The following case study is adapted from the report Centers for Medicare and Medicaid Services (CMS) Direct Service Workforce Demonstration Promising Practices in Marketing, Recruitment and Selection Interventions. The report was prepared by the University of Minnesota, Research and Training Center on Community Living in partnership with The Lewin Group.

 “The Kentucky grantee developed the Support Providing Employee’s Association of Kentucky (SPEAK) project, which brought together eight employer agency members and their DSWs. One of SPEAK’s primary initiatives is to provide a pre-service orientation to prospective job candidates—a kind of realistic job preview (RJP) that occurs before an individual is hired. In this partnership, each agency member continues to market and recruit applicants using strategies of their own choosing. Once an agency finds a prospect, they conduct an initial interview. If they are still interested in the job candidate after the interview, they refer the individual to SPEAK to participate in the RJP. The RJP is delivered in person by the SPEAK project coordinator, an employee of one of the lead organizations in the project. The session lasts up to 5 hours and includes three components—an initial visit with the SPEAK coordinator, a site visit, and a family visit. The RJP session and experience is extremely informal by design, to increase the comfort level of the prospective employee. Prospective employees are given a $50 cash payment at the completion of the session.

 

Nearly all of the partnering organizations participate in the RJP aspect of Kentucky’s demonstration project. A few partners already had RJPs in place before the project began. When one of these organizations is considering an applicant, they usually refer them directly to the family visit part of the SPEAK RJP.

 

The RJP session typically begins at the coordinator’s office, where he and the prospect “visit and chat” for about 15 minutes. During this time, the prospect is told what to expect and the purpose of the RJP, i.e., to help applicants make informed choices, reduce turnover, and improve the quality of support received by consumers.

 

The site visits are conducted in both residential and employment settings. The job candidate is given the opportunity to ask existing DSWs questions about their work. Topics frequently discussed include the highs and lows of the work, any incentives in place within the organizations to encourage DSWs to work hard, the extent to which upper management is supportive of DSWs and their decisions within the organization, the realities of reimbursement and raises, and the most difficult aspects of the work. Job candidates observe DSWs working on site.

 

Each candidate participates in a family visit, when possible, with a family that receives services from the organization in which the prospect is applying for a job. A pool of 30 families volunteered to participate in these visits and they were trained in the purpose of the family visits and what to expect. The family describes the disability of their loved one, how it affects the lives of their family members, why they chose the agency, what they like about the agency, and what they feel could be improved upon. Families also share their perspectives concerning how the agency supports direct care staff. The RJP coordinator tries to facilitate questions that will expose the pressures DSWs feel when they work for a particular family and organization (e.g., long work hours).

 

Finally, the job candidate and RJP coordinator conduct a debriefing and the candidate completes a response form that asks what they learned during the session (e.g., challenges of the job, aspects of the job the prospect will enjoy, attributes the prospect feels will make them good at direct support). This form is sent back to the prospective employer. In addition, the RJP coordinator sends an objective report to the prospective employer, based on his observations of the candidate’s behavior and response to the RJP. No recommendations for employment are made in the report, but it is used by the employer organization to determine whether a second interview will be offered, and whether they ultimately hire the prospect.

 

The RJP has been beneficial to the participating organizations in screening out applicants for whom the job would not have been a good match. About 10 percent of prospects who complete the RJP have opted not to consider the job. Another 10 percent are not hired by the agency following the RJP. Of those that are hired, 93 percent are retained at the end of first 3 months.

 

Obtaining the support and cooperation of all partnering organizations has been a challenge for the Kentucky grantees. Development of the RJP took time because the SPEAK coordinator needed to learn about how each organization marketed, recruited, and selected employees. Once the intervention was designed, the agencies had to agree to incorporate this process into their organization’s hiring process. Partner meetings were spent discussing and refining the purpose, value, and process of the project intervention. Once “buy-in” was obtained for the pre-service orientation, the implementation process moved forward.”