Home health care aides as extenders of therapy services: A managed care pilot program

This project examined the feasibility of utilizing the home health care aid e as extender of therapy services. The pilot was conducted over a one-year period involving four Kaiser home health agencies. A scope of practice anal ysis was completed. A resource manual and training program for home health care aides were developed. A case study approach was used to evaluate the f easibility and cost-effectiveness of this program in lieu of skilled nursin g home rehabilitation. The findings of this study showed that therapists' a ttitudes, perceptions, and practice patterns are critical to successful imp lementation of this practice. Furthermore, management buy-in and leadership were also found to have a significant impact on the use of home health car e aides. Recommendations included documentation and competency testing proc edure redesign. Overall, this study concluded that there is opportunity to increase the therapist to home health care aide skill mix with positive cli nical outcomes, but that further study is needed to identify optimum skill mix and appropriate case mix indicators.