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New Home Care Aide Training and Employment Initiative Improves Job Satisfaction and Retention, Study Finds

February 20, 2015

— Better Training Is Essential for Building a Home Care Workforce that Meets the Nation's Growing Need for Quality Care —

BRONX, NY — An evaluation of the Homecare Aide Workforce Initiative (HAWI), a new, multi-year, foundation-funded training and employment initiative for home health aides serving thousands of elders in New York City, found that the aides who graduated from the program were more satisfied with their jobs and more likely to stay on them.

HAWI was designed to improve the skills, job satisfaction, and retention of the entry-level home health aide workforce as a strategy for improving the quality of home care for older adults. The project was implemented in 2013 at three New York City-based UJA-Federation of New York home care agencies with lead funding from the Harry and Jeanette Weinberg Foundation and UJA-Federation.

"This initiative addresses the Weinberg Foundation's complementary funding priorities of aging services and workforce development," said Weinberg Foundation Board Chair Ellen M. Heller. "Judging by the survey responses of Homecare Aide Workforce Initiative (HAWI) participants, and their three- and six-month retention rates, HAWI was a success. Findings from this pilot initiative offer a model to strengthen direct-care workforce training, employment, and quality of care throughout New York City and beyond."

Over 500 newly hired home health aides graduated from HAWI. Of the graduates, 228 completed a three-month follow-up survey; 91 percent were either "very satisfied" (62 percent) or "satisfied" (29 percent) with their jobs. These findings suggest that the HAWI training was effective in setting the aides' expectations about the work, reports the evaluation.

The newly trained home health aides also had "demonstrably higher" retention rates at three months (88 percent) compared to the retention rate of aides who were hired prior to the HAWI implementation period (79 percent) and aides who were hired during the implementation period but did not have HAWI training (76 percent). These "superior" retention rates persisted at six months (76 percent) for the HAWI-trained aides compared to the aides hired before the training was implemented (70 percent) and aides without HAWI training who were hired during the implementation period (64 percent).

"The evaluation provides strong evidence that the HAWI adult-learner centered training model adequately prepares entry-level home care workers for the job, allowing for high levels of job satisfaction and confidence about their work. These aides are more likely to remain on the job," said Jodi M. Sturgeon, president of PHI, which designed and implemented HAWI. "Good training with the right curricula and employment supports for entry-level home care aides is critical to building the adequate, stable home care workforce our nation needs to meet rapidly increasing demand for the in-home services and supports these essential workers provide."

Home care aide turnover plagues the home care industry with one of two home care aides leaving the job each year. Turnover is both costly to home care agencies and compromises the quality of care for consumers.

The HAWI curricula requires 120 hours of classroom training as well as the regulatory requirement of 16 hours of supervised practical training with a home care client. Yet the federal government (and New York State) only requires that home health aides employed by Medicare- or Medicaid-certified agencies or facilities have 75 hours of pre-employment training, including the supervised practical training. In 2008, the Institute of Medicine reported that the federal training standards for home health aides were "insufficient" for providing quality care. (There are no federal training requirements for personal care aides.)

The HAWI core curriculum consists of the following five core components:

  • Special home health aide recruitment and screening procedures designed to select the most able, work-ready trainees
  • Customized adult-learner centered home health aide training with a model home health aide curriculum and training of trainers
  • Peer mentoring for home health aides
  • Coaching of home health aide supervisors
  • Supportive services/case management for home health aides both pre- and post-employment

"We believe that a logical chain of association can be traced from the HAWI model — particularly its carefully implemented training component — to the satisfaction, confidence, and expectations of the training graduates and the superior three- and six-month retention rates of HAWI new hires," concluded the independent evaluation conducted by the Center for Home Care Policy & Research, Visiting Nurse Service of New York.

"The success of the HAWI pilot demonstrates the importance of quality recruitment and training techniques as well as enhanced workforce supports, which we believe will ultimately lead to improved care for the growing population of older adults," said Alisa Rubin Kurshan, UJA-Federation's executive vice president of Community Planning and Agency Resources. The UJA-Federation home care agencies that participated in HAWI were Best Choice Home Health Care, a member of the CenterLight Health System; Jewish Home Lifecare; and Selfhelp Community Services, Inc.

The findings from the HAWI evaluation (pdf) were released today at a presentation hosted by UJA-Federation of New York's Roundtable on Aging in the Jewish Community.

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PHI (Paraprofessional Healthcare Institute) works to transform eldercare and disability services. We foster dignity, respect, and independence — for all who receive care, and all who provide it. The nation's leading authority on the direct-care workforce, PHI promotes quality direct-care jobs as the foundation for quality care (www.PHInational.org).

About The Harry and Jeanette Weinberg Foundation

The Harry and Jeanette Weinberg Foundation, one of the largest private charitable foundations in the United States, provides approximately $100 million in annual grants to nonprofits that provide direct services to low-income and vulnerable individuals and families, primarily in the U.S. and Israel. Grants are focused on meeting basic needs and enhancing an individual's ability to meet those needs with emphasis on older adults, the Jewish community, and our hometown communities of Maryland, Northeastern Pennsylvania, and Hawaii. The trustees, some of whom also serve as executive officers of the Foundation, are Donn Weinberg, Barry I. Schloss,  Robert T. Kelly, Jr., Alvin Awaya, and Chair Ellen M. Heller. Rachel Garbow Monroe serves as the Weinberg Foundation's President and Chief Executive Officer. For more information, please go to www.hjweinbergfoundation.org.

About UJA-Federation of New York

For more than 95 years, UJA-Federation has inspired New Yorkers to act on their values and invest in our community for the biggest impact. Through UJA-Federation, more than 50,000 donors address issues that matter most to them, pooling their resources to care for New Yorkers of all backgrounds and Jews everywhere, to connect people to their Jewish communities, and to respond to crises close to home and around the globe. Working with nearly 100 beneficiary agencies, synagogues, and other Jewish organizations, UJA-Federation is the world's largest local philanthropy; our reach spans from New York to Israel to more than 70 other countries around the world, touching 4.5 million people each year. For more information on how to donate or volunteer, please visit our website at www.ujafedny.org.

Deane Beebe, PHI Media Relations Director

646-285-1039; dbeebe@phinational.org

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