It’s all about empowerment and innovation. A new report examines ways to overcome the challenges of providing quality training for home care workers.
Don’t underestimate the role of training and education in attracting and retaining a strong, capable caregiver workforce. According to a new report from PHI, “A strong training system is essential for workforce development, job quality, and care quality.” However, the report observes that “the current training system for home care workers is fragmented, inconsistent, and often inadequate.” While training often is uneven, the report stresses that there are “pockets of promise in the home care training landscape, ranging from localized pilot projects to state-level efforts and national demonstrations.”
Why is training so urgent? The PHI report lays out a strong case:
- The number of people requiring home care services is growing rapidly, as is the demand for capable caregivers. Home and community-based services (HCBS) training systems must attract enough capable workers to meet growing demands.
- Without adequate training, workers must figure out how to address job challenges on their own and, sometimes, spontaneously. This can create risk for both workers and their clients/patients. It also can contribute to turnover.
- Clear training pathways and standards help improve the profile of home care as a viable career choice.
The greatest barrier to improving training for home care workers is cost, says the report, as there is limited funding available within the health system. Most training, from small-scale pilots to national demonstration projects, tends to be grant-funded. However, these are often unsustainable and hit or miss. As a result, training is often supplemented through home care agencies, colleges, universities, trade schools, and high schools. There also are online training resources, such as through the College of Direct Support.
Costs for trainees varies by providers and location. Some states regulate allowable costs for trainees, while others don’t. For instance, in New York, home care agencies may not charge tuition for their training programs, but may charge up to $100 for training materials. Proprietary training schools tend to be the most expensive option, sometimes costing several hundred dollars.
One way to reduce training barriers, the report suggests, is to create partnerships that bridge gaps between programs and employment opportunities. Recently, for example, PHI worked with several partners to introduce a home care training program at several City University of New York (CUNY) campuses. The program offers guaranteed job placement for students who successfully complete the program. In 2016, 408 students enrolled, and 88% completed the coursework.
Increasingly, states are looking for ways to improve and expand training for home care workers. The 2014 Workforce Innovation and Opportunity Act provides one way for states to develop education, training, employment, and support services for these caregivers. However, the PHI report notes, these programs “typically skew towards healthcare jobs that offer better compensation and career ladders, creating a catch-22 situation for the currently underdeveloped home care workforce.” However, states can tap into other funding sources, such as training and employment funding under the Supplemental Nutrition and Assistance Program (SNAP).
As in many professional education programs, home care worker education is moving toward competency-based curricula. Competencies are defined by the National Institutes of Health as “knowledge, skills, and abilities, combined with other personal characteristics such as values, initiatives, and motivation, that contribute to successful individual and organizational performance.” Core competencies can serve as training program building blocks and help create a career development structure for home care workers. For instance, PHI has a set of competencies for direct care workers that apply to home care. This includes topics such as consumer rights, ethics, and confidentiality; communication, problem-solving, and relationship skills; personal care skills; health care support; in-home and nutritional support; infection control; safety and emergencies; and self-care.
Training methods matter, says the report. While many programs still rely on didactic methods, more are moving to an adult learner-centered approach. This method assumes that adult learners are motivated, problem-oriented, and focused on skills acquisition. Adult learning programs are oriented around the students’ learning process, with a special emphasis on inquiry, application, and reflection. These efforts tend to be more interactive and involve elements such as role playing, case studies, and small group discussions.
The report authors conclude, “What is still needed is consensus on the core competencies for direct care, including home care, and their incorporation into a coordinated training system—with enough standardization to address the current inefficiencies and inconsistencies in the training landscape….” Coordinated and standardized training systems, they say, are “critical for enhancing career mobility and supporting quality assurance across services.”