Building California’s Health Care Workforce through Labor Management and Community College Partnerships

Health care in California has a problem. Like many places in this country, the state needs thousands more allied health workers than it is on track to train in critical roles like licensed vocational nurses and certified nursing assistants. Current and future allied health workers should be able to access training that fits into their lives with wages and benefits that meet their needs. They should be at the center of career training and registered apprenticeship pathways to meet California’s need for a well-trained, diverse, and economically resilient workforce. That isn’t always the case, but with smart state investment and the right partners in place, states can foster a highly-trained, diverse, and economically resilient health care workforce.

California has already made great strides toward drawing on the strength of unions to strengthen the health care workforce. Take the Education Fund for example. This labor management training partnership and High Road Training Partnership serves 105,000 allied health workers across six SEIU local unions and 19 employers in six western states. They provide workers with subsidized and even free training to advance their careers, maintain their skills, and gain new skills as jobs in health care evolve. Workers participate directly with their employers in governance, program development, and recruitment. The workforce served is 70 percent women and 70 percent workers of color. Program graduates on average earn 45 percent wage increases when they move up the clinical job ladder, and employers experience 50 percent higher retention for workers trained through the partnership.

To support working learners, the Education Fund is building out program pathways in occupations like medical imaging, respiratory care, and nursing. To provide classroom-based learning for these pathways, they need reliable, well-established, and affordable providers. Enter the nation’s largest system of higher education: California community colleges. In California, community colleges are either free or very affordable for students, which would stretch the partnership’s training benefits further. Community college allied health programs also have strong retention–analysis of 10,000 allied health workers’ career paths showed that community college graduates stayed in allied health roles for twice as long as peers who graduated from for-profit institutions.

Despite the benefits, a minority of allied health workers are trained at community colleges. Up to 80 percent of graduates in roles like medical assistants and licensed vocational nurses (LVNs) are trained through private, for-profit providers. Unfortunately, community colleges have limited space in many allied health programs, and program structures aren’t necessarily designed with working learners in mind. With more capacity to support adult learners in allied health programs–and the flexibility to deliver training that fits into their lives–communities across California would benefit. Think of the strength of training and career support that would come with resources from the labor management fund and the financially and geographically accessible community college allied health programs working together.

Here is what needs to change to increase the capacity of community college allied health programs in California to make them better partners with training funds:

• Funding for clinicals. Clinical placements for allied health programs are in high demand and difficult for community colleges to secure. This means that colleges have to cap the number of students in their programs because they don’t have enough clinical placements available with their current employer partners. One way to address this is for the state to provide funding for labor management partnerships to subsidize paid clinical training time. Staffing costs for training time are duplicated when the employer is paying for the time of both the trainee and the preceptor or mentor. Providing a direct worker benefit to offset the employer cost of clinical placements is one step to increase the affordability of clinical training and add capacity to allied health programs. Funding this benefit through a labor management partnership ensures that these dollars directly benefit learners in these programs and align with both employer demand and worker needs–consistent with the state's High Road Training Partnership support of employers who invest in training and support worker voice.
• Development of a community college statewide system of registered apprenticeship. Community colleges need to engage in regional, multi-employer registered apprenticeship programs aligned with health care workforce demand. Colleges will need support to shore up their role in apprenticeships and partner with unions to ensure worker voice and job quality. This systematic approach to registered apprenticeship would improve access to high-quality classroom and on the job training, breaking down occupational segregation along lines of gender and race while providing opportunities for incumbent and non-incumbent allied health workers.
• Increased wages for allied health faculty. Many community colleges have difficulty providing wages to allied health faculty that compete with what they can make as practitioners. Increasing pay for allied health faculty would help with the recruitment of experienced healthcare workers, many of whom left their patient care jobs over the past year, but would be interested in applying their skills and knowledge to training the next generation of allied health workers. California should consider creating a fund to raise the wages of allied health faculty to compete with professional practice, thereby allowing community colleges to offer more allied health classes.
• Night and weekend schedules, and hybrid or online options for programs. With these extra resources going into allied health programs at community colleges, the schools should expand their schedules to offer classes at convenient times for adult learners and with continued options for flexible hybrid and online options that have proliferated in the pandemic. For-profit providers offer plentiful night and weekend classes, which is one reason many working learners choose them. Many working learners pay up to $40,000 for a licensed vocational nursing certificate because for-profit providers have classes on evenings and weekends which they need for their busy schedules. Had they attended a community college instead, they would have paid between $12,000 and $15,000. The community colleges should take a page out of the for-profit playbook here and offer more flexible schedules for the high quality and affordable programs they’re known for.

Labor management training funds, like the Education Fund in California, offer their members an important resource for financing tuition and clinical training for non-degree programs in allied health. Critically, they have a fiduciary obligation to the learner and have worker voice and employer partnership at the center of their work.

With boosted capacity through state investment, community colleges in California could serve every student who needs additional education to advance in their allied health career. Support for these colleges’ capacity and flexibility will help them enroll more students, who then earn better wages without the burden of debt. And, crucially, investing in community college program capacity and partnerships with training funds will help the state prepare more desperately needed health care professionals.

If community colleges and states work to increase the capacity and flexibility of allied health programs, partnership with labor management training funds can do even more to serve colleges, learners, and state workforce needs.

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