This trial investigates whether high-quality training for consumer-directed home health workers impacts health outcomes for care consumers and employment outcomes for care workers. The investigators are conducting this study in the context of the In-Home Supportive Services (IHSS) program, a consumer-directed, Medicaid-funded home care program in California serving elderly and disabled Medicaid recipients. The investigators will partner with the Center for Caregiver Advancement (CCA), a training provider based in California, to conduct a randomized evaluation of the impact of training for IHSS workers on labor and health care outcomes. The evaluation will enroll IHSS workers in San Bernardino County, where CCA will be expanding its program. Participants will be randomized to either a group that receives CCA's training or a control group that does not receive training. Participants randomized to the training group will complete a 30 hour online course that teaches fundamental caregiving skills. Training includes personal care, infection control, nutrition and body mechanics, medication adherence, and home safety. Researchers will compare outcomes between IHSS providers in the two groups and between IHSS consumers who receive care from the IHSS providers in the two groups to see if training impacts health, health care, and labor market outcomes.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
2,500
The intervention is the Center for Caregiver Advancements 30-hour IHSS Basic training course.
San Bernardino County
San Bernardino, California, United States
RECRUITINGNumber of emergency department visits (for consumer)
Time frame: 1 year after training begins
Any emergency department visits (for consumer)
Time frame: 1 year after training begins
Estimated annual health care spending (for consumer)
Estimated annual health care spending will be calculated by multiplying the number of inpatient admissions, emergency department visits, outpatient office visits, long term care stays, and prescription drugs by estimated average costs for those services among low income publicly insured adults.
Time frame: 1 year after training begins
Share of participants with falls resulting in a health care visit (for consumer)
The share of consumers with falls will be measured using diagnosis codes from medical claims
Time frame: 1 year after training begins
Share of participants with urinary tract infections resulting in a health care visit (for consumer)
The share of consumers with urinary tract infections will be measured using diagnosis codes from medical claims
Time frame: 1 year after training begins
Share of participants with pressure ulcers resulting in a health care visit (for consumer)
The share of consumers with pressure ulcers will be measured using diagnosis codes from medical claims
Time frame: 1 year after training begins
Share of participants with nursing facility utilization (for consumer)
The share of consumers who have a stay in a skilled nursing facility, rehab, or long term care facility during the year after training begins.
Time frame: 1 year after training begins
Share of participants still employed in IHSS (for provider)
The share of IHSS provider participants who remain as workers in the IHSS program 1 year after the start of training.
Time frame: 1 year after training begins
Caregiving knowledge (for provider)
Proportion of correct answers out of 18 true false knowledge questions
Time frame: 0-3 months after completion of training
Total length of stay in nursing facilities (for consumer)
The number of days spent per consumer in a skilled nursing facility, rehab, or long term care facility during the year after training begins.
Time frame: 1 year after training begins
IHSS earnings (for provider)
IHSS earnings for providers, measured weekly, quarterly, and annually, drawn from IHSS payroll data
Time frame: 1 year after training begins
IHSS hours worked (for provider)
IHSS hours worked for providers, measured weekly, quarterly, and annually, drawn from IHSS payroll data
Time frame: 1 year after training begins
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