Recruiting qualified apprentices can be challenging for all sites (Table 2). Human resources staff members at Developmental Services noted that while they can consistently hire 25-30 apprentices a month, they never turn away qualified applicants and always have vacancies to fill. Most sites mentioned that the greatest challenge is finding apprentices who have the right personal disposition and dedication to the job to be successful in the long-term care industry. Developmental Services can have difficulty in finding enough qualified applicants as many applicants see direct support work as a babysitting job, and are naïve about the challenges associated with the work.Thus, Developmental Services targets hiring on those applicants who can manage stress and who have a good understanding of the job.Good Samaritan, Home Care Associates, Air Force Villages, and Agape address this problem by only recruiting apprentices from incumbent workers, who are screened for these qualities. The staff at Air Force Villages emphasized the importance of selecting motivated incumbents by highlighting that poorly motivated workers who fail to attend training would lower morale for all apprentices. Agape LTC RAP staff use the apprenticeship as a mark of distinction for CNAs that they want to highlight as particularly productive workers.
Another recurrent obstacle to recruiting new apprentices is the challenge of funding training and wage increases. Most sites are dependent on the adequacy of Medicare and Medicaid reimbursements to finance this essential feature of apprenticeship. Usually, these reimbursement rates are not sufficient to maintain the expenses of a LTC RAP. Each site responded to these pressures differently. Air Force Villages does not accept Medicaid, relying instead on clients with private insurance, Medicare, or out-of-pocket payments. Developmental Services serves only Medicaid patients, but the organization is supported by funding from the United Way and other charitable sources. Home Care Associates is able to support basic training for staff who receive TANF through a local training grant and enhanced training with grants from two foundations. However, it is currently not operating its LTC RAP as the funding for the enhanced training has ended. Agape has been profitable and is not limited to Medicaid reimbursements, so it has not been as concerned about affording the wage progression. However, Agape staff emphasized South Carolinas $1,000 tax credit for each apprentice trained as an important method of defraying the $2,080 per year cost of its $1 wage increase. Agape staff suggested that the CNAs who became apprentices were the most likely to receive wage increases anyway because they were the most productive workers.