Monroe Community College is Making Care Jobs, Better Jobs

In 2012, many long-term care facilities in the Rochester, New York area were desperate for staff.

Some facilities had lost the authorization to train their own Certified Nursing Assistants (CNA) due to state citations of their facilities. Turnover of CNAs was high. With the typical starting wage of a CNA in Rochester around $12 an hour, local community colleges and other training providers were balking at the idea of training people for a job with such low pay, few career pathways, and uncertain scheduling.

Luckily, Marcy Lynch and the team at Finger Lakes Community College were confident they could come up with a win-win solution where students would end up with better jobs and employers would end up with lower turnover.

The plan was simple: the college would provide high-quality, cost-effective CNA training programs in exchange for employers committing to better wages and opportunities for graduates.

The care facilities agreed to pay the wages for the new CNAs while they were taking the five-and-a-half-week program along with 20 percent of the tuition (for which they can be reimbursed by Medicaid). The rest of the tuition was covered by various other workforce training funds. Care facilities also agreed to increase the starting pay and scheduling flexibility for new CNAs, so that they could participate in additional professional development. At the same time, employers would provide career pathway opportunities into different types of jobs like senior CNA and hospital office administration.

In short, the college’s partnership with employers improved most markers of job quality for CNAs.

Throughout the next several years, Marcy and her team gathered and analyzed impact data to see how this partnership changed CNA retention. When the numbers came in, the impact was obvious. In the first year, retention had increased from 47 percent to 76 percent, the second year it increased to 83 percent, saving employers more than $30,000 on turnover and training annually. The partnership had proven to be a winning model. In 2019, Marcy moved to Monroe Community College to take their health care programs to scale and replicate the CNA program model. By March of 2019, the first cohort of students had graduated from the Monroe program.

In all, 10 employers now participate in the program and have hired over 550 CNAs to date. About 95 percent of the graduates get jobs as CNAs, and they make an average of $17.00 an hour with additional pay differential based on their shift.

The program is tight knit with lots of support for each cohort of students. “The teachers make us feel loved and supported,” said Keisha Seymore, a CNA student and mom of two in her 30s. “When someone lost her sister, we all sent a card. We threw a baby shower for another student. It’s a little like family or a group of friends.”

During the pandemic, the CNA program was allowed to introduce more hybrid learning opportunities for students. As the program progressed, students were assigned to small groups with 10 in class at a time, alternating with attending regular lectures via Zoom. Laboratory sections were spread across four classrooms with eight beds apiece. This flexible delivery model worked well for many students, and Monroe plans to continue to offer these options going forward.

But Marcy knew that there was so much more to do to make a real difference.

Aware that the population she was serving--mostly Black single mothers--needed more support to create the upward mobility they deserved, she expanded support for CNAs three months after they transitioned to the workforce. This support included services like providing professional development to help the CNAs plan for what is next in their career and hands-on, personal support connecting students with community resources like childcare, transportation, and mentoring. For example, they helped a single mother find a new position when her son got sick and she needed to change her shift and work nights.

In August 2021, Monroe received a $4 million grant from the Finger Lakes Performing Provider System to increase this kind of critical support for students and create a regional model of more equitable pathways in health care. The grant includes funding to subsidize food, child care, and transportation, things that we know can help keep students enrolled.

And Marcy hasn’t stopped there. Relatively few CNAs climb the nursing career pathway and become practical nurses or registered nurses. One reason is that Licensed Practical Nursing programs—the next step in the pathway—have inflexible structures that do not work well for working, adult students and tend to be small.

So, MCC is starting their own LPN program that does things a little differently.

Scheduled to launch in September 2021, the program will take a full year rather than the typical 10 months to allow students to work while studying. Students’ job sites will also serve as their clinical placements, where they will benefit from mentorship, flexible schedules, and tuition support. Monroe Community College will also provide students with short math and science bootcamps to prepare for the rigorous program, as well as time to develop an academic and financial plan for the upcoming year.

This model has worked so well that Marcy has replicated it in other entry-level health care occupations like patient care aide (PCA) and home health aide.

Most PCAs make minimum wage, so Monroe is working with an employer to train them up to a home health aide with an agreement that the employer will pay them the same hourly rate as a CNA. That employer has also agreed to support additional on-the-job training and new career pathways for graduates moving into clinical or medical office assistant roles. This employer had 22 students in their first class, and 18 of them are still working there four months after the program.

Employer demand for entry to mid-level healthcare professionals is projected to grow much faster than most occupations in the economy as the population ages and health care workers burn out because of the pandemic. Nurse assistants are vital to our care infrastructure. But we must improve the quality of their jobs. As this program shows, better job conditions will improve retention, as well as a better bottom line for employers.

As Monroe Community College has proven, colleges can help.

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