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Impact study: Training results in better care

In 2012, the California Long-Term Care Education Center, which is now the Center for Caregiver Advancement received a three-year, $11.8 million Health Care Innovation Award from the Centers for Medicare and Medicaid Services’ Innovation Center, established by the Affordable Care Act to test innovative service delivery models, for a pilot project called the Care Team Integration of the Home-Based Workforce.

This project’s innovative contribution to health care was to recast and enhance the role of home care providers through training and integration into the health care system. This project showed that training home care workers is associated with better care, stronger health outcomes and at lower costs through reductions in consumers’ use of the Emergency Department and hospitalizations, particularly repeat visits to the Emergency Room and readmissions to the hospital, which has the potential to create tremendous cost savings to Medicare and Medicaid. Home care providers are in direct and frequent contact with the consumers they care for and are in the unique position to positively impact consumers’ health.

Read the report here: HOME CARE INTEGRATION TRAINING PROJECT BRIEF

Adjusting to Virtual Learning

In her hands, Cecilia Rodriguez held a bag.

“In my dream, I grab a bag and in it, I place all my dreams and the pain of having left my children,” she said. She was 33 and a young mother in 1986 Honduras. Her youngest child was only 7. Still, she had to leave.

Rodriguez, now 66, found work trimming clothes in Chinatown. Then she began making tamales to sell. Eventually, she was able to send for her six children.

“Thanks to God, I have all my children living legally in the United States,” she said.

One of them has a disability, and he is the reason she came to the doorstep of the California Long-Term Care Education Center (CLTCEC). “I have always liked challenges, and I like to learn more,” Rodriguez said. 

CLTCEC is the largest provider of long-term care training in California. Its IHSS+ training program is a 10-week course that educates and empowers caregivers who provide services to seniors and persons with disabilities. In these classes, caregivers learn skills such as assisting in activities of daily living (bathing, dressing, etc), infection control, medication adherence, nutrition, communication, home safety, CPR, and personal care.

Before the pandemic, classes were held in person in multiple languages across Los Angeles County. 

During her IHSS+ training, Rodriguez gained valuable skills and knowledge on how to better care for her son. But what she most enjoyed during class was interacting with fellow caregivers and sharing experiences. She missed that camaraderie when the coronavirus outbreak forced CLTCEC to pause in-person classes in March. 

“I felt bad (when classes stopped),” she said.

Classes resumed two weeks later but it was in a format that caused her to worry. 

“I’ve never enjoyed meetings via technology, because I felt I wasn’t prepared. But I learned to enjoy the challenge.”

Rodriguez said her field representative, Isabel Menjivar, talked her through using her phone to access Zoom meetings, persevering until both of them felt confident in her newfound skills.

“Now I’m really good,” Rodriguez said. “I’m much more prepared.”

Dr. Antonio Borras, CLTCEC instructor, said his students panicked and were hesitant at first, but quickly grew in confidence and enthusiasm once online classes began.

“It was an unforgettable experience to see my students face a new challenge, something they would have not thought about and overcome all difficulties,” he said.

Rodriguez is using her training not only to protect and nurture her son, but also to keep herself healthy and strong. She is fastidious about hand-washing, and she has learned how to carefully and properly assist her son with dressing, bathing, and moving.

“My day is happy when my son wakes up and hugs and kisses me,” Rodriguez said. “We have breakfast together and we exercise. I bathe him and I thank God that he has given me this angel who is never in a bad mood.”

Rodriguez said overcoming her fear of technology, especially since English is not her first language, brought back memories of when she first arrived in the United States.

“I received my strength when I stepped out of Honduras in 1986,” she said. “I defeated (my fears) and triumphed. I got all my dreams and what I wanted with faith in God.”

It is something she tells her son, and all her children: “Dream and practice fighting for what you want. Fighting and dreaming is how goals are achieved.”

From Kitchen to Care Team

The transition from her initial job preparing meals for nursing home residents to becoming part of their care team as a Certified Nursing Assistant (CNA) was an easy one for Alba Marroquin.

“Everything is going awesome with the residents because I kind of know what they like and what they don’t,” she says. “I am so comfortable working as a CNA now. I loved working as a Dietary Aide too, but this is what I really wanted to do.”

Marroquin graduated in December 2019 from the CNA certification program offered by the Education Fund. Her cohort, which included nursing home workers from participating facilities and a few In-Home Supportive Services (IHSS) workers, took classes through the American Medical Career College in Pomona. A new cohort has already started in the first quarter of 2020.

After passing her state exam, Marroquin was hired immediately as a CNA at Laurel Wellness (Longwood facility) where she had been working as a Dietary Aide since June 2019. For  workers in dietary, housekeeping and other non-clinical positions at skilled nursing facilities, the certification sets them on a new career path.

“I never thought I might be able to achieve this goal, but now I feel more secure than before,” she says. “I am truly grateful for this opportunity that the Education Fund has given me.”

The Education Fund offers the CNA program to eligible workers employed at nursing home facilities participating in a labor-management partnership with SEIU Local 2015. The program provides a solution to the severe staffing shortage in California’s nursing homes, which need an estimated 1,700 to 2,400 additional nursing assistants [1] as an industry to help meet state staffing requirements. It also helps reduce employee turnover by increasing staff morale and job satisfaction.

To help nursing homes retain and strengthen their nursing staff, the Education Fund also offers a 30-week mentoring program with employer and union collaboration that matches longtime CNAs with those who, like Marroquin, are just starting out. Additionally, eligible CNAs can earn a Restorative Nursing Assistant (RNA) certification through the Fund.

While she was undergoing the CNA training, Marroquin gained a new appreciation for the work of nursing assistants and the patients under their care. “I learned to have more respect for elderly people and for all CNAs.”

Marroquin has her sights on advancing her career through more training programs such as the ones the Education Fund offers. “I want to go for Licensed Vocational Nurse or a Registered Nurse,” she says. “I want to continue studying because now I’m confident I can do everything that I put my mind to. This (CNA course) gave me that confidence.”

[1]https://lao.ca.gov/Publications/Report/3815

Gerontology Journal Highlights ADRD Training

In August 2019, CLTCEC’s In-Home Supportive Services (IHSS+) Alzheimer’s training program was published in the peer reviewed journal Gerontology & Geriatrics Educationco-authored by CLTCEC Executive Director Corinne Eldridge. We are glad to see the Alzheimer’s program make a meaningful contribution to the body of research around the impact of training IHSS workers.

The IHSS program in California provides direct care for low-income seniors and people with disabilities. Yet, the vast majority of these workers receive little to no training in caring for consumers, especially those with Alzheimer’s disease and related dementias (ADRD). This article details how CLTCEC developed and implemented a competency-based training program for IHSS caregivers who provide care for persons with ADRD. Read more here.

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