Report: Advancing the Home Care Workforce


Care Team Integration

Several of the programs we identified that created formal advanced roles and enhanced training opportunities for HCWs also worked to integrate them into clients’ health care teams. Despite the recognized complexities and challenges associated with care team integration noted in program evaluations, the model offers some of the strongest evidence available that optimizing the roles of HCWs can improve client health and well-being outcomes and lead to associated health care cost savings. 4.4. Stakeholder Engagement Overwhelmingly, strong partnerships and stakeholder engagement were credited by program leaders as a key component in program planning, implementation, sustainability, and evaluation. Stakeholder groups commonly cited across the programs we reviewed included state agencies, community colleges, non-profits, and higher education institutions (see Appendix 4). These entities played roles in curriculum development, training facilitation, and data-driven program assessment. For some programs, such as the Advanced Home Health Aide initiative (NY), the Care Team Integration of the Home-based Workforce (CA), and several of the PHCAST demonstration projects, multi-disciplinary stakeholder advisory groups were convened to guide program efforts and leverage resources for statewide program models. Two stakeholder groups rose to the top in the literature as crucial to fostering program success: employers and workers. Several of the programs we identified were employer-based (implemented at-home care agencies for their workers), often collaborating with training partners like PHI. In other examples, employer engagement was recognized as an important facilitator of training program scalability and built into the program design. In Building Training…Building Quality (BTBQ; MI), employer engagement was actively sought to garner program recognition and buy-in by attendance at employer meetings and the distribution of communications materials. Employer agencies were also provided a list of BTBQ program graduates to aid them in identifying and hiring highly qualified candidates. Home care worker engagement has informed training program designs, evaluations, and even employer business models. In designing the Massachusetts Supportive Home Care Aide curriculum, for example, project consultants conducted focus groups with workers, using their feedback to help in developing a training curriculum that was not only evidence-based but worker-supported. 53 From an evaluation perspective, most of the assessed programs included worker perceptions and reactions as part of their assessments, including satisfaction with training and feedback on how to improve them. In the most detailed example of engaging HCWs to enhance training opportunities and provide high-quality jobs, Cooperative Home Care Associates of NY represents a worker-owned home care agency. Worker-owners have majority voting rights,


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