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Advanced Aide Models Showcased at New York City Home Care Summit

May 15, 2014

New and expanded roles for home care workers was the topic of a conference held in New York City on April 30 attended by home care providers, workers, advocates, funders, union leaders, and government officials.

At the conference, Innovations in Home Care: Transforming the Role of the Home Care Worker for Better Quality Care (pdf), several models that incorporate an “advanced aide” position into home care management and care teams in New York City were discussed during two panel presentations. (One model is California-based.)

Several presenters — including home care aides participating in the projects — said that the expanded roles give home care workers a much-needed voice on the team and more satisfaction on the job. Presenters also reported that these innovative models have led to lower health care costs and improved quality of care.

On the “Integrating the Home Care Worker into the Care Team” panel, four models were featured:

  • a telehealth project aimed at reducing hospitalizations for consumers at risk for re-hospitalization. Aides serving consumers who had at least two hospitalizations in the last year were trained to use e-Caring software on a tablet to relay information in real time to the telehealth nurse. Aides receive a bonus for participating in the initiative.
  • a project employing health coaching during transitions in care for consumers who are at risk for recurring stroke. This project teaches aides motivational interviewing techniques and provides training on diet, exercise, medications, and the relationship between blood pressure and stroke. Aides interview consumers every two weeks, alternating between phone and in-person interviews, to help consumers become more in control of their own health. Aides who become health coaches are guaranteed a 40-hour work week.
  • a senior aide project in which the aides are trained in peer coaching, communications, and problem-solving to provide support to aides in the field and provide input into the care team, which includes a nurse, social worker, and care coordinator. Team leaders receive training in facilitation skills to ensure that everyone on the team has a voice. Senior aides receive a 5 percent increase in wages.
  • a training for integration pilot project in three California counties. A direct line of communication between the In-Home Supportive Services personal care aides and the consumer’s health care team is promoted, creating an infrastructure for the aide to be an integral part of the team. Aides get 17 weeks of 3.5 hours of training; consumers attend the first and last session. The project reportedly gives consumers more control over their care and reduces hospitalizations. The aides are not paid for training.

The “Changing Roles for Home Care Workers” panel featured:

  • a chronic disease management project that uses advanced home health aides to improve transitions, reduce hospitalizations and emergency room visits, and remain competitive in the industry. Aides receive an additional 32 hours of training in areas such as disease management, signs and symptoms of decompensation, and communication. Professional staff chosen for this project were those willing to recognize the aides as vital members of the team. RNs were trained to be responsive to the aides’ calls.
  • a physical therapy and rehabilitation project that creates a specialized orthopedic program in which home health aides are trained to work with patients as an alternative to rehabilitation in a hospital or nursing home. Presenters noted that aides jumped at the opportunity to work with patients whose health was going to improve.
  • a presenter reporting on the expanding scope of practice said that home care aides are “capable of so much more” and could be trained to administer medications, reinforce dressings, and other tasks like preparing special diabetic meals. Aides are the eyes and ears in consumers’ homes and thus in the perfect position to prevent hospitalizations, especially when they are the consistent caregiver.

A third panel presentation on funding and investing in innovative models for home care aides was moderated by PHI New York Policy Director Carol Rodat.

The names of the agencies employing innovative models in home care and presenters are available in the conference program (pdf).

An action agenda (pdf) that states what New Yorkers, funders, government, providers, payers, aides, and training programs can do to transform the role of home care workers was made available to everyone who attended the event.

The conference was sponsored by 1199 SEIU United Healthcare Workers East. The cosponsors included PHI, H&HC, JASA, Jewish Home Lifecare, People Care, Bestcare, Inc., and 1199 SEIU Training and Employment Funds.

The planning committee was comprised of individuals (pdf) from multiple organizations.

More information on advanced roles for aides and the shift to Medicaid managed long-term care in New York is available on the PHI website.

— by Deane Beebe

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