Community College Pathway Programs
Community colleges remain one of the primary educational institutions receiving funding and being used within career pathways. Community college programs give students directly transferrable credentials to further education or advanced credentials.
This section features examples of community college pathway programs including Good Jobs Hawai’i, Indiana’s Certified Nursing Assistant Bridge Program, and Maine’s Partners in Behavioral Health Pathways.
Hawaii: Good Jobs Hawai’i
Good Jobs Hawai’i is a state-sponsored pathway program run through the University of Hawai’i Community Colleges designed to help local residents qualify for high-quality jobs and careers while helping employers meet their demand for a skilled, local workforce. This program offers free skills training in high demand industries, including health care, for professions such as:
- Adult Residential Care Home
- Certified Nurse Aide
- Dental Assisting
- EKG Tech Certification
- Medical Receptionist and Patient Services
- Mental Health Technician
- Pharmacy Technician
- Phlebotomy Technician
The program is primarily funded through a federal grant from the U.S. Economic Development Administration and the City and County of Honolulu, among other sources.
Indiana: Certified Nursing Assistant (CNA) Bridge Program
The Governor’s Health Workforce Council was established in 2016 to coordinate health workforce-related policies, programs and initiatives with a particular focus on reducing cost, improving access and enhancing quality. In 2018, SB 223 required additional information to be collected from individuals in a variety of health professions who renewed their license online and established additional health workforce data management strategies. The state’s largest community college, Ivy Tech Community College, leveraged this data to create a Certified Nursing Assistant (CNA) bridge program. This program gives students five credit hours towards a “Certificate in Pre-Nursing Studies” which is considered a pathway into the Practical Nursing and Associate of Science in Nursing programs.
Maine: Partners in Behavioral Health Pathways
Washington County Community College offers students multiple pathways to advance their careers in the behavioral health workforce through stackable credits and credentials. In 33 credit hours, students can earn a certificate in Substance Use Disorder and Recovery or become a community-based Mental Health Rehabilitation Technician. Students may then pursue an associates of applied science in health and human Services or an associates of applied science in career studies. Finally, students may pursue a bachelor’s degree, more professional development experiences or more credentials at partnering local academic institutions.
In 2021, the Maine State Legislature increased Maine's Community College System funding by $10 million in in an effort for Washington County Community College to keep tuition and fees low, ensuring this pathway program remains accessible to students.
Maternal and Child Health (MCH) Leadership, Education, and Advancement in Undergraduate Pathways (LEAP) Training Program
In 2006, HRSA created the Maternal and Child Health (MCH) Leadership, Education, and Advancement in Undergraduate Pathways (LEAP) Training Program, formerly referred to as the Maternal and Child Health Pipeline Training Programs. The purpose of the LEAP program is to promote the development of a diverse and representative public health and health care workforce by recruiting undergraduate students from underserved or underrepresented backgrounds into MCH public health and MCH-related health professions. HRSA awards funding to universities to recruit, train and mentor undergraduate students in a comprehensive MCH-focused approach. As of 2022, HRSA is funding six programs.
Each training program includes some form of academic supports (advising, peer mentors, faculty mentors, etc.), required courses or training, community engagement and support for students’ professional development. Some schools also included research opportunities or conference presentations.
Another target population for career pathway programs is undergraduate students. These programs are either a continuation of a high school or community college program or independent programs. Undergraduate career pathways can be used to funnel students into education programs for more highly skilled sectors of the health care workforce like physicians, dentists, advanced practice registered nurses and other professions that require post-baccalaureate degrees. They also can be leveraged as the next step in career advancement through obtaining a bachelor’s degree.
This section features examples of undergraduate programs including Iowa’s Nursing Ladder Program, Nebraska’s Rural Health Opportunities Program and Utah’s Rural and Underserved Utah Training Experience.
Iowa: Nursing Ladder Program
At Indian Hills Community College (IHCC) in Iowa, students can enroll in their state-approved “ladder program” in nursing. Students can choose from two primary paths or levels:
- Level 1 is a pathway to becoming a licensed practical nurse (LPN).
- Level 2 is a pathway from LPN to an associate’s degree in nursing, the next step to becoming a registered nurse (RN).
The college has agreements with the University of Iowa, Grand Canyon University and William Penn University as part of the ladder program. These colleges will accept IHCC credits and allow students to continue along this career pathway to earn a bachelor’s degree in nursing (BSN). These universities feature online classes and flexible schedules that allow students to work full-time in nursing while also taking BSN coursework. These partnerships are designed to ease the transition and provide further career advancement while also cutting costs.
Nebraska: Rural Health Opportunities Program
The Nebraska Rural Health Opportunity Programs and Kearney Health Opportunity Programs are pathway programs designed to recruit and educate students in healthcare fields who are committed to practicing in rural areas upon graduate. The Nebraska Legislature passed LB 792 in 2022 which provides ongoing annual funding for these programs through 2025. This program targets both traditional and nontraditional students. The U.S. Department of Education defines nontraditional students as students who have at least one of the following characteristics: older than typical age, part-time attendance, being independent of parents, working full time while enrolled, having dependents, being a single parent or being a recipient of a GED/high school completion certificate.
Undergraduate program options include medicine, dentistry, medical laboratory science, physical therapy, physician assistant and radiography. Students accepted into the program will receive a full scholarship to a participating college, are put into a like-minded cohort and once they complete their requirements are accepted into the health care program they applied for at the University of Nebraska Medical Center.
Utah: Rural and Underserved Utah Training Experience
The Rural & Underserved Utah Training Experience (RUUTE) program consists of a collection of programs at the University of Utah. The goal is to “improve medical education and training, health care access and long-term socio-economic benefit for rural and underserved communities of Utah and the intermountain west by expanding interest, awareness, and placement of students and physicians.” RUUTE provides opportunities for K-12 students, undergraduate students, medical students and residents. Offerings range from community outreach, mentorship, gaining hands-on experience in the medical field, housing and mileage reimbursement, application support, and more. RUUTE is funded through appropriations from the Utah legislature.
One unique program offered through RUUTE is the Summer Undergraduate Research Experience. This is a 10-week research experience for undergraduate students enrolled in the states of Utah or Idaho who may want to pursue a career in rural health care. This program allows students to gain experience with research, work on projects related to rural and underserved health, and improve their resume/CV for future admission into medical school.
Program Spotlight: Minnesota, North Dakota and Wisconsin’s Rural Residency Program
With support from HRSA, a multi-state health system collaborated with an accredited Midwestern doctor of nursing practice/family nurse practitioner (NP) program to expand a transition-to-practice program into a one-year residency program for new NPs. The regional integrated health system, which represented four clinics in North Dakota, Minnesota and Wisconsin, identified a need to improve recruitment and retention of rural NPs through enhanced transitional support. The program combined a traditional nurse practitioner residency curriculum as well as other focus areas that are particularly relevant to rural practice.
The program is a formal postgraduate residency training program for new NPs working in rural areas. The program includes curriculum, weekly meetings with mentors, twice-monthly didactic lectures, resiliency sessions and personalized onboarding activities based on clinical needs assessments. Instead of the traditional pay of around 60% to 70% of market value of traditional residency programs, this program pays the NPs at market value and allows them to bill for services. Within 12 months, there was an 11% increase in productivity, turnover decreased from 15% to 9% and participants said they would be extremely likely to recommend the program to other new graduates.
Career Pathways for Nontraditional Students
Some career pathway programs may want to target or focus on nontraditional students, such as second career students or parents, who do not fit neatly within existing education models or training frameworks. Creating pathway programs for nontraditional students may look a little differently than their traditional counterparts as these students face a unique set of challenges. They include work/caregiving responsibilities during the day, lack of reliable transportation, no childcare, lack of educational literacy and cost.
The Office of Planning, Research and Evaluation (OPRE) conducted an analysis of these challenges and identified potential strategies to better support non-traditional students or workers. These include:
- Offering flexible delivery strategies such as offering evening courses, self-paced instruction or technology-supported distance learning.
- Creating accelerated courses that are condensed into a shorter amount of time.
- Assigning tailored advisors to students to ensure all of the students’ needs are being met.
- Providing referrals, stipends or other assistance for outside needs such as housing, childcare or transportation.
- Granting scholarships within the program or assisting students in applying for financial aid or outside scholarships.
Creating New Professions – New York’s Advanced Home Health Aides and Peer Advocate and Recovery Coaches
In 2016, New York enacted legislation (A10707/S08110) to establish a new profession: the advanced home health aide. Advanced home health aides can perform certain advanced tasks like administering routine or prefilled medications and other tasks specified by the State Education Department in consultation with the Department of Health. Advanced tasks must be performed in accordance with an authorized health professional’s orders and are directly supervised by a licensed registered professional nurse.
In addition, New York’s Staten Island Performing Provider System and partners piloted a 30-hour recovery coach training program to create a new profession: Peer Advocate and Recovery Coach. Trained recovery coaches are embedded in hospitals and recovery centers to provide people in crisis with counseling and resources, and connect them with a local treatment program. The training program targeted individuals with lived experience with addiction or unhealthy substance use, to develop a peer support dynamic. The system offers scholarships to make the training program more accessible.
The program also trains community health workers and care managers through partnerships with local higher education and labor unions. Together, they designed and developed certificate training programs for these positions that meet specific, employer-defined needs and include college credits. They also offer scholarships to economically disadvantaged students who want to pursue education in social work and mental health counseling. The program was successful at creating a variety of new jobs and decreasing incidence rates of mental illness.
Legislators and state agencies play an important role in creating, crafting and funding career pathway programs to create a future pipeline of health care workers. States have great flexibility in choosing what professions to target and how they would like to target them.
This report is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $813,543 with 100% funded by HRSA/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS or the U.S. Governmen