Characteristics of Long-Term Care Registered Apprenticeship Programs: Implications for Evaluation Design. 6.5. Partner Perspectives on the Long-Term Care Registered Apprenticeship Program

09/13/2011

Almost all interviewed apprentices had very positive feedback for the program. While many commented that learning the material requires substantial effort, almost all considered this effort worthwhile and the unpaid time for classes well spent. Many of the apprentices interviewed said that they recognized the improvement in their skills learned during the LTC RAPs. These apprentices and apprenticeship completers interviewed said that they felt better qualified to help their clients. They were also more likely to cite their higher quality work as a benefit of the program before they mentioned the wage progression they received. Apprentices at Agape were astonished at the depth of the information they received during the related technical instruction. They had been introduced to the material during their basic CNA training but did not know how much else there was to learn. In particular, Agape hospice employees reported great benefits from learning how to support families and their clients through dementia progression, end of life, and dying. These apprentices said that they were eager to apply this knowledge on-the-job. In Air Force Villages, apprentices said that their new role as HSSs allowed them more time with clients and reduced their overall caseload. Apprentices at Good Samaritan mentioned that they learned more specialty skills such as caring for dementia patients.

Apprentices also valued the wage increase related to the program participation. Although most apprentices reported that the wage increase was not their primary reason for participating in the program, it was valued and provided a good incentive for participating in and completing the program. In fact, Agape apprentices reported that they did not know about it until they actually started the program. However, some apprentices commented that the wage increase is relatively small. Apprentices at Home Care Associates indicated that they saw the wage progression as important because HHAs are perceived as being the “bottom of the nursing career ladder” with less of an opportunity for career advancement and earnings growth. Agape executives also noted that CNAs were the “lowest rung of the career ladder,” but that they were “the most important rung.”

Mentoring opportunities were another feature of the program that elicited many positive responses from apprentices. While the mentoring component is not formalized in all the programs visited, apprentices at each of the sites said that they enjoyed serving as mentors. They felt that being seen as more experienced and valued after completing the program helped them be good mentors to other employees. Apprentices at Developmental Services found that the emphasis on mentoring and peer-mentorship in the OJT component of the LTC RAP was more fulfilling than the more isolated work that they had conducted in long-term care facilities. Apprentices at Good Samaritan mentioned that they learned about mentoring skills and considered these skills valuable.

One weakness of the LTC RAPs highlighted by several apprentices across sites is that other employers and community colleges may not recognize a completion of certification from a registered apprenticeship as a meaningful occupational credential. Apprentices noted that it is not a certification from a formal degree program or a training program that is familiar to most employers. Apprentices at Agape disagreed with this perception noted by apprentices from other sites, saying their apprenticeship certification was from Northeastern Technical College, and was therefore considered “legitimate” to employers. Apprenticeship and the technical college system are recognized as important components of the workforce investment system in South Carolina, which contributes to the portability of the apprenticeship certification in the state. Agape apprentices also participated in the palliative care worker test and received additional national certification that they understood was portable across jobs. In contrast, staff at Developmental Services suggested that the State of Indiana was not deeply invested in apprenticeships, and as a result Developmental Services apprentices doubted their certification would be fully appreciated by other employers. Home Care Associates staff and apprentices noted this challenge to the recognition of the apprenticeship credential with other employers.

6.5. Partner Perspectives on the Long-Term Care Registered Apprenticeship Program

LTC RAP partners were indirectly involved in assisting sponsors by providing the programs support through grants or donations or technical assistance at the beginning of the programs. Some organizations, such as PHI, are dedicated to the promotion of successful health care workforce models and thus benefit from the success of organizations like Home Care Associates. Home Care Associates also receives funding from local welfare and workforce agencies to train entry-level HHAs but does not receive funding or support for the registered apprenticeship program. Developmental Services received some short-term foundation support and worked with the state apprenticeship office to get its program off the ground; however, it has no current partners that support its efforts. Likewise, the Center for Adult and Experiential Learning provided funding to Good Samaritan for establishing its program, but the program had not received any additional funding since. All the sites received assistance from their state’s OA representative or their state’s apprenticeship agency in developing and registering their programs. Thus, at much of the partnering occurred at the beginning of the programs, the sites had few active partners from which to draw perspectives.

TABLE 9. Apprentice Participation in the Long-Term Care Programs Studied
Apprentice Participation, Completion, and Employment Levels Program Site
Indiana
Developmental Services
Program Site
Idaho
Good Samaritan
Program Site
Pennsylvania
Home Care Associates
Program Site
Texas
Air Force Villages
Program Site
South Carolina
Agape Senior
Number of apprentices who entered the program 1,150 387 (entire organization) 26 62 112
Number of apprentices who completed the program to date 314 60 (entire organization) 17 23 37
Number of apprentices currently registered or completed 497 178 (entire organization) 25 59 52
Number of apprentices not completing the program 651 211 (entire organization) 1 3 25
Reasons for not completing program Most dropouts left in the first several weeks of the program because they could not handle the stress of direct support work Restorative, dementia, and medication aide competency trainings taken if interested or if a related position is available Dropping out is rare Dropping out is rare Dropping out is rare
SOURCES: Data collected from Interviews at and materials from LTC RAP sites, October 2010-June 2011; and calculations by authors, RAPIDS, January 2005-May 2011.

TABLE 10. Outcomes Measured by Selected Long-Term Care Registered Apprenticeship Program Sites
Outcomes Program Site
Indiana
Developmental Services
Measured
Program Site
Idaho
Good Samaritan Measured
Program Site
Pennsylvania
Home Care Associates Measured
Program Site
Texas
Air Force Villages Measured
Program Site
South Carolina
Agape Senior Measured
Wages X X X X X
Benefits X X X X X
Promotions X X X X X
Bonuses --- --- X X X
Tenure X X X X X
Turnover X X X X X
Client satisfaction X --- --- --- ---
SOURCES: Data collected from Interviews at and materials from LTC RAP sites, October 2010-June 2011; and calculations by authors, RAPIDS, January 2005-May 2011.

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