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- Three years after random assignment, what were the effects of Health Careers for All on Educational attainment, including school-issued healthcare credentials and exam-based certifications received?
- Three years after random assignment, what were the effects of Health Careers for All on entry into employment and higher earnings?
- Three years after random assignment, what were the effects of Health Careers for All on individual and family well-being, including income and other life outcomes?
The Workforce Development Council of Seattle–King County’s Health Careers for All program aimed to help low-income adults, including Temporary Assistance for Needy Families (TANF) recipients, access and complete healthcare occupational training that could lead to increased employment and higher earnings. It is one of nine programs being evaluated under the Pathways for Advancing Careers and Education (PACE) project sponsored by the Administration for Children and Families (ACF) within the U.S. Department of Health and Human Services. PACE is a multi-site experimental evaluation of programs that incorporate features of a career pathways framework.
Health Careers for All combined four key components:
- Navigation and case management services to help participants select healthcare training programs and address barriers to program completion. Navigation started at the application stage and continued post training.
- Access to healthcare occupational training at three levels—foundational (e.g., healthcare career discovery classes), entry (e.g., Nursing Assistant), and advanced (e.g., Licensed Practical Nurse). These courses were funded either through Individual Training Accounts (ITAs) or as grant-funded “cohorts” (course packages open exclusively to program participants and fully funded by the program) based at community or technical colleges.
- Employment services including group-based job clubs, individual consultations, and assistance with resume development and interview skills.
- Financial assistance during and immediately following training to address barriers to program completion or employment. Assistance included financial support to address barriers such as transportation and to help pay for one-time emergency costs such as housing assistance to avoid eviction or utilities being cut off.
This project, the Career Pathways Intermediate Outcomes Study, extends the follow-up period to three years for programs in the PACE project. Future reports produced by the Career Pathways Long-Term Outcomes Study will extend the follow-up period further.
This research was undertaken to evaluate whether Health Careers for All was successful in providing training to low-income, low-skilled adults and whether the program’s efforts led to impacts on credentials, earnings, healthcare employment, and other life outcomes. The Workforce Development Council of Seattle–King County operated Health Careers for All with funding from ACF’s Health Profession Opportunity Grants (HPOG) Program. Like all HPOG-funded programs, Health Careers for All sought to address the dual goals of (1) helping low-income individuals enroll in and complete occupational healthcare training and find healthcare employment and (2) addressing the rising demand for healthcare workers.
Key Findings and Highlights
Analyses in this report indicate that after three years:
- Health Careers for All had no detectable impact on average quarterly earnings in follow-up quarters 12-13, the study’s confirmatory outcome.
The difference in average quarterly earnings in Q12-Q13 between treatment group and control group members was negative (−$404) but not statistically significantly different from zero.
- Health Careers for All had a positive impact on receipt of postsecondary healthcare credentials from schools during the first three years, but not on receipt of exam-based certifications and licenses from other authorities such as state boards.
Health Careers for All increased the receipt of any postsecondary healthcare credential at non-colleges by 15 percentage points. There was not a statistically significant difference between the treatment and control groups in the receipt of exam-based credentials.
- Health Careers for All did not increase the average duration of education and training across all levels of schools during the first three years, but it did increase duration at non-college schools.
There was not a statistically significant difference in average duration of education and training overall. However, there was a small but statistically significant difference in average duration enrolled at non-college schools between the treatment group (0.84 months) and control group (0.34 months); a net impact of half a month.
- Health Careers for All increased the proportion of treatment group members working in the healthcare field at the end of Year 3 by 6.5 percentage points.
The program did not change the overall employment rate, however.
- Health Careers for All had no detectable impact at the end of Year 3 on most measures of financial well-being and parenting.
The program did not have a significant effect on health insurance coverage, receipt of means-tested public benefits, personal student debt, or financial distress.
To assess the effectiveness of Health Careers for All, the PACE project used an experimental research design in which program applicants were assigned at random to a treatment group that could access the program or to a control group that could not, then compared their outcomes. From September 2012 to December 2014, the study randomly assigned 654 program applicants to either the treatment or the control group. The impact study used data from a follow-up survey conducted three years after random assignment and earnings records from the federal National Directory of New Hires. The Health Careers for All impact study measured impacts on educational, employment, and earnings outcomes approximately three years after random assignment for all measures and close to five years after random assignment for earnings.
Glosser, Asaph, and David Judkins. 2020. Workforce Development Council of Seattle–King County’s Health Careers for All Program: Three-Year Impact Report. OPRE Report 2020-112. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.