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Is a Federal Program Helping Low-Income Adults Get Good Healthcare Jobs?

Kim Campbell has been a certified nursing assistant (CNA) with Geisinger Medical Center in central Pennsylvania since January 2012. As she told the Office of Family Assistance, the job has helped Campbell, the mother of a young daughter, provide for her family. She sees a future for her at Geisinger, with opportunities to be promoted.
But her future wasn’t always so bright.

Campbell found out she was pregnant when she was 18, shortly after moving in with her grandparents. A local program for vulnerable mothers helped her and her fiancé find an apartment. Campbell got a job as a file clerk for a physician, who suggested she pursue training to be a CNA certified nursing assistant CAN)from a program funded by the Health Profession Opportunity Grants (HPOG).Since 2010, HPOG has been helping low-income Americans enter and succeed in training to advance economically and fill high-demand healthcare jobs.

Campbell finished her training to be a CNA in September 2011. “Now I have a stable, better paying job where I can give my family what we need,” Campbell said.

us mapShe also is filling a critical need: The U.S. will need 40,800 to 104,900 more physicians by 2030, a gap that could be partially closed by training more nurses, physician assistants, and other support staff to perform some tasks otherwise done by doctors, according to the Association of American Medical Colleges.

So is Campbell an unusual HPOG success story, or does she represent a common experience among HPOG trainees? 

Scaling Up with Sound Evidence

HPOG currently funds more than 30 career pathways programs across the U.S. Abt is evaluating overall HPOG Program implementation, outcomes, and impacts. Currently, Abt is completing final reports on HPOG outcomes and short-term impacts for the first round of grantees, and is conducting studies to estimate intermediate (36-month) and longer-range (72 months) impacts.

“We’re showing if these programs work and, if so, why they work,” said Robin Koralek, a senior associate at Abt who is managing one of several HPOG evaluations for the Administration for Children and Families, part of the U.S. Department of Health and Human Services.

Under HPOG and other career pathway programs, adult learners may receive modular training in relatively short time frames. The compressed timeframes enable them to quickly ramp up skills and earnings while also meeting employer workforce demand and putting them on a pathway to higher skilled, higher paying jobs over time. The training programs feature clearly defined paths with articulated education and training steps, so participants can “stack” progressively higher education and industry-recognized credentials while working or in-between jobs to continue advancing in their careers.

“The ultimate goal of HPOG – and other career pathways programs – is increased earning potential and getting people employed,” Koralek said.

“Our work on HPOG is deepening our understanding of how the programs are designed and the challenges in implementing them. Many other organizations and states want to replicate these kinds of programs to address their own workforce needs.”

What Do the Data Show about Outcomes?

A summary of outcomes from Abt’s HPOG evaluation work finds that the program is successfully training many other people like Campbell. The report, released by Abt, the Urban Institute, and ACF, found that:

  • The program served the targeted population. HPOG participants are mostly low-income, working single mothers. Participants are racially and ethnically diverse.
  • Participants completed foundational courses. A high percentage of participants completed training in a lower-level course, such as nursing aide training.
  • A large majority of participants enrolled in, and completed training courses within 18 months of entering an HPOG program. About 85 percent (10,660) participated in healthcare training, either beginning a course or continuing one started before enrollment; of those enrolling in training, 70 percent completed training within 18 months of entering HPOG.
  • Most participants received supportive services. Almost all participants received supportive services including case management, training, such as tutoring, transportation, or help with child care.
  • Most participants were working after program completion. Two-thirds of those who exited HPOG after completion were working, and more than half were working in healthcare jobs.

Supportive Services and Other Factors

In the near future, Abt will examine whether supportive services, such as personal, financial, and academic counseling, appear to affect HPOG participants’ success.

Alan Werner, a principal associate at Abt, said financial and general help – such as transportation assistance – may be critical factors for potential participants like Kim.

“Most people in these programs are low-income and must make short-term financial sacrifices to receive the training,” Werner said. “They have to give up some work in order to train. But if they can make it through and finish, there will be jobs available for entry- and mid-level health care workers.”

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