Report: Advancing the Home Care Workforce

receive annual dividends, and are encouraged to take leadership roles. They also have guaranteed employment upon training completion and are offered full-time hours and benefits – factors associated with HCW job satisfaction and retention. 4.5. Sustainability Many of the programs we identified in this national scan are no longer active or appear inactive based on web searches that did not provide evidence of their current operation. This includes all grant-funded programs for which the initial grant funding period (usually 1-3 years) ended. However, a handful of enduring programs have employed alternative funding mechanisms, providing valuable lessons in funding and planning for program sustainability. Instituted in 1995, the Massachusetts Supportive Home Care Aide program is a state-based initiative codified in regulations of the commonwealth’s Executive Office of Elder Affairs. As such, it is an employer-recognized and client-sought advanced HCA role, with about 70% and 50% of agencies offering Supportive Home Care Aide services in Alzheimer’s care and mental health, respectively. 49 Since the 1980s, Cooperative Home Care Associates of NY, has embraced investing in workforce training and development as part of their “worker-centric” business model and bottom line. While the agency has used private foundation funding for program design and implementation efforts in the past, ongoing costs associated with workforce development, such as the salaried peer mentor position, are built into the business’s operating budget. However, program leaders acknowledge the cost necessitates other staff hiring restrictions (personal communication, April 20, 2021). Similarly, agencies that partnered with PHI to implement the Care Connections Senior Aide Project (NYC) and that which ran the Jewish Home Lifecare Peer Mentor Aide program (NYC) demonstrated a commitment to honoring the advanced roles created under pilot program funding by retaining workers at their increased salary levels. Washington’s SEIU Healthcare NW Training Program represents arguably the most progressive and sustainable funding model. Through a collective bargaining agreement, most program revenue comes from participating employers, which includes the State of Washington. This revenue funds administrative costs and state certification for home care aides; students do not have to pay for tuition, materials, or testing fees. The partnership remains a thriving, broad-scale, and sustainable model nearly 15 years after it started. In addition to offering basic and advanced training opportunities to almost 50,000 HCAs each year, in 2014, the partnership announced plans to expand its apprenticeship model nationwide and founded a multi-stakeholder collaborative to plan the effort. 4.6. A Strong Evaluation Plan Evaluations of programs that aim to advance the home care workforce present an opportunity to build the evidence base for the meaningful impacts they can have on workers, clients,

21