Health Care Industry Conference Call
February 19, 2004
Participants: Laura Ginsburg, Don Reese, Anne Wetmore, Judy Rich, Steve Myers,
Donna Scalia, Lymus Capehart, Ken Lemberg.
Recorder: Nadia Libbus
Update on CAEL Project
Laura Ginsburg gave an update on the CAEL Project. David Jackson and Harry
Dispensa were in Chicago, working with two hospitals, Children’s Memorial, the
University of Chicago Hospital and a third. They have developed a new CNA model and
will share the information with ATELS staff.
Laura provided some background to the development of the new CNA model. David
Jackson had worked with the Good Samaritan Hospital to develop the model, which
consisted of four tiers that are competency-based:
Tier 1: The first level requires 170 hours of training to pass the basic competency level.
Tier 2: The second level identifies additional skills needed to become an advanced CNA,
with all the core skills. Although this level is competency-based, it is six months in
duration (1000 hours).
Tier 3: The third tier involves specializations, with approximately1000 hours for each
specialization. The specializations that have already been developed include: geriatrics,
restorative care, dementia for long-term care; and pediatrics, cardiology and outpatient
for acute care.
Tier 4: This is a stand-alone tier for training mentors. It requires about 600 hours of
training, which results in a mentor certificate.
Laura indicated that this is the wave of the future: Core competencies are needed,
followed by a series of certifications to add needed skills. Currently, there is discussion at
the national level on how to register the program, count the hours, and add to the RAIS
system. Three specialties are before Mr. Swoope, for his signature: Geriatrics, Dementia,
and Restorative Care.
Laura indicated that this is a model that is new to the Registered Apprenticeship System.
It is very simple. Everyone can take the model and present it to a health care facility. It
has endless potential.
Steve Myers asked if copies of information on this model can be given to Judy for her
conference on April 30. Laura responded by saying that she hopes the model will be
approved soon. She offered to share a Power-Point presentation and other information
she has that explain the model.
Laura additionally reported that they had meetings with two health care associations in
long-term care. They asked them to: 1) contact their affiliates in WA, MD, and IL to join
in at the site demonstration and 2) examine the model and validate it.
Letters were sent to all directors of state nursing boards, inviting them to work with
Reports from Participant States
Anne Wetmore reported on WA’s activities with the CAEL project. There are two
assisted-living organizations that are interested in sponsoring an apprenticeship program
(CNA). One of the organizations has 8 facilities. The two organizations estimate
recruiting 50 apprentices. A VA hospital is also interested in sponsoring a program. They
are interested in the LPN program and would train 12 apprentices. Their concern is cost.
Anne was asked whether these programs will be registered with SAC or the Federal
program. She said that the VA program will be registered with the Federal system. Other
programs are usually registered with the SAC. She added that they have no problem with
SAC registration since the WA SAC is focusing on health care apprenticeship.
Anne indicated that the nursing associations in WA are concerned about the inclusion of
specializations in the apprenticeship model. Specializations are usually associated with
higher-level occupations. Anne and her assistant, Danielle, who has a human resources
background and worked at assisted living facilities, had to explain the need for
specializations in the CNA apprenticeship model.
Another challenge is the Memorandum of Understanding (MOU), which is difficult to
work with. Anne indicated that the MOUs may now be revised to fit the needs of each
health care facility.
To address the issue of cost to the sponsor, they have requested, and obtained, 10% of the
WIA Government funding that is designated for apprenticeship training. These monies
will be used for those organizations that are interested in implementing apprenticeship
programs but hold back because of cost. Additionally, they are talking with their
established partners (12 workforce development partners). Anne indicated that they have
their support but the process takes time. They are considering the sustainability of this
program beyond CAEL funding and are building on established partnerships.
Anne reported that they are developing standards for the state of WA. There is a “big
jump” in skills from CNA to LPN. In addition, there are restrictions on what an LPN can
practice legally. They almost need a third component, clinical training by law, in addition
to on-the-job learning and related instruction. They are working with the community
colleges to develop the standards and curricula. The Health Education Institute has four
Anne asked if CAEL was working on a national LPN program. Laura responded that
they had approached the National Council of State Nursing boards to develop a national
program that could be replicated and tweaked in each state, but it is not possible. LPN
standards cannot be established on a national level, because legal requirements are
different for each state. Each state needs to work with a community college on their
existing LPN curriculum and make the program apprenticeable.
It appears that most of the organizations interested in Registered Apprenticeship are in
assisted living. Hospitals have concerns about the program.
Anne believes the WA state nursing commission will approve the program because the
related instruction utilizes existing courses [at colleges].
Donna Scalia reported that NJ is having a hard time, because workers in this occupation
are not open to apprenticeship. About 50 apprentices will be registered in assisted living.
Apprenticeship will be required for employability. A pay raise is also associated with
apprenticeship, which provides an incentive. Another incentive is the availability of
courses. There is a long wait to get into schools for LPN training (up to two years).
Apprentices can take courses right away.
Donna additionally reported that she spoke to a principal of a vocational school that has a
health care career department. She had noticed several job postings for dental assistants.
However, the principal was very resistant and could not see the benefits of
apprenticeship. Donna plans to work through nurses’ associations. Laura indicated that it
is better to approach associations first, then involve the schools, because schools view
apprenticeship as a competitor. Hospital associations and long term care associations are
receptive to apprenticeship.
Laura indicated that there is more need for CNAs at nursing homes/long term care
facilities than hospitals. Long-term care facilities embrace apprenticeship and it helps
their employees. Hospitals show less interest, but they are not against the idea. Anne said
that the WA State Nursing Association, which has a membership of 12,000, was worried
that apprenticeship will reduce the quality of care (take them back to diploma days). They
are meeting with their senator and a Labor representative to show that apprenticeship is
endorsed by DOL.
Lymus Capehart reported that they have registered the surgery technician occupation at
two facilities. They also registered dispensing opticians, which has standards higher than
what the state requires (increased number of hours). He added that the health association
hires lobbyists to address the statutes.
Anne commented that participants may want to contact the state department of health if
interested in working with COSTCO on Dispensing Optician.
Judy reported that they are working with the Department of Education to promote nurse’s
aides and assistants apprenticeship. They plan to meet with representatives from the
Department of Aging and Long Term Care. They are examining what Nevada has done to
find what they can apply in PA. Judy indicated that on April 28, 2004, a state-wide
teleconference will be held to promote apprenticeship and mentoring. They expect 300
participants. They are hoping to lay the groundwork and “change minds,” particularly
with associations. There is a large aging population in PA and therefore a large need for
health care workers.
Don Reese registered programs in ambulance services: Paramedic and EMT (Emergency
Medical Technician). Last week, he registered a nurse’s aide program at one of the three
top hospitals in St. Louis. He plans to promote apprenticeship in small communities.
The next conference call will be held on Thursday, March 11, 2004, at 3:00 pm (EST).
One of the topics of discussion will be the experiences of David and Harry with the