ASPE Contract: Understanding the Home and Hospice Care Workforce

| August 26, 2012

Social and Scientific Systems Inc., and the LeadingAge Center for Applied Research have begun work on a new contract from the Office of the Assistant Secretary for Planning and Evaluation (ASPE). The project will shed light on the ability of the home and hospice care workforce to meet the growing demand for high-quality care for elderly and younger individuals living at home or in community-based settings.

Two
prominent research organizations are joining forces to analyze the frontline
workforce in home and hospice care.

Social and Scientific Systems Inc., and the LeadingAge Center for Applied Research, its
subcontractor, will conduct the analysis using a contract from the U.S.
Department of Health and Human Services, Office of the Assistant Secretary forPlanning and Evaluation (ASPE). 

The
project is expected to help researchers better understand the ability of the
home and hospice care workforce to meet the growing demand for high-quality
care for elderly and younger individuals who live at home or in community-based
settings.  

Building on Ongoing Work 

The
ASPE contract will help Social and Scientific Systems, Inc. and the Center for
Applied Research continue their ongoing ASPE-supported work to analyze the 2007
National Home Health Aide Survey (NHHAS) and the 2007 National Home and Hospice
Care Survey (NHHCS) datasets.  

Using
a 2011 ASPE contract, the two research partners are developing a state policy database
featuring information about health care, long-term care, and labor policies.
The database also includes information about key state characteristics,
including socio-demographic characteristics, public program expenditures, and size
of the health care labor force.  

The
project team is currently linking its state database to the NHHAS and NHHCS and
conducting a series of inter-related analyses intended to further its
understanding of the home health care industry. 

Linking Databases for Increased Understanding 

The
research partners will use the newest ASPE contract to continue their analysis
of the NHHAS and NHHCS. Specifically, the team will link those databases with
national, state, and county-level data to examine the association between state
polices and:

  • Outcomes
    associated with frontline home care workforce, such as supply, recruitment and
    retention. 
  • Organizational
    characteristics like training and culture. 
  • Because
    study data is limited to agency-employed workers, the
    research team will not be exploring the consumer-directed workforce.  

Broad Interest in Developing a Quality
Workforce 

A number of policies
are driving much of the broad-based interest in the development and
sustainability of a quality frontline home care workforce. These policies
include: 

  • Expansion of home and community-based service programs in response
    to consumer preferences and legal mandates.
  • Growth of home-based post-acute and palliative care. This growth has
    encouraged substantial use of home health and hospice care.  
  • An increased focus on care coordination and
    integration. The success of this coordination depends on the participation of home
    health and home and community-based providers, and a trained, competent home
    care workforce. 
  • Laws that allow nurses to delegate certain tasks to direct care workers
    under their supervision. Such delegation requires a knowledgeable,
    skilled and stable home care workforce and nurse supervisors who can facilitate
    the safe empowerment of these workers. 

Implications for
Policy Makers and Providers 

The
ASPE project offers a unique opportunity to explore,
and provide evidence-based solutions to address, the myriad care-related issues
facing policy makers, providers, and consumers. This multi-level study will provide
a better understanding of: 

  • The
    size and major characteristics of the frontline home care workforce.
  • How
    policy, agency-level and other environmental characteristics influence the
    availability of the workforce.
  • The
    impact that these caregivers have on successful policy implementation, provider
    practice and quality outcomes.   

About The Office
of the Assistant Secretary for Planning and Evaluation 

ASPE is the principal
advisor to the secretary of the U.S. Department of Health and Human Services (HHS) on
policy development, and is responsible for major activities in policy
coordination, legislation development, strategic planning, policy research,
evaluation, and economic analysis. More information is available at ASPE.