BILL ANALYSIS Ó
AB 1797
Page A
Date of Hearing: April 23, 2014
ASSEMBLY COMMITTEE ON LABOR AND EMPLOYMENT
Roger Hernández, Chair
AB 1797 (Rodriguez) - As Amended: April 1, 2014
SUBJECT : California Workforce Investment Board.
SUMMARY : Requires the California Workforce Investment Board
(CWIB), in consultation with the Division of Apprenticeship
Standards (DAS) to conduct specified activity related to
expanding job training and employment for allied health
professions. Specifically, this bill :
1)Requires the CWIB, in consultation with the DAS, in efforts to
expand job training and employment for allied health
professionals, to do the following:
a) Identify opportunities for "earn and learn" job training
opportunities that meet the industry's workforce demands
and that are in high-wage, high-demand jobs.
b) Identify and develop specific requirements and
qualifications for entry into "earn and learn" job training
models and establish standards for corresponding skills
training programs that result in an industry-recognized
credential certifying that the individual is ready to enter
an "earn and learn" job training model in the allied health
professions.
c) Develop means to identify, assess, and prepare a pool of
qualified candidates seeking to enter "earn and learn" job
training models.
2)Requires the CWIB to prepare and submit to the appropriate
policy committees of the Legislature a report on its findings
and recommendations on or before December 1, 2015.
FISCAL EFFECT : Unknown
COMMENTS : According to the author, the demand for healthcare
workers in the United States has remained high for many years,
growing at a rate faster than the overall employment rate for
the past fifty years. The U.S. Department of Labor's (DOL)
Bureau of Labor Statistics (BLS) projects that of the twenty
AB 1797
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industries projected to gain the most jobs between 2008 and
2018, five of those industries relate to health care: (1)
offices of physicians (772,000 new jobs); (2) home health care
services (441,000); (3) services for the elderly and persons
with disabilities (431,000); (4) nursing care facilities
(394,000); and (5) offices of dentists (233,000)
The author states that currently, health care providers face a
range of employment and workforce issues. There are significant
shortages of healthcare workers in certain occupations and
geographic areas, while there is oversupply in other areas.
According to a recently published survey by the California
Hospital Association, California's hospitals could need more
than one million new allied health professionals by 2030. An
aging population, population growth, and federal health reform
will likely contribute to the increased demand.
The author argues that "earn and learn" job training programs
(including apprenticeship) have been increasingly recognized as
a highly effective workforce strategy for building skills and
earnings in entry- and middle-level jobs, for increasing
productivity and for aligning employer demands with the supply
of workers for this critical industry. These training programs
can be a critical part of the workforce strategy related to
healthcare reform as it is seen as a way to train long-term care
workers and address some of the workforce issues including
recruitment and retention, training a quality workforce and
improving quality of patient care.
The author states that lack of clear career pathways for
healthcare workers means that people with the greatest longevity
and experience in the industry may find themselves "stuck" in
low-skill, low-wage jobs with little opportunity for
advancement, and employers may be less able to take advantage of
the skills they have gained over the years. Because the cost to
train healthcare workers is high, turnover can be a significant
expense for healthcare industry employers.
What are "Earn and Learn" Job Training Programs?
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According to a recent white paper<1> produced on behalf of the
CWIB, the recent economic downturn has caused high levels of
unemployment in all sectors of California's economy, but
low-skilled adult workers and youth have disproportionately
borne the brunt of the economic crisis and require support as
they seek to enter the workforce.
Training programs that connect new employment opportunities to
access to training and education, allowing workers to earn a
paycheck while developing the skills necessary to transform
short-term jobs into longer career pathways, are commonly
referred to as "earn and learn" models.
The white paper identified "earn and learn" models to include
on-the-job training, summer youth employment programs,
subsidized employment under the Temporary Assistance for Needy
Families (TANF) emergency fund, and registered apprenticeship
programs. With respect to the latter, the white paper noted:
"Earn and learn" training models offer great opportunities
to address the needs of these populations. One such model,
formal stateregistered Apprenticeship, is a time-tested,
onthejob, training and education delivery system and is an
essential component of Californias economic growth.
Apprenticeship training is uniquely designed to bring
frontline workers, who are often unemployed or displaced,
into secure highskill jobs with strong wage progression.
The apprenticeship model is once again being seen as a
critical component of economic development and
international competitiveness policy.
Recent studies have shown that investment in apprenticeship
programs provides a positive return for employers,
apprentices, government, and society.
---------------------------
<1> "Apprenticeship as a Critical Component of an 'Earn and
Learn' Job Training Strategy in California." White Paper
Produced on Behalf of the CWIB by the Interagency Working Group
on Earn and Learn Job Training Strategies and Apprenticeship in
California." (December 2012).
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How to Build and Fill Healthcare Career Paths
According to a recent report<2> by the U.S. Department of Labor
Employment and Training Administration, there is increasing
recognition that "earn and learn" training programs (such as
apprenticeships) are a highly effective workforce strategy for
building skills and earnings in entry- and middle-level jobs,
for increasing productivity and for aligning employer demands
with the supply of workers in the healthcare industry:
"Registered Apprenticeship can be a critical part of the
workforce strategy related to healthcare reform as it is
seen as a way to train long-term care workers and address
some of the workforce issues including recruitment and
retention, training a quality workforce and improving
quality of patient care. The potential in utilizing the
Registered Apprenticeship model is that worker skill levels
can be raised along with patient care without huge cost
increases. This can lead to jobs with higher wages as
workers show their increased value, creating the
opportunity for upward mobility. Additionally, if entry-
and middle-level healthcare workers are better trained,
then higher level professionals-nurses and doctors-will be
free to do the clinical work they are trained to do instead
of lower level tasks.
This model can also provide a career lattice to higher
level occupations-in essence-providing a clear pathway out
of poverty for many individuals who might not otherwise
have an opportunity for a career in healthcare.
Recognizing the potential of the Registered Apprenticeship
model to train a highly-skilled workforce, the U.S.
Department of Health and Human Services (HHS) and DOL are
undertaking a joint evaluation of the Registered
Apprenticeship long-term care model to assess the impact
and effectiveness of this approach."
The report points to a program in the State of Washington
involving the Service Employees International Union (SEIU) as a
model in this regard:
---------------------------
<2> "Using Registered Apprenticeship to Build and Fill
Healthcare Career Paths: A Response to Critical Healthcare
Workforce Needs and Healthcare Reform." U.S. Department of
Labor Employment Training Administration.
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"Washington State has long been a leader in creating a
comprehensive long-term care system for its citizens. Part
of the overall strategy is increased state requirements for
training of Home Care Aides and formal certification. The
SEIU Healthcare NW Training Partnership, a 501(c)(3) school
and labor-management partnership whose mission is to train
and develop professional long-term care workers to deliver
high quality care ("Training Partnership"), is working on a
competency-based Apprenticeship program which includes
Basic and Advanced Training, as well as Peer Mentorship.
After completing a leading-edge curriculum of Basic
Training and working with a mentor both one-on-one and in
peer-based groups, apprentices will have an opportunity to
choose specialties depending on their interests and the
consumer population for whom they will care. As the
Training Partnership delivers training to over 40,000 Home
Care Aides annually, this Home Care Aide Apprenticeship
will be one of the largest Apprenticeship programs for
healthcare professionals in the country. While the program
is still in development, the Training Partnership and DOL
see potential for broad replication of this effort in
numerous other states."
The CWIB Health Workforce Development Council
The CWIB has already been looking at ways to address health
workforce needs for some time.
In order to proactively address emerging health workforce
challenges, in August 2010, the CWIB established the Health
Workforce Development Council (Council) as a subcommittee of the
State Board. The Council engages a broad range of public and
private stakeholders to achieve its mission of helping to expand
California's health workforce in order to provide access to
quality healthcare for all Californians. A core goal is to
expand California's full-time primary care workforce by 10 to 25
percent over the next ten years.
To achieve its mission, the Council is engaged in an extensive
process to understand statewide and regional priority health
workforce needs and develop a comprehensive strategy. To
support the process, the CWIB in concert with Office of
Statewide Health and Planning Development (OSHPD), secured a
federal health workforce planning grant from the Health
AB 1797
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Resources and Services Administration.
A report issued by the Council in January 2013 made the
following key findings:
California does not have sufficient capacity in many key
professions and regions to meet current and future health
workforce needs. Primary care is one of the greatest
concerns.
Underserved urban and rural areas and health safety net
providers face significant supply and distribution
challenges; particularly in primary care and other
professions that are critical to health access, quality,
outcomes and cost. Significant growth in population and
those insured are expected in these areas and there are
many barriers to recruitment, retention and training.
The diversity and language capabilities of the health
workforce and health professions students do not reflect
emerging populations and needs. Funding for proven programs
to address this is being reduced at a time when the need is
growing.
Educational capacity is already insufficient in many key
health professions and in associated pre-requisite courses
and has been further restricted by cuts to education.
Further cuts in key professions would undermine production
of a quality diverse workforce in needed areas.
Rising costs of education and health professions
training are becoming barriers to graduates going into
needed professions, such as primary care, and underserved
geographic areas.
New health population health and delivery models and
use of technology offer the opportunities to use health
workforce more productively and for better outcomes.
Investment in and coordination of statewide and
regional infrastructure and data is needed to develop,
implement and achieve innovations in health workforce and
adjust to changing needs.
REGISTERED SUPPORT / OPPOSITION :
AB 1797
Page G
Support
American Federation of State, County and Municipal Employees
California State Council of the Service Employees International
Union
Opposition
None on file.
Analysis Prepared by : Ben Ebbink / L. & E. / (916) 319-2091