

50%

50%

0%

0%

Nursing coordinators and supervisors

2

50%

0%

50%

0%

37

40%

60%

0%

0%

2

100%

0%

0%

0%

Licensed practical nurses

49

20%

60%

10%

10%

Nurse aides, orderlies and patient service associates

119

0%

86%

14%

0%

Other assisting occupations in support of health services

23

0%

100%

0%

0%

382

0%

78%

22%

0%

Registered nurses and registered psychiatric nurses Allied primary health practitioners

Home support workers, housekeepers and related occupation January Survey: 77% plan to hire in the next year.

Rating of Qualified Workers in the Area October Survey:

The overall rating of qualified workers in the area is low

No respondents rated the availability of qualified workers in their area as excellent.

Building The Health Care Workforce From The Ground Up

27

Training Available

Private Colleges/Trainers • Computer Skills, Documentation

October Survey • 82% feel that there is available training adequate to the meet the needs of existing employees

There are significant training gaps, especially related to new and future employees

• 59% feel that there is currently available training adequate to the meet the needs of new employees • 41% feel that there is currently available training adequate to the meet the needs of future employees

• Consistency with training requirements to produce qualified graduates • Funded PSW program, lifts and transfers, mental health, wound care, boundaries education • more long-term care training • More preparation of PSW’s for home care • PSW training

• 76% of businesses feel there is a GAP in available training

• same as above

Training Needed

Internal Industry Training Modules

• Telus Practice Solutions

• PSW training

October Survey Community College/University • Additional cooperation with receiving organizations so that graduates can access jobs efficiently when being hired • Behavioural Management, Training on Acquire Brain Injuries

Others • Earlier introductions to health services - in high schools • Funders should recognize training expenses and it should meet industry standards for all positions being funded

• Graduates should be equipped with all necessary certifications/training needed in order to obtain employment after graduation. In saying that I don’t expect Educators to be responsible after the first year of graduation • more focus on the different populations that can be served in nursing/support work. Feel like the focus on developmental services is non-existent • more long-term care training • More preparation of PSW’s for home care • PSW training • Telus Practice Solutions

28

A Workforce Development Strategy for the Health Care Sector in Waterloo Wellington Dufferin

APPENDIX B Top Jobs by Number of On-line Postings by National Occupation Classification (NOC) We are well aware that many more jobs are not posted on-line than are posted on-line however looking at the types of jobs currently being posted is a potential indicator of where demand is highest. The number of job postings indicated in the table below list only those positions listed on-line and so this type of data can only be used as an indicator as to the types of jobs available.

Many jobs in the sector are posted internally and often one posting can account for many positions. e.g. one ad posted for Nurse aide but employer is actually hiring to fill 20 Nurse aide positions.

Name

NOC

Jan-Jun 2017

Jan-Jun 2016

Nurse aides, orderlies and patient service associates

3413

229

246

Registered nurses and registered psychiatric nurses

3012

171

160

Other assisting occupations in support of health services

3414

123

148

311

91

93

Medical administrative assistants

1243

82

83

Massage therapists

3236

80

97

3411

78

90

Managers in health care

Dental assistants Nursing co-ordinators and supervisors

3011

67

37

Dental hygienists and dental therapists

3222

63

64

3131

52

43

Inspectors in public and environmental health and occupational health and safety

2263

48

43

Licensed practical nurses

3233

43

50

Family, marriage and other related counsellors

4153

33

55

Physiotherapists

3142

31

39

Health information management occupations

1252

20

11

Animal health technologists and veterinary technicians

3213

20

14

Medical laboratory technologists

3211

18

11

Medical laboratory technicians and pathologistsâ&#x20AC;&#x2122; assistants

3212

17

18

Opticians

3231

17

32

Psychologists

4151

16

8

411

12

17

Occupational therapists

3143

10

13

Other professional occupations in health diagnosing and treating

3125

9

7

Pharmacists

Government managers - health and social policy development and program administration

Building The Health Care Workforce From The Ground Up

29

Name

NOC

Specialist physicians

Jan-Jun 2017

Jan-Jun 2016

3111

8

11

3132

8

7

Audiologists and speech-language pathologists

3141

8

6

Cardiology technologists and electrophysiological diagnostic technologists, n.e.c.

3217

8

3

Other medical technologists and technicians (except dental health)

3219

8

5

Health policy researchers, consultants and program officers

4165

8

5

3113

7

3

Dental technologists, technicians and laboratory assistants

3223

7

11

Medical sonographers

Dietitians and nutritionists

Dentists

3216

6

4

General practitioners and family physicians

3112

5

12

Veterinarians

3114

5

2

Other professional occupations in therapy and assessment

3144

5

14

Medical radiation technologists

3215

5

6

Other technical occupations in therapy and assessment

3237

5

8

Paramedical occupations

3234

4

3

Allied primary health practitioners

3124

3

1

Respiratory therapists, clinical perfusionists and cardiopulmonary technologists

3214

3

13

Court reporters, medical transcriptionists and related occupations

1251

2

0

Chiropractors

3122

2

2

Practitioners of natural healing

3232

2

2

Receptionists

1414

1

0

Optometrists

3121

1

2

1,441

1,522

Total Source: Talent Neuron

30

A Workforce Development Strategy for the Health Care Sector in Waterloo Wellington Dufferin

APPENDIX C

Building The Health Care Workforce From The Ground Up

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Workforce Planning Board

of Waterloo Wellington Dufferin

Partnership Agreement Between The Workforce Planning Board of Waterloo Wellington Dufferin (Planning Board) and

f)1{;(?.A--P�nc t7�1) o/\l

or.Ji'ft/U o (�izatft:Jm"Name"S'), herein referred to as The Partner(s)

This Partnership Agreement (PA) outlines the responsibilities and expectations of each partner in the effort to support local Health Care Sector Workforce Initiatives identified in the Health Care Sector Workforce Development Strategy 2017-2020.

Accordingly, The Planning Board and its Partner agree to the following: I. Background

Workforce Planning Board of Waterloo Wellington Dufferin's Vision, Mission and Mandate

Vision: We envision the continuous development of a leading-edge workforce.

Mission: Engage partners to find solutions to local workforce development needs.

Mandate: To act in partnership with all sectors of our community including Business, Labour Education/Trainers and Community Representatives to collaboratively develop solutions to address labour market needs. The Workforce Planning Board serves all of Waterloo Region, Wellington County and Dufferin County.

Health Care Sector Workforce Development Strategy: The Planning Board has long recognized that significant challenges and opportunities are facing the local health care sector. In June 2017, the Planning Board had an opportunity to submit a proposal to the Ministry of Advanced Education and Skills Development (MAESD) to develop a new workforce strategic plan specifically for the local health care sector in Waterloo Wellington Dufferin under their Sector Specific Partnerships Grant (SPPG). This project has Conestoga College, Institute of Advanced Learning as its key partner.

Starting in late August 2017, this initiative, completed in November 2017, has resulted in an action plan which will provide guidance and direction to Ontario's provincial government regarding how best to support investment in local health care workforce development priorities in the immediate future.

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A Workforce Development Strategy for the Health Care Sector in Waterloo Wellington Dufferin

Workforce Planning Board of Waterloo Wellington Dufferin

Ill. Purpose of the Agreement This PARTNERSHIP AGREEMENT recognizes both parties commitment to addressing the challenges of projected shortages of qualified workers in the local healthcare sector by working to implement the actions identified in the Health Care Workforce Development Strategy 2017.

IV. Scope and Duration This PARTNERSHIP AGREEMENT is at-will and between The Planning Board and The Partner. This PARTNERSHIP AGREEMENT shall become effective upon signature by the authorized officials from The Planning Board and The Partner(s) and will remain in effect until modified or terminated by any one of the Partners. This PARTNERSHIP AGREEMENT shall end on November 12, 2020.

V. Responsibilities

Based on the availability of resources to conduct this work, The Partner agrees to participate in the planning, implementation, and evaluation of the Healthcare Sector Workforce Development Strategy. The Partner has agreed to commit to this PARTNERSHIP AGREEMENT and shall: • • • • • •

Contribute time to prepare for and attend meetings or participate in calls with other Planning Board partners on this initiative as required Contribute use of meeting room facilities and equipment if or where available Assign staff to project working groups if necessary Maintain confidentiality Provide written support to funding applications by The Planning Board or other partners to carry out the work detailed in the Health Care Workforce Development Strategy 2017 and other initiatives which may be identified during the course of this PARTNERSHIP AGREEMENT; Retain responsibility and liability for the actions of their staff

VI. Communication Communications will be coordinated by the Planning Board and will take place through various methods including face to face meetings and/or conference calls on a quarterly basis.

VII. Accountability Process and Problem Solving The Partner will participate in the joint evaluation of how the partnership is working including its progress towards meeting the established goals. The Partners are committed to open communication with each other to address areas for improvement.

VIII. Addition of New Participating Partners Project Partners may from time to time recommend additional partners. If the invited Partners agree to participate, then they will be required to sign a copy of this PARTNERSHIP AGREEMENT. IX. Termination of this Agreement This agreement shall terminate on November 12, 2020. Each Partner reserves the right to withdraw earlier upon giving the Planning Board 30 days' written notice of its decision.

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Workforce Planning Board

of Waterloo Wellington Dufferin

X. Extension of this Agreement This agreement may be extended after the termination date upon mutual agreement by all member Partners.

XI. Signatures The signatures of the designated representative of The Partner below represents The Partner's commitment to participate actively in the collaboration and implement all elements of this agreement.

The Workforce Planning Board of Waterloo Wellington Dufferin: Carol Simpson 218 Boida Ave, Unit 5 Ayr, ON, NOB lE0 Tel: 519-622-7122 carol@workforceplanningboard.com

Partner: Therapeutic Recreation Ontario Rozalyn Werner-Arce 20-850 King Street East Oshawa, ON L1K2V6 Tel: 289-626-8761 x.1 email ed@trontario.org

Signed:

Name: Carol Simpson

Date:

Title: Executive Director

On behalf of Partner

42

Signed:ďż˝#

Name: Rozalyn Werner-Arce

Date:

Title: Executive Director

November 23, 2017

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