January 2020 LeadingAge Catalyst

LeadingAge Catalyst | January 24, 2020 | by Gene Mitchell

Learn about the LeadingAge Catalyst for January 2020: The Geriatrics Career Development Initiative at The New Jewish Home, New York, NY.

January 2020 LeadingAge Catalyst

The New Jewish Home, New York, NY

The New Jewish Home’s Health Care Explorers Program gives high school students a way to launch careers in long-term services and supports. Here is the class of 2020, celebrating the end of their CNA course. Photo courtesy of The New Jewish Home.

Excellence in Workforce Development

“We really have to look at the ways our young people may be underserved, and put them in a place where they can be valued and [have] professional development. That's the only way we can really solve our untrained workforce problem.”

Those are the words of John Cruz, senior director for workforce initiatives at The New Jewish Home in New York City. Cruz and his staff run large and sophisticated programs that offer career training, life skills preparation, and support for high school students and for young adults who are no longer in school, but who face challenges and are looking for direction. The program’s primary purpose is to prepare participants to launch health care careers (especially in long-term services and supports). Because of its hands-on, person-centered focus, its participants often think of it as a supporting “family” helping them build careers and adult lives.

For its creativity, comprehensive nature, and contribution to the holistic well-being of low-income young people, The New Jewish Home’s Geriatrics Career Development is our LeadingAge Catalyst for January 2020.

A Long History

Beginning in 1989 and into the early 2000s, The New Jewish Home offered an after-school work program (the Intergenerational Youth Program) for at-risk high school students, and a Summer Youth Employment Program in Manhattan and the Bronx. Participants received social services support, stipends, some career counseling, an annual college fair, and selective mentoring.

In 2006, those programs were replaced by Geriatrics Career Development. These programs have 3 major elements:

  • The Health Care Explorers Program is for high school students (beginning in their sophomore year) who have an interest in health care careers. It offers after-school and summertime programming that teaches students to become certified nursing assistants (CNAs), helps them learn life skills, and prepares them for postsecondary education and other health-related careers.
  • The Young Adult Program is a shorter-term program for older people (ages 18-24) who are “out of school and out of work.” These participants may have dropped out of high school, or perhaps have faced life obstacles that prevented them from launching health care careers. It is primarily oriented toward helping participants become home health aides, but some participants have become CNAs and sought further education.
  • The Alumni Program offers continuing services to graduates of the first 2 elements: help with resumes, job placement, opportunities to learn from other alums (and to help people still in the GCD), and social events.

We spoke with John Cruz for a breakdown of GCD, how it works, and why The New Jewish Home supports it.

LeadingAge: Let’s start with the oldest segment of Geriatrics Career Development—the Health Care Explorers program. How did it start?

John Cruz: It started in 2006 as a high school program. It was an intergenerational program at first, which meant that our participants would come to our site in the Bronx, get some homework done, and go up to our units to work with our clients. [The] students would participate in therapeutic recreational activities, support the nurses on the floor, and provide social and emotional support to the clients we serve.

LeadingAge: What do the students get out of that? What is their incentive to join?

John Cruz: It is targeted toward low-income youth coming from underserved high schools in the Bronx. The Bronx has a high unemployment rate, and one of the highest high school dropout rates. There's a lack of after-school or enrichment programming for youth in the Bronx. We looked at this as an opportunity to get them into our [community] and serve them by having them help our own vulnerable population—the older adults we serve.

It is targeted toward individuals with an interest in health care, especially for students from schools that are heavily focused on health care, or have specific programs on health care. They might need to have an internship, or volunteer at a local health care provider in order to meet the [school’s] criteria. The idea is to look at these individuals as future employees of the New Jewish Home because we have so many CNA job openings.

Profile: Adamary Leal

Adamary Leal, 17, is a senior at the Marie Curie School for Medicine, Nursing and Health Professions, Bronx, NY. She joined the Health Care Explorers program in her sophomore year.

Adamary Leal
Adamary Leal

“I’m a 2nd-generation student in it,” Leal says. “My brother was in it, and really enjoyed it.”

She is now in a patient care technician (PCT) class, and is seeking EKG and phlebotomy certifications. She is also working in her paid internship, and has gained her CNA certification.

“This program has really helped my communication skills,” she says. “I was very timid originally, but in my first year in GCD I started talking to more people. Then I started approaching people in my 2nd year. I am becoming more outgoing!”

What else did she get out of the program? “I got a new family—people I can trust and know, people I can talk to. They have helped me develop into somebody new and I’m grateful for that.”

“After I graduate, I will go to college for a bachelor’s degree in biology,” Leal adds. “I have 4 [college] acceptances so far. There’s one college I like from that group, but I’m still waiting on one more response.”

Long-term, her goal is to become a trauma surgeon: “It’s a difficult field, but it’s worth it. You see something new every day.”

LeadingAge: How has the Health Care Explorers program evolved since its creation?

John Cruz: We realized we needed to offer more skills-based learning in a clinical setting, specifically geared toward working with this population. We wanted our participants to be trained in all 22 skills necessary to become a CNA. We then have them take a CNA course at a local college in their senior year of high school. It's a 130-hour course: 100 hours of didactic learning in a lecture-based skills training, [followed by] a 30-hour clinical at a local health care facility. If they complete all of those requirements and pass their final exam, they are allowed to test for the state certification exam.

Colleges have a lot of continuing education programs for adult learners. What is unique about us is that these students are enrolled in high school, so we had to sell it to the schools—to say that these students are capable of taking this course and passing at a high rate.

LeadingAge: How many high schools do the students come from?

John Cruz: We started with one partner school, which gave us about 20 students. Since then we've expanded, and to date we serve 10 schools in New York City, mainly in the Bronx, Harlem, and upper Manhattan. We now serve about 225 to 250 students annually.

LeadingAge: How are the university courses paid for?

John Cruz: GCD has primarily been funded by outside organizations. Our development department solicits funds from various foundations, government entities, and individual donors. GCD started with seed money from The Harry and Jeanette Weinberg Foundation, the J.E. & Z.B. Butler Foundation, the Pinkerton Foundation, and New York City’s Department for the Aging.

LeadingAge: How old are the students when they start the GCD program?

John Cruz: Sophomore year of high school is their entry point, about age 14-15. We set up presentations in September at each of our partner schools, for students and administration, about GCD and what it has to offer. They fill out an application, and come to The New Jewish Home to participate in a group interview. It takes about an hour to complete, and from there, we determine [the student’s] maturity level, the level of engagement, and the ability to work in a team, to find the right fit for the program.

The program starts in October, and it's after school, 2 days a week for our sophomores, going through May. We offer some enrichment programs as well. We also offer programming for about 4 days a week in July and August. We keep them engaged throughout the year, from their sophomore through their senior years. We serve about 75 sophomores annually. In their junior year, they follow the same schedule, October through May, with a summer enrichment program.

When the juniors transition into their senior year, they take the CNA course at a local college or university. And in their senior year, they [may have] additional certification training or a paid internship that would be sponsored by The New Jewish Home.

LeadingAge: Can you talk about the features of the after-school program?

John Cruz: It's holistic. We offer food; we want to be sure the students have a hot meal every day when they come to the program, and a snack, before they go home.

We also offer tutoring, with specific components that they participate in. It can be professional development or it can be a life skill that they're learning. They can learn about leadership, teamwork, and financial literacy. We talk about privacy and liability. We talk about working with this population as a whole, and about bereavement, and the frailty of this population, just so they know what they're getting themselves into.

Once they're comfortable enough, there's intergenerational programming. We will send the participants up to the floors to work with our clients, in tandem with the nurses and other clinical staff on the floor.

In their junior year, it's a little bit different because we offer SAT prep to our participants. We want to be sure that they have postsecondary options once they complete our program. In their senior year, we focus more on college access, help them with applications, their financial assistance packages, and their personal statements. We help them make their decisions about what colleges they want to apply to, or, if college is the right option for them.

LeadingAge: How do the paid internships work?

John Cruz: These are for the individuals who have participated in our summer CNA program. Instead of volunteering on the floors, they are being paid for what they're doing, working about 8-10 hours a week as interns at our communities.

Profile: Delisah Brown

Delisah Brown, 21, is an alumnus of the Young Adult Program.

Delisah Brown
Delisah Brown, at her GCD
graduation ceremony.

“I had a friend in the program, who sent me the link,” she says. “It was about 6 weeks in the ABC Training Center, and 4 at The New Jewish Home. They taught us how to take care of patients, build a resume, be punctual, learn customer service, and be organized. They were setting us up for the work world. We learned how to interact.”

Brown earned her CNA certification in the summer of 2019, and has worked at The New Jewish Home since September.

“The whole GCD program did a lot for me,” she says. “I also get opportunities for other places to work. There’s a union here, and I’m in it. Before that, I was just all over the place. If not for GCD, I would never even have known I wanted to do nursing. It’s like a family here, you feel welcome. You can talk to them about anything, that’s the good part.”

Brown is beginning a 2-year LPN course in February at Monroe College in the Bronx.

LeadingAge: What is the attrition rate for students who join this program?

John Cruz: Our 3-year retention rate is 80%. There are a lot of reasons for that: It's the level of support that we provide. We have a very caring staff that is trained in youth development, that enjoys working with this population, and that looks like the students that they're serving. In terms of diversity and inclusion, we want to make sure that we have a diverse staff that can work with our very diverse population.

We ensure that we provide any services that they need, and we pay students to be a part of the program. A lot of our students come from low-income backgrounds, maybe from single-parent families, and they may need to generate some sort of income to support their families. We give them a scrub top that has a New Jewish Home logo on it, we give them an ID so they can feel like they're part of The New Jewish Home family, so they can get into the idea that “I'm a professional and this is how I need to dress if I'm going to be working in this type of community.”

LeadingAge: Do all students get a stipend?

John Cruz: The sophomores do not. We want to ensure that our sophomores are invested in the program. They are told that if they complete year one, we look at it as a probationary period. They are paid a stipend in their junior year, and in their senior year, they are offered an internship and are paid hourly.

LeadingAge: What is the proportion of students that end up staying in our field, working in these kinds of jobs?

John Cruz: A majority of them stay within the field. Some may not necessarily be working in it, but are studying to become a nurse, or nurse practitioner, or physician. We recently had an alumni survey where over 60% of individuals stay in this field—either working now or planning to get a degree in this field.

LeadingAge: How many of the New Jewish Home’s current employees are alumni of this program?

John Cruz: About 40-50 people. But [over the years] we've hired about 175 to 200 of them out of the program.

LeadingAge: Can you talk about the relationships between the students and your residents?

John Cruz: A lot of our students have said they were a little apprehensive about joining a program working with older people. But a lot of them have said this program has changed their perspectives on working with older adults. Some consider becoming geriatricians. Each individual, after their first few months in the program, is assigned [an older adult] mentor that they will be with for the rest of their time in GCD. They and the mentor go through an application process, just to make it official, so that we can track their interactions with one another. A lot of [them] actually come back to us post-program and continue to meet with their older adult mentors.

LeadingAge: Can you describe the Young Adult Program, which started in 2014?

John Cruz: The Young Adult Program was a spin-off of our Health Care Explorers program. It is an opportunity to engage a population that may be forgotten—that is considered disconnected. A lot of the youths that we serve through this program are out of school, and out of work. They could be [people] that may have may have not graduated high school, or may have dropped out for whatever reason. There are other individuals who have graduated high school but may have had a life challenge—maybe they have experienced homelessness, or may have had a child, and now have to focus more on working. They're underdeveloped professionally, and don't have the necessary skills in order to take a high-paying job.

And they have a general interest in health care. Perhaps they wanted to become a nurse or a physician, but life got in the way and now they had a barrier that they couldn't overcome. So this is an opportunity for them to become trained in a specific profession to climb that health care career ladder. The program is a lot shorter than the Health Care Explorers program. It's 12 weeks, 25-30 hours a week, training to become a health care professional. We started this program with seed money from the Pinkerton Foundation, and we have a community partner called the Stanley M. Isaacs Neighborhood Center. We partnered with them to start what was then called the Out of School Youth Program, and it's now been rebranded and renamed as the Young Adult Program, for 18-24-year-olds living in New York City. These individuals cannot be enrolled in college, and cannot have a 4-year college degree. It serves 50 participants annually, broken up into 3 cohorts.

LeadingAge: Does this program only train them to be home health aides, or are there more job descriptions available?

John Cruz: The idea was, at first, to work for high school dropouts, because to become a home health aide, you don't need a high school diploma. But we’ve expanded our offerings, so people can become CNAs. People who take that option have an opportunity to join a union, which could be considered more appealing. Also, working in a health care [community] may be less intimidating than working in someone's home, for their first job.

This program has almost everything that the high school program offers, it's just highly truncated. Participants have a professional development phase and a clinical training and educational phase. We had to incorporate job placement as a part of the program, to ensure that individuals have a job at the completion of it. We can’t just say, “Okay, you're done. Good luck finding work.”

Profile: Anthony Matos

Anthony Matos, 17, is a senior at the Marie Curie School for Medicine, Nursing and Health Professions, Bronx, NY. He joined the Health Care Explorers program in his sophomore year.

Anthony Matos
Anthony Matos

“I was told about it in freshman year by some seniors I knew, and I was very intrigued,” he says.

Early in his time with GCD, Matos worked as a volunteer with New Jewish Home residents, and enjoyed that interaction as well as the courses and team building activities.

“I’m now in the paid internship,” Matos says. “I work about 8-9 hours a week, and also in the NYPD Police Explorers program. After high school, I’ll go to college and go to a pre-med program; I don’t want to waste any time! After that, I’ll do my residency and want to be an orthopedic surgeon. I’ve been accepted to Mercy College, but am waiting for other acceptance letters.”

Matos has really enjoyed his time with GCD: “You can ask anybody in the program. They all say they never thought it would be like this. It’s like a family. They accept you with open arms. They help me with everything I need to do to apply to college.”

LeadingAge: What is the attrition rate in that program?

John Cruz: It’s about 30%, after the first phase of the program. A lot of these individuals have many barriers, but we provide wraparound services for them as well. We have social workers on staff that help with case management. If they have specific challenges, whether it be childcare or housing, or specific benefits that they need, our staff will support them in obtaining those benefits so that they can participate. This is where we work in tandem with our community-based organization, the Isaacs Center, ensuring that they are able to become successful in this type of setting.

LeadingAge: The last element of GCD is for alumni, and it serves hundreds of people.

John Cruz: We felt that just because we got our participants to a certain point, it didn’t mean it would ensure long-term success. So the alumni program is really born out of the need of young people who continue to reach out to us. We looked at this as an opportunity to provide additional services to our alums after they graduate. If an individual wants to apply for a job, we can help look over their resume, look over their cover letter, or provide them with options or specific communities where they could potentially work. We have alumni events where they can come back and talk to people currently enrolled in the program, or social events so individuals can catch up on what's been going on in their lives. We have an alumnus of the month feature that will talk about a person in detail. We have annual alumni surveys to gather information on what our alumni are doing.

LeadingAge: What stands out to you from the survey results?

John Cruz: We've noticed a lot of them are continuing on in postsecondary programs. Many of them have [progressed] from an associate degree to a bachelor's degree, or from a bachelor's to a master's degree. Some of our students are going to medical school, and some are completing Ph.D. programs.

LeadingAge: This sounds like a massive undertaking that requires a lot of staff and a lot of time. What resources are involved?

John Cruz: We work with a large number of community partners, we have about 15 staff that work for GCD, and we have volunteers as well. We also do a lot of fundraising and receive a lot of support from government and foundations.

The program has grown. It has gone from being a $700,000-$800,000 per year program to about $1.5 million [today]. And we've been successful in replicating the program as well. We have a partner organization in Wisconsin that has just started its own GCD programming. LeadingAge Wisconsin was a big support in making that happen, so we're really excited to continue to work with LeadingAge to identify partners that would be interested in taking on GCD as a potential initiative.

Gene Mitchell is editor of LeadingAge magazine.