Earning & Learning.

What do you call a program that helps ...

... transition people off welfare rolls

... move workers from dead-end jobs into skilled professions

.... provide skill-based training to the economically disadvantaged

... unite schools, hospitals and the local workforce board

... and meet a critical shortage of trained health care workers?

In Pinellas County, Florida, they call it a reality.

Known as the "Earn-as-You-Learn" program, this unique cooperative effort to train economically-disadvantaged adults and dislocated workers to fill a critical need for hospital workers has already made a big difference for this Florida county. The groundbreaking program began in response to the severe shortage of skilled nurses and aides in the county--a problem stemming in part from the low unemployment rate and successful customer service industry in the region.

According to Dr. Sandra Cassity, director of Workforce Development at St. Petersburg Junior College, many workers were opting to go into fields where they could make a decent wage immediately with little training. Meanwhile, some health care facilities were at such a crisis state that they had to limit patient care--even close emergency rooms on weekends. Through a coordinated effort of St. Petersburg Junior College, the Pinellas County School District, the local workforce investment board and four local hospitals, Earn-as-You-Learn was born. Operating under a $500,000 state Workforce Investment Agency (WIA) grant from July 2000 to June 2001, the program recruited workers who are economically disadvantaged, underpaid or dislocated. Many of these individuals have had limited education and previously would have had little hope of landing a job in a health care facility. Hospitals have implemented the program in slightly different ways, however the basic idea remains the same. Facilities hire individuals and pay them while they pursue an education in the field. The workers are treated as full-time, although they might be in school 25 hours a week and initially work at the facility only a few shifts.

A Real Solution

"It is an investment in the future," says Darlene Davis, director of Development and Practice in the Department of Education Services at Morton Plant Mease Health Care Facility. Morton Plant Mease has been one of the key participants in the program. According to Davis, her facility has been at the forefront of this kind of training for several years, pre-dating the cooperative effort known as Earn-as-You-Learn, and now their internal program has been significantly enhanced through last year's grant.

"We don't leave the training just to the school--we feel that the hospital needs to be very involved in worker education. It is a partnership," says Davis.

Morton Plant Mease has three established career path programs: Patient Care Technicians/Nursing Assistant (PCT/NA), Unit Secretaries and Monitor Technicians. A number of those who become PCTs will also go on to become Licensed Practical Nurses (LPNs)--or even Registered Nurses (RNs). A new LPN program has just been introduced and currently 28 students are enrolled.

Since beginning in 1992, 167 people have completed the PCT/NA program at Morton Plant. The Unit Secretary program--in place for the last couple of years--has graduated 22, and the Monitor Technician program had seven people finish last year.

Morton Plant Mease is part of Bay Care Health Systems--a joint operation with nine hospitals in Florida representing approximately 17,000 people.

Davis is enthusiastic about the future for worker training and retention.

"In the years to come, every area will see this nursing shortage," says Davis, "We often spend a lot of money hiring temporary and contract nurses. But it is really a major win to get a core staff that is committed--and this program helps create that kind of relationship."

According to Craig Brethauer, vice president of Team Resources at Bay Care who also serves on Worknet (the Workforce Board for Pinellas County), this program has fulfilled the old adage: "If the workers aren't there to recruit, you have to make them."

"Other industries could certainly learn from this model and adopt it," says Brethauer. "This success is a result of a real commitment to education and nurturing these workers--not just expecting to have skilled workers come ready-made."

Dr. Dennis Mullins, coordinator of Medical Education at the Bay Pines VA Medical Center in Pinellas County, also has strong praise for Earn-as-You-Learn in his facility. "This is one of the best programs I've seen in a long time," says Mullins.

At the VA Medical Center, workers are hired as Patient Care Service Specialists (PCSSs)--a position which combines some necessary housekeeping duties with non-skilled nursing activities. Workers attend classes to learn more nursing skills, and can choose to continue on and become Certified Nurse Assistants (CNAs).

If students qualify and are motivated to do so, they may continue even further with their education. The grant will help pay for classes, as well as books, transportation, child care and other incidental costs--all the way through an advanced degree in nursing. The VA Medical Center similarly trains Health Unit Coordinators/Ward Clerks and Medical Records Technicians. These programs likewise have the potential to lead to higher degrees for qualified students.

Mullins says that this project has worked so well because of the strong sense of collaboration among all those involved.

"Open lines of communication are crucial to success," Mullins notes. "Internally and externally, there are so many different `customers' involved who want to have their needs met. We have to find consensus."

And Mullins makes another important point. "All of this must be done with no compromise in health care services. So it is vital that everyone work within their training and capabilities--for their sakes as well as everyone else's."

Back to School

Students in the Earn-as-You-Learn program take classes through the Pinellas Technical Education Center (PTEC) in St. Petersburg, and St. Petersburg Junior College.

Dr. Clide Cassity, PTEC director, calls this effort one of the most exciting things in which the school has been involved because it is truly changing people's lives. "Some of these individuals in the program have not been in school for many years--or they never finished high school," says Cassity, "Now some of them will go on to college in nursing. The students say `I never thought I could do this.' It's an amazing thing to see," says Cassity.

Through PTEC--a comprehensive trade and technical center featuring over 50 vocational programs and serving over 10,000 students a year--classes are set up specifically for students at the school or in their workplaces. PTEC also helps students who need remedial classes to catch up academically. Clearly, the commitment is in place for supporting these students in every way possible through the classes and helping them become happy and successful health care workers in their facilities. Yet a program this revolutionary requires adjustments by everyone involved.

"It's not necessarily easy to say we're going to do things differently than we've always done," says Cassity. "It requires a complete change of attitude on the part of the education institution--extremely flexible and responsive to the needs of the industry. But," he notes "the payoff is there."

According to Dr. Sandra Cassity of St. Petersburg Junior College, the Earn-as-You-Learn has been a clear success. The goal of the initial grant was to train 120 people, and Cassity says that they will well exceed that number. "Right now I don't know of anything else like it out there," she says. Her advice to others about starting similar programs?

"Work with local businesses to identify their workforce needs. And, to be successful, know what all the parties involved are willing to commit--schools, health care facilities, funding agencies. This has to be a real team effort to work."