Rural Healthcare Preparation Pipeline in Pennsylvania: Building Networks for Frontline Talent Development - Digital Promise

Rural Healthcare Preparation Pipeline in Pennsylvania: Building Networks for Frontline Talent Development

Map pinpointing Central Susquehanna Region, Pennsylvania

June 30, 2020 | By

“We all compete sometimes for the same funding. We’re all trying to show that we can do good work. But sometimes we have to get over ourselves a little and decide that I would rather say, ‘Look at all of what we did together to assist members of our community.’” – Mary Mingle, Adult Education Program Manager, Central Susquehanna Intermediate Unit

Ascent: Central Susquehanna Region

In the Central Susquehanna region of rural Pennsylvania, “the majority doesn’t rule—it’s consensus,” says Timothy Campbell, director of Central Susquehanna LPN Career Center. Deeply rooted in the local Quaker belief that all people are equal and equally worthy of respect, leaders in the region have learned to operate as a collective, from adult education students to CEOs. When local employers announced a critical shortage of qualified healthcare workers, leaders across programs at the Central Susquehanna Intermediate Unit (CSIU) came together to address the challenge with a collaborative mindset and dataset.

CSIU is a regional education service agency that provides extensive services—from educational programs and technical assistance to financial and marketplace services—for 17 school districts, three career and technical centers, and more than 60 nonpublic schools. Even though all of the programs were affiliated with the CSIU network, leaders had to innovate their recruitment efforts to connect adult learners from remote areas of the state to health career opportunities. Beyond access, CSIU leaders identified social capital as the key component to postsecondary success and designed a mechanism to connect learners across disparate communities using technology.

Collaborating Organizations

  • CSIU Adult Education including English as a Second Language (ESL)
  • Central Pennsylvania Workforce Development Corporation (CPWDC)
  • Central Susquehanna LPN Career Center (Timothy Campbell)
  • Central Susquehanna Intermediate Unit (CSIU)
  • CSIU WATCH Project
  • CSIU YES to the Future
  • ESL Student
  • Evangelical Community Hospital
  • LPN Student/Frontline Worker
  • State Representative Lynda Schlegel-Culver
  • University of Pittsburgh Medical Center Susquehanna

Identifying the Shared Challenge

In rural Pennsylvania, healthcare is one of the fastest growing industries with anchor employer institutions like Geisinger Medical Center, University of Pittsburgh Medical Center (UPMC) Susquehanna, and Evangelical Community Hospital. Careers in healthcare—especially nursing—are in demand, but there are not enough workers in Central Pennsylvania who are qualified to meet the demand. Most of the entry-level health positions require a high school diploma or equivalent and a state-administered certification, such as a Licensed Practical Nurse (LPN) license, from an approved program.

CSIU was well-prepared to join local employers in addressing the talent shortage, with established programs in high school equivalency preparation, English language instruction, and workforce preparation. CSIU also provided specialized career and technical training programs, including the Central Susquehanna LPN Career Center, the Work Attributes Toward Careers in Health (WATCH) Project, a federal Health Profession Opportunity Grant, and YES to the Future, a Workforce Innovation Opportunity Act (WIOA) grant for out-of-school youth ages 16-24. But training and connecting talent would require more than partnering with employers. Program leaders had to partner with each other to ensure students were able to seamlessly transition between programs and services, and stay on track to meet their goals.

As Linda Walker, healthcare education coordinator from CSIU’s WATCH Project, said, “You can have all of the partnerships in the world, but if it’s not what the adult learner needs, you will not experience the successes.” CSIU leaders knew they had to design a nimble and adaptive talent pipeline—one that reflected the complex challenges that adult learners in rural Pennsylvania often face, such as poverty, geographic isolation, and interrupted education.

Drawing on Ascend, the Aspen Institute’s two-generation approach toward economic security, CSIU formed a task force which they called “Team ASCENT” (Advancing Social Capital through Enhanced Networks and Training) to take a cross-sector, data- and human-centered approach.

Leveraging Existing Resources

As a requirement of the 2015 Workforce Innovation and Opportunity Act (WIOA), CSIU had to report on performance measures, such as credential rate and measurable skill gain, and address barriers to employment for adult learners in the community. CSIU leaders drew on student performance data to identify gaps in education that may prevent students from entering the talent pool for health careers. They looked at outcomes from the YES to the Future program, and as Program Manager Paula Dickey found, the students who were most successful in obtaining a high school equivalency diploma or a postsecondary credential, such as an industry certification, were also engaged in supportive services.
In addition to reviewing performance data, Team ASCENT conducted focus groups with current and prospective students, many of whom were single parents, to understand what it would take to successfully complete their education. Some of the questions included in the focus groups were:

  • What was your reason for leaving school?
  • What motivates you to pursue a career in healthcare?
  • Do you know which jobs are available to you?
  • What kind of skills, training, and/or certifications do you need?
  • What resources do you need to make this happen?
  • How can we help you succeed?

Shannon, a single mom who is now enrolled in the LPN program, was an original Team ASCENT member representing adult learners and also participated in the initial focus groups. Shannon worked as a certified nursing assistant (CNA) for more than 10 years before enrolling in the Susquehanna LPN Career Center. When Shannon took the LPN entrance exam, she learned that her math scores were too low to start a practical nursing program, and that she was eligible to take WIOA-funded adult education courses in math. Like many adult students, Shannon said that a fear of going back to school, a lack of confidence, and the lack of information about available programs and services prevented her from becoming an LPN. Her adult education instructor told her about the WATCH Project; she applied and was accepted, and is now supported by the WATCH Project and the ASCENT Team as she completes a practical nursing program and becomes an LPN.

CSIU leaders also interviewed students from their English as a Second Language (ESL) program to understand their perspective on pursuing career pathways. Assem, a recently arrived immigrant and native Russian speaker, had worked as a teacher in her home country, but did not know how to transfer her education credentials upon arrival. She started working as a home health aide, taking care of Russian-speaking elders in the community, and when she learned about CSIU English classes from a friend, she immediately enrolled to advance her English proficiency and learn about certification opportunities. Similarly, Georgiana had recently immigrated to the United States after her husband accepted a position in a local hospital in Central Pennsylvania. She enrolled in CSIU ESL courses and over time, became a leader in immigrant communities of rural Pennsylvania, recruiting fellow students for ESL programs, adult education, workforce training courses, church, and other community events. As Timothy Cambell, director of the LPN program, poignantly noted, “In listening to students, we realized that it wasn’t about the outcomes. It was about what—and who—was coming in.” They pinpointed social capital as the key factor of student success and designed their talent pipeline accordingly.

Leveraging External Resources

Katherine Vastine, CSIU WATCH Project Manager, connected with local employers to design an integrated curriculum. She explained, “It’s so critical to embed adult education in direct care worker training; it speeds up the process for learners and makes it more relevant.” Healthcare education coordinator Linda Walker noted, “In teaching basic cardiac life support, it’s important to understand the weight of a person. My co-instructor might say, ‘Let’s quickly do this math lesson about calculating weight,’ and that is how we were able to combine education and workforce training.” Working directly with employers also provided the opportunity for adult education students to develop a professional network and connect with others who had successfully advanced in health careers.

As Team ASCENT sought avenues to bridge rural connections and build social capital, it was selected as one of 10 teams to participate in the Minds That Move Us adult career pathway design challenge led by ECMC Foundation and the Institute for Educational Leadership. During the challenge, the team identified several strategies, including using the text-messaging platform, Signal Vine. Signal Vine was an ideal communication vehicle to use across multiple adult learner programs in a region where nearly all students have cell phones but where many students do not have access to available or reliable at-home internet service. While Team ASCENT did not win the challenge, funding was found to implement Signal Vine.

A March 2020 survey indicated that 90 percent of the students were somewhat or very satisfied with the content and number of text messages received from their adult learner programs. According to Shannon, receiving daily texts made her feel connected to her LPN instructors and classmates. Whether it was a message about the upcoming exam schedule or an inspirational quote, Shannon said, “It’s that one thing that you need to get you through the day and keep going.” And that’s the critical purpose of the texts: to engage and retain students.

Moving the Needle for Greater Impact

The iterative process of iteration has been central to CSIU’s ability to further their mission in connecting adult learners to career pathways, and the group has developed innovative ways to fund their programs. In 2010, they received federal funding through the Health Profession Opportunity Grant (HPOG) to develop the WATCH Project, which allowed them to coordinate systems and services in health career pathways. In 2015, the YES to the Future WIOA Out-of-School Youth funding deepened capacity to integrate education and workforce training. The Adult Education and ESL program, YES to the Future, WATCH Project, and LPN Career Center work together, and with workforce development and local employers, to create a synergistic and seamless whole.

In addition to federal funding, CSIU pursues grants to conduct research and pilot projects. As Ellen Withrow, CSIU’s grants, research, and development coordinator explained, “We have developed a rubric to evaluate funding opportunities. The first thing we look for is whether the funder is aligned with our mission, and then we go from there. Adhering to rubric standards has helped us finetune our grant-seeking efforts.”

The WATCH Project supports participants and their families with education, training, credentialing, and employment, and was the result of a grant-funded demonstration project. As Adult Education Director Mary Mingle notes, “We came up with the idea for the WATCH Project, then applied for funding [while], thinking, ‘This is something we can do. It furthers our mission to lift not just the individual, but the family, and the community.’”

CSIU’s ability to respond to their community is especially evident in the wake of COVID-19. Within days of local closures, CSIU leaders acted quickly to provide immediate online resources for districts, teachers, students, and parents and digital professional development support. To address digital divide issues, classroom lessons are provided both online and with paper-based packets. CSIU continues to continuously share updates and information with the community.

Strategies for education providers, government agencies, employers, funders, and other stakeholders:

  1. Collect postsecondary education and workforce data in your region.
    Think about data regionally and cross-organizationally, not just at the institutional level, to enable workers to access resources and upskill in their careers, create personalized pathways, and evaluate and improve programs and services.Key insight: Address systemic challenges that a single program or organization could not solve independently, and establish cross-organization and cross-sector partnerships to connect workers to gainful employment opportunities.
  2. Establish a coalition of key stakeholder groups across the region, including workers.
    Invite local drivers of change, including employers, government representatives, education and workforce providers, funders, and workers, to review and interpret the data and make data-informed decisions as a group.Key insight: Nominate a lead organization or individual to research, coordinate, and facilitate collective efforts across multiple organizations and establish communication norms and expectations.
  3. Identify a shared challenge, shared solution(s), and a shared deadline.
    Co-develop and commit to a shared vision with individuals who are most directly impacted, including workers in your community. Develop collective strategies on individual projects to advance the work of the entire community.Key insight: Identify an external deadline, such as a pitch or shared funding opportunity, such as the Minds that Move Us challenge, to ensure the work is prioritized, actionable, and gets done.
  4. Align resources for greater impact.
    Explore ways to align resources, including personnel and disparate funding streams, for greater community impact.Key insight: Allow for flexible funding and invest in shared systems. For example, each organization could contribute a small amount to invest in shared programs, technology, and interoperable data-tracking systems.
  5. Tell the whole story, over time.
    Create intermediate goals and short-term, measurable outcomes. In addition, track data longitudinally to understand the long-term impact on workers in the community, in terms of talent development and income mobility.Key insight: Be willing to shift focus and recognize when duplicative efforts may be doing more harm than good.

Visit Digital Promise’s Building Networks for Frontline Talent Development report to learn more about similar regional efforts to build learner-centered solutions to advance frontline worker talent development.

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