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The Impact of Offering IHSS Training in Multiple Languages

As California’s largest provider of free and accessible caregiver training, the Center for Caregiver Advancement (CCA) makes sure our programs are understandable to as many as possible. We strive to create spaces where all caregivers can learn, regardless of background.

Accordingly, CCA offers In-Home Supportive Services (IHSS) training in multiple languages. For the state’s IHSS Career Pathways Program, CCA teaches the courses in seven languages in addition to English: Spanish, Korean, Mandarin, Armenian, Cantonese, Russian, and Vietnamese.

The majority of caregivers who completed the CPP took the training in a language other than English.   

Higher quality of care should not be limited for immigrant communities

Offering IHSS training in multiple languages means that more of California’s immigrant populations and immigrant families have access to caregiver education. 

Fei Tian is a part-time Chinese language teacher and part-time IHSS provider for her parents. Her weeks are spent divided between time with her father and mother who live in different towns and each have their own unique needs. Fei is a Career Pathways Program student who takes courses in her first language, Mandarin. “Having the training in my first language is very important,” Fei said, “It is so beneficial because [in Mandarin] I understand everything and I’m more ready and able to learn.” 

Living in the United States as immigrants from China, Fei and her parents often face language barriers. For example, Fei has had to accompany her father at his appointments and sometimes has needed an interpreter to understand his condition. Having the choice to take the training in Mandarin made a huge difference for Fei and her parents as she now comprehends their needs better, giving them higher quality care. 

“I came from China, but there are people coming from Russia, Japan and Korea. They all want to learn in their own language where we can readily benefit from [the training]. We are very happy that we have this kind of opportunity,” Fei said.

Fei Tian

Bill Zhang, who also took CCA’s multi-week IHSS training program in Mandarin, shares Fei’s opinion. “I think the fact that the training is offered [in other languages] is extremely important,” he said. Bill and his classmates all agreed that they were able to learn so much new material thanks to it being taught in Mandarin, the language in which they are the most comfortable.

Spanish is the second most widely spoken language in California and is the most popular language among all non-English courses provided by CCA. Many of our state’s caregivers can take advantage of free IHSS training in Spanish, just like Elka Ventura Escobar. She took the multi-week IHSS Essentials course. Elka is her mother’s caregiver and said the lessons helped improve their relationship. 

Elka’s mother was a lawyer in their home country and the decline in her health and cognitive abilities has been challenging for Elka to navigate. The course offered in Spanish meant that her mother was able to follow along with her. They both learned valuable lessons that improved the quality of Elka’s care and their overall relationship. “Both of us listened to the classes together. So sometimes she’d say, ‘Did you hear that? Did you see? You do things that are not right,’” Elka said.  This created an environment of trust and mutual respect.  

Material that might otherwise be lost in translation is now captured in the right context, preserving the quality of instruction and care. “[My mother] and I both recognize our [prior] mistakes. I heard a lot of what we needed to do and now we don’t argue as much,” Elka said. 

Language barriers should not compromise quality of care

Maricela Serrano is a Spanish language CPP student whose typical day in her role as her mother’s IHSS caregiver never truly ends. Maricela draws upon what she learned in her courses throughout her daily caregiving tasks. When describing the positive impact of these lessons, she said, “it’s like a blindfold has been lifted from my eyes.” 

Prior to her participation in the Career Pathways Program, Maricela felt very stressed and did not understand her mother’s condition and why she reacted in certain ways. She learned many things such as how to read medicine labels, and how to tell if emergency services are needed or not. Maricela said her instructors were excellent and “I hope that [the program] receives more funding because this is a big blessing for every one of us who will take care of our family members and other people.” 

Maricela does not speak English. Without the option to take courses in Spanish, she could not benefit from the free training. Maricela compares her situation beforehand as being a soldier without weapons, but now is equipped with the proper knowledge necessary to give her mother the highest quality of care she can. 

Maricela and her mother

Many IHSS providers also benefit from CCA’s Armenian and Russian language CPP courses such as Ruzan Samvelyan, who moved from Europe to the United States seven years ago. With a lifelong dedication to education, Ruzan previously worked as a supervisor to 160 schools in Yerevan, Armenia. After moving to California, her educational journey traveled a different path. She became a caregiver when her husband was diagnosed with cancer. Ruzan naturally wanted to learn as much as she could to provide the best care possible in her new caregiving role. Fluent in Armenian and Russian, she took courses in both languages. 

Speaking of fellow caregivers in her Armenian community in California, Ruzan says, “a lot of people who moved from Armenia to the states don’t know English. It’s really hard but they need to have this knowledge because it helps, it helps a lot.”

Personal Fulfillment and Job Satisfaction

When caregivers are equipped with training in their native languages, they can navigate caregiving scenarios with greater ease.  This fosters a sense of professional fulfillment and job satisfaction, and helps them better meet the needs of their consumers. 

“For me, there was a lot of useful and necessary information, for not only my work but also for me personally,” said caregiver Anna Nadejda, who took CCA’s CPP courses on traumatic brain injuries, cardiovascular disease, and autism spectrum disorder in Russian. “The most important thing is that it is easier to understand this amazing material provided by [CCA] in my native language,” she said.

Reflective Listening

If your client or consumer is experiencing trauma, it is important to support them by practicing reflective listening (also known as active listening). Reflective listening focuses on understanding the speaker, rather than giving your reaction or opinion on what was said. This communication strategy involves two key steps:

  1. Seeking to understand a speaker’s idea
  2. Offering the idea back to the speaker to confirm the idea has been understood correctly by you

This helps caregivers provide support to their clients when they are experiencing trauma. It focuses on the meaning and emotions behind the speaker’s words, to ensure the speaker feels listened to and understood. This listening technique has numerous observable benefits such as the following: 

  • It prevents miscommunication and wrong assumptions
  • It makes people feel they are being heard and understood
  • It encourages people to hear and reflect on their own statements
  • It builds and deepens the conversation

To accurately practice reflective listening, it is also imperative to avoid the following:

  • Asking a series of questions to get information from someone
  • Giving unsolicited advice
  • Minimizing the person’s concern

Advancing Opportunities for Caregivers Empowers Women 

In California, around one in three women are currently providing long-term care for a family member or friend, according to the 2024 annual Report on the Status of Women and Girls in California. Caregiving, a field predominantly consisting of female workers, is a vital role many Americans depend on. Yet, it often remains an “invisible workforce;” despite the value it brings to the economy and healthcare system, the workforce is not given the compensation or recognition that it deserves. 

“The idea of the selfless woman who puts everyone else first is ingrained in our culture and even our communities. It is even reflected in our institutions and structures that were built without women in mind, increasing barriers for women and limiting our economic opportunity,” said Holly Martinez, Executive Director of the California Commission on the Status of Women and Girls, during the Report’s public release event on March 22.

As California’s largest provider of free and accessible training for caregivers, the Center for Caregiver Advancement (CCA) is a staunch advocate for dismantling barriers and promoting equity for long-term care workers. One of CCA’s core organizational beliefs is that caregiving is a profession deserving of respect and recognition. Around 90 percent of CCA-trained homecare workers are women. Similarly, 89 percent of skilled nursing workers who were trained at CCA are women. The highest percentage of both homecare and skilled nursing workers were in their 50s. Also among CCA-trained home care workers, 70 percent report they take care of a family member.

These statistics directly align with the data presented at this year’s Report on the Status of Women and Girls in California, which suggests that “the average caregiver is a 58-year-old woman caring for an 81-year-old parent.”

CCA’s training makes it possible for hard-working caregivers to step out of invisibility as a workforce by acquiring specialized skills and knowledge that establish them as professionals. This was our mission since the beginning as our organization’s founders, a group of resilient female caregivers, fought to provide long-term care workers with three crucial things that had been previously lacking: livable wages, benefits, and training. 

Since then, CCA has trained over 35,000 of California’s paid caregivers. One of the key goals of our organization is to inspire system-change conversations around specialized skills and translating those into higher wages for caregivers. Those who participate in our programs are paid for their time in training, with some programs offering stipends upon completion. This is a step in the right direction towards breaking long-established barriers and recognizing the profession of caregiving for the noble and respectable role that it is. 

Although significant improvements have been made in recent decades regarding advancing women’s roles in the workforce, progress remains as we strive to build a more equitable world. For example, according to the Report, “women still take on more unpaid caregiving duties than men.” 

Building a more equitable future in the Caregiving workforce and beyond

An important aspect of our vision at CCA is centering our work on race and health equity, acknowledging that progress for women is not truly achieved unless that includes all women – regardless of their background. 

The inequities in society are multifaceted and go beyond gender. For example, as shared in the Report, in order to make as much in her lifetime as a 65-year-old white male, a White or Asian-American woman would need to work until she is 75 years old. However, a Black woman would need to work until she is 95 and a Latina until she is 115 years old. 

According to the Pew Research Center, “differences in factors such as education, hours, experience and occupations significantly affect the overall earnings between different groups of women.” Building a more equitable workforce entails removing barriers that limit access to these crucial factors. 

Immigrant women of color comprise the majority of the caregiving workforce. In 2022, 61 percent of CCA-trained homecare workers identified as Hispanic or Latino, 19 percent identified as Black or African American, 13 percent were Asian, and four percent White.

Among the skilled nursing workers trained that same year, 58 percent were Hispanic or Latino, 22 percent identified as Black or African American, 15 percent as Asian, and four percent as White.

Access to education is a barrier that CCA is actively working to remove. All of our training programs are completely free of charge, removing the financial burden of funding an education.

Additionally, we offer training in several different languages in addition to English, including: Spanish, Korean, Mandarin, Armenian, Cantonese, Russian, and Vietnamese. 

While data reporting gender and race-based inequities can be sobering, it is an important step to acknowledge these truths. These statistics help guide further progressive action as we strive to build a more equitable workforce where everyone, regardless of their gender, race, or wealth, has an equal chance at success.

Pioneering research on IHSS training

CCA Partners with J-PAL North America at MIT for Groundbreaking IHSS Training Evaluation

In collaboration with the Center for Caregiver Advancement (CCA), the Abdul Latif Jameel Poverty Action Lab (J-PAL) North America at MIT will conduct the nation’s first randomized controlled trial (RCT) to evaluate the impact of CCA’s training on In-Home Supportive Services (IHSS) workers. This pioneering study aims to delve into both the caregiving and healthcare outcomes of the training, marking a significant step forward in workforce development and healthcare research.

The RCT is part of CCA’s “Upskilling IHSS Providers in San Bernardino” project, funded by the California Workforce Development Board’s High Road Training Partnership (HRTP). It will evaluate data from CCA’s 35-hour IHSS Essentials course, which equips caregivers with critical skills and knowledge in areas such as infection control, medication safety, activities of daily living, mandated documentation, self-care, and more.

“We are proud to work with the J-PAL team on this groundbreaking randomized evaluation on IHSS training,” said Corinne Eldridge, CCA President and CEO. “This joint project validates the critical role that home care workers play in keeping older adults and people with disabilities out of institutional care. We know that access to high-quality training programs not only contributes to increased worker retention but also facilitates recruitment in a field facing a care crisis.” 

This study addresses a critical gap in research as no prior RCTs have been conducted on IHSS training or any home care training programs, according to Matt Notowidigdo, PhD, Professor of Economics at the University of Chicago Booth School of Business and Co-Scientific Director of J-PAL North America.

In an era where job training initiatives predominantly focus on reskilling workers in fields like technology and IT, this project underscores the importance of evaluating training programs within the healthcare sector.

“Healthcare is just as important, especially direct care, as it is very much the future of work. It means we, as academic researchers, have an obligation to evaluate different kinds of training programs to study their impact on healthcare workers and the people they care for,” said Notowidigdo. “CCA is the perfect partner for this as they are pioneers in this space.”

The randomized controlled trial will operate on a cohort basis, with participants selected at random for the IHSS training, while others will be part of a control group. Each cohort will serve as a sub-study, and participants will be followed for a full year post-training. This comprehensive approach includes surveys, administrative data from the state of California, and access to Medicare and Medicaid data of the individuals receiving care.

The primary goal is to observe the impact of training on both IHSS workers and the individuals they care for. The evaluation will assess healthcare utilization, costs, and outcomes on the IHSS consumer side, including factors such as hospitalization rates and preventable incidents like accidents and falls. On the caregiver side, the RCT will examine worker attachment to the job, duration of employment, job satisfaction, confidence, and various aspects of mental health such as stress and anxiety.

“There are reasons to think training helps caregivers feel better about the job, more confident, and more comfortable which helps them stay in their job longer,” said Notowidigdo.

CCA’s work with other university-based research institutes shows that caregivers report post-training confidence in their ability to do their jobs. CCA regularly evaluates the value of its training programs on the workforce and the quality of care through impact studies in partnership with academic institutions and research organizations. UC San Francisco’s Institute on Health and Aging studies CCA’s caregiver training on Alzheimer’s disease and related dementia. Vital Research analyzed data for the Caregiver Resiliency Teams Impact Study and is doing the same for the Career Pathways Program.

CCA’s curriculum and program design relies on evidence-informed practice, using results from these impact studies, qualitative research, and subject matter expert opinion, to guide the training framework. The findings from the RCT, combined with CCA’s existing body of research, will move the evidence base into actionable strategies and policy that will advance workforce development for long-term care workers.

For Notowidigdo and his research team, the rarity of the intersection between labor and healthcare research makes this project even more significant. The study not only explores the impact of the training on healthcare outcomes but also considers its influence on the labor market.

“(California’s) IHSS program and the innovative training provided by the Center for Caregiver Advancement represent promising models for other states around the country that are considering new programs to support in-home caregiving,” said Notowidigdo.

Dementia training for family caregivers


Diagnosis of Alzheimer’s Disease in California to Increase 20% by 2025

LOS ANGELES, CA – [February 9, 2024] – To meet the anticipated growing number of dementia and Alzheimer’s cases in California, the University of California, Irvine (UC Irvine), the Center for Caregiver Advancement (CCA), and Alzheimer’s Orange County have announced the launch of a free eight-module virtual training course for caregivers of those diagnosed with dementia in southern California. A 2023 report from the Alzheimer’s Association predicts cases of Alzheimer’s disease in California will increase by more than 20% between 2020 and 2025.

To meet the increasing anticipated needs of populations diagnosed with Alzheimer’s disease and other dementias, the number of caregivers must grow significantly. Currently, more than 11 million Americans provide unpaid care for a family member or friend with dementia, according to the Alzheimer’s Association.

In California, more than 1 million Alzheimer’s caregivers provide 1.8 billion hours of unpaid care. Caregiving can have a profound impact on the health of the individual providing the care, associated with higher levels of depression, anxiety, medication use, compromised immune function, and vulnerability to elder abuse.

CCA’s multi-week, virtual evidence-based caregiver training, was developed in collaboration with UCI Health geriatricians, Alzheimer’s Orange County, and funded by a California Department of Public Health grant. The live training will be offered via Zoom and participants can enroll now through March 2024. To qualify for the free training, participants must be either an unpaid caregiver for persons with dementia or a family member designated as the caregiver for persons with dementia (paid or unpaid) living in Southern California.

The program will train caregivers on effective communication strategies to support activities of daily living (ADLs), safety, and the management of symptoms and distress for those diagnosed with ADRD (Alzheimer’s Disease and Related Dementias). Caregivers will learn how to prevent caregiver burnout and stress mitigation. Caregivers will also learn proactive strategies to prevent challenging situations and reduce caregiving stress.

The course is specifically designed for family (or unpaid) caregivers of individuals with Alzheimer’s disease and related dementias (ADRD).

CCA, with its expertise in curriculum development and caregiver training programs, will deliver the training in English and Spanish. CCA’s ADRD program for In-Home Supportive Services (IHSS) providers has proven to impact those who completed the training: 96% say they learned new skills and 94% say their communication with the person they’re caring for improved.

UC Irvine will conduct an educational assessment of the family caregiver training program, comparing caregiver health and stress levels before and after training, as well as skills and knowledge competency. The assessment will also evaluate caregiver behavior change to measure the impact of the training on the person receiving care.

About the Center for Caregiver Advancement

The Center for Caregiver Advancement (CCA), 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 The CCA is committed to improving care and building better lives for caregivers in California and the people they serve. We measure our impact through improved wages and career development for caregivers, the quality of care for their consumers, and reducing the stress on California’s over-burdened healthcare system.

About the University of California, Irvine Division of Geriatrics and Gerontology

The Division of Geriatric Medicine & Gerontology at the UCI School of Medicine is made up of an interdisciplinary group of professionals whose mission is to address the changing health needs of older adults and those who love them. We are committed to delivering high-quality, comprehensive care in a variety of settings and to providing leadership in geriatric education, research, advocacy, and community outreach. The skill and dedication of our physicians to elder care has led to UCI Medical Center being named repeatedly as one of the nation’s best hospitals for geriatric care by U.S. News & World Report.

Moving the work of advancing caregivers

2023 was a year of remarkable growth for our organization and for the long-term care workforce. The state’s extension of the Career Pathways Program, funding of the CNA Registered Apprenticeship Program, and continued investment in specialized caregiver training show the growing recognition of the value of training caregivers. All of these align with our commitment to advancing the professionalization of long-term care work. 

As we look ahead to 2024, we remain committed to setting the standard for caregiver training and building a workforce of highly trained caregivers that many Californians can’t live without. 


Language equity: We continue to address the need for equitable access to training by providing our programs in multiple languages. We increased our language offerings to eight: English, Spanish, Armenian, Korean, Mandarin, Cantonese, Russian and Vietnamese. This ensures training and continuing education courses are accessible for IHSS workers who are most comfortable learning in a language other than English.

Nationally recognized curriculum: Our training programs are evidence-based, refined through worker feedback, and backed by our impact studies. Our specialized curriculum has been licensed by organizations outside California, utilizing our experience and expertise to support sister training funds and union workers across the country. 

Condition-specific training: We offer condition-specific training courses to equip caregivers with the skills and knowledge they need to provide quality care. IHSS providers can enroll in courses that teach them essential skills, basic health and safety, emergency preparedness, as well as condition-specific knowledge (Alzheimer’s and related dementia, autism, diabetes, heart disease, traumatic brain injury). 

SNF industry solutions: Since the launch of the CNA Registered Apprenticeship Program earlier this year, we have trained and placed Certified Nurse Assistants at skilled nursing facilities across the state. We also now run our own CDPH-approved NATP as a hybrid offering to alleviate some of the barriers workers face, such as demanding schedules and transportation needs. 

Climate-resilient workforce: We released our Impact Report and hosted an Impact Study Briefing about the outcomes of our pioneering Caregiver Resiliency Teams project, underscoring the importance of investing in caregiver workforce training to build a climate-resilient California. cca.fyi/crtimpact  

Stipends for specialized skills: Part of our long-term goal of linking specialized skills to increased wages for caregivers, stipends are a hallmark of our training programs. 

  • IHSS providers: Paid the hourly wage rate of their hours in training
  • CNA Registered Apprenticeship Program participants: Receive stipends for child care, transportation and grocery expenses, as well as retention bonuses.  


Groundbreaking research: We are partnering with the renowned J-PAL North America at MIT, which will conduct a randomized control trial on our IHSS Essentials training program in San Bernardino County. This will be the first RCT across the nation on IHSS training. The RCT, along with the impact study from UC San Francisco on the ADRD training, 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. 

Upskilling the IHSS workforce: We will deliver IHSS Essentials, Alzheimer’s Disease and Related Dementia care, and Caregiver Resiliency training to IHSS providers in San Bernardino County, addressing the need for highly trained caregivers in under-invested communities. Access to this specialized Alzheimer’s training is especially important to support the caregivers caring for those with ADRD in San Bernardino. Given the extreme heat the region experienced in 2023, the Caregiver Resiliency training will give IHSS providers an increased understanding of climate change impact and the skills they need to address climate-related emergencies. 

Training for unpaid family caregivers: We are excited to start providing Alzheimer’s and dementia care training for unpaid family caregivers in the Inland Empire. This project is in partnership with CDPH and UC Irvine, which will research the impact and value of the training program. Classes begin in February.

Impact studies: We will continue to measure the impact of our training programs through knowledge checks and pre- and post-training surveys. Through our relationships with academic institutions and research organizations such as UC San Francisco and UC Irvine, we can demonstrate how our customized training programs advance quality care, improve retention, and reframe the value of care work.

Elevating care: Now on the seventh year of our partnership with L.A. Care, we continue to elevate the quality of care the health plan’s members receive from their IHSS providers. L.A. Care’s utilization studies of the training’s impact have consistently shown a decrease in emergency department visits and inpatient utilization among members whose caregivers completed our training.

Multi-week training for San Bernardino caregivers

Free Training Programs for San Bernardino County Caregivers Address Need for Specialized Skills on Alzheimer’s Care and Climate-Related Emergency Preparedness

Free specialized training courses are launching this January for caregivers in San Bernardino County. These multi-week, competency-based training programs are offered at no cost to the county’s In-Home Supportive Services (IHSS) providers by the Center for Caregiver Advancement (CCA) through a grant from the California Workforce Development Board (CWDB) and High Road Training Partnership (HRTP). 

Caregivers can enroll in one of three programs: IHSS Essentials, Alzheimer’s Disease and Related Dementia (ADRD), and Caregiver Resiliency / Emergency Preparedness. The sessions will be offered in English and Spanish.

The Essentials course will teach caregivers about medication safety, nutrition, assistance with activities of daily living, and communication skills. Caregivers in the ADRD course will learn how to recognize signs of Alzheimer’s, as well as how to manage symptoms such as hallucination, sundowning, and behavioral changes. The Caregiver Resiliency course will help caregivers with climate-related emergency preparedness and response and how to recover from post-disaster trauma.

Henrene Barris, an IHSS provider in San Bernardino, is looking forward to the training. “It is important for in-home caregivers to have training programs available so we can provide quality care. CCA’s curriculum is so detailed and relevant. The multi-week format allows for more interaction, more time for learning, and more knowledge to be shared,” says Barris, who helped shape the project as a member of the Advisory Committee.

In addition to providing these three programs to San Bernardino’s IHSS caregivers, CCA will conduct a randomized control trial in partnership with researchers affiliated with the Abdul Latif Jameel Poverty Action Lab (J-PAL) North America 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. 

“We are excited to be a part of the first-ever randomized evaluation of training for IHSS providers. We are looking forward to studying the impacts on the workforce of caregivers who receive the training as well as the individuals who are cared for by the caregivers. The IHSS program and the innovative training provided by the Center for Caregiver Advancement represent promising models for other states around the country that are considering new programs to support in-home caregiving,” says Matt Notowidigdo, Professor of Economics at the University of Chicago Booth School of Business and Co-Scientific Director of J-PAL North America.

UC San Francisco will conduct an impact study on the Alzheimer’s program. CCA is the only organization within California utilizing an evidence-informed curriculum that has already been tested and delivered to thousands of IHSS providers in California.

“We continually push to advance the caregiving workforce through an evidence-informed approach. Our goal is to shift the narrative on the professionalization and value of the workforce. Access to training provides IHSS providers with opportunities for advancement within IHSS. The specialized training on Alzheimer’s focuses on much-needed skills critical to providing care in under-invested communities where rates of Alzheimer’s are increasing. And our Caregiver Resiliency program gives IHSS providers an increased understanding of climate change impact and the skills they need to address climate-related emergencies that impact the consumers that they serve,” says Corinne Eldridge, President and CEO. 

CCA links skill development with increased wages: Caregivers will be paid their hourly wages for their time in training. Those who complete the program can earn between $700 and $1,400.

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

A milestone celebration for IHSS caregivers

None of CCA’s IHSS training courses is complete without a virtual graduation ceremony. Each trimester culminates with this special celebration that, to some, may be their first-ever graduation.

It’s an occasion for caregivers to take center stage, to have their moment to shine and acknowledge their hard work and successes. Participants are given the chance to speak about their experiences in the course and discuss the impact of the skills acquired in the program with their fellow graduates. 

Tondaris Southward, an IHSS Provider who shared about her experience at her graduation, said, “I learned how to be more aware of client needs.” She mentioned that the lessons related to body mechanics, in particular, were the most beneficial for her and she was able to implement what she learned in the course right away in her role as a caregiver. 

IHSS Bilingual Mandarin Class Graduation photo with Sherry Wu

The CEO of L.A. Care Health Plan, John Baackes, attended one of the graduation ceremonies held this December. 

“This program is very important to your clients but also to you as the caregivers,” he told the class. “It gives you a leg up in your professionalism and your self-confidence. And if you have more confidence, your consumer will be confident in you!” 

“Whatever you learned here will help your client immensely,” he said. “I am convinced that during the pandemic, this program saved lives.”  

L.A. Care has partnered with CCA to provide free training to the IHSS providers who care for L.A. Care Health Plan members. Since the partnership began seven years ago, nearly 6,000 IHSS providers have completed the training under this program.

In addition to student success, another benefit to this partnership is caregiver satisfaction. According to post-training survey responses, 99% of the students believe that participating in the training was helpful to them in their roles as caregivers. 

IHSS Bilingual Spanish Graduation photo with Samuel Kwon

Resources beyond the classroom

Many graduates shared that the training equipped them with richer knowledge of how to communicate with their consumers. IHSS provider Arlene Alfaro said she learned “to have more communication with the consumer and to build more trust with [them]. Based on the skills you taught us and the things we learned in the book, I built a better relationship with my consumer,” Arlene told her instructors during her graduation. 

As a part of the material taught in class, participants are given additional resources that they may use in their caregiving careers beyond the classroom, such as nurse hotline numbers to call in case they need advice. “I learned about the other services that are available to us,” said Maria Martinez during her graduation speech. 

Additionally, the training provides caregivers a platform to meet others in the caregiving profession and establish connections that last beyond their time in the training. Another caregiver spoke about how she was positively surprised about how much she enjoyed the breakout rooms portion of the coursework because she was able to interact and establish connections with other caregivers. 

Honoring the families who care for those with Alzheimer’s

Alzheimer’s is more than a mere diagnosis for countless families globally; it marks the beginning of a life-altering journey that exacts a toll on their emotional, mental, and physical well-being. The role of a caregiver is demanding, requiring immense patience and empathy. It often involves witnessing a loved one’s cognitive decline, which can be heart-wrenching. 

“There are times … my dad would wake up and knock on my door in the middle of the night and ask me, ‘How is your mom? You have any information about your mom?’ My mom has passed away for many years,” says Qi Zhen Louie, an In-Home Supportive Services (IHSS) provider who has taken CCA’s Alzheimer’s care training.

More than a quarter of the IHSS providers in the program take care of a parent with Alzheimer’s disease and related dementia. Like Qi Zhen, caregivers are often children, or even spouses or close friends, who step into this role out of love and commitment. And, often, they do so without the training necessary to help them adapt to the ever-changing needs of their loved ones.

The Alzheimer’s care training helped Qi Zhen understand the symptoms and stages of the disease. “Now, I am more patient, and it helps with my communication with my dad,” she says. “Before, as soon as he threw a tantrum, I felt very upset …But I learned from (CCA’s) teachers a lot, and also from the sharing of our peers, the students. After the training, I have a lot of positive energy. And I’m able to understand some things that I did not know before.”

(Note to reader: Qi Zhen did this interview with a Cantonese interpreter).

CNA Apprenticeship Strengthens Nursing Staff

Apprenticeship programs, such as CCA’s Certified Nurse Assistant Registered Apprenticeship Program (CNA RAP), have proven to be a game-changer in preparing much-needed CNAs for the demanding roles they play within skilled nursing facilities. The earn-and-learn model inspires higher levels of performance amongst apprentices, increases productivity, and enhances their problem-solving ability. Because the apprentices become skilled, enculturated, engaged and loyal employees, apprenticeship programs can help reduce staff turnover and improve recruitment.

Since the first cohort of apprentices started their CNA training through CCA’s apprenticeship program earlier this year, 18 have been promoted to a CNA role and are now working at a partner facility. An additional 20 apprentices have completed their training and are either waiting for the results of their CNA certification exam or in the process of scheduling their exam date.

Duane Esquer, Nursing Home Administrator at College Vista Post Acute (a Sun Mar Healthcare facility) in Los Angeles, said, “The benefit of this apprenticeship program for our facility is that we get to increase our staffing so that we’re not struggling with turnover… This program has really had a positive effect on job satisfaction.”

Watch how the CNA Registered Apprenticeship Program has made an impact.

College Vista Post Acute’s parent company, Sun Mar Healthcare, is our inaugural corporate employer to partner with CCA for this apprenticeship program. In 2022, CCA received a $14 million High Road Training Partnership (HRTP) grant from the California Workforce Development Board (CWDB) to add 500 CNAs and 12 LVNs to the skilled nursing facility workforce in three years to help address an industry-wide staffing shortage. In partnership with employers and SEIU Local 2015, the apprenticeship program offers the CNA and LVN training at no cost to participants and guarantees them a job and wage increase when they pass their state exam.

Another employer group Pursue Healthcare also joined the partnership in 2023 and now has a few apprentices working as CNAs, with more are on track to complete classes, pass the state exam, and be promoted to CNA in the coming months. More employers are slated to join in 2024.

There is a clear demand for the training program: the wait list of interested candidates has grown to over 500.

Chrystal Miranda, an apprenticeship program graduate who is now a CNA at College Vista Post Acute, shares her journey: “I don’t think it would have been possible if I did not have this program. I have a daughter at home, so financial stability was always a top priority for me. It was really awesome that they were able to help me out. I didn’t have to worry about one thing or another. I could completely focus on just getting my studying done.”

Watch Chrystal’s story.

All tuition and related expenses are covered so participants do not pay for anything out of their own pockets. They also receive stipends to cover the cost of child care, transportation, and groceries so they can focus on learning in the classroom and practicing their skills during clinicals.

The apprenticeship program offers invaluable hands-on experience, allowing learners to work alongside experienced nursing staff. But the support doesn’t end there. CCA’s CNA program provides one-on-one mentorship to the newly promoted CNAs so they can build the confidence they need to excel in a healthcare setting. Aside from mentorship, the new CNAs also receive retention bonuses throughout their first six months of employment and access to free high-quality training through their SEIU 2015 Education Fund. They can access free continuing education classes, obtain their Restorative Nurse Assistant (RNA) Certificate, get certified in CPR, and many other trainings.

Duane Esquer said all the elements of the apprenticeship program – especially the partnership between the nursing home employers, the union, and CCA – greatly benefit the workers, the facilities and, most importantly, the residents.

“The students who then turn into Certified Nurse Assistants hit the ground running because they’ve had the education, they’ve had the training, they’ve been working directly with our current staff. So it flows very well,” Esquer says. “We’re invested in their success because when they win, we win, and at the end of the day, the residents win the most. They get caring individuals who want to be working in this industry, who want to be a CNA. And we’re so excited to see how this program will grow and continue to succeed and hopefully help other facilities and other companies, and at the end of the day give people opportunities in healthcare that they may have not had before.”

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