New Models in Healthcare Apprenticeships

New Models in Healthcare Apprenticeships

NN2 National Network of Health Career Programs in Two-Year Colleges We are an organization composed of health education leaders from across the nation from two-year colleges. It is the ONLY interdisciplinary professional organization serving two-year colleges and programs.

NN2 is dedicated to: Promoting and encouraging innovation, collaboration, cooperation, and communication with two-year colleges sponsoring health career programs Developing new leaders in health career education Expressing and advocating the interests of health career programs in two-year colleges (i.e., accreditation issues, practice issues, federal policy issues, etc.) Working collaboratively with other professional communities of interest to further policy related to health career education and higher education in general.

Healthcare Apprenticeships Traditional Experiential Learning Redefined Why healthcare must adopt this model Current healthcare apprenticeship models that are working Challenges and Opportunities Resources for Implementation

Traditional Model: Healthcare Education Experiential Learning: Experiential Models Historically Integrated: Clinical Practice ie: Internships, Practicums, Directed Practice Models are developed by college faculty based upon accreditation and college requirements Require cooperation and collaboration with Employers No requirement to hire or provide a pathway to hiring by Employer

Health Care Apprenticeships: Traditional Model Redefined Total Program Integration between Education Provider and Employer Model must be constructed to benefit both and lead to employment Education provider and accreditors must be open to adaptation of traditional curriculum and program implementation Employers must be open to adaptation and willing to take responsibility for providing internal resources to support students learning and to hire upon successful completion.

Challenges: Adapting complicated models in which defined roles and responsibilities are historically accepted within communities. Workforce, education and professional organizations work together to embrace apprenticeship pathway models Most implementation has been with entry level non licensed professionals. Next step is to implement Associate Degree and beyond apprenticeships for much needed Licensed Professionals as well as development of pathway programs to increase pool of qualified health professionals. Work with accreditors, educators, state and local workforce boards and employers to implement to clear obstacles to apprenticeship pathways. Provide pre-apprenticeship programs for high school students. Provides opportunity and incentives for early access to health careers. Increase future pool of health professionals.

Why HC must adopt apprenticeships: To meet workforce needs for the future!!!! Healthcare is the largest U.S. Industry. GNP nearly 18% of Budget (3 x the next largest country in the world) Among top 20 nations we rank last on quality and outcome indicators Healthcare demands for service will continue to increase ACA (Obamacare) has added 30 million new participants Bureau of Labor Statistics estimates unmet demand of 3.5 million health care workers Current employer and education practices are not sufficient or efficient enough to meet demand.

How Apprenticeships Can Help Stabilize Healthcare Employment Needs Increasing supply of skilled healthcare workers Reducing maldistribution by expertise and geography Reducing turnover and related costs Improving Career Pathways within Healthcare Improving leadership and supervisory skills in the healthcare workforce *Mouldin, Bronwyn, Apprenticeships in the Healthcare industry 2011

Successful Models: Washington State Statewide Model utilizing Greater Cincinnati Health Careers Collaborative Incumbent Worker, Regional pathways including High School Southwest Michigan Medical Assisting Initiative

Resources to Aid in Development of Successful Healthcare Apprenticeships http://www.doleta.gov/oa/pdf/apprenticeship_build_healthcare_paths.pdf https://www.vcn.org/health-care/get-qualified/resources/apprenticeshiptraining www.hcapinc.org toolkit https://skillupwa.org/initiatives/health-care/ http://www.lni.wa.gov/tradeslicensing/apprenticeship/files/pubs/apprentic eshipshealthcareindustrymauldin.pdf

About Grand Rapids, Michigan Rapids Michigan City population: 196,445 Region: 1,027,703 (2016) Region s unemployment rate: 2.9% (July 2017) 5 City of GR neighborhoods between 18-24% unemployment Leading Industry Manufacturing & Healthcare

West Michigan Experience The first CAAHEP accredited Medical Assisting Program in the nation to be offered as a Federally Registered Apprenticeship. The first registered apprenticeship where the workforce development organization hold the standards. Currently expanding to other registered apprenticeships in healthcare

It all started at a meeting Workforce Need for Medical Assistants

West Michigan 8,500 Colleagues 5 Hospital Campuses 1,300 Medical Staff Physicians 491 Employed Network Providers Over 60 Medical Offices

GRCC Located in Grand Rapids, Michigan Serves Kent, Allegan, and Ottawa counties Urban Campus with multiple satellite locations 13,846 credit students 2015/2016 14,465 non-credit students -2015/2016

High Need for Medical Assistants High Cost of Turnover Primary care and specialty care practices projected 25% growth Medical Assistant are in high demand and low supply

Partners: Department of Labor, Office of Apprenticeship Russell Davis David Jackson

West Michigan Works! Local Workforce Development Agency Employer-Focused, Demand Driven West Michigan Works! adopted this model in 2012 Regionalized in October 2015 7 Counties Address business needs that affect the ability of the business to achieve, maintain, and increase competitiveness including the need for a skilled workforce Became the Sponsor of the Apprenticeship

Employers were recruited by W MI Works and Educators Cherry Health, Mercy Health, Spectrum Health Have individualized on-boarding processes, pay rates. Some created new job codes, others didn t Two had only new hires, one only incumbent workers End wage must be at least $13/hr

Community Colleges in the 7 county region came together

How can we meet our employers needs for medical assistants? Differences Commonality Different Formats Same Accreditation Different Competency Measures Different Schedules Same focus on meeting employer need Different Certification Exams

GRCC Open Enrollment MA Program 6 month Accelerated Program 34 hours/week for 18 weeks 4 week, full time, unpaid externship for 160 hours End of January, early August start dates Non-credit, certificate program RMA Certification Exam CAAHEP Accreditation Program began in 2010, Accreditation approval in 2012 *The Medical Assistant Program at GRCC is accredited by the Commission on Accreditation of Allied Health Education Programs (www.caahep.org) upon the recommendation of the Medical Assistant Education Review Board. CAAHEP 25400 US Highway 19 North Ste 158, Clearwater, FL 33763 717-210-2350, www.caahep.org

24/16 Model Apprentices are on the Job Site 24 hours per week (Mondays, Wednesdays, and Thursdays) All Learning and Externships are scheduled on Tuesdays and Fridays for 16 hours total/week Apprentices are paid 24 hours/week. Learning and Externship are not paid

GRCC Schedule: 2017 Cohort Phase 1 Phase 2 Phase 3 Phase 4 January 10 March 17 Learning (10 weeks; 2 days/wk) March 21 March 31 Practicum 1 st week in April off April 10 June 16 Learning (10 weeks; 2 days/wk) June 2- June 30 Practicum Week of July 4 off July 10 September 1 Learning (8 weeks; 2 days/wk) September 5 15 Practicum September 19 November 10 Learning (8 weeks; 2 days/wk) November 14 December 12 Practicum (No 11/24) December 15 Graduation

Obstacles we overcame Differences in programs Paid employment and Non-paid practicum at the same employer Terminology in Program Marketing On the job training coordination with practicum sites

Here s our end product: Intake Participating employers are recruited by W MI Works, colleges All Candidates (internal and external) are screened through West Michigan Works! Candidates complete application of interest and attend an information session W MI Works uses the specific college admission criteria for an initial screening Candidates Portfolios* are sent to employers Employers hire/identify internal candidates W MI Works identifies potential funding streams for the students W MI Works informs schools of the students who will be in the class *Career Portfolio Handbook by National Career Pathways Technical Assistance Center

End Product: The School Experience 2 days of school, 3 days of employment per week Divided the curriculum into 3 or 4 levels Retained our different schedules identified which competencies would be evaluated in each segment of the program Offer practicum hours after each segment on the same days that the school learning takes place (e.g. GRCC school days are Tuesdays and Fridays for in class learning and practicums) Mandatory competencies are the ones required for CAAHEP accreditation. Optional competencies are school specific learning based on employer need

End Product: DOL/OA Approval Competency Based program CAAHEP Accreditation (Appendix B) Psychomotor and Affective competency standards are the mandatory education competencies Employers identified a list of employability competencies

Why Apprenticeship in Healthcare? The Numbers Educated 53 apprentices from 3 employers at 2 colleges. There are 40 apprentices in the 2018 cohort. GRCC s open enrollment Medical Assistant Program before apprenticeships had less than 3% diversity in classes. Since the apprenticeship program has started 24.8% of students are people of color. 2016 Year 1 application Numbers: 42 for GRCC (18 students) Application of Interest (Regional) in 2017: 196 (26 students) Application of Interest (Regional) for 2018 cohort: 470 58% people of color

Why Apprenticeships in Healthcare? One Employer s Perspective Current openings as of 9/30/15-40 individuals (26.49 FTE). Projected openings - September 2015 to June 2018-180 individuals includes separations and new positions. MA First-year turnover is 23%. Average cost of turnover - $26,769/individual. If turnover is reduced to 15%,the difference is $107,076 which is a savings of 4 MA's.

One Employer s Projected cost for 10 apprentices at GRCC Total cost per apprentice $24,633 GRCC tuition cost $7585, labor+benefits = $17,048) Hire 10 -.6FTE The total cost in FY16/FY17 for 10 apprentices $246,330.00 (half budgeted each year) Comparison to turnover cost of 10 MA's = $267,690.00

One Employer s Long Term Benefit Opportunity to build a diverse pipeline of highly competent Medical Assistants Attracts career minded applicants Fosters a workforce to keep organization competitive, flexible and adaptive Develops a competent colleague, who is certified and completed clinical orientation Develops a colleague who embraces the organizational culture

Advantages for Applicant Tuition completed funded Part time pay while learning with expectation of full time pay/job afterwards Ability to apply knowledge and build skills concurrently with learning Develops a competent colleague, who is capable of advancing Immersion in to organizations culture Increase success in first year experience Reduce turnover

Why are Healthcare Apprenticeships Important? is this important? Becoming more reflective of the community these health employers serve Low unemployment rate Developing employment opportunities that will keep our youth in West Michigan Opportunities for post secondary education without the debt Certifications leading to careers Increase retention Quality employees, quality jobs and thoughtful career pathway

Suggested steps for those who want to offer health education in an apprenticeship format Gather all potential partners employers, workforce development, DOL/OA. There must be commitment from employer and educator in order to move forward Contact your local DOL/OA staff to access the approved standards If the profession isn t already approved for apprenticeship: Gather workforce development, employer, and education partners Consider having the Workforce development organization hold the apprenticeship it works well for us! Agree on format and competency measures Work with your employer partners to coordinate skill attainment/practicum content

Next Steps Sterile Processing Tech Apprenticeship will started in January 2018 After that - Surgical Technician? Community Health Worker? Others?

Questions? Linda Witte, MPA, RMA, CBSP lwitte@grcc.edu Marianne Krismer, Ph.D. mkrismer61@gmail.com Diane Neefe, Ph.D. NeefeD@westerntc.edu www.nn2.org