In addition to the annual impact report that the Center for Caregiver Advancement (CCA) prepares for the L.A. Care Health Plan, we provide an interim report after each trimester.
CCA regularly evaluates the value and impact of its training programs on the caregiver workforce and the quality of care they provide through impact studies. Many of these studies are conducted in partnership with academic institutions and research organizations. Once an impact study is complete, the Research and Policy team at CCA helps our program directors compile the data into impact reports.
The Learning and Instruction team at CCA designs curricula and programs based on the data resulting from these studies. They use the results from impact studies, qualitative research, and subject matter expert opinion, to guide and improve the training.
The findings from our research help to move the evidence base into actionable strategies and policies that help advance workforce development for long-term care workers.
The “IHSS+ Home Care Integration Training Interim Report, March 2023” is the result of an impact study. Please access the report via the button below.
When Felipe Murillo suddenly became his mother’s full-time caregiver, everything seemed like an emergency and they made a lot of ER visits.
“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 (ER).
However, after completing CCA’s 10-week caregiver training program, Felipe can now distinguish between a situation that requires an ER visit and those that can be handled via an urgent care facility. Through this training I am “… learning about the differences. [I learned that] maybe she doesn’t really need to go to the ER every time, 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 was approved to offer a hybrid CNA training and certification program as an official Nurse Assistant Training Program (NATP) provider by the California Department of Public Health (CDPH).
The NATP is offered in a hybrid format and consists of 160 hours of instruction, split between 60 hours of live instructor-led theory (online) and 100 hours of in-person clinicals. Participants take part in on-the-job training while being employed as a nursing assistant trainee at a partnering nursing facility.
The training program is the first step for those interested in nursing and providing quality care for others. Participants are 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 CNA Registered Apprenticeship Program is offered through a unique partnership with the CDPH that enables CCA to provide generous support services. The CNA RAP is a short-term program that offers support to CNA trainees in the form of stipends. These support funds may include a child care expense stipend of up to $1,600, a grocery stipend of up to $400, and a transportation stipend of up to $100.
To ensure student success, CCA also offers mentorship from experienced CNAs. Participants are typically paired with a case manager, coach, and mentor who will be there to guide them throughout their training and the initial months as a working CNA. Upon completion of the program and passing the state CNA certification exam, graduates will be promoted to a CNA job with a guaranteed wage increase.
PLEASE NOTE:The CNA RAP training program ended in August 2025, and a different CNA training program was launched. The new program follows a slightly different training model. Please explore CCA’s CNA Training Pathway program for more information:https://advancecaregivers.org/cna-training-pathway-program/
If you have questions about our training programs, you can also email the Education Fund team at: edfund@advancecaregivers.org.
Veronica Mendoza’s role as a nurse assistant trainee 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.
Training as a CNA Is a Step Toward Career Advancement
Recently, Veronica decided to take another step in her career path when she enrolled in CCA’s Certified Nurse Assistant (CNA) training 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 CNA certification, she will be promoted to CNA at Paramount Convalescent with a guaranteed wage increase.
The CNA training program is a tuition-free program that is designed to create a pathway for workers in skilled nursing facilities (SNF) who are interested in a nursing career. The program helps to provide a solution to the staffing crisis in the nursing home industry by providing access to free training and placing trained CNAs in skilled nursing facilities who know the facilities’ procedures and practices.
CNA Training Offers Personal and Professional Growth
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. 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 CNA training program through her union, the 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 to offer support. If I have any questions, I am free to go and ask them anything,” Veronica said.
Mentoring Is a Bonus of This Training Program
The Education Fund’s training program provides tuition and support services to participants. It also supports the skilled nursing facilities where the nursing assistant trainees 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. Many CNAs continue those mentoring relationships for their first months as CNAs after they pass their state CNA exam.
“To me, the training is motivating me to continue my healthcare career, and I would say it is 100% worth it,” she said.
* CNA training programs through CCA and its partners are subject to eligibility requirements. Please contact our programs team to learn more at: edfund@advancecaregivers.org
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
Lizette Mendoza’s inspiration to pursue a nursing 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 (CNA RAP) 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 and, eventually, in a nursing role.
Participants in the CNA Registered Apprenticeship Program are not required to have any prior medical 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 in nursing. The CNA program will allow her to begin her healthcare 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.
CCA regularly evaluates the value of its online training programs on the caregiver workforce and the quality of care they provide. Through studies conducted in partnership with academic institutions and research organizations, CCA measures the impact of its caregiver training programs.
Our partners often publish their research in peer-reviewed journals. Here we share with our readers the published research findings of a team led by Jarmin Yeh, PhD, MPH, MSSW, at the University of California, San Francisco (UCSF). This study was focused on increasing caregivers’ knowledge of dementia.
Enhancing Dementia Knowledge and Self-Efficacy of IHSS Caregivers Through Online Training
Study Authors: Jarmin Yeh, Brittney Pond, Matthew Beld, Andrea Garcia, Juvenal Mauricio, Juliana Mata-Pacheco, Corinne Eldridge, Leslie Ross
California’s In-Home Supportive Services (IHSS) program provides vital home care to low-income consumers, some of whom live with Alzheimer’s disease or related dementias (ADRD). Yet, most IHSS caregivers receive little or no training in dementia care.
The study authors present preliminary descriptive results of the IHSS + ADRD Training Project, a 10-week, competency-based dementia training program that was delivered online by the Center for Caregiver Advancement (CCA), for IHSS caregivers in Alameda County, California. Increase in dementia knowledge and self-efficacy at training completion supports the importance of continuing and expanding this work.
This is curated content using information from the original article. For details, please read the published article online in the Journal of Applied Gerontology.
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.
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.
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.
Before Rebekah Acosta transitioned to being her daughter’s full-time caregiver, she was already entrenched in the developmental disabilities community. She has a bachelor’s degree in psychology, a master’s in special education, and two teaching credentials. She taught special education for 10 years.
But to be a better caregiver for her daughter, who has autism spectrum disorder, Rebekah knows she needs more than her master’s degree.
One thing that can be hard is the advocacy piece … making sure that all the pieces fit together. Kind of take things from different doctors and synthesize them into her and her needs, making myself familiar with any new medical needs that she has. I kind of have to become like a mini expert on her,” Rebekah shared.
For the past two months, Rebekah has been immersing herself in caregiver training. Rebekah is one of the IHSS providers taking courses with CCA through the IHSS Career Pathways Program. She has been focusing on CCA’s autism learning pathway, specifically because of her daughter.
“…the classes really taught me how to analyze what my daughter needs and integrate that into what I do every day with her,” she said. The autism pathway is tailored for what Rebekah and her daughter need.
CCA’s Autism Spectrum Disorder (ASD) 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 what they learned into practice through case scenarios.
Photo by Watchara Phomicinda
Caregivers like her, Rebekah said, “over time, become an expert on their child. When you have a child with a disability, you’re just kind of thrown into it. And as a parent, as a caregiver, you have doctors being like, ‘Well, you’re mom, you have to make the decision.’ And it can be kind of daunting.”
The autism care training helps familiarize caregivers with the terminology used by medical care professionals. This gives them the confidence to be decision makers and active participants in the care planning, Rebekah said.
With that in mind, Rebekah has been taking as many courses as she can with the Career Pathways Program. It’s a much-needed program for caregivers, she said.
Most other professions have continuing education opportunities, Rebekah said. This program gives “caregivers a chance to continue to have education and continue to build their knowledge base throughout their career. I know people think differently, but it’s still a career to be a caregiver.”
Perri Kendrick and her son Trevor have an unbreakable bond. They do almost everything together: ice skating with Perri pushing Trevor’s wheelchair on skates, watching TV while Perri exercises on her stationary bike, or hosting friends at their home like they do several times a week. They are truly an inseparable duo. Not only is Perri his mother, but she is also Trevor’s full-time caregiver.
As Trevor’s In-Home Supportive Services (IHSS) provider, Perri recently completed CCA’s caregiver training program to help make herself “the best caregiver [she] could possibly be.” Just like they do almost everything else together, Perri and Trevor both learned and grew as a team during the 10-week training.
A Mother-Son Bond Grew Even Stronger With Caregiver Training
Throughout the course, Perri said she learned essential caregiving tips that she had originally overlooked because she is caring for her own son. In the training course, she learned about documentation, the use of gloves, and the proper way to wash hands. Trevor learned along with her. “He has learned that we are a team that has to work together because if we’re not going to keep each other healthy, then nobody else is,” Perri said.
“Really, in my heart to know Trevor is to love Trevor,” Perri said
Photo by Kim Fox
Love is at the forefront of both Perri’s roles in Trevor’s life – as his caregiver and as his mother. “I think everything about taking care of Trevor is exhausting, but it’s so rewarding,” she said. “I absolutely love taking care of him.” This truly is a bond that cannot be broken.
Trevor was born with Cerebral Palsy (CP) and was diagnosed when he was one year old. Since then, he has defied so many odds. “Doctors said that he wouldn’t live through the night, and then doctors said he wouldn’t live past 14,” Perri said. Trevor is now 38 years old, outliving his prognosis by 24 years.
Trevor’s prognosis is not the only challenge that he and Perri had to overcome in his 38 years. As a direct result of his CP, Trevor is also non-verbal, Perri explained. Yet, that does not stop him from interacting with others and making new friends wherever he goes. He uses a communication device that is activated by auditory scans to produce phrases such as “Hey, how’s it going?” or “Hi, I’m Trevor, nice to meet you.”
Trevor uses this device to connect with others – something he truly enjoys. Perri said Trevor makes friends with anyone – from the waiters at restaurants, to community members at the grocery store and even with the local firefighters who attend his birthday parties every year.
When Perri began her caregiver training course, it was no surprise that when Trevor attended alongside her, he interacted with the other caregivers. “He went to every Saturday class and he was as excited about the classes as I was,” she said. “He had so much fun.”
Perri shared that the course improved her life by teaching both her and Trevor to be more patient with one another. “I have learned this wasn’t his choice to have to be cared for and (now) I always try to put myself in his position. I think that just makes me do everything with more love,” she said.
