by John Baackes, L.A. Care
February 20, 2018
About 76 million Baby Boomers live in the United States right now. By 2024, all Baby Boomers will be 60 and older. The numbers put a strain on the health care industry, in general, and on the home care industry, in particular.
Here in California, one study predicted the state would need 200,000 more homecare workers by 2024, and that’s provided the state simply maintains current levels of home care coverage. If the industry were to cover everyone who needs some amount of home care, that number could jump to more than 3 million.
The vast majority of older people want to stay in their own home, even when their health declines. Health insurance providers strive to help members remain in the comfort and security of their own homes and communities. And this is where homecare workers come in—they help fulfill this goal, especially for those who are dually eligible for Medicare and Medicaid, commonly known as dual eligibles.
While there is no required training for in-home caregivers, the responsibilities can be enormous. They can include simple things like housecleaning, laundry, and meal preparation, and they often include personal care services that can be much more challenging. For instance, the care may involve keeping track of multiple medications, or providing supervision to a person who could pose a threat to his or her own wellbeing. Without training, the caregiver’s ability to recognize and report issues to health care providers and plans is limited. L.A. Care decided to do something about that.
Last year, L.A. Care launched a pilot program with the California Long- Term Care Education Center (CLTCEC) to provide training and education to In-Home Supportive Services (IHSS) caregivers of our dual-eligible members. The 10-week course trains the caregiver on CPR, first aid, administering medication, nutrition, and personal care—skills that will certainly help our members’ overall well-being at home.
However, we had another goal.
We wanted to teach the caregivers to capture a change in function in the member, so they can report that change immediately to the health care provider and our plan. Catching a problem early benefits the member and the plan. Of course, we don’t expect caregivers to diagnose a medical condition, but they would be the first to detect any small change that might signal a bigger problem for the member. The training also helps to bridge the language and culture gap that often exists between the physician and patient, giving caregivers the tools needed to help members communicate effectively with medical personnel.
The pilot program aims to train 900 caregivers over three trimesters. The second trimester of classes just wrapped up, and I’m happy to say we are at 64 percent of our goal. The graduates report a greater sense of confidence in their ability to help those they care for. They also express a greater understanding of how to access L.A. Care resources. During a recent culmination ceremony, a graduate called it a “beautiful learning process.”
Dual eligibles often have the most complex and costly needs, but trained caregivers can help enhance the health and happiness of these extremely vulnerable people. The caregiver becomes more active in the member’s care and, ultimately, it supports our objective of allowing members to stay in their homes as long as possible.
John Baackes is CEO of L.A. Care Health Plan, the nation’s largest publicly operated health plan serving more 2 million members. L.A. Care is dedicated to providing access to quality and affordable health care for Los Angeles County residents through a variety of health coverage programs, including Medicaid, L.A. Care Covered™, L.A. Care Cal MediConnect, and the PASC-SEIU Homecare Workers Health Care Plan.