A February 19, 2025 news story by health reporter Ana B. Ibarra on the CalMatters.org website highlighted the need for emergency preparedness among caregivers assisting people who are disabled or those with limited mobility during wildfires and other emergencies. The Emergency and Disaster Readiness training provided by the Center for Caregiver Advancement (CCA) is part of the solution.
The CCA offers its Emergency and Disaster Readiness course to workers of the In-Home Supportive Services program in San Bernardino County as part of a partnership with SEIU, the labor union representing caregivers. CCA CEO Corinne Eldridge reported that CCA has provided this training to about 4,000 In-Home Supportive Services workers across California since 2021.
CCA appreciates Ibarra’s recognition of the need for disaster readiness training to help caregivers navigate fires and other emergencies.
To read the full news story, please visit CalMatters.org.
Andrew So is a dedicated educator and mentor whose diverse experiences have shaped his unique approach to teaching. As a bilingual (Cantonese) instructor at the Center for Caregiver Advancement (CCA), he brings a natural flair for teaching to his in-home caregiver training courses. Andrew feels that he is enriching the lives of his students through education and personal connection.
Transitioning from Entrepreneur and Music Teacher to Caregiving Teacher
Born and raised in Hong Kong, Andrew moved to Los Angeles for his studies. He spent eight years there before returning to Hong Kong. He later married and worked in his home city. He even started his own business — a café offering specialty coffees. However, he and his wife decided to raise their family in the United States, settling there after briefly considering Canada.
With a degree in music composition, Andrew has a strong background in the arts. He has taught music extensively. He transitioned into providing training for in-home caregivers at CCA through a mixture of luck and personal experience. A friend told him to consider applying to CCA because of his role as an in-home caregiver for his grandfather, who had dementia. This firsthand exposure to caregiving fueled Andrew’s interest in learning more about the field. He now finds great fulfillment in equipping students with the knowledge and skills needed to care for others effectively.
“I see that I am having an impact on my students and on the care consumers they serve.”
Andrew has discovered that teaching, regardless of the subject, is his true calling. Whether he is mentoring college students in music, training people in coffee brewing, or educating caregivers, Andrew finds fulfillment in sharing his knowledge. Today, he teaches in-home caregiving courses to Cantonese-speaking students at CCA. He also conducts coffee brewing workshops for at-risk youth, providing them with practical skills and a constructive outlet.
Teaching Caregiver Students of All Levels Has Challenges and Rewards
For Andrew, the most rewarding aspect of teaching caregiving is witnessing the impact it has on his students. He often receives messages of gratitude from graduates who have successfully applied his teachings in their caregiving roles. The heartfelt messages he receives, especially during Chinese New Year, affirm the value of his work. He takes pride in knowing that he is helping caregivers provide compassionate and competent care, particularly for individuals with dementia.
“In-home caregivers are not very highly paid workers, but they are people with good hearts. I am very touched by my students, and I’m grateful for the connections I form with them.”
Teaching Cantonese-speaking students at CCA comes with its challenges, due to the wide disparity in educational backgrounds among his students. Some students have advanced degrees, while others struggle with basic literacy and technical skills. Andrew addresses this challenge by taking a step-by-step approach in his classes. This ensures that all students, regardless of their starting point, become proficient in digital learning technology by the end of a 6-8-week course.
Andrew has developed a deep appreciation for the emotional connections he forms with his students. Although he considers himself an unsentimental person, he finds the compassion and care that his students bring to their work very moving. Reflecting on his own caregiving journey, he wishes he had received the type of training that CCA provides, which would have better equipped him to care for his grandfather.
CCA Training Offers Value, Resources, and a Community of Supportive Caregivers
In addition to CCA’s caregiving courses for the elderly, Andrew highlights CCA’s unique offering of courses on autism and spectrum disorder care. He sees these as invaluable resources for parents and caregivers alike. Beyond providing essential caregiving knowledge, CCA classes also serve as a support network, where caregivers can share their experiences and challenges in a safe environment. The sense of community fostered in these classes helps caregivers navigate the emotional and physical demands of their work.
With a deep commitment to education and caregiving, Andrew So continues to inspire and empower his students at CCA. His journey — from being a music educator and café owner to caregiver instructor — reflects his adaptability and passion for teaching. Whether he is guiding students in caregiving, or mentoring youth in coffee brewing, Andrew’s impact extends far beyond the classroom, changing lives one lesson at a time.
Andrew So was recently recognized by CCA leadership for his teaching contributions to the CCA training programs, with a promotion to Lead Instructor.
LOS ANGELES – February 5, 2025 – The Center for Caregiver Advancement (CCA), California’s most experienced provider of free accessible caregiver training, has announced the appointment of Quintilia Ávila as its first Senior Director of External Affairs, a leadership position that reflects CCA’s steadfast commitment to supporting California’s caregiver workforce. With more than 30 years of experience in advancing healthcare research and initiatives, strategic planning and civic engagement, Ávila brings a wealth of expertise and knowledge to the role.
“We are eager for Quintilia to help expand our reach, connecting CCA to more policymakers, community leaders, and philanthropists as we celebrate our 25th anniversary this year,” said CCA President and CEO Corinne Eldridge. “Each new partnership and deepened relationship can amplify worker voice, diversify our funding, and provide high-quality training to more caregivers. We have a great opportunity to work more closely with the Latino community in a state where Latinos comprise 40% of direct care workers.”
Ávila, who holds a Master of Public Administration from the University of Southern California and a Bachelor of Arts in Women’s Studies from the University of California, Santa Barbara, will build on her successful track record serving government agencies, nonprofit organizations, and academia. Most recently, she served as the California Director of Civic Engagement for the NALEO Education Fund and was previously appointed Regional Program Manager Southern California Lead for the California Census 2020 by Governor Jerry Brown. Bilingual in English and Spanish, she volunteers as a behavioral health advocate appointed to the Riverside County Behavioral Health Commission and is an alumna of the 2024 Leadership Institute of Hispanas Organized for Political Equality.
Overseeing a newly formed department comprising Communications, Fund Development, and Data and Research, Ávila will play a pivotal role in keeping CCA at the forefront of an equity-driven movement for quality training and quality jobs. Her primary responsibility will be to help develop and implement strategic initiatives that enhance CCA’s visibility, reputation, and impact.
“I am thrilled to join an organization that advocates for a society where older adults and people with disabilities live longer, healthier, and happier lives,” said Ávila, “My passion is helping organizations strategically manage initiatives with a social equity focus, driving meaningful and inclusive change.”
For more information about Quintilia Ávila’s appointment or to inquire about how to support the Center for Caregiver Advancement, please contact Corinne Eldridge at (844) 725-8232.
About the Center for Caregiver Advancement The Center for Caregiver Advancement believes in building the workforce of highly trained caregivers that many Californians can’t live without. We are the state’s most experienced provider of free, accessible training that focuses on a supportive, experience-based learning environment. Our impact studies advance policy initiatives to develop career pathway opportunities and build professionalization within long-term care. For more information, visit https://advancecaregivers.org.
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Media Contact Neyda Campos Account Coordinator (626) 692-2591 neyda@millergeer.com
Aida Rustemova Bonfiglio, a single mother and immigrant from Kazakhstan, had always dreamed of working in the medical field. She never imagined that a paid apprenticeship would make that dream a reality. Inspired by her family’s deep roots in healthcare—her grandmother was a nurse who became a surgeon, and her mother was a doctor—Aida grew up with a strong desire to care for others. But heeding her mother’s advice not to follow in their footsteps because of the demanding work and long hours in the medical field, she earned a bachelor’s degree in international relations and a master’s in international law in Kazakhstan. However, as a newcomer to the United States, Aida faced a range of challenges: language barriers, financial instability, and the daunting task of supporting her young daughter as a single parent.
Despite her background as an attorney with a bachelor’s degree in international relations and a master’s in international law, Aida’s credentials were not recognized in the U.S. Instead of pursuing a career in law, she found herself drawn to the healthcare field—a dream that, for a while, seemed out of reach.
The Game-Changer: CCA’s CNA Registered Apprenticeship Program
Aida’s life changed when she heard about a Certified Nursing Assistant (CNA) registered apprenticeship program offered by the Center for Caregiver Advancement. The program promised more than just training—it provided a holistic support system, including paid tuition, financial stipends, and mentorship, giving Aida the opportunity to continue her studies without incurring debt. “It felt like someone always had my back,” Aida shared, reflecting on her experience.
“The financial support allowed me to focus on my studies and care for my daughter at the same time. I didn’t have to choose between my family and my education.”
Support Every Step of the Way
The apprenticeship program was a game-changer for Aida. As a single mother who doesn’t receive child support, she long struggled to make ends meet. The apprenticeship paid for her time in class, making it possible for her to support her family while gaining the education and experience she needed to enter an allied health profession. The program also covered tuition and stipends for food and gas, relieving the stress of living paycheck to paycheck.
What Aida appreciated most about the program, however, was the mentorship. “It wasn’t just about the training. It was about the people who supported me every step of the way,” she explained. From her initial interview with her program coordinator, Martha, to ongoing guidance from a dedicated mentor once she started working as a CNA, Aida felt encouraged and empowered throughout her journey
A Career Transformed: Thriving as a CNA
Today, Aida is thriving in her career as a CNA, with a renewed sense of purpose and a growing passion for caregiving.
“This program changed my life. I’ve always wanted to help others, and now I’m living my dream.”
But Aida’s ambitions don’t end there. She dreams of becoming a Licensed Vocational Nurse, a goal she is actively working toward to make an even greater impact on the lives of her patients.
Advice for Aspiring Apprentices: Go for It
Aida’s story is a powerful example of resilience and determination. It highlights how apprenticeship programs not only provide individuals with the skills and training needed for a successful career but also offer essential support during times of personal struggle. For Aida, the apprenticeship program was more than just a job opportunity—it was a life-changing experience that gave her the tools to build a better future for herself and her daughter. When asked what advice she would give someone considering the apprenticeship program, Aida’s answer is simple yet profound.
“Go for it. CCA’s program offers you everything you need to succeed—training, financial support, and the chance to build a career without experience. It changed my life, and it can change yours too.”
As we celebrate National Apprenticeship Week this November, Aida’s journey is a testament to the power of opportunity and the importance of support in overcoming obstacles. CCA’s CNA Registered Apprenticeship Program provided her with both and helped Aida realize a lifelong dream.
For Cassandra Parker, becoming a full-time caregiver wasn’t something she expected, but when her family faced crisis after crisis, it became a role she embraced with grace and determination. Her story is one of resilience, love, and learning—both as caregiver and daughter.
In 2021, Cassandra’s life took a turn when her father was diagnosed with stage four kidney cancer during the COVID-19 pandemic, making it difficult for him to get the surgery he needed. This came just after she had lost her mother to stage four pancreatic cancer. With her sister preoccupied with a newborn, Cassandra took on the responsibility of caring for her father. “The baton was passed to me,” she explains.
Despite her limited knowledge of caregiving systems like IHSS (In-Home Supportive Services) at the time, Cassandra quickly stepped into her role, beginning her journey as a full-time caregiver for her father.
Navigating Dual Roles: Daughter and Caregiver
One of the hardest parts of Cassandra’s journey has been finding a balance between being a caregiver and a daughter. “Asking for help has been crucial,” she shares. “When you’re a caregiver, your focus is on making sure your consumer is properly taken care of, but as a daughter, especially after losing my mother, it’s tough. You need that emotional support.”
Cassandra found solace and structure in CCA’s courses, which provided her with tools to manage the dual roles.
“Participating in CCA’s course gave me permission to be a daughter again.”
The courses not only allowed her to take a step back from the constant demands of caregiving but also gave her the knowledge and skills to better support her father.
For Cassandra, caregiving is more than just tasks—it’s about preserving her father’s independence and humanity. “You want them to feel like they can still take care of themselves. We don’t want them to feel like they’re less than,” she explains.
The Power of Community and Lifelong Learning
According to Cassandra, one of the most valuable aspects of CCA’s courses is the peace of mind they provide. She learned critical skills, like managing medications and navigating healthcare, but also discovered something even more powerful: the importance of self-care. “You can’t take care of anyone else unless you take care of yourself,” she stresses.
Cassandra first learned about the courses through her involvement with SEIU Local 2015. “I came across Rodney, one of the field assistants. He told me about the free course—worth $9,000—and I thought, ‘I have to take this.’ It wasn’t just about the stipend; it was about gaining the knowledge I needed to take care of my father.” For Cassandra, the course was transformative. “I got so much more than I expected. It wasn’t about the money; it was about making sure I was doing everything I could for my father.”
A Message for New Caregivers
To those considering caregiving, Cassandra’s advice is clear: “You can do it. It’s not going to be easy, but you’re not perfect, and that’s okay. It’s important to take care of yourself mentally and emotionally before you can take care of your consumer.”
Cassandra’s journey has taught her the importance of community. Through the courses, she found a support system that helped her care for her father and herself. “You’re not on your own,” she reminds others. “You’ve got this.” As she continues to care for her father, Cassandra is thankful for the resources and community CCA has provided.
“Being a caregiver is the most rewarding thing. CCA really cares about their caregivers, and I’ve learned that you have a community—you’re not in this alone.”
Research appearing in the March/April 2024 edition of the peer-reviewed journal Professional Case Management suggests the Center for Caregiver Advancement’s high-quality caregiver training contributes to reduced emergency room visits.
The study looked at caregivers who completed 16 weeks of in-person In-Home Supportive Service (IHSS) training and compared them to a group who did not receive the training. Researchers tracked each group for three years. The CCA training program was developed with support from a Center for Medicare and Medicaid Services’ Innovation Grant, established by the Affordable Care Act.
Reduction in Hospitalizations 30% reduction in hospital readmissions for consumers who received care from trained home care workers compared to those who did not receive training.
Emergency Room Visits There was a reported 25% decrease in emergency room visits among consumers cared for by trained caregivers.
These reductions in utilization led to an average savings of $1,500 per consumer annually.
OUR IMPACT
Training was associated with several other factors that impact quality of life. For consumers with trained caregivers, researchers saw:
20% fewer complications for consumers with chronic illness
35% increase in adherence to care plans
40% increase in consumer satisfaction
These findings were published in Professional Case Management.
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.
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:
Seeking to understand a speaker’s idea
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
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.
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.
