Report: Advancing the Home Care Workforce

3.1.

Worker Outcomes

Most of the evaluations we identified assessed program impact on HCWs, with outcomes that included program satisfaction, knowledge and skills, wages, and employment status. Findings were consistently positive across program models. Four programs in our scan that included upskilling approaches reported positive learning or competency gains. HCWs in St. John’s Enhanced Home Care Pilot Program (CA) reported improved ability to perform more highly skilled paramedical tasks and medication management. HCAs in the Care Team Integration of the Home-Based Workforce Pilot Program (CA) passed at least 80% of their demonstrated competency checks. The Family Care Advocate Training for Experienced Aides (AR, CA, HI, TX) program evaluation found that participants were more likely to report learning stress reduction techniques and skills specific to caring for patients with cognitive impairment than a control group. Scores on post-tests measuring knowledge gains for BTBQ (MI) trainees who attended the program’s dementia in-service also increased significantly compared to pre-test scores (92% vs. 82%). Four programs identified in our scan assessed program impact on HCW wages or employment. Graduates of the Family Care Advocate Training for Experienced Aides (AR, CA, HI, TX), an upskilling program for HCAs focused on chronic disease management, communication, and care coordination, self-reported working more hours per week (42 vs. 39) and earning higher wages (average of $9.37/hour vs. $8.96/hour) than a comparison group of trainees. Peer mentor aides from the Jewish Home Lifecare Peer Mentor Aide Program (NYC) for HHAs worked significantly more hours per week than other aides at the organization (40 vs. 28). An analysis of HCWs in Massachusetts found that wages rose with more advanced positions; Supportive Home Care Workers, who specialize in mental health or Alzheimer’s care, earned a starting wage and average hourly wage higher than all other HCWs. 49 Lastly, Care Connections Senior Aides’ (NYC) salary increased by 60 percent for HHAs compared to entry-level wages of HCWs. 3.2. Client Outcomes Of the programs we identified that examined client health or well-being outcomes, all reported positive findings. Most of the programs that assessed client outcomes were focused on both upskilling and care team integration. Two programs examined hospitalizations or ER visits as outcomes. The Care Team Integration of the Home-Based Workforce (CA) evaluation was a two-part intervention that included training PCAs to keep clients safe and healthy at home and integrating them on the client’s care team. Using data from six health plans, the study found that the program was associated with reductions in client hospitalizations and emergency room visits at one and two years after worker training was implemented. The rate of reduction of hospitalization utilization was greater than

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