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Impact of Climate Resiliency Caregiver Training

CCA is proud to share the outcomes of our Caregiver Resiliency Teams training program pilot, which we developed through a California Workforce Development Board (CWDB) High Road Training Partnership (HRTP). In just 13 months, we successfully trained over 500 long-term care workers in foundational knowledge on climate change and essential emergency planning and response techniques. 

As you can see in this Report, the In-Home Supportive Services (IHSS) providers and nursing home workers who completed the six-week comprehensive course showed substantial gains in skills and knowledge. These caregivers now possess the critical skills to act swiftly and effectively during times of crisis, ensuring that our seniors and people with access and functional needs receive the assistance they need, when they need it most.

We also hosted an Impact Study Briefing to accompany this Report. During the presentation and subsequent panel discussion, we underscored the importance of investing in caregiver workforce training, which plays a pivotal role in building a climate-resilient California.

Our primary goal for the webinar and the Impact Report was to demonstrate, based on the outcomes of our Caregiver Resiliency Teams project, that investing in permanent, compensated training programs aimed at equipping caregivers with emergency preparedness skills can serve as a critical component of California’s response to climate change.

IHSS+ Training Decreases Consumer ER Visits and Inpatient Utilization

When Felipe Murillo suddenly became his mother’s full-time caregiver, everything seemed like an emergency.

“Initially, after my mom came out of the hospital, I would get scared about everything that would come after that, like when she started coughing,” he said. Felipe’s initial reaction anytime his mother was experiencing anything out of the ordinary was to take her to the emergency room.

But after completing CCA’s 10-week caregiver training program, Felipe can now distinguish between ER and urgent care situations. “… learning about the differences, [I learned that] maybe she doesn’t really need to go to the ER, maybe I could just take her to urgent care,” he said.

A new report from L.A. Care Health Plan shows that CCA’s IHSS+ training program reduces consumer emergency room visits and inpatient utilization. L.A. Care is CCA’s partner in delivering quality, evidence-based training to hundreds of IHSS providers whose consumers are L.A. Care members.

The utilization study, entitled Evaluation of In-Home Support Services (IHSS) Training on Health Care Outcomes and authored by Matthew Pirritano, PhD,says that.. among the consumers whose caregivers participated in the training, “there was a statistically significant decrease in ER utilization over time.” This trend was reported as decreasing prior to the end of the training and subsequently continued to decrease after graduation. Similarly, “inpatient utilization went from relatively flat prior to graduation to decreasing.”

Providing caregivers with high-quality training reduces the need for external medical care in certain situations. Caregiver Jennifer Ballesteros, who completed the multi-week training program, said, “The training is helpful to navigate the medical part of what I do for my mother.”

The material taught in the course may also be linked to the decrease in consumer ER visits and inpatient utilization. As part of the curriculum, students are instructed on how to distinguish between when their consumers need to visit urgent care and when they need emergency care. 

The report concluded that “there is a relationship between the training and a change in utilization.” These results are in line with the results of other prior evaluations of similar training programs. “This pre-post design which aggregated results across multiple classes bolsters the argument that the training might be causally related to the changes in utilization.” 

The sample population for the study was drawn from cohorts who completed the training between September 26, 2017 and August 6, 2021. The participants were only included in the analysis if the consumers they were caring for were continuously enrolled in L.A. Care within a year prior to and after graduation from the program.

CCA Soon to Offer Hybrid CNA Training Program

CCA has been approved to offer a hybrid CNA certification program as an official Nurse Assistant Training Program (NATP) provider by the California Department of Public Health.

The NATP will be offered in a hybrid format and will consist of 160 hours of instruction, split between 60 hours of live instructor-led theory and 100 hours of in-person clinicals. Participants will take part in on-the-job training while being employed at a partnering nursing facility. 

The training program is the first step for those interested in nursing and providing quality care for others. Participants will be exposed to health care basics and have a chance to interact with residents at a skilled nursing facility and get hands-on experience. A CNA’s role typically involves assisting patients with activities of daily living, such as basic tasks that include bathing, grooming, toileting, eating, and moving. 

CCA’s NATP is a Registered Apprenticeship Program, which means participants get paid for their training and classroom hours and they earn a nationally recognized apprenticeship credential from the U.S. Department of Labor upon program completion.  

CCA’s program provides a wide range of support services, including a child care expense stipend of up to $1,600, and a grocery stipend of up to $400 and a transportation stipend of up to $100. To ensure success, CCA also offers mentorship through experienced CNAs. Participants will  be paired with a case manager, coach and mentor who will be there to guide them throughout their training and initial months as a CNA. Upon completion of the program and passing the state exam, graduates will be promoted to CNA with a guaranteed wage increase.

For more information or to check your eligibility, visit this page or email the Education Fund at edfund@advancecaregivers.org.

From Caregiver to CNA

Veronica Mendoza’s role as a nurse assistant apprentice is new for her, but she is no stranger to the healthcare field. Her journey began nine years ago when she became the caregiver for her aging father. After he passed away, Veronica continued in her role as an In-Home Supportive Services (IHSS) provider for other people who needed care. 

“I felt that I could help others,” she said. 

Recently, she decided to take another step in her career path when she enrolled in CCA’s Certified Nurse Assistant (CNA) Registered Apprenticeship Program. Her goal is to become a CNA and eventually a Licensed Vocational Nurse (LVN). Currently, she’s a nurse aide at Paramount Convalescent Hospital (Sun Mar Healthcare). Once she gets her state certification, she will be promoted to CNA at Paramount Convalescent with a guaranteed wage increase.

The CNA Registered Apprenticeship Program is a free training program* that is designed to create a pathway for existing SNF workers who are interested in a nursing career. The program helps to provide a solution to the staffing crisis in the nursing home industry by placing highly trained CNAs in skilled nursing facilities who are well-versed in the facilities’ procedures and practices.

On a personal level, Veronica said that she is participating in the program “to better myself, to learn more, and to advance in my career.” But the biggest motivation is her passion for helping others and as a CNA at a skilled nursing facility, she will be able to provide direct care to more people.

Veronica first found out about CCA’s apprenticeship program through SEIU Local 2015. She encouraged her daughter to enroll as well. They both agree that they have received great support from the Education Fund staff and their instructors throughout the program. “They’re always there for support. If I have any questions, I could be free to go and ask them anything,” Veronica said.

The Education Fund’s apprenticeship program provides robust support services to all participants and to the facilities where the apprentices are getting on-the-job training as nurse aides. A key factor to the participants’ success is the mentoring they receive while they’re in training and during their first months as CNAs after they pass their state exam. 

“To me the training is motivating me to continue my healthcare career and I would say yes, 100%, it’s worth it,” she said. 

* subject to eligibility requirements

CCA to provide caregiver training in San Bernardino County


Center for Caregiver Advancement Receives $10 Million Grant to Provide Free Training for Caregivers in San Bernardino County

Specialized training includes Alzheimer’s and related dementia care, emergency preparedness

San Bernardino, Calif. (May 18, 2023) – The Center for Caregiver Advancement (CCA) has been awarded a $10 million grant from the California Workforce Development Board (CWDB) and the Labor and Workforce Development Agency to bring its caregiver training programs to In-Home Supportive Services (IHSS) providers in San Bernardino County. The grant is part of CWDB’s HRTP Resilient Workforce Fund.

Through the grant, CCA will conduct a randomized control trial in partnership with the Abdul Latif Jameel Poverty Action Lab (JPAL) at Massachusetts Institute of Technology (MIT). This will be the first RCT on IHSS training. Building on CCA’s existing research, the study will lay the foundation for policy change that will recognize worker specializations, improve worker retention, create advancement within the home care workforce, and secure long-term funding for caregiver training. JPAL will conduct the RCT on IHSS+ Basic training, while UC San Francisco will continue to study the impact of the Alzheimer’s care and Caregiver Resiliency Teams programs.

“As California prepares for demographic changes, including the growth of the 60-and-over population, it’s critical that we develop a direct care workforce that is adaptable and responsive to the State’s unique challenges,” said Tim Rainey, Executive Director of the California Workforce Development Board. “This grant recognizes the essential role that the caregiving workforce plays in ensuring Californians age with dignity and respect, and will positively impact both the job quality of caregivers, and the care they provide, in San Bernardino County.”

The training will be offered in two languages: English and Spanish. CCA’s IHSS training programs consist of successive classes over multiple weeks that build on each other to progressively develop participants’ skills. The IHSS Basic training program will have a total of 35 hours of learning, while the two specialized training programs will each have 15 hours of learning.

“CCA is thrilled to have been chosen to receive this grant from the CWDB. It will help us provide essential training and resources to caregivers in San Bernardino County, improving both quality of care for consumers and developing specialized skills for workers. Through the research that will come out of this grant, we have the potential to generate systems change that will positively impact half a million IHSS caregivers in California,” said Corinne Eldridge, President and CEO of the Center for Caregiver Advancement.

Access to CCA’s specialized training programs is critical to support older adults and people with disabilities in San Bernardino County. Alongside basic caregiver skill-building, CCA will offer Alzheimer’s Disease and Related Dementia care training. Majority of the IHSS population in San Bernardino is Latino, and individuals of Hispanic origin have a higher prevalence of ADRD, with cases predicted to increase by 21% across the state. CCA has offered the Alzheimer’s care training in Alameda County since 2020, and has started offering it in Los Angeles County this spring.

The grant will also enable CCA to offer the Caregiver Resiliency Teams to San Bernardino’s IHSS providers. CCA developed the nation’s first climate-related emergency preparedness training for long-term care workers. Over 70% of San Bernardino County census tracts have high levels of pollution and are considered disadvantaged areas, according to the CalEnviroScreen index. The disproportionate environmental pollution that can lead to negative public health effects highlights the need for caregiver training. CCA’s Caregiver Resiliency program helps caregivers connect climate change with their roles as first responders, and helps them understand how climate change affects different communities.

CCA is the only organization within California utilizing evidence-informed curriculum that has already been tested and delivered to thousands of IHSS providers in California.

ABOUT CCA: The Center for Caregiver Advancement is the largest provider of training for caregivers in California and has trained more than 20,000 nursing home workers and in-home caregivers. advancecaregivers.org

Stepping Stone to a Nursing Career

Lizette Mendoza’s inspiration to pursue a career in the healthcare field comes from two main sources: the medical drama TV show “Grey’s Anatomy” and her mother who has been a caregiver for nine years. 

Lizette and her mother, Veronica, are currently training to become Certified Nursing Assistants (CNAs) through CCA’s CNA Registered Apprenticeship Program. Veronica, an IHSS provider, encouraged Lizette to enroll in the program and participate with her. 

The CNA Registered Apprenticeship Program is a free training program* that is designed to create a pathway for workers who are interested in becoming a CNA. The program provides a solution to the staffing crisis in the nursing home industry by placing highly trained CNAs in skilled nursing facilities who are well-versed in the facilities’ procedures and practices.

Although she knows that “Grey’s Anatomy” is not an accurate reflection of reality, Lizette admires how the characters in the show “were able to help people who are in trouble,” which is ultimately what she wants to do in her future role as a CNA. 

Participants in the CNA Registered Apprenticeship Program are not required to have any prior experience or education in healthcare. This seemed like the perfect option for Lizette. She opted for the apprenticeship program instead of a four-year college degree since it will allow her to begin her nursing career much sooner. “In such a short amount of time, you can actually get to be a CNA,” Lizette said. 

As part of the registered apprenticeship program, Lizette is currently working as a Nurse Aide at Paramount Convalescent Hospital (Sun Mar Healthcare). She is set to take her state exam in late April. Once she passes the exam and receives her certification, she will be promoted to CNA with a guaranteed wage increase. 

Participants in the CNA Registered Apprenticeship Program get to work in nursing home facilities while they complete the training. This allows them to put what they learn in class into practice. The hands-on learning is helpful for Lizette and her fellow apprentices to prepare for when they become CNAs, “so we actually know what we’re doing,” she said. 

She believes this program is helping her achieve her career goals. “Overall, it’s good. It’s a very stable job and I like helping people,” Lizette said. She said she would recommend the CNA Registered Apprenticeship Program to anyone and is excited for her future role as a CNA.  

For more information about the CNA Registered Apprenticeship Program, see our website or email edfund@advancecaregivers.org.

* subject to eligibility requirements

Training for autism, other complex health needs

The Center for Caregiver Advancement (CCA) now offers caregiver training courses that specialize in complex physical and mental health needs: autism spectrum disorder, diabetic care and nutrition, traumatic brain injury, and heart diseases and care.

All four learning pathways are part of CCA’s course catalog for the IHSS Career Pathways Program, a state initiative that funds training for California’s In-Home Supportive Services (IHSS) providers. CCA is one of the approved training providers for this program. These four pathways join the six other training specializations CCA started offering in January.

Each pathway has six courses that are designed to help caregivers build strong foundational knowledge that is  condition-specific

The Autism Spectrum Disorder courses cover an overview of ASD and key terms and definitions, learning to identify signs and manage maladaptive behaviors, supporting ASD in different age groups, among others. The series concludes with a skills practice session, where participants can put everything they learned into practice through case scenarios.

Related story: Learning the language of autism

The Diabetic Care and Nutrition pathway discusses the different types of diabetes, how diabetes impacts different populations in the U.S., and the complications that can affect an individual’s overall health. Caregivers also learn how to support the person they’re caring for in the management of their Type 2 diabetes, particularly through proper nutrition and portion sizes. Emergency management and response is also covered, so that caregivers can recognize potential emergencies and learn the difference between an urgent versus emergency situation.

The Traumatic Brain Injury courses help caregivers define and describe the different types of TBI, identify risk factors and recognize the health disparities associated with them. They will learn how the injury affects a person’s everyday function and the caregivers’ role in the observation, monitoring and documentation of consequences. Emergency response is also covered.

The Heart Diseases and Care pathway discusses causes, prevalence and impact of heart attacks and heart failure. Caregivers will learn to identify common signs, symptoms, and risk factors; and learn preventative tools to help reduce risk of heart disease through lifestyle medications. Emergency response is also discussed, including the correct order of steps a caregiver needs to take when a person complains of chest pain.

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