Report: Advancing the Home Care Workforce

employers, health systems, and other stakeholders. Important lessons gleaned from the evaluation components of programs identified in the national scan include working with partners to develop and execute strong evaluation designs and including outcomes measures that have the potential to demonstrate an ROI for employers and health systems. Concerning the former, many programs noted the value of partnering with experienced third-party researchers to design and conduct evaluations. In most cases, university partnerships were solicited for evaluations, while private-sectorconsultants such as the RAND Corporation® were utilized in others. We observe that these evaluation partners commonly employed rigorous study designs, included comparison groups in their analyses, and in some cases, published results in peer-reviewed scholarly journals. PHI notes that data linking worker advancement approaches to client and health systems outcomes can leverage worker training and compensation adjustments. 17 While many programs we identified did not include these outcomes in their evaluations, those that did all reported positive findings, as discussed in the prior chapter. These programs may represent promising practices in evaluation design and data sharing. For example, the Care Team Integration of the Home-Based Workforce pilot program (CA), with evaluation partner UCSF, included multiple client outcome measures in the evaluation design, including healthcare utilization data obtained from clients’ health plans. This objective data was used to demonstrate marked decreases in client ER visits and hospitalizations post-program implementation and were further used to demonstrate significant potential health care cost savings. The Homecare Aide Workforce Initiative (NYC) represents the only program we identified that demonstrated the potential of workforce training benefits for employers using objective retention measures. Third-party program evaluators used payroll data to demonstrate increased retention among trainees compared to a comparison group. Despite the recognized challenges associated with obtaining proprietary or third-party data, the programs included in our scan that were able to do so provide persuasive evidence for their effectiveness. 4.7. Addressing Equity and Socioeconomic Factors There was broad recognition of the socioeconomic barriers HCWs face across the programs we assessed. Programs representing all models addressed these challenges through multiple efforts to make access to training and advancement opportunities more equitable. Immigrants make up a significant proportion of the direct care workforce, and PHI recommends that workforce programs account for cultural and linguistic differences. Several programs, including the SEIU Healthcare NWTraining Partnership (WA), Care Team Integration of the Home- based Workforce (CA), and PHCAST demonstrations, acknowledged worker language barriers by translating training materials and sessions into multiple languages or offering interpretation services. Building Training…Building Quality (MI) prioritized concordance between trainees and


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