Report: Advancing the Home Care Workforce

4. Emerging Best Practices Our literature review revealed a range of program models that serve to elevate and advance the roles of HCWs. Although there was variation in individual program characteristics, several standard core components central to effective planning, implementation, and evaluation were observed. Interviews with 12 experts, some of whom were also stakeholders, supplemented the review and allowed us to identify areas of consensus around “best practices” in designing training programs for advanced roles of HCWs (see Appendix 3 for list of interviewees). We discuss these below and summarize them in Table 4. Table 4: Summary of Emerging Best Practices • Worker Respect and Wage Recognition: Programs that created formal advanced roles for home care workers commonly acknowledged their advanced training and professional development with a promotion, wage increase, and other benefits. • Multiple Pathways for Advancement: Rather than a “one size fits all” or “one and done” approach, programs that offer multiple pathways or career lattices for professional development and career advancement appear to be more successful. • Care Team Integration: Integrating home care workers into the broader healthcare team appears to optimize workers’ roles and result in positive client health outcomes. • Stakeholder Engagement : Involving a diverse group of stakeholders - including employers and home care workers themselves - in program design, implementation, and evaluation facilitates program success and buy-in, which may help make programs more sustainable. • Planning for sustainability: Program sustainability is inextricably linked with funding. State- sponsored programs are more sustainable, though foundations have been able to get buy-in from employers to retain advanced role positions created out of initial grant funding. • Strong Evaluations: The ability to demonstrate program effectiveness and gain continued buy- in from stakeholders is linked to the strength of program evaluations. Research savvy evaluation partners can aid in rigorous evaluation planning and execution. • Addressing Equity and Socioeconomic Factors: Home care workers represent inherently marginalized populations and face multiple socioeconomic factors. Efforts to address equity in program designs can increase access to training and professional development opportunities for workers. • Training Approach: Train-the-trainer models, competency-based curricula, and adult learner- centered training methods that emphasize interactive, practical learning opportunities are preferred home care worker training elements, although experts agree that COVID-19 may have opened an opportunity for on-demand distance learning.

18