Evaluation of FY15 Home Health Aide Trainings Underlines Success of the Enhanced Model

2015 Summer Newsletter, Initiative Updates

As 24 cohorts of enhanced home health aide (HHA) trainings come to a close, data from an internal evaluation shows that those graduates now working feel well prepared for the work.  Training was provided by three CUNY colleges through the CUNY HHA Training and Employment Program, and by four home care agencies through the Quality Home Care Workforce Pilot Program Phase I, with capacity building, coaching, and technical assistance provided by the Paraprofessional Healthcare Institute (PHI).  From January to August of 2015, across CUNY and employer-based training, 394 people were enrolled in training.

In an industry where training is often inadequate given the challenges of the job, leading to poor retention and high turn-over, HHA preparedness and confidence play key roles in improving patient care and operational efficiency.  A post-graduation phone survey with a 62% response rate showed that 95% of working HHAs from the CUNY program and 92% from the employer-based program felt that the training prepared them “well” or “very well” for the job.  While the characteristics of the respondents may be slightly different, it is interesting to note that a national survey of HHAs conducted by the US Department of Health and Human Services in 2007 found that only 82% of HHAs felt that their training prepared them “well” for the job.[1]

Qualitative data from the phone survey confirmed this sentiment.  One respondent explained, “I did a 14 day training and an 11 day training previously. You come into class and they try to cram a lot of information down your mind and it doesn’t work. This 21 day course – when you walked out of that classroom you were truly qualified. This 21 day course is the best thing in New York and even the country that could happen to us in this field.” Students were not the only ones who had a positive experience with the model. At least three of the four employer-based training partners plan to incorporate the enhanced curriculum and model, with a few tweaks, into their ongoing trainings.

The enhanced training model, developed in partnership with PHI, utilizes an interactive, adult-learner centered curriculum and tools such as role-plays and return demonstrations to engage students.  Reading materials and exercises are accessible to individuals with lower literacy levels. One or two experienced home health aides serve as teaching assistants to the lead RN instructor, sharing on the ground knowledge and serving as role models for the students. Workforce1 partners with home care agencies to recruit for the program, using a comprehensive information session and pre-screening process to bring in those most interested and suited for the job. The vast majority of students were unemployed prior to the training and struggled to find work, but had previous caregiving experience, sometimes caring for a relative or friend, and a passion for working with people. Students are majority female and majority African-American or black, with roughly one third being 25 years or younger and roughly one third receiving pubic cash assistance at the time of recruitment.

While satisfaction with the training was high, survey questions about satisfaction with the job revealed both successes and challenges. 80-85% of working graduates stated that they were either “satisfied” or “very satisfied” with their HHA job. When asked about the factors contributing to their satisfaction, many of them commented that they found the work rewarding because of their ability to help others in need and to have positive interactions with clients. One respondent commented, “It’s a new field for me. I enjoy it – the hands on, the different people, helping people, serving a purpose.” Another elaborated, “I get to meet people. You meet older people with a lot of history and knowledge. You get to hear their life experiences. You get to know them, and you learn from them.” On the other hand, qualitative data also revealed frustrations with not being able to get enough hours, low pay, difficulty getting in touch with coordinators, travel time, and disorganization at the office. These comments reinforced the need for improved practices around scheduling, supervision, and communication between HHAs and staff at the office, which is the focus of NYACH and SBS’s job quality pilot, the Quality Home Care Workforce Pilot Program Phase II. The second phase of this pilot program will offer home care agencies technical assistance on improving scheduling and supervisory practices so as to both raise job quality for HHAs as well as improve operational efficiency and the quality of the workforce for home care agencies.

NYACH and SBS are also tracking the impact of this program on retention.  Of those who graduated from FY14 HHA trainings and began work, 67% of them are still working with the same agency a year later.[2]

[1] U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, and National Center for Health Statistics, “An Overview of Home Health Aides: United States, 2007,” National Health Statistics Reports, Number 34, May 19, 2011.

[2] This is based on data collected from two of the three participating home care agencies; one of the agencies was unable to be reached for reporting.