NEW YORK – As President Barack Obama noted Thursday when introducing proposed regulations for minimum wage and overtime protection for home healthcare workers, the home healthcare workforce is the largest and fastest growing in the country. A new analysis finds that required training for some of these workers has gone largely unchanged in almost 25 years.
In 1987, the federal government set a training standard of 75 hours for home health aides and certified nurse aides employed in Medicare-certified nursing homes or home care agencies. In the quarter-century since, finds a new analysis by PHI, a nonprofit supporting improving conditions for direct-care workers, only 15 states have increased the number of training hours required for home health aides even though a majority of states have required increased training hours for certified nurse aides.
[See also: Analysis: Job quality endangers long-term care industry.]
“If you think about the situation of those workers – at least in terms of the CNAs, there are other workers around – peers – there are supervisors on site – there’s many other folks they can access if there’s a problem – but the home health aide generally is in a house by themselves,” said Steve Edelstein, PHI’s national policy director. “You would think there would be similar attention to making sure their skills and knowledge were as developed as possible, especially since as a nation we’re trying to promote home- and community-based care, to the extent possible, and trying to make it possible for people to receive care in their homes, where they prefer. To be able to do that, you need to pay more attention to preparing the workers for those jobs rather than less.”
In its 2008 report, “Retooling for an Aging America,” the Institute of Medicine said that the country’s growing older population faces a “healthcare workforce that is too small and critically unprepared to meet their health needs.” Among the report’s recommendations: that the federal minimum training for certified nurse aides and home health aides be raised to at least 120 hours.
Six states, including Maine, Alaska and California, require 120 training hours or more. Ten states, including Kansas, New Hampshire and Hawaii, require 76 to 119 hours.
Edelstein argues that given the advances made in healthcare in the last 25 years and the larger numbers of seniors with complex and multiple chronic conditions living at home, it only makes sense to increase training hour requirements for home health aides.
“I think it’s just part and parcel of what we need to be focusing on as a nation as our population ages,” he said. “How are we going to ensure that folks have access to good quality service and the kind of service that they want and … as policy makers, that we have some assurance of the quality of services that are being provided?”
Follow HFN associate editor on Twitter @SBouchardHFN.
