One of the key findings from our past research on career education (Bohn, McConville, and Gibson 2016a; Bohn, Jackson, and McConville 2018) is that the economic advancement possible from completion of community college degrees and certificates varies considerably depending on the type of program and the intensity of the training (ranging from short-term, low-unit certificates to associate degrees). Completing early care and education programs at community colleges with either a certificate or an associate degree provides a relatively small bump up in earnings level: before earning the credential 30 percent earned middle-income levels, and by 6 years after earning the credential that share shifts to just 50 percent An important caveat to these early care and education results is that they do not include self-employed workers, who dominate the family care provider space.
The story for health programs is quite different: most graduates (80%) earn middle-income earnings within a year after completing their health programs. However, these large gains are driven primarily by associate degrees in nursing and, to a lesser extent, certificates for licensed vocational nursing. Students who complete only a CNA program do not see any significant earnings gains relative to what they would otherwise have earned.
Other Providers Offer Training for Care Workers
Community colleges are not the only providers of training for care jobs. Adult education and regional occupation training programs, workforce development agencies, and other nonprofit and for-profit organizations also offer care worker training.
Private for-profit colleges also provide training, though at a much higher cost than the programs offered by community colleges. Nonetheless, private for-profits awarded slightly more CNA and many more HHA awards in 2022 relative to the community colleges (see Technical Appendix Tables C9–C10).
Community colleges seem to be the primary postsecondary training provider for ECE workers; for-profit colleges do not seem to be engaged in ECE training in two-year colleges. Several local and state agencies—including First 5 California, the California Department of Education, county Resource and Referral (R&R) agencies, California Preschool Instructional Network (CPIN), and WestEd Program for Infant Toddler Care (PITC)—fund and/or offer ECE training.
The California Department of Social Services has a career pathway program for IHSS workers that offers different courses and trainings aimed at improving basic skills and more specialized caregiving skills. The California Department of Aging recently implemented a similar program, CalGROWs, that provides training options for non-IHSS personal care aides and other support positions (e.g., care coordinators and community health workers) that provide direct care services. Both programs offer paid time off and stipends for completion and also provide incentive payments for remaining in the job for a set period of time. Several nonprofit organizations throughout California—including Opportunity Junction, Homebridge, and the Center for Caregiving Advancement—partner with the state to offer many of these training programs. Both programs are also funded by federal pandemic relief funds and slated to wind down over the next year. It will be important to learn from these efforts to inform policies aimed at retaining direct care workers.
Some Career Pathways Offer Economic Mobility, but Often Take Workers out of Care Sector
Training plays an important role in building skills among those entering caregiving occupations—it can help protect workers’ health and well-being and improve the quality or efficiency of services provided. Given the limited range of earnings in the sector overall, additional training for advancement on a career ladder may be necessary for larger jumps in earnings potential.
As mentioned above, some care occupations offer opportunities for workers to climb a career ladder by building their skills over time. Though a single credential may not offer substantial earnings returns in some care fields, building credentials and skills on a career pathway may broaden opportunity over the longer run.
For instance, CNAs who stack higher-level nursing certifications see sizable earnings gains (up to 50% higher earnings than peers who do not stack) and considerable economic mobility. However, only about 20 percent of students who finish CNA programs at the community colleges go on to successfully stack higher-level health credentials (Bohn, McConville, and Gibson 2016b). Making sure that students who want to earn higher-level nursing credentials are able to finish those pathways in a timely manner should improve economic mobility for at least some direct care workers. It is also important to ensure that people know about available programs and understand what they can offer in terms of increased earnings. Black and Latino students who complete short-term health credentials such as CNAs are less likely than their white and Asian peers to return to pursue additional courses and degrees. More effort may be needed to make sure students who want to advance are able to do so.
In the care sector, higher-paying jobs often require additional training and education as well as changes in employers or settings. For example, preschool teachers can transition to other settings like elementary schools or Head Start programs that tend to pay higher wages but also require college degrees to be qualified. Similarly, CNA jobs (and to a lesser extent HHA jobs) can serve as a training ground for people aspiring to become licensed vocational nurses or registered nurses. However, career pathways are not always well-defined or designed to be completed quickly and many care workers face significant barriers—including low education levels, family responsibilities, and/or immigration issues—to moving up to these higher-level, higher-paying jobs.
There are efforts in both the ECE and health workforce spaces to develop pipeline programs including earn-and-learn models. For example, the Early Care and Education Pathways to Success program offers apprenticeships where ECE workers can earn college credits (at no cost) that correspond to state education requirements for higher-wage positions in the sector. The program offers on-the-job training, coaching and mentoring, academic supports, and perhaps most importantly, pathways to increased compensation. Many health workforce pipeline programs focus on engaging people in pursuit of health care jobs that require graduate-level education and clinical training (e.g., physicians, social workers, nurse practitioners).
Changing jobs is one way workers advance, and we observe measurable earnings gains among care workers who change employers. Figure 13 shows the average monthly earnings in the first two quarters of 2013 compared to average monthly earnings in the last quarter of 2014 across the employment trajectories discussed in the previous section. Care workers who change employers but continue doing the same type of care job see about double the gains of those who stay in the same job (31% earnings gains compared to 17%).
Care workers who switch to occupations outside the sector see their earnings increase a bit more (40%). Indeed, low-wage workers across the economy are most likely to improve their economic circumstances by changing employers and often times moving to a new industry and occupation (Escobari et al. 2021; Duffy, Baughman, and Smith 2021).
