Scrutiny of Health Care Training Programs Increasing

by George Lauer, California Healthline Features Editor

As California gears up to increase an understaffed health care workforce, private schools training health care workers of the future are coming under more scrutiny on several fronts. For example:

  • An Assembly bill aimed at giving students more accurate consumer information about private, for-profit post-secondary schools is making its way through the Legislature;
  • The Center for the Health Professions at UC-San Francisco is launching a research project examining health care training programs in California with special attention to private, for-profit programs; and
  • A state investigation into vocational schools operating without current state authorization "almost certainly includes programs training health care workers," according to a state official.

Common themes in the legislation, research projects and state oversight include the high costs of education compared with graduation rates and graduates' ability to find jobs.

Most of the attention is trained on vocational training at private schools. The increased demand for a wide range of health care workers, from physician assistants to vocational nurses and dental assistants, has sparked an increase in private educational programs.

"Other states are definitely looking at this issue as well," said Timothy Bates, senior analyst at the Center for the Health Professions.

"Workforce issues are a driver in the increase of educational programs," Bates said. "No question about that."

Susan Chapman, associate professor at UCSF School of Nursing and director of Allied Health Workforce Studies at the Center for the Health Professions, said medical assistants -- "a quickly growing section of the workforce" -- are illustrative of the changes in health care training.

"About 80% of [medical assistant] graduates are from private schools," Chapman said. "A lot of those people got loans to pay for their education. How many of them are going to find jobs and how hard will it be to repay those loans?"

Assembly Bill Increases Consumer Information

Although the bill targets a wider sphere than health care, AB 2296approved by the Assembly last month, would affect many health care vocational training programs.

Aimed at private, for-profit post-secondary schools, the bill would require the state to alert students about:

  • Lack of accreditation. Some schools are not accredited, and students may learn too late that potential employers and professional licensing boards require degrees or credits from accredited institutions;
  • Student loan default rates. High default rates often mean unemployed or underemployed graduates;
  • Post-graduation job rates. Placement is defined as working at least part-time and holding the job for at least 13 weeks; and
  • Graduate salary rates.

"Folks in the health care industry should care about the broader issue of vocational education because there are some problems and some loopholes in that arena," said Elisabeth Voigt, senior staff attorney at Public Advocates, a law firm and advocacy organization in San Francisco.

"We're strong supporters of AB 2296. We think it will close some of those loopholes and provide some protection for students," Voigt said.

The bill, by Marty Block (D-San Diego), head of the Assembly Higher Education Committee, is scheduled to be heard by the Senate Education Committee later this month.

UC-San Francisco Research Project Forming

Over the next several months, Chapman and Bates will guide a research project on health care training programs with funding from the California Wellness Foundation.

"We've been interested over the course of our work at the center about how and where students get educated," Chapman said. "We're seeing now a preponderance of private and particularly for-profit schools. We're going to look at that growth and how students are faring during and after their education," Chapman said.

According to a national study released earlier this year, for-profit colleges play an important and growing role in training the country's health care workforce, but they could be doing a better job. Researchers at the Center for American Progress made several recommendations in the study, "Profiting From Health Care: The Role of For-Profit Schools in Training the Health Care Workforce."

Vocational School Oversight Trying To Catch Up

The California Bureau for Private Postsecondary Education is investigating 77 schools operating with expired state authorization.

"We don't know how many of those 77 have health care programs," said Russ Heimerich, spokesperson for the California Department of Consumer Services, which oversees the private post-secondary bureau.

"We could do the research and find all the health care programs, but by the time we did that I think most of the schools would have made their paperwork current," Heimerich said.

Heimerich said the current investigation and much of the bureau's backlog stems from a number of political moves, including a governor's veto, that have the state agency playing catch-up with private school oversight. Funding for the bureau was vetoed by Gov. Arnold Schwarzenegger (R) in 2006. A new law reinstated the bureau in 2010.

"We didn't have enforcement people until fall of last year," Heimerich said.

Earlier this year, state regulators closed the Institute of Medical Education, a private, for-profit vocational school with campuses in Oakland and San Jose.

The Bureau for Private Postsecondary Education determined that the school's claims of accreditation were false and that the school was operating training programs for MRI technologists and ultrasound technicians without valid state authority. The school also had training programs for dental hygienists and other health care vocations.

"That was an emergency decision, essentially ordering the school to stop teaching. The actual hearing to close down the school is scheduled June 21. We don't do that often, but it does happen," Heimerich said.


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