Investing in the Direct Care Workforce: Lessons From the CalGrows Training and Stipend Initiative

The California Growing a Resilient and Outstanding Workforce (CalGrows) program sought to address the challenges of low retention and low pay among direct care workers (DCWs) and improve the quality of care delivered to older adults and people with disabilities by distributing $150 million in grant funding to organizations that provided free training to paid DCWs and unpaid caregivers. This study evaluated the design and delivery of CalGrows training courses and DCWs' and caregivers' attitudes about their training experiences.

A mixed methods approach was used.

DCWs and caregivers in home and community-based settings.

A survey measuring DCWs' and caregivers' perceptions of their CalGrows training was sent to participants. Interviews were conducted with training providers, DCWs and unpaid caregivers, and CalGrows program administrators to understand program design and delivery, perceptions of training's impact on confidence in skills, and program impact on quality of care.

CalGrows participants were racially and ethnically diverse. Approximately 90% of participants indicated that the training made them feel better prepared across a range of knowledge and skill areas and agreed or strongly agreed that CalGrows training helped them learn new information about careers in caregiving or made them consider having a career as a paid DCW. More than 90% of participants agreed or strongly agreed that the training made them want to remain in their current job or the caregiving field. More than 95% of participants felt that the CalGrows training improved the quality of care they provided and made them feel more confident about providing that care. In interviews, grant recipients who provided training to their own employees described improvements in employee retention resulting from their CalGrows-funded training.

CalGrows demonstrated the need for and value of providing free and accessible training to DCWs and caregivers. Future efforts supporting the direct care workforce should emphasize both innovation and sustainability.