Background

California is home to the largest population of older adults in the United States, and the demand for a skilled direct care workforce continues to grow rapidly. To meet the needs of this aging population, the state projected that an additional 275,000 direct care workers would be needed within the decade. Certified Nurse Assistants (CNAs), Home Health Aides (HHAs), and health care social service professionals play a critical role in supporting older adults across nursing care facilities, community care settings, and home and community-based services. In California alone, more than half of CNAs work in facilities serving older adults, often acting as the primary caregivers with the most consistent and personal contact.

The Gateway-In Project© CNA & HHA

In 2022, LeadingAge California was awarded over $25 million by the California Department of Health Care Access and Information (HCAI) to implement The Gateway-In Project© CNA & HHA. This initiative was designed to strengthen the workforce pipeline by training and placing 2,700 Certified Nurse Assistants and Home Health Aides into Home and Community-Based Services settings throughout California. Read the press release here.

Through targeted recruitment, comprehensive training, wrap-around supports, and incentives for career development, the project addressed key barriers to entering and remaining in the direct care workforce. These supports helped individuals both new to the field and already employed advance their skills while contributing to meaningful progress in addressing the statewide workforce shortage impacting aging services.

Project Expansion

Building on the success of the original CNA & HHA initiative, LeadingAge California secured an additional grant in 2023 from HCAI’s Caring4Cal program to expand the project’s reach. Known as The Gateway-In Project© Expansion, this phase focused on further strengthening the workforce pipeline by training an additional 380 Certified Nurse Assistants and 50 Home Health Aides for entry into the field.

The Gateway-In Project© Health Care Social Worker

In 2023, LeadingAge California also launched The Gateway-In Project© Health Care Social Worker in response to a growing shortage of social workers in the Home and Community-Based Services sector. At the time, California had approximately six million adults aged 65 and older, a number projected to rise to nine million by 2030. This demographic shift underscored the increasing need for professionals who could support the mental health, social well-being, and care navigation needs of older adults.

To implement this initiative, LeadingAge California secured over $8 million in funding through CalGROWS. The project aimed to enroll and educate up to:

• 300 Service Coordinators

• 300 Activities Professionals

• 620 Certified Nursing Assistants

A central focus of the program was supporting individuals from marginalized communities. Participants received financial assistance and wrap-around supports to offset costs related to childcare, transportation, food, textbooks, and required program supplies. These supports were designed to reduce barriers to completion and help develop a qualified, committed workforce prepared to serve as integral members of interdisciplinary care teams supporting older adults.

Program Impact

Together, the Gateway-In initiatives represented a coordinated, multi-year effort by LeadingAge California to address workforce shortages across multiple roles critical to aging services. Through strategic partnerships, targeted training, and comprehensive participant support, these programs made meaningful contributions toward strengthening California’s caregiving workforce and improving access to high-quality care for older adults statewide.

The Gateway-In Project, including all funding for free training, concluded in July 2025. If you are interested in future training opportunities, please complete our interest form.