A Descriptive Analysis of the U.S. Department of Labor's Long-Term Care Registered Apprenticeship Programs. 3. Results

This section of the report presents results of descriptive analyses of the DOL RAPIDS data and sponsor interviews regarding data entry issues. First, we describe the findings from data at the apprentice-level to understand how important apprentice characteristics vary across and within major occupations. We then present results at the program level to understand how programs vary across and within occupational groups. Apprentice-level analyses are presented in Tables 1-5, and program-level analyses in Tables 6-10.

• 3.1. Apprentice-Level Analyses

  • Apprentice-level analyses in Tables 1-5 include descriptive results on 3,744 apprentices in the RAPIDS database describing demographic characteristics, enrollment status, and apprenticeship characteristics.

    Highlights of Apprentice-Level Findings More than half of apprentices are older than might be expected for an initial training program (age 30 and over). They are usually female and are more racially diverse than the general population. Most apprentices are high school graduates or have a general equivalency degree (GED). Apprenticeships last about a year, including about 200 hours of formal related instruction, which is largely provided by employers. Approximately 72% of apprenticeships are in competency-based or hybrid apprenticeships (rather than time-based apprenticeships). 1,445 of the 3,744 apprentices (39%) during the last 5 years are currently participating (registered) in a training program. The proportion of apprentices who have completed a training program in the last 5 years is 27%. CNAs have the highest proportion of completed trainings (34%), followed by DSSs (33%). HHAs have the highest proportion of cancellations (62%). CNAs comprise 45% of all apprentices, DSSs -- 29%, HSSs -- 15%, and HHAs -- 11%. Advanced or specialty training is available for two of the four major occupations in these data (CNAs and HHAs). About 32% of apprentices (391) in competency-based apprenticeships have participated in advanced or specialty training when available.

    The sample derived from the RAPIDS data extract included 3,744 apprentices representing four broad occupational groups. There are 1,695 (45% of the sample) CNAs employed mostly in nursing homes, 1,087 (29%) DSSs employed in group homes/facilities providing housing and supportive services to persons with intellectual disabilities, 567 (15%) HSSs employed in assisted living facilities, and 395 (11%) HHAs employed in home health or hospice agencies.

    Table 1 presents the overall distribution of apprentices on selected characteristics and also across the four major occupations. Overall, a majority of apprentices are more than 30 years old. The age distribution varies by major occupational group, with CNAs being younger than DSSs and HSSs. CNAs have the highest proportion of those under the age of 20, with 21% of CNAs under age 20 compared to only between 5% and 9% of apprentices in the other major occupations. Of all occupations, CNAs also have the lowest proportion of those aged 50+ (9%). In comparison, 27% of DSSs and 18% of HSSs are aged 50 and over. In terms of age distribution, HHAs resemble CNAs with 47% under the age of 24 and 9% aged 50 and over.

    As expected, most of the apprentices are female. Overall, only 14% of apprentices are males. The proportion of females is similar across occupations.

    TABLE 1. Characteristics of Long-Term Care Apprentices by Occupational Group
    Characteristics	N	Overall	Major Occupational Group: CNA (824)	Major Occupational Group: DSS (1040)	Major Occupational Group: HSS (1086AA)	Major Occupational Group: HHA (1086)
    Number of Apprentices	---	3744	1694	1087	567	395
    Age (%)	3,744	---	---	---	---	---
    Under 20	---	13.0	21.1	5.4	6.5	8.9
    20–24	---	21.2	21.7	15.1	19.8	38.0
    25–29	---	12.1	12.2	9.4	13.8	16.5
    30–39	---	20.3	20.8	21.4	20.6	13.9
    40–49	---	18.0	15.2	21.9	21.7	13.7
    50+	---	15.5	9.0	26.8	17.6	9.1
    Female (%)	3,744	85.7	88.5	79.3	89.4	86.1
    Race(%)	3,744	---	---	---	---	---
    White	---	70.4	54.6	89.2	79.4	72.9
    African-American	---	18.1	28.0	5.9	7.9	23.5
    Hispanic	---	8.0	13.8	1.8	7.1	1.8
    Unknown Race	---	3.6	3.6	3.0	5.6	1.8
    Education(%)	3,631	---	---	---	---	---
    Up to 11 years of schooling	---	9.7	17.6	0.7	6.0	4.6
    GED	---	12.7	21.9	1.7	8.5	8.1
    High School Graduate	---	72.9	53.3	95.3	82.7	85.1
    Some Post-Secondary Education	---	4.7	7.2	2.4	2.9	2.3
    Enrollment Status (Last Event Code)(%)	3,740	---	---	---	---	---
    Registered	---	38.6	33.5	33.5	73.2	25.1
    Completed	---	27.3	34.3	33.4	4.4	13.2
    Cancelled	---	34.0	32.2	33.1	22.4	61.5
    Suspended	---	0.1	0.1	0.0	0.0	0.3
    Term Length (hours)	3,744	2,200	1,345	2,638	4,139	1,874
    Related Instruction Length (hours)	3,464	198	112	239	398	125
    Related Instruction by Sponsor (%)	3,744	72.7	71.3	92.1	23.6	96.0
    SOURCE: RTI International/Urban Institute analysis of RAPIDS data. NOTES: Registration after 1/1/2005, most recent training.

    Apprentice programs recruit a relatively diverse group of people: 70% are White, 18% are African-American, 8% are Hispanic and 4% are identified as other race. There is substantial variation in diversity across occupations: CNAs are the most diverse group of apprentices (28% of CNAs are African-American and 14% are Hispanic, followed by HHAs, who are 24% African-American and 2% Hispanic). In contrast, DSSs and HSSs are the least diverse occupations -- 89% and 79% respectively are White.

    Regarding educational background, apprentices rarely have a college education and high proportions of some occupations did not complete high school. Overall, most apprentices (86%) are high school graduates or have a GED and almost 5% have some post-secondary education. About 10% have up to 11 years of schooling but have not completed high school or received a GED. Again, some differences are apparent across major occupations. Only 75% of CNAs have either completed high school or a GED. In contrast, over 90% of the other three major occupations completed high school or a GED, with the highest proportion among DSSs (97%).

    We compared the findings on demographic characteristics of CNA and HHA apprentices with findings from two national surveys, the 2004 National Nursing Assistant Survey and the 2007 National Home Health Aide Survey to understand how representative apprentices are of the national population of these workers (Exhibit 7). First, compared to CNAs working in nursing homes nationally, CNAs in apprenticeships are younger (50% of CNA apprentices are under the age of 30 compared to 30% of CNAs nationally). There are slightly more male apprentices than among all CNAs (11.5% versus 8%). CNA apprenticeship programs attract a higher proportion of Latinos (15% in programs versus 9% nationally) but fewer African-Americans (31% in programs versus 39% nationally). CNA apprentices have lower educational attainment compared to CNAs nationally: almost 93% of CNA apprentices have a high school or less than a high school education, compared to 75% of CNAs nationally.

    Similar patterns hold for HHAs. HHA apprentices on average are younger than HHAs working in home health and hospice agencies across the country: 45% of HHA apprentices are under the age of 30 compared to only 13% of HHAs nationally. Almost twice as many males are apprentices (12% versus 5%). However, it appears that HHA apprenticeship programs enroll fewer minorities: 5% of HHA apprentices are Hispanic and 15% are African-Americans compared to 8% of Hispanics and 35% of African-Americans nationally. Similar to CNA apprentices, HHA apprentices are less educated than HHAs in general: virtually all (97%) of HHA apprentices have high school education or less, compared to 60% of HHAs nationwide.

    The apprenticeship enrollment status categories presented in Table 1 are registered, completed, cancelled and suspended. An apprenticeship may be cancelled if an apprentice elects not to complete training, or if their employer cancels their participation for some reason. An apprentice may be granted a suspension if their apprenticeship is interrupted for some reason, but they still plan on returning to complete it at a later date.

    Apprenticeship enrollment status pertains to the latest status recorded for the specific training in which each person was registered. For example, CNAs may be in entry-level training, advanced training, or one of the four “specialty” trainings in which one may enroll after completing advanced training. Therefore, an enrollment status of “registered” for a given CNA in advanced training means they have already completed entry-level training and are registered for advanced training. Each apprentice appears only once in the data, meaning that their completion status for prior trainings is not shown in the table -- only the status for the training in which they most recently enrolled appears. The proportion of trainings completed would have been only slightly higher had we analyzed the data at the training-level rather than the apprentice-level because relatively few apprentices are in trainings beyond entry-level training.

    EXHIBIT 7. Demographic Characteristics of Apprentices Compared to National Estimates (percent)
    Characteristics	CNA Apprentices	CNAs Nationally	HHA Apprentices	HHAs Nationally
    Age
    Under 30	49.7	29.8	45.4	13.2
    30-44	29.3	35.9	27.4	30.3
    45+	21.0	34.3	27.1	56.5
    Gender
    Male	11.5	8.0	11.9	5.0
    Female	88.5	92.0	88.1	95.0
    Race
    White only	68.5	53.4	83.2	53.3
    African-American only	30.8	38.7	15.2	34.9
    Other	0.7	7.9	1.6	11.8
    Hispanic or Latino	15.0	9.4	5.0	8.3
    Education
    <12 years	17.6	12.9	5.4	7.2
    GED	21.8	17.8	8.3	14.4
    HS graduate	53.2	44.6	83.7	38.2
    1–3 years college/trade	0.2	19.8	0.0	34.2
    College/post grad	0.0	4.9	0.0	5.9
    Unknown	7.2	0.0	2.6	0.0
    SOURCE: RTI International/Urban Institute analysis of RAPIDS data, the 2004 National Nursing Assistant Survey, and the 2007 National Home Health Aide Survey.

    Of all apprentices enrolled in the database since January 1, 2005, as of December 1, 2009, 39% (1,445 apprentices) were currently registered in a specific training, 27% (1,020 apprentices) had completed a training since 2005, and 34% (1,273 apprentices) had cancelled (e.g., dropped out) their participation since 2005. Only two apprentices had a status of suspended, meaning that they had been granted a leave of absence. The enrollment status results presented are cumulative over time, therefore, the proportions for “completed” and “cancelled” are much higher than results from a cross-sectional snapshot of only calendar year 2009, where 75% of apprentices were registered, 7% had completed their training, and 18% had cancelled their participation.

    Again, as with other characteristics, enrollment status varies greatly by major occupation. Among CNAs and DSSs, about 33% of apprentices are currently registered (568 and 364 apprentices respectively). The proportion of registrants is much higher for HSSs at 73% (415 apprentices) in part because of recent DOL grants to expand apprenticeships for this occupation. About 25% (99 apprentices) of HHAs are currently registered. The proportion of completed trainings vastly varies depending on major occupation: CNAs have the highest proportion (34%), followed by DSSs (33%). About 13% of HHAs have completed training, and only 4% of HSSs, again because of recently awarded DOL grants for this occupation that led to new registrants who have not had sufficient time to complete their training as of December 2009. As stated earlier, the proportion of cancellations is high and ranges from 62% for HHAs to 22% among HSSs. The proportion of cancellations for CNAs and DSSs is similar (32% and 33% respectively).

    Finally, the RAPIDS data provide information on the training aspects of apprenticeships. Term length comprises both the OJT component and the related instruction for a competency training (e.g., entry-level or a single specialty, as opposed to the length of the whole apprenticeship, which may include several trainings across time), with a mean of 2,200 hours. Term length across competency trainings within occupations is lowest for CNAs (1,345 hours) and highest for the HSSs (4,139). Term length for DSSs was 2,638 hours and 1,874 hours for HHAs.

    On average, there are 198 hours of related instruction for each competency training. HSSs have the longest related instruction period per competency training (almost 400 hours). DSSs had an average of 239 hours per competency training. Related instruction for HHAs and CNAs is shorter, 125 and 112 hours per competency training, respectively.

    Related instruction may be obtained directly at the employer work site, or offsite (e.g., community college, vocational school). Related instruction by sponsor describes whether the employer provided the related instruction onsite or whether it was obtained at an offsite location (e.g., community college). Overall, 73% of apprentices had their related instruction provided onsite. There are significant differences by occupation: most of the HHAs receive this training onsite (96%), followed by DSSs (92%) and CNAs (71%). Only 23.6% of HSSs receive their related instruction at their sponsor’s location (again, because DOL provided grant funds to these employers to have apprentices receive this training from an external source).

    RAPIDS includes data on some very large providers that potentially skew the results, particularly on total workforce size (apprentices plus other employees) and possibly other characteristics examined. Therefore, we re-ran the analyses with four large employers removed. We removed the two largest employers who contribute the largest numbers of apprentices within each of the four occupations (St. John’s Mercy Medical Center, which contributes 644 currently registered CNAs, HSSs, and HHAs, and Developmental Services, Inc. which contributes 924 currently registered DSSs). We also removed the two employers (Gary Job Corps and Women’s East Reception Federal Prison with 396 and 297 CNAs respectively) who contributed the largest numbers of apprentices who were not currently registered (had either completed or cancelled their apprenticeships) so that the data would reflect the most recent composition of registered apprentices.

    Removing these four programs changed the results on some characteristics substantially:

    • Apprentices in all occupations were somewhat older, particularly CNAs and DSSs.
    • Substantially more DSSs were female.
    • More CNAs were White and fewer DSSs were White.
    • CNAs were better educated, and there was more variance in the educational status of DSSs instead of clustering around high school graduates.
    • CNAs and DSSs had higher proportions of registered apprentices.
    • DSSs and HSSs had notably higher term lengths and related instruction lengths than the full sample.
    • Fewer apprentices had related instruction provided by the sponsor across all occupation groups.

    Tables 2-5 disaggregate the results by whether the apprenticeships are time-based (requiring the apprentice to complete a certain number of hours of work and related instruction) or competency-based (requiring an apprentice to acquire specific competencies through work and related instruction regardless of the apprenticeship length). Approximately 72% of all apprentices across the four major occupations are in competency-based apprenticeship programs.

    Further, two of the major occupations (CNAs and HHAs) have competency-based training beyond entry-level, and these “advanced” or “specialty” training programs are grouped together to provide a better understanding of the characteristics of workers who progress beyond entry-level training. About 32% of apprentices (391) in competency-based apprenticeships have participated in advanced or specialty training when available. Detailed information at the apprentice-level on each of the individual advanced or specialty apprenticeship trainings for CNAs and HHAs is provided in Appendix A. Currently, the DSS model does not offer interim credentials or advanced and specialty training, and the HSS model is a hybrid model combining both competency-based and time-based apprenticeships. Although HSSs have specialty trainings, the model does not offer interim credentials so these data did not separately delineate these trainings as such.

    Table 2 displays characteristics of apprentices working as CNAs. Among the three categories presented, 416 apprentices are in time-based training (Code 824), 922 apprentices are in entry-level competency-based training (Codes 824C and 824CB), and 356 apprentices are in advanced or specialty trainings. Specialty trainings include a dementia specialty (Code 824D) providing training to care for persons with various levels of dementia, a geriatrics specialty (Code 824G) focusing on care for older nursing home residents, a restorative specialty (Code 824R) focusing on care for persons requiring rehabilitative services after surgery or other similar event, and a mentoring specialty (Code 824M), designed to be completed after one other specialty training has been completed, which provides instruction on how to mentor other apprentices in their job responsibilities. Details on apprentice demographics by individual training can be obtained from Table A-1 in Appendix A.

    TABLE 2. Characteristics of Certified Nursing Assistants
    Characteristics	N	Time-Based   (824)	Entry-Level Competency-Based   (824C & 824CB)	Advanced or Specialty   (824A, 824R, 824D, 824G & 824M)
    Number of Apprentices	---	416	922	356
    Age (%)	1,694	---	---	---
    Under 20	---	16.1	30.6	2.3
    20–24	---	27.9	22.2	12.9
    25–29	---	16.1	10.1	12.9
    30–39	---	20.9	20.3	22.2
    40–49	---	12.5	11.6	27.8
    50+	---	6.5	5.2	21.9
    Female (%)	1,694	88.5	87.0	92.4
    Race (%)	1,694	---	---	---
    White	---	70.9	40.4	72.5
    African-American	---	22.6	33.8	19.1
    Hispanic	---	2.2	22.6	4.8
    Unknown Race	---	4.3	3.3	3.7
    Education (%)	1,681	---	---	---
    Up to 11 years of schooling	---	9.0	25.4	7.6
    GED	---	7.3	31.5	14.1
    High School Graduate	---	60.1	41.4	76.1
    Some Post-Secondary Education	---	23.6	1.8	2.3
    Enrollment Status (Last Event Code) (%)	1,691	---	---	---
    Registered	---	59.8	21.7	33.4
    Completed	---	18.3	43.6	28.9
    Cancelled	---	21.9	34.6	37.6
    Suspended	---	0.0	0.1	0.0
    Term Length (hours)	1,694	2,305	1,116	814
    Related Instruction Length (hours)	1,440	193	83	83
    Related Instruction by Sponsor (%)	1,694	72.8	88.4	25.0
    SOURCE: RTI International/Urban Institute analysis of RAPIDS data. NOTES: Registration after 1/1/2005, most recent training

    Compared to advanced or specialty trainings, both time-based and entry-level competency-based trainings enroll younger apprentices: 16% of those in time-based training, and 31% of those in entry-level competency-based training are under the age of 20, compared to only 2% among those in advanced or specialty training. Additionally, 28% of CNAs in time-based training and 22% in entry-level competency-based training are aged 20-24. In comparison, 13% of CNAs in advanced or specialty training belong to this age group. Only 6% of CNAs in time-based training and 5% in entry-level competency-based training are aged 50 and over, and among advanced or specialty trainees this proportion reaches 22%, which might be expected to be higher than entry-level training.

    In all CNA trainings, most apprentices are female, but the highest proportion of females is in advanced or specialty trainings (92%). These trainings attract CNAs of different racial composition: 71% of apprentices enrolled in time-based trainings are White, compared to 40% of apprentices in entry-level competency-based training and 72% among those in advanced or specialty trainings. Similarly, entry-level competency-based training attracts the highest proportion of Hispanics -- 23%, which is much higher than 2% for time-based and 5% for advanced or specialty trainings. Seemingly, Hispanics may be more attracted to entry-level competency-based training than time-based training.

    In terms of educational attainment, the profiles differ by training type. In time-based and advanced/specialty training, apprentices with 11 years of schooling or less comprise 9% and 8% respectively, while they represent a quarter of apprentices in entry-level competency-based training. On the other hand, 32% of apprentices participating in entry-level competency-based training have a GED and 41% are high school graduates, compared to 7% and 60% among apprentices in time-based training and 14% and 76% of apprentices respectively in advanced/specialty training. Time-based trainings also enroll the highest proportion of those with some post-secondary education (24%).

    Regarding enrollment status, almost 60% of apprentices (249) enrolled in time-based training are registered, meaning they were currently participating in training, compared to 22% of apprentices (200) in entry-level competency-based and 33% (118) in advanced or specialty training. Apprentices in entry-level competency-based training exhibit the highest proportion of completed trainings: 44%, followed by those in advanced/specialty trainings (29%), with time-based training last (18%). Almost 22% of CNAs in time-based training are reported as having cancelled their training, followed by 35% among those in entry-level competency-based training and by 38% of those in advanced/specialty training. Only one CNA, in entry-level competency-based training, is reported as having been granted a suspension.

    In line with expectations, term length is highest for time-based training with 2,305 hours, followed by 1,116 hours for entry-level competency-based training and 814 hours for advanced/specialty training.

    The time-based trainings also have the highest number of hours for related instruction (193), followed by 83 hours for each entry-level competency-based and advanced/specialty training.

    Time-based and competency-based trainings are characterized by a high proportion of CNAs receiving related instruction onsite (73% and 88% respectively). Only a quarter of CNAs involved in the advanced/specialty trainings receive such instruction onsite.

    Table 3 displays characteristics of apprentices in the DSS occupation, who are apprentices working in facilities providing housing or services to persons with intellectual disabilities in order to promote independence and community inclusion. There are two types of training for DSSs: entry-level time-based (Code 1040), comprising 565 apprentices and entry-level competency-based (Code 1040CB) comprising 522 apprentices. There are no interim credentials or advanced specialties for DSSs, but ANCOR and NADSP are in the process of revising apprenticeship standards to develop them.

    TABLE 3. Characteristics of Direct Support Specialists
    Characteristics	N	Overall	Time-Based   (1040)	Competency-Based   (1040CB)
    Number of Apprentices	---	1,087	565	522
    Age (%)	1,087	---	---	---
    Under 20	---	5.4	3.0	8.1
    20–24	---	15.1	13.5	16.9
    25–29	---	9.4	8.5	10.3
    30–39	---	21.4	20.7	22.2
    40–49	---	21.9	21.6	22.2
    50+	---	26.8	32.7	20.3
    Female (%)	1,087	79.3	87.7	74.5
    Race (%)	1,087	---	---	---
    White	---	89.2	96.1	81.8
    African-American	---	5.9	2.3	9.8
    Hispanic	---	1.8	1.6	2.1
    Unknown Race	---	3.0	0.0	6.3
    Education (%)	1,033	---	---	---
    Up to 11 years of schooling	---	0.7	0.8	0.6
    GED	---	1.7	0.2	3.2
    High School Graduate	---	95.3	99.1	91.3
    Some Post-Secondary Education	---	2.4	0.0	5.0
    Enrollment Status (Last Event Code) (%)	1,086	---	---	---
    Registered	---	33.5	9.2	59.9
    Completed	---	33.4	55.9	9.0
    Cancelled	---	33.1	34.9	31.1
    Suspended	---	0.0	0.0	0.0
    Term Length (hours)	1,087	2,638	2,127	3,190
    Related Instruction Length (hours)	1,075	239	226	252
    Related Instruction by Sponsor (%)	1,087	92.1	100.0	83.5
    SOURCE: RTI International/Urban Institute analysis of RAPIDS data. NOTES: Registration after 1/1/2005, most recent training

    DSSs in time-based training tend to be older: 25% of them are under the age of 30 compared to 35% among those who are enrolled in competency-based training. Similarly, almost 33% of DSSs in time-based training are aged 50 and over, compared to 20% among those who are enrolled in competency-based training. A higher proportion of apprentices in time-based training are female -- (88% versus 75%) and White (96% versus 82%). Respectively, competency-based training has a more diverse group of apprentices: almost 10% are African-American compared to 2% in time-based training.

    While time-based training enrolled more apprentices who are high school graduates (99% versus 91%), competency-based training attracted 25 individuals with post-secondary education while time-based training attracted none.

    Enrollment status varies substantially by training type among DSSs: only 9% of apprentices (52) in time-based training are currently registered compared to almost 60% (312) among those in competency-based training. Conversely, 56% of apprentices in time-based training have completed the apprenticeship compared to only 9% among those in competency-based training. The proportion of cancellations is similar between the types of training (35% and 31%). It appears that none of the DSSs were granted a suspension.

    For these trainings, competency-based trainings involve even more hours (3,190) than time-based programs (2,127 hours). Similarly, the related instruction length is 226 hours for time-based training and 252 hours for competency-based training. All of the related instruction is conducted onsite for time-based training and 84% of teaching is done onsite for competency-based training.

    Table 4 provides details for the apprenticeship program in the HSS occupation (1086AA), which is a hybrid model combining competency-based and time-based training. There are no interim credentials offered for this model (as the research was underway, a large national employer developed an interim credentialed model). Although there is only the single occupational code in the data, DOL has developed work process schedules for various roles in which HSSs may participate depending on their assigned role in an assisted living facility or home. These roles include rehabilitative aide, HHA, environmental services aide, dining services aide, certified nursing aide, certified medication aide, and activity director. It is not clear whether HSSs in these data participate in apprenticeships specifically designed for these various roles. There are 567 HSSs employed in these data.

    Almost 7% of HSSs are under 20 years old and 20% are 20-24 years old. About 18% are over 50 years old. Most HSSs are female (89%) and 80% are White. About 8% are African-American. Six percent of HSSs have less than 11 years of schooling and almost 9% have a GED. However, the great majority of HSSs have graduated from high school (83%). About 3% have some post-secondary education.

    Among all the major occupations, HSSs have the highest proportion (73%) of apprentices currently registered (415). Slightly over 4% have completed training, and 22% have cancelled their enrollment. Term length for this occupation is 4,139 hours, which is much larger than other occupations. The apprenticeship for HSSs involves about 400 hours of related instruction. Only 24% of programs for this training conduct their teaching onsite.

    TABLE 4. Characteristics of Health Support Specialists
    Characteristics	N	1086AA
    Number of Apprentices	---	567
    Age (%)	567	---
    Under 20	---	6.5
    20-24	---	19.8
    25-29	---	13.8
    30-39	---	20.6
    40-49	---	21.7
    50+	---	17.6
    Female (%)	567	89.4
    Race (%)	567	---
    White	---	79.4
    African-American	---	7.9
    Hispanic	---	7.1
    Unknown Race	---	5.6
    Education (%)	521	---
    Up to 11 years of schooling	---	60
    GED	---	8.5
    High School Graduate	---	82.7
    Some Post-Secondary Education (%)	---	2.9
    Percent by Enrollment Status (Last Event Code) (%)	567	---
    Registered	---	73.2
    Completed	---	4.4
    Cancelled	---	22.4
    Suspended	---	0.0
    Term Length (hours)	567	4,139
    Related Instruction Length (hours)	553	398
    Related Instruction by Sponsor (%)	567	23.8
    SOURCE: RTI International/Urban Institute analysis of RAPIDS data. NOTES: Registration after 1/1/2005, most recent training

    Table 5 provides details on all trainings in the HHA occupation: 71 apprentices are involved in time-based training (Code 1086), 289 apprentices are involved in entry-level competency-based training (Code 1086 CB) and 35 apprentices are involved in various specialty trainings, including disability, hospice and palliative care, dementia, or mentoring (Codes 1068A, 1068B, 1068D and 1068E respectively). Although there are two other specialty trainings for HHAs (mental illness and geriatric occupations), there were no apprentices in the data for them. Data on these specific specialties are presented in Table A-2 in Appendix A.

    Age distribution varies by type of HHA training. For example, HHAs in time-based training tend to be older -- none of them are under 20 years of age, with higher proportions concentrated in the top age groups: 15% are aged 30-39, 34% are aged 40-49 and over a quarter are aged 50 and over. In contrast, almost 12% of HHAs in entry-level competency-based training are younger than 20 years old, and 45% of them are between 20 and 24 years old. Less than 4% of HHAs in entry-level competency-based training are aged 50 and over. HHAs enrolled in specialty trainings largely are on the far ends of the age distribution; 38% of them are under the age of 24, 29% are between ages of 40 and 49, and 20% are aged 50 and over.

    Time-based training has the highest proportion of females (94%) and minorities (48% African-Americans, 7% Hispanic). In contrast, entry-level competency-based training enrolls 19% African-Americans and less than 1% Hispanics. Eleven percent of HHAs in specialty trainings are African-American.

    TABLE 5. Characteristics of Home Health Aides
    Characteristics	N	Overall	Time-Based   (1086)	Entry-Level Competency-Based   (1086CB)	All Specialty   (1086A, 1086B, 1086D, & 1086E)
    Number of Apprentices	---	395	71	289	35
    Age (%)	395	---	---	---	---
    Under 20	---	8.9	0.0	11.8	2.9
    20-24	---	38.0	12.7	44.6	34.3
    25-29	---	16.5	12.7	18.3	8.6
    30-39	---	13.9	15.5	14.5	5.7
    40-49	---	13.7	33.8	6.9	28.6
    50+	---	9.1	25.4	3.8	20.0
    Female (%)	395	88.1	94.4	85.8	71.4
    Race (%)	395	---	---	---	---
    White	---	72.9	40.9	78.9	88.6
    African-American	---	23.5	47.9	19.0	11.4
    Hispanic	---	1.8	7.0	0.7	0.0
    Unknown Race	---	1.8	4.2	1.4	0.0
    Education (%)	395	---	---	---	---
    Up to 11 years of schooling	---	4.6	16.9	1.7	2.9
    GED	---	8.1	8.5	7.3	14.3
    High School Graduate	---	85.1	74.7	88.6	77.1
    Some Post-Secondary Education	---	2.3	0.0	2.4	5.7
    Enrollment Status (Last Event Code) (%)	395	---	---	---	---
    Registered	---	25.1	14.1	25.3	45.7
    Completed	---	13.2	56.3	2.1	17.1
    Cancelled	---	61.5	28.2	72.7	37.1
    Suspended	---	0.3	1.4	0.0	0.0
    Term Length (hours)	395	1,874	1,656	2,000	1,281
    Related Instruction Length (hours)	395	125	184	113	106
    Related Instruction by Sponsor (%)	395	96.0	100.0	100.0	54.3
    SOURCE: RTI International/Urban Institute analysis of RAPIDS data. NOTES: Registration after 1/1/2005, most recent training

    Time-based training also seems to attract the highest proportion of workers with 11 years of schooling or less (17%). In comparison, other HHA trainings attract less than 3% of apprentices with 11 years of schooling or less. None of the apprentices in time-based training have any post-secondary education. Educational attainment is higher for those involved in entry-level competency-based training (2.4% have some post-secondary education) and specialty trainings (6% have some post-secondary education).

    In terms of enrollment status, time-based training has the lowest proportion (14%) of currently registered apprentices (10) followed by entry-level competency-based training (25%; 73 apprentices) and specialty trainings (46%; 16 apprentices). However, the proportion of trainings completed shows a different trend: HHAs in time-based training have the highest proportion of completion at 56%, followed by specialty trainings at 17% with apprentices in entry-level competency-based training having the lowest proportion of completion of only 2%.

    Cancelation rates are high in this group: 28% of apprentices in time-based training, 73% of apprentices in entry-level competency-based training and 37% of apprentices in HHA specialty trainings have cancelled their involvement. One HHA, in time-based training, was granted a suspension.

    Regarding the length of apprenticeship, term length is lowest for specialty trainings (1,281 hours) and highest in entry-level competency-based training (2,000). Apprenticeships in time-based training average 1,656 hours.

    On average, there are 125 hours of related instruction. Time-based training is characterized by the longest related instruction of 184 hours, followed by the 113 hours in entry-level competency-based training. The mean for related instruction for specialty trainings is 106 hours. For time-based and entry-level competency-based training, all of the instruction is provided onsite by sponsors. Slightly over half of those in specialty training are trained at the sponsor’s site.

• 3.2. Program-Level Analyses

  • Program-level analyses describing program characteristics, geographic location, apprenticeship characteristics and training information on source/mode of related instruction are presented in Tables 6-10 and include descriptive results on 121 apprenticeship programs in the RAPIDS database. The sample size for these program-level analyses can be very small (single digits), so the results should be interpreted with caution.

    Table 6 presents data on program-level statistics by the four large occupational groups. Of the 121 programs in the database, 56 programs (46%) enroll CNAs with an average total workforce (defined as apprentices plus all other employees) of 1,803 persons across an average of 16 sites, 18 programs (15%) enroll DSSs with a mean total workforce of 259 apprentices across a mean of 16 sites, 34 programs (28%) enroll HSSs with an average total workforce of 147 apprentices, and 13 programs (11%) enroll HHAs with a mean total workforce of 311 apprentices. The assisted living facilities employing HSSs and the home health agencies employing HHAs each have only an average of one site. Only CNA and DSS programs involve multiple sites (18% and 11% respectively). None of the assisted living facilities or home health agencies operate their apprenticeship programs across more than one site.

    There are six nationally-sponsored apprenticeship programs, representing 5% of all programs in the RAPIDS database. Only CNA programs have any national sponsored programs (11% of these programs).

    Highlights of Program-Level Analyses 79 of the 121 programs sponsoring apprenticeships during the last 5 years currently have registered apprentices. Almost half (56) of the 121 programs are for CNAs, followed by 34 for HSSs working in assisted living facilities, with the remaining programs split between DSS programs (18) and HHA programs (13). The most common program is administered by a relatively small nursing home or assisted living facility, but several large hospital systems, nursing homes, and a group home operator have large programs with substantial numbers of apprentices. Almost all programs operate in single sites, with a few nursing home and assisted living chains operating in multiple sites. Half the programs (61) are located in the Midwest, with most of the remaining in the Southeast (12), Central (16), and West (16) regions. Only a few programs are in the Northeast (5) and Mid-Atlantic (5) regions. Only 6 programs are national programs. Trainings on average last about one year, but length greatly varies across the four major occupations. Trainings on average have about 320 hours of related instruction. Community colleges are the most frequent source of related instruction (38%), with onsite instruction (27%) and vocational schools (23%) the next most frequent sources of such instruction. All but one of the DSS and HSS programs are competency-based (as opposed to time-based), as are 8 of the 13 HHA programs but only half of the 56 CNA programs. Only 21 of the 121 programs offer advanced or specialty training.

    The geographic distribution of all programs is as follows: five programs each are located in Northeast and Mid-Atlantic (4% each), 12 programs are located in Southeast (10%), 16 programs in the Central region (14%), 61 program in the Midwest (53%) and six programs in the West (14%). CNA programs are distributed in every geographic region. Not all programs are represented in each geographic region. For example, there are no DSS programs in the Mid-Atlantic region, no HSS programs in the Northeast and Mid-Atlantic regions and no HHA programs in the Northeast and West regions. The largest concentration of programs by region for each occupation is in the Midwest region (48% for CNA programs, 38% for DSS programs, 68% for HSS programs and 77% for HHA programs).

    The overall mean length of apprenticeship program is 2,621 hours across all programs. CNA programs have 1,720 hours on average, compared to 3,296 hours for DSS programs, 4,256 hours for HSS programs, and 1,289 hours for HHA programs. The average length of related instruction of 319 hours is distributed as follows: 330 hours for CNA programs, 349 hours for DSS programs, 361 hours for HSS programs and 122 hours for HHA programs. Related instruction in each of these occupations is longer than the federally required 75 hours of instruction.

    The program-level RAPIDS data provide the opportunity to examine where and how the related instruction takes place. However, RAPIDS mixes the source (where) and the mode (how) within the same categorical variable, so it is not possible to completely disentangle the issues of location of training and method of training delivery because only a few programs respond to both issues. Rather than losing one of these characteristics (source and mode) by omitting them from the analysis, we report on both characteristics together as found in the single RAPIDS variable. Over 26% of all related instruction takes place onsite where each sponsor is located. Community colleges provide instruction for 38% of all programs, and vocational schools provide instruction for 23% of all programs. Ten percent of programs are offered on line (web-based), 9% are offered by correspondence course, and slightly less than 2% are located at technical schools.

    TABLE 6. Characteristics of Long-Term Care Programs by Occupational Group
    Characteristics	N	Overall	Major Occupational Group: CNA (824)	Major Occupational Group: DSS (1040)	Major Occupational Group: HSS (1086AA)	Major Occupational Group: HHA (1086)
    Number of Employers	---	121	56	18	34	13
    Employer Characteristics
    Mean Employer Total Workforce	121	948	1,803	259	147	311
    Mean Number of Affiliated Sites	121	10	16	16	1	1
    Percent with Multiple Sites	121	9.9	17.9	11.1	0.0	0.0
    National Program	6	5.0	10.7	0.0	0.0	0.0
    Geographic Characteristics (%)	115	---	---	---	---	---
    Northeast-DOL Region 1	---	4.35	6.0	11.1	0.0	0.0
    Mid-Atlantic-DOL Region 2	---	4.35	8.0	0.0	0.0	7.7
    Southeast-DOL Region 3	---	10.43	18.0	5.6	2.9	7.7
    Central-DOL Region 4	---	13.91	10.0	22.2	17.7	7.7
    Midwest-DOL Region 5	---	53.0	48.0	22.2	67.7	76.9
    West-DOL Region 6	---	13.9	10.0	38.9	11.8	0.0
    Apprenticeship Characteristics
    Mean Term Length	121	2,621	1,720	3,296	4,256	1,289
    Mean Related Instruction Length	117	319	331	349	361	122
    Source/Mode of RI*
    Onsite	121	26.5	26.9	33.3	2.9	76.9
    Community College	121	38.0	19.6	44.1	73.5	15.4
    Technical School	121	1.7	0.0	0.0	5.9	0.0
    Vocational School	121	22.8	44.6	8.6	0.0	7.7
    Correspondence	121	9.1	0.0	33.3	14.7	0.0
    Web-based	121	10.0	7.1	22.2	12.1	0.0
    SOURCE: RTI International/Urban Institute analysis of RAPIDS data. NOTES: Registration after 1/1/2005, most recent training * Source/Mode of Related Instruction -- categories are not mutually exclusive: one program can have instruction from several sources.

    The source/mode of related instruction varies by program type. Among CNA programs, the most frequent source/mode was a vocational school (45%), followed by onsite sponsor location (27%), and community college (29%). For DSS programs, the most frequent source/mode was a community college (44%), followed by correspondence course and onsite sponsor location (33% each) and web-based programs (22%). For HSS programs, the most frequent source/mode was a community college (73%), followed by correspondence course (15%) and web-based (12%). Among apprenticeship programs for HHAs, most related instruction was conducted onsite (77%), followed by community college (15%) and vocational school (8%).

    We also conducted the same sensitivity analyses for these program-level statistics by removing the four large employers noted in the prior section on apprentice-level findings. The change in results though was much less substantial. Only total workforce size for DSSs, HSSs, and HHA employers became smaller after removing the four programs. No other program-level characteristics changed greatly.

    TABLE 7. Characteristics of Certified Nursing Assistant Programs
    Characteristics	N	Overall	Time-Based   (824)	Entry-Level Competency-Based   (824C & 824CB)	Advanced or Specialty   (824A, 824R, 824D, 824G & 824M)
    Employer Characteristics	---	---	---	---	---
    Number of Employers	---	56	28	13	15
    Mean Employer Total Workforce	56	1,803	232	3,109	3,604
    Mean Number of Affiliated Sites	56	16	2	24	37
    Percent with Multiple Sites	56	17.9	7.1	23.1	33.3
    National Program	6	10.7	0.0	15.5	26.7
    Geographic Characteristics (%)	---	---	---	---	---
    Northeast-DOL Region 1	3	6.0	3.6	0.0	18.2
    Mid-Atlantic-DOL Region 2	4	8.0	7.1	0.0	18.3
    Southeast-DOL Region 3	9	18.0	14.3	9.1	36.4
    Central-DOL Region 4	5	10.0	10.7	18.2	0.0
    Midwest-DOL Region 5	24	48.0	57.1	72.7	0.0
    West-DOL Region 6	5	10.0	7.1	0.0	27.3
    Apprenticeship Characteristics
    Mean Term Length	56	1,720	2,240	1,071	1,312
    Mean Related Instruction Length	52	331	525	155	121
    Source/Mode of RI*
    Onsite	56	26.9	17.9	38.5	33.8
    Community College	56	19.6	10.7	15.4	40.0
    Technical School	56	0.0	0.0	0.0	0.0
    Vocational School	56	44.6	60.7	38.5	20.0
    Correspondence	56	0.0	0.0	0.0	0.0
    Web-based	56	7.1	7.1	0.0	13.3
    SOURCE: RTI International/Urban Institute analysis of RAPIDS data. NOTES: Registration after 1/1/2005, most recent training * Source/Mode of Related Instruction -- categories are not mutually exclusive: one program can have instruction from several sources.

    Table 7 presents the same characteristics as in Table 6, but only for CNA programs, comparing time-based (28 programs), competency-based (13 programs), and specialty programs (15 programs). Most of the time-based programs are concentrated in the Midwest, Southwest and Central regions. No CNA programs are nationally sponsored in the time-based program. In addition to national programs which represent 16%, entry-level competency-based CNA programs are only available in three regions -- the Midwest, Southwest and Central regions. Advanced and specialty programs for CNAs are available in the Southeast, West, Northeast and Mid-Atlantic regions. Twenty-seven percent of advanced and specialty CNA training programs are national.

    Regarding term length, time-based CNA programs are on average the longest (2,240 hours), compared to 1,312 hours for advanced/specialty programs and 1,071 hours for entry-level competency-based programs.

    TABLE 8. Characteristics of Direct Support Specialist Programs
    Characteristics	N	Overall	Time-Based (1040)	Competency-Based (1040CB)
    Employer Characteristics
    Number of Employers	---	18	1	17
    Mean Employer Total Workforce	18	259	700	233
    Mean Number of Affiliated Sites	18	16	1	17
    Percent with Multiple Sites	18	11.1	0.0	11.8
    National Program	0.0	0.0	0.0	0.0
    Geographic Characteristics (%)	18	---	---	---
    Northeast-DOL Region 1	---	11.1	0.0	11.8
    Mid-Atlantic-DOL Region 2	---	5.6	0.0	5.9
    Southeast-DOL Region 3	---	0.0	0.0	0.0
    Central-DOL Region 4	---	22.2	0.0	23.5
    Midwest-DOL Region 5	---	22.2	100.0	17.7
    West-DOL Region 6	---	38.9	0.0	41.2
    Apprenticeship Characteristics
    Mean Term Length	18	3,296	2,127	3,365
    Mean Related Instruction Length	18	349	226	356
    Source/Mode of RI*
    Onsite	18	33.3	100.0	29.4
    Community College	18	44.1	0.0	46.6
    Technical School	18	0.0	0.0	0.0
    Vocational School	18	8.6	0.0	9.1
    Correspondence	18	33.3	0.0	35.3
    Web-based	18	22.2	0.0	23.5
    SOURCE: RTI International/Urban Institute analysis of RAPIDS data. NOTES: Registration after 1/1/2005, most recent training * Source/Mode of Related Instruction -- categories are not mutually exclusive: one program can have instruction from several sources.

    Related instruction length and source/mode also varies by type of training: time-based programs average 525 hours of related instruction and are mostly conducted at vocational schools (61%) and onsite (18%), compared to a mean of 155 hours for entry-level competency-based programs and an average of 121 hours for advanced/specialty programs. About 7% of related instruction for time-based programs is web-based. Entry-level competency-based programs are equally likely to be conducted at vocational schools and onsite (38% each) followed by community colleges. None of the entry-level competency-based programs are conducted via the web or by correspondence, or at technical schools. Related instruction for the advanced/specialty programs is most frequently conducted at community colleges, followed by onsite training and vocational schools. About 13% of related instruction for advanced/specialty programs is web-based. Additional detailed information for each specialty competency for CNAs is shown in Table A-3 in Appendix A.

    Table 8 presents the program characteristics for DSS programs comparing the one entry-level time-based program versus the 17 entry-level competency-based programs. In terms of geographic location, the only time-based program is located in the Midwest. There are no national programs. Entry-level competency-based programs are distributed across the country and are located in every region with the exception of the Southwest with the highest concentration in the West and Central regions.

    The one time-based program has a term length of 2,127 hours with 266 hours of related instruction which is conducted onsite by its sponsor. On average, the entry-level competency-based DSS programs are 3,365 hours long and have a mean of 356 hours of related instruction. Related instruction for these programs is most commonly conducted at a community college (47%), followed by training by correspondence (35%), onsite training by the sponsor (29%) and web-based training (23%).

    TABLE 9. Characteristics of Health Support Specialist Programs
    Characteristics	N	1040AA
    Employer Characteristics	---	---
    Number of Employers	---	34
    Mean Employer Total Workforce	34	147
    Mean Number of Affiliated Sites	34	1
    Percent with Multiple Sites	34	0.0
    National Program	0	0.0
    Geographic Characteristics (%)	34	---
    Northeast-DOL Region 1	---	0.0
    Mid-Atlantic-DOL Region 2	---	0.0
    Southeast-DOL Region 3	---	2.9
    Central-DOL Region 4	---	17.7
    Midwest-DOL Region 5	---	67.7
    West-DOL Region 6	---	11.8
    Apprenticeship Characteristics
    Mean Term Length	34	4,256
    Mean Related Instruction Length	34	360
    Source/Mode of RI*
    Onsite	34	2.9
    Community College	34	73.5
    Technical School	34	5.9
    Vocational School	34	0.0
    Correspondence	34	14.7
    Web-based	34	12.1
    SOURCE: RTI International/Urban Institute analysis of RAPIDS data. NOTES: Registration after 1/1/2005, most recent training * Source/Mode of Related Instruction -- categories are not mutually exclusive: one program can have instruction from several sources.

    Table 9 presents the program-level data for HSS programs. The mean workforce size across the 34 programs was 147 workers. Geographically, 23 of the programs (68%) are in the Midwest, with the remainder spread fairly evenly across the Central and West regions, and only one in the Southeast. The mean term length was 4,256 hours, and the average length of related instruction was 360 hours. Regarding the source/mode of related instruction, community colleges provided 74% of training, 15% was provided through correspondence courses, and 12% was via web-based courses.

    Table 10 compares characteristics on the 13 HHA programs across the five time-based programs (38% of the total), the two entry-level competency-based programs (15% of the total) and the six specialty programs (46% of these programs). The mean employer workforce size is largest for the entry-level competency-based programs (840) as compared to the much smaller workforces in the time-based (307) and specialty (137) programs. None of the programs has multiple sites (each program is a standalone program).

    TABLE 10. Characteristics of Home Health Aide Programs
    Characteristics	N	Overall	Time-Based   (1086)	Entry-Level Competency-Based   (1086CB)	All Specialty   (1086A, 1086B, 1086D, & 1086E)
    Employer Characteristics
    Number of Employers	---	13	5	2	6
    Mean Employer Total Workforce	13	311	307	840	137
    Mean Number of Affiliated Sites	13	1	1	1	1
    Percent with Multiple Sites	13	0.0	0.0	0.0	0.0
    National Program	0	0.0	0.0	0.0	0.0
    Geographic Characteristics (%)	13	---	---	---	---
    Northeast-DOL Region 1	---	0.0	0.0	0.0	0.0
    Mid-Atlantic-DOL Region 2	---	7.7	20.0	0.0	0.0
    Southeast-DOL Region 3	---	7.7	0.0	50.0	0.0
    Central-DOL Region 4	---	7.7	0.0	0.0	16.7
    Midwest-DOL Region 5	---	76.9	80.0	50.0	83.3
    West-DOL Region 6	---	0.0	0.0	0.0	0.0
    Apprenticeship Characteristics
    Mean Term Length	13	1,289	1,211	2,000	1,117
    Mean Related Instruction Length	13	122	168	128	82
    Source/Mode of RI*
    Onsite	13	76.9	100.0	50.0	66.7
    Community College	13	15.4	0.0	50.0	16.7
    Technical School	13	0.0	0.0	0.0	0.0
    Vocational School	13	0.0	0.0	0.0	16.7
    Correspondence	13	0.0	0.0	0.0	0.0
    Web-based	13	0.0	0.0	0.0	0.0
    SOURCE: RTI International/Urban Institute analysis of RAPIDS data. NOTES: Registration after 1/1/2005, most recent training * Source/Mode of Related Instruction -- categories are not mutually exclusive: one program can have instruction from several sources.

    Geographically, most of the time-based programs are located in the Midwest (80%), with the others located in the Mid-Atlantic region. The entry-level competency-based programs are in the Southeast and the Midwest. One specialty program is located in the Central region and five are in the Midwest.

    Term length in time-based programs averages 1,211 hours with a mean of 168 hours of related instruction which is conducted onsite by employers. The two entry-level competency-based programs average 2,000 hours of instruction and average 128 hours of related instruction with one conducted onsite by the sponsor and one conducted at a community college. Term length in specialty programs averages 1,117 hours with a mean of 82 hours of related instruction, which is mostly conducted onsite (67%), followed by community colleges and vocational schools (17% each). Additional detailed information for each specialty training for HHAs is shown in Table A-4 in Appendix A.

    Appendix A Table A-5 and Table A-6 provide a list of the programs contained in the data and the number of apprentices they contribute by major occupation. Table A-5 lists all programs (121) regardless of whether they had currently enrolled (registered) apprentices at the date of the RAPIDS data extract (December 2009). Table A-6 lists only those programs (79) with currently enrolled (registered) apprentices as of December 2009. We discuss results across these two tables to provide sufficient context for understanding.

    The most common program is located within a relatively small (100 total employees) nursing home or assisted living center, which may or may not be part of a chain. Several entities operate small group homes for persons with intellectual disabilities with approximately 25 employees in each home. A detailed review of the data provides an understanding of several large programs that skew the results on total workforce size and apprentices upward. Several large hospital systems and large providers of group homes employ substantial numbers of apprentices. For example, St. John’s Mercy Medical Center in St. Louis, Missouri, has employed 644 apprentices over time and now trains 324. Developmental Services, Inc. in Indiana, which services group homes for persons with intellectual disabilities has provided 924 apprenticeships over time and 274 currently. Nearly 400 apprentices have been sponsored by the Gary Job Corps in Texas, but none were currently enrolled as of December 2009.

    In addition, several large nursing home programs contribute large numbers of apprentices. The Evangelical Lutheran Good Samaritan Society is a chain of nursing homes with 122 branches (nursing homes), each having approximately 100 employees, contributed 254 apprentices overall but only 84 currently. The Georgia Health Care Association program is an association with 55 participating nursing homes averaging 100 employees each, contributed 120 apprentices overall and 69 current apprentices.

    The three largest contributors of currently enrolled CNAs are St. John’s Mercy Medical Center in St. Louis (174), the Evangelical Lutheran Good Samaritan Society in South Dakota (84), and the Georgia Health Care Association located in suburban Atlanta (69). The three largest contributors of currently enrolled DSSs are Developmental Services, Inc. in Indiana (274), Macomb Oakland Regional Center in Michigan (22), and Hope Community Resources in Alaska (19). The three largest contributors of currently enrolled HSSs are St. John’s Mercy Medical Center in St. Louis (82), Comfort Keepers in San Diego (43), and Memorial Health System in Kansas (39). The three largest contributors of currently enrolled HHAs are St. John’s Mercy Medical Center in St. Louis (68), Harbor Home Healthcare in Michigan (9), and Home Care Associates of Philadelphia (8).

• 3.3. Findings from Interviews with Program Sponsors

  • We conducted interviews with staff from two organizations selected by OA staff to inform our understanding of the quality of RAPIDS data and the data entry process. These organizations were Evangelical Lutheran Good Samaritan Society, a large owner of nursing homes, and the Georgia Health Care Association, an association for nursing homes in Georgia. Topics included the overall data entry process, sources of information for wage data, and problems encountered during RAPIDS data entry and recommendations for improvement. Generally, one person is responsible in these organizations for entering data into RAPIDS from information contained in enrollment forms at the beginning of an apprenticeship. Thereafter, both programs entered data at the completion of trainings or on an as needed basis. On a 10-point scale, with 10 being the best quality and 1 being the worst quality, one program rated information contained in an apprentice’s application form at a 7, requiring follow-up with an apprentice to obtain or clarify information. After all data were collected though, these programs rated data entry at a 9-10.

    Regarding problems entering data, or changes needed in the RAPIDS system, one program experienced problems in “transitioning” data electronically between the advanced training data fields and specialty training data fields, saying that instead of entering the data into RAPIDS, they sent the data in an e-mail to DOL. Another program said that using RAPIDS was cumbersome and not user friendly. For example, one cannot go back to the previous screen. One program stated that it would be useful to add one more data field to track the entire length of time of one’s apprenticeship across all trainings completed.

    Wage data entered into RAPIDS are hourly data. Entry and exit wages were the apprentice’s actual wage at apprenticeship entry and exit. The pre-apprenticeship wages entered are the same as the entry wage. One program granted an automatic 25 cent hourly increase in wages for completing a training, while another program provided a wage increase or bonus only at the discretion of various nursing homes within the larger organization, largely dependent on whether there were budgeted funds at the time to do so.

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