Perspectives of the Community Choice Counselors: Report on a Focus Group
Executive Summary
Overview
As part of our evaluation of the Senior Initiatives in general and the Community Choice Counseling program in particular, the Rutgers Center for State Health Policy conducted a focus group with ten Community Choice Counselors, addressing role perception, program elements, and implementation issues.
Purpose
The focus group had a dual purpose: 1) to understand program functioning from the point of view of the Counselors, the front-line workers, and 2) to utilize this information to help focus future research on the program and the Senior Initiatives more generally.
Method
The focus group was conducted on September 13th with ten counselors selected by the program director to reflect staff heterogeneity. To focus the discussion, counselors were presented with a written list of questions developed with feedback from program management and from a previous discussion with the counselors not participating in the focus group. While the questions helped guide the discussion, it was open to other topics as well.
Results /Conclusions
Community Choice Counselors take pride in their work and see their core role as the four intertwined tasks of providing hope, choice, education, and advocacy for clients. Counselors see themselves as differing from nursing home social workers in terms of perspective, interests, and the time they can spend with a client. Although their primary goal is to help residents leave the home, they recognize that there are some residents whom they need to caution about this.
Counselors noted some significant obstacles, including: 1) their dependence on the county Welfare Boards, 2) opposition by some nursing homes, 3) the resistance of clients' families, and 4) insufficient access to appropriate living situations - especially Senior Subsidized Housing and Assisted Living Residences. Hard-to-serve populations are those on Medicaidseeking ALR slots, those with psychological impairment, and those just over the Medicaid income cap.
Counselors gave high marks to the Community Choice Counseling program for its continual reevaluation and improvement, the quantity and quality of training, and the cohesiveness and support among the counselors. They expressed a need for more fieldbased training, and commented on difficulties in keeping up with the rapid changes in the program.