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University Focusing on Home Care Staffing Issues

Programs stemming from Michigan State University are tackling huge problems in home health care. And one grant-funded pilot program is aiming to improve the caregiver shortage as demand continues to rise.

With nearly $900,000 in grants from the Michigan Health Endowment Fund (MHEF), two MSU professors—Clare Luz, PhD, an assistant professor of family medicine, and Joan Ilardo, PhD, director of research initiatives at MSU’s College of Human Medicine—will engage in separate but complementary programs to better enable home care in their state, and possibly elsewhere in the future.

A Growing Crisis

Demand for home health care aides is expected to rise rapidly over the next several years, but factors like low pay and lack of training have made it one of the hardest jobs to fill. And home health care agencies are already doing more to boost recruitment and retainment of caregivers.

In Michigan alone, the growing demand is huge. By 2020, an estimated 196,000 personal care aides will be needed, with the shortage ranging between 20,000 and 30,000 workers, according to Luz.

With $500,000 in support, Luz has launched the Integrated Model for Personal Assistant Research and Training (IMPART) program to enforce what some studies have shown—that more training in this workforce leads to less turnover, better patient outcomes and satisfaction, and likely more attraction for the job in the long term.

Ilardo’s complementary program received $376,000 from the Michigan Health Endowment Fund and looks to improve communication between patients, their families and health care providers by teaching the self-management of chronic diseases.

The IMPART program builds off the successes of Luz’s prior pilot, the grant-funded Building Training, Building Quality (BTBQ) program, which revealed empirical evidence that better training for personal care aides led to better outcomes for patients and greater marketability for PCAs in the job market.

“There’s a huge shortage already of these workers, and it’s just going to get worse,” Luz told Home Health Care News. “We need to increase the size of this workforce as well as the quality. Most employers would agree you don’t get quality care without quality training. One of our long-term goals is to have a big enough workforce that’s well qualified.”

Employers, too, have seen benefits with reduced turnover from enhanced training programs like BTBQ.

The BTBQ training is unique in that it teaches personal care aides how to deal with situations that are specific to in-home care, such as communication skills to help secure relationships with patients and how to work in an isolated setting. The training does have some overlaps with typical certified nursing assistant programs, but also offers more information for meal preparation and other household activities. One of the cornerstones of the program is the philosophy that person-centered care should be infused in all aspects of supportive services.

“One of the problems with shortage is turnover,” she said. “Part of it is how we treat them—we don’t pay them well, there aren’t strong benefits. One of the things we have to do is stabilize this workforce and training is shown to do that. With high quality training, just like any other job, you get paid more.”

‘Pocketbook’ Problem

Paying for this higher quality training is still an ongoing puzzle, despite growing evidence of its effectiveness at combating one of the industry’s top challenges. For example, when the BTBQ grant fund ended, the training for hundreds of personal care aides (PCAs) also stopped. However, the solution could be net positive for general health care savings.

“The cost savings in reducing adverse events is huge, but also keep in mind this is the lowest-paid workforce,” Luz said. “All the way around, this is the cost-effective way of improving health care and reducing costs.”

With the new two-year grant, Luz will be working with a coalition of partners, including the College of Human Medicine’s Department of Epidemiology and Biostatistics; MSU Usability/Accessibility Research and Consulting; Community Services Network; the MI Department of Health and Human Services Aging and Adult Services; and Yale University. The coalition will work toward several goals, including figuring out how to make these programs sustainable and scaleable like other accreditation programs.

“There’s the pocketbook aspect, the need to demonstrate how it affects business, the job market, the economy,” she said. “And there’s the personal aspect of it—that this is something affecting all of us. It seems like the more we can get the key players to understand the connection between training, quality of care, better health care outcomes and lower heath care costs—the more we can establish that connection for payers and insurance and health plans—I hope it would seem like a no-brainer.”

IMPART will work with a coalition of stakeholders, including home care agencies, personal care aides, local aging agencies and advocacy groups, in order to help achieve the program’s aims, according to Luz.

“They will be challenged to come up with strategies, potential win-win strategies that benefit not only the employer but the employee to get this training out there in a feasible and affordable way,” she said. “We’re hoping this group will be the nucleus of a larger coalition to come up with a plan.”

The coalition is expected to have its first meeting at the end of March or beginning of April, and will continue to meet throughout the grant’s run.

By Amy Baxter, Home Health Care News

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