Apprenticeships in rural Colorado fill the healthcare worker gap

GRAND JUNCTION, Colo. — During her 12-hour overnight shift, Brianna Shelton helps residents at BeeHive Homes Assisted Living go to the bathroom. Many of them have dementia, and some cannot get out of bed on their own. Only a few can remember her name, but it doesn’t matter to her.

“They’re somebody’s mother, somebody’s grandmother, somebody’s great-grandmother,” Shelton said. “I want to take care of them like I take care of my family.”

Shelton trained to become a personal care assistant through an apprenticeship program designed to meet the growing demand for healthcare workers in rural western Colorado. Here, away from Denver’s bustling urban corridor, labor shortages are growing as baby boomers retire, young people move away from these established communities and the increased demand for home and institutional health care.

Rural areas generally have a higher proportion of residents aged 65 and older than urban areas. And most rural areas have relatively few direct care workers, such as personal care assistants, to help people with disabilities compared to less rural areas, according to a recent study in the UK. Health Affairs magazine.

In addition to increasing the number of direct care workers, Colorado’s apprenticeship program offers the opportunity to improve earning capacity for residents living at or below the poverty line who have lost their jobs during covid-19 pandemic or those who are unemployed or underemployed. They are trained to be personal care assistants who help patients with daily tasks such as bathing or cleaning the house, or certified nursing assistants who can provide some direct health care services, such as blood pressure checks.

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Apprentices take training classes at the Western Colorado Regional Health Education Center in Grand Junction, and the center pays students who live in more rural areas to take classes at the College. Engineering Rockies in Delta County. Apprentices receive on-the-job training with one of 58 local employers — an assisted living facility, for example — and they are required to work there for a year. Each apprentice has an employer advisor. The staff at Western Colorado AHEC also provide counseling services, and a life coach is available at the center.

“We really just want students to get health care, get a job, and keep it,” said Georgia Hoaglund, executive director of Western Colorado AHEC. in 2021.

Some students just graduated from high school. Others are single mothers or veterans. They often have educational or economic barriers to employment. Hoaglund and her 10 employees buy scrubs for the apprentices so they can start their new jobs with the right uniforms; otherwise, they may not be able to afford it. Employees pay apprentices for gas if they can’t afford a full tank to drive to work. They talk to apprentices on the phone monthly, sometimes weekly.

While the apprenticeship program gives these workers a solid head start, the work can be stressful, exhausting, and low wages are common. Hoaglund said career advancement is another obstacle because of logistics or the cost of higher education. Hoaglund, who calls the family of her staff and some of the practitioners her children, dreams of getting more advanced training – such as nursing – with scholarship money.

Apprenticeships are perhaps better known as a tool for workforce training among electricians, plumbers, carpenters, and others. Robyn Stone, senior vice president of research at LeadingAge, a nonprofit association of aging service providers, said they are also seen as a way to build a team of healthcare professionals. directly needed.

“Traditionally, healthcare employers have hired people after they have completed their program,” says Susan Chapman, a registered nurse and professor in the nursing school at the University of California-San Francisco. training program. “Now, we’re asking the employer to take that training and pay the person while they’re training.”

Both Chapman and Stone said the pandemic exacerbated shortages of direct-care workers, which could encourage employers to invest in apprenticeship programs. Federal investment could also help, and an initiative by the Biden administration to improve the quality of nursing homes includes a $35 million grant to address workforce shortages in the United States. rural areas.

Shelton had never worked in healthcare before moving to Fruita, a small town about 12 miles northwest of Grand Junction and surrounded by red sandstone towers. She left Fresno, California, a year ago to care for her uncle who has multiple sclerosis. She and her 16-year-old daughter live in a trailer house on her uncle’s estate, where Blackie, the Labrador retriever she saved, roams with chickens and cats.

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Blackie also sometimes accompanied Shelton to BeeHive to visit residents. Shelton says it’s not just a job for her, and she’s grateful the apprenticeship program has helped her get there. “It opened a door for me,” Shelton said.

Shelton works three 12-hour shifts a week, in addition to taking care of her uncle and daughter. However, she said, she struggled to afford gas, bills and food and took out small loans to cover her living expenses.

She is not alone. Personal care assistants are often underpaid and undervalued, said Chapman, who has found poverty rates among these workers to be significantly higher than in the general population.

According to a study by nonprofit policy group PHI, direct care workers nationwide earn an average of $13.56 an hour, and these low wages make recruiting and retaining workers difficult. difficult, leading to further shortages and instability.

In an effort to keep workers in the state, Colorado raised the minimum wage for certified nursing and personal care assistants to $15 an hour this year with money from the Accounting Act. United States Rescue Plan. And the Colorado Department of Health Care Policy and Financial Policy’s 2023-24 budget request includes an increase to $15.75. Similar efforts to raise wages are underway in 18 other states, including New York, Florida and Texas, according to a recent article by the National Association of Governors.

Another way to keep apprentices employed, while encouraging career growth and wages, is to provide opportunities for specialist training in dementia care, medication management, or behavioral health. “What an apprenticeship offers is mobility and career advancement,” says Stone.

To practice in Colorado, newly certified nursing assistants must complete classroom training, clinical rotation, and pass a certification exam that includes a written test and a skills test. Hoaglund said the test requirements can be stressful for students. Shelton, 43, passed the written exam but had to retake the skills test to become licensed as a certified nursing assistant.

Hoaglund’s program started in 2019, but it’s been really successful with a 2021 federal grant. Since then, 16 people have completed the program and received a raise or promotion. More than twice as many people left without completing. The largest hospital in Grand Junction, Intermountain Healthcare-St. Mary, recruit staff from the program.

Hoaglund says every person entering the healthcare field is a win.

Brandon Henry, 23, was a student at the University of Colorado Mesa in Grand Junction and was working at PetSmart before joining the apprenticeship program in 2019. After signing up, he trained and worked with as a certified nursing assistant during the worst of the pandemic. As an apprentice, he said, he learned the importance of grace while taking care of patients.

He went back for further training at Western Colorado AHEC to obtain a license that would allow him to dispense drugs at accredited facilities, such as assisted living centers. He currently works at Intermountain Healthcare-St. Mary’s Medical Center, where he attended training classes in wound care and physical therapy offered by the hospital. This winter, he will graduate from Colorado Mesa with a Bachelor of Science in nursing.

“At the hospital, I found more opportunities for salary growth and job growth,” says Henry.

Kaiser Health News is a national health policy news service. This is an editorially independent program of the Henry J. Kaiser Family Foundation that is not affiliated with Kaiser Permanente.


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