By Geralyn Magan
The Moving Forward Coalition and LTSS Center will help Geriatric Workforce Enhancement Programs work with nursing homes to promote career advancement.
The Moving Forward Nursing Home Quality Coalition and the LeadingAge LTSS Center @UMass Boston are supporting and evaluating an initiative to develop and test registered apprenticeship programs (RAP) for certified nursing assistants (CNA) working in nursing homes. Funding for the RAP initiative comes from a three-year, $1.6 million grant that the coalition received from The John A. Hartford Foundation (JAHF).
The LTSS Center will work with Moving Forward to help 19 Geriatric Workforce Enhancement Programs (GWEP) around the nation collaborate with nursing homes in their communities to establish CNA apprenticeship programs. The project team will also work closely with the GWEP Coordinating Center (GWEP-CC), a JAHF-supported learning network that seeks to identify synergies across GWEPs.
The GWEP project is designed primarily to increase CNA retention rates by developing a national infrastructure for robust training, career development, and aligned compensation that encourages CNAs currently working in nursing homes to remain in the workforce, says Molly Carpenter, the LTSS Center’s Director of Workforce Strategy and Development. The project focuses specifically on developing advanced CNAs who are geriatric specialists and have expertise in dementia care.
What is a GWEP?
The Health Resources & Services Administration (HRSA) established the GWEP program in 2015 to address future geriatric workforce challenges and improve care for older adults. In 2024, HRSA provided funding to support the establishment and development of GWEPs at 42 academic and healthcare institutions in 37 states.
GWEPs work in collaboration with community partners to:
- Address care gaps in their communities.
- Develop a healthcare workforce that maximizes engagement by older adults and their families.
- Integrate geriatrics and primary care.
What is a Registered Apprenticeship?
The LTSS Center and the Moving Forward Coalition will work closely with 19 GWEPs interested in establishing a registered apprenticeship program approved and validated by the U.S. Department of Labor.
DOL-approved RAPs offer an industry-driven career pathway for employers seeking to develop and prepare their future workforce. Registered apprenticeships typically require a minimum of 2,000 hours of on-the-job training per year and 144 hours of related classroom instruction per year. In addition, participants:
- Work with a mentor.
- Receive progressive wage increases as they move through the program.
- Earn a portable, nationally recognized credential.
Supporting GWEPS
The GWEP funding opportunity from HRSA required each applicant to include plans to develop and implement a RAP for direct care professionals such as CNAs. Nineteen awardees have requested guidance on carrying out those plans in their state or region.
The Moving Forward Coalition will support this work by:
- Understanding and navigating the steps involved in establishing apprenticeship programs and educating GWEPs about nursing homes.
- Building relationships among GWEPs, state partners, and nursing home employers.
- Connecting GWEPs through a learning collaborative by sharing resources, key learnings, and best practices associated with apprenticeships.
- Providing resources to help GWEPs talk to employers about registered apprenticeships and why they are a good option for LTSS providers.
The project team also hopes to help GWEPs in multiple states collaborate on developing a standardized RAP model for CNAs. The coalition believes this collaborative model will help researchers identify common barriers and challenges to developing CNA apprenticeships, inform the design of approaches to reduce those barriers and challenges, and promote more efficient and effective RAPs that can be scaled and spread in U.S. nursing homes.
Evaluating the Apprenticeship Initiative
In addition to supporting the GWEPs, the project team will evaluate the RAP initiative over three years. Researchers will conduct interviews and focus groups with program stakeholders to identify challenges and best practices associated with designing and implementing a RAP, document the progress GWEPs are making in developing their RAPs, and identify best practices and potential standards for implementing RAPs in nursing homes.
“This is groundbreaking work,” says Carpenter. “Our evaluation will help us understand if the DOL registered apprentice program is the right career path for a CNA and, if so, how it can best serve nursing homes and CNAs.”
The project team hopes its work with GWEPs will lead to the development of additional CNA career pathways that can be replicated and adapted to the needs of local communities while strengthening the nursing home workforce.
“The Moving Forward Coalition and LeadingAge have a strategic intent to promote career lattices and ladders to help CNAs grow in their careers and remain in our field for many years,” says Carpenter. “This project will help us move closer to achieving that goal.”