A large proportion of the health and social service workforce is comprised of direct care workers who have no formal preservice education and receive a limited amount of on-the-job training. These workers are essential in all geographic areas and are especially critical in rural and frontier regions where access to advanced health care professionals is limited. Driven by stakeholder demand, the State of Alaska launched the multiyear Alaskan Core Competencies initiative to strengthen the training of its direct care workforce. This article details the development of a set of cross-sector core competencies relevant to workers in the fields of mental health, addictions, developmental and physical disabilities, and the long-term care of older adults. Also described are the related assessment tools, curriculum, and train-the-trainer learning communities, which were developed to enable the dissemination of the competencies. The authors conclude by discussing the growing interest nationally in competencies for this workforce, the challenges of adapting one set of competencies for varied jobs in diverse health and social service sectors, and the financial barriers to widespread adoption of competency-based worker training.
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