It sounds like two distinct challenges: transforming elder care and disability services and creating stable, dignified employment opportunities in low-income communities. However, for the Paraprofessional Healthcare Institute (PHI) these issues go hand-in-hand.
From offices in New York, Michigan and Washington, D.C., PHI strengthens low-income communities in more than 20 states, collaborating with employers, consumers, labor groups, policymakers and other community leaders to implement sustainable changes in workforce policy and practice.
In New York City, PHI works with its community-based affiliate, Cooperative Home Care Associates (CHCA) to enroll low-income individuals in a high-quality home care training and employment program. By providing training in the fastest-growing sector of the U.S. economy, PHI and CHCA support individuals that face numerous challenges to achieving economic and social mobility. Each year, many trainees report living in households with annual earnings of less than $5,000 prior to enrollment, and in 2013, more than 86 percent reported household incomes below $10,000. Nearly all trainees rely on at least one form of public assistance at enrollment, and in 2013, 42 percent relied on at least two forms. Reflective of the program’s experience, 72 percent of participants were unemployed, and an additional 14 percent had never worked. But the results of PHI’s program are effective and profound.
“Cooperative Home Care Associates gave me my life back.” Powerful words spoken by Alice Prospere, who, before entering the CHCA training program in January 2013, had admittedly hit “rock bottom” following several years of unemployment and financial struggles.
CHCA, a nationally recognized, worker-owned home care agency located in New York City, trains approximately 600 unemployed women in the Bronx each year for quality home care jobs. In 2013, Alice just happened to be one of those 600 women. Once enrolled, she entered CHCA’s program, which provided a free, intensive, four-week home health aide training program, which guarantees employment for successful graduates. During this time, Alice completed almost double the amount of the 75 hours of training required by federal and state regulations. She acquired the clinical skills necessary to cover preventive health measures and assist clients with management of chronic diseases. She also strengthened the interpersonal and problem-solving skills that are essential to completing tasks such as bathing clients, toilet assistance and meal preparation, which in a diverse community like the Bronx often requires a deep respect and understanding of religious and cultural differences.
Home health care workers are a lifeline to clients, providing social connection and essential services that allow family members to go to their own jobs knowing loved ones are receiving essential care and support. As a result, in addition to the drug screening and criminal background checks required by New York State, potential trainees are screened for reading and math skills, informal caregiving experience, a compassionate disposition and job readiness.
But, it is no wonder that Alice – a 32-year-old Bronx native and mother of two girls (ages 9 and 14), who was praised by her training instructors for “her talent and skill, showing promise and potential” – now, 15 months later, finds herself gainfully employed, staffing the receptionist desk at CHCA five days a week and working with her client every Saturday.
This opportunity and her work have done more than just give Alice a stable income with benefits; Alice is also thankful for CHCA helping her become a role model to her two daughters. “When I was in the training program, they saw that mommy was in school and improving her life by working hard, and they, in turn, worked harder in school,” she said. “Now, that I have a good job and can support my family, they are so proud of me – and I am proud of myself!”
PHI and CHCA have leveraged their evidence-based model to provide more than 8,000 New Yorkers with opportunities to secure high-quality home care jobs since 1985. They have also focused on workers receiving full-time hours, competitive compensation, high-quality supports, financial literacy and opportunities for worker ownership. In turn, CHCA staff have provided care and support for tens of thousands of elders and people living with disabilities in low-income communities across the city. Applying lessons learned from this model to achieve nationwide impact — in policy and practice — represents the core of PHI’s work.
The W.K. Kellogg Foundation is now a part of that effort, supporting PHI in its national and regional efforts to build and shape increased public awareness of direct‐care workforce issues and their importance to low-income families, with a focus on raising the floor for wages, benefits, asset-development and advancement. The U.S. direct-care workforce is expected to add 1.6 million new jobs to the economy during the current decade and will total nearly 5 million workers by 2020. By strengthening training, credentialing, compensation and employment advancement opportunities, the work of these organizations will help to lift direct-care workers and their families out of poverty –creating more stable households and greater opportunities for children, and positioning women to offer leadership examples in their communities.
Home health aides like Alice feel passionate about the work they do, and “the love I get in return from my work with my client.” They also possess the perseverance and drive to achieve greater things for themselves and their children – efforts that the foundation and PHI both seek to empower and support.