The Commonwealth of Massachusetts initiated the Extended Care Career Ladder Initiative
(ECCLI) as part of a broader Nursing Home Quality Initiative, adopted by the Legislature in 2000.
This legislation is a response to high turnover and vacancies among paraprofessionals in
long-term care, creating instability that threatens quality and access to health care.
Basic to these initiatives is the equation of good care for consumers with good jobs and
opportunities for frontline caregivers. Thus it asks long-term care providers to partner with
other organizations (including community based groups, unions, work force development
agencies, community colleges, and other long-term care providers) to mount demonstration
projects that offer insight into new care-giving and workplace practices that improve the
quality of care and the quality of jobs. These projects should also demonstrate how the
accomplishment of care giving and workforce quality goals can be mutually reinforcing.
Sponsors hope that such projects will offer clear and replicable models for both the
long term care industry, and the workforce development community that supports the industry
and its potential and existing labor force.
ECCLI'S overall program goal is to promote systemic change and build capacity
within the long-term care and work force development communities in support of the
following goals and objectives: (1)Improve quality of care; (2) Promote skill development;
(3) Create and institutionalize career ladders and other workplace practices that
support and develop workers; and (4) Improve employee retention.
The attached baseline evaluation report is presented as a working paper for the information
of researchers and practitioners in the field of nursing home quality and workforce development.
It covers the period from March 2001 to June 2001 when the ECCLI program was getting
underway, and was submitted to the Commonwealth Corporation of Massachusetts, the
quasi--public agency that is administering the funds from the Nursing Home Quality
Initiative. Future reports will analyze data collected by the researchers after this baseline and
Major findings include insight into the process of forming consortia across unfamiliar realms of
human services (health care and workforce development and education), and challenges for the
participants as they consider and implement organizational change as well as training
programs for frontline workers as well as supervisors.