Looking for good workers? Check welfare

Exempla program provides a great example

While many folks are having trouble finding work, many hospitals are having trouble finding employees. But while it might seem like a simple task to take out-of-work folks and slot them into jobs at hospitals, it isn’t that simple. Or at least, it isn’t at most facilities. But at Exempla HealthCare in Colorado, a welfare-to-work program called WorkStart has paid off in spades for the system.

The program started in 1999 as part of a program in conjunction with the Enterprise Foundation. Exempla is located in the Five Points area of Denver, which has an unemployment rate estimated at higher than 18.5%. Meanwhile, the system has an average of 200 job openings at any one time.

The Enterprise Foundation contracted with Goodwill Industries and the Community College of Denver to provide basic job skills training, post-employment support, and continuing vocational education for WorkStart participants. Exempla provides internships at regular pay for clerical positions in the hospital. Eligible candidates than apply for permanent positions with Exempla. Those who achieve employment receive case management and continuing education support during their first year of employment.

Potential WorkStart employees usually find out about the program from a social worker. Once accepted into the program, they take courses in medical terminology, filing, billing, computer skills, and basic anatomy. A case manager helps participants deal with social issues such as childcare, transportation, and basic job skills such as workplace dress, the importance of attendance, and attitude.

After the course work, participants get a three-month paid internship, says Sister Melissa Camardo, program manager for WorkStart. Initially, the internships were part-time, but now they are full-time. In most cases, the department that requested the intern is the one that subsequently makes job offers to those who meet the needs and expectations of the department. However, Camardo says that sometimes there isn’t a full-time job in that department. In those cases, a position in another department is sought — and usually found. "The beauty of the program is that kind of flexibility," she says.

In the three full years of the program, there have been 28 interns, about half of whom have become full-time employees. However, Camardo says that of the last nine, seven have been hired. Of those hired since 2002, all are still with Exempla. "We keep them once they are here," she says. Camardo adds, "The early years may not be the best way to judge the success of the program," she notes. "We have certainly learned from experience."

For instance, initially, the goal wasn’t full-time employment, and positions were offered in multiple areas. Now, medical clerical jobs such as unit secretaries are the focus. However, Camardo says that can be expanded. For example, the day Camardo spoke to Hospital Recruiting Update, someone from a research department asked about getting an intern. "That would work because of the data entry element," she says. "But I wouldn’t have considered that on my own."

Initially, the cost of the internships was fully reimbursed through the Denver mayor’s Office of Workforce Development. With the recession, that has changed. "But if money is a larger factor now, we don’t care because of the success we have had with the participants to date," she notes.

The program has always been voluntary, and there is plenty of support for managers who opt into it. An internal contact person worked as a liaison between the department and the external community partners. The managers also had input into the content of the classes. "Some of that was trial and error, seeing how the training helped or didn’t help an intern once they got on the job."

While Exempla, as part of a religious-based health care system, has a higher moral obligation to the community, Camardo thinks welfare-to-work programs can work in other systems and facilities that may be more acutely aware of bottom-line implications. "What speaks to the bottom line in this kind of program is the opportunity to build an extremely dedicated, loyal workforce. WorkStart participants are usually hungry for a job and to make a difference, and will be loyal to the person or company who gives them a chance. It also allows other people in the department to feel good about something that really makes a difference in the community."

Data bear out Exempla experience

Back in 2001, the VHA Health Foundation of Irving, TX — one of the research arms of VHA Inc. — published a report based on a 15-month study of nine welfare-to-work programs. According to the report, Welfare-to-Work Strategies for Health Care Work Force Development, the retention rate for these workers was 69% — equal to or better than other industries such as hotels. The report states that average wages for participants after a year was nearly $9 per hour — 9% more than what was needed in 1999 to lift a family out of poverty. One participant noted in the report that the benefits of having a welfare-to-work program outweigh investment costs by 68%.

The common components of successful welfare-to-work programs, according to the report, include:

  • making the programs part of the traditional recruiting process;
  • recognizing the welfare-to-work program as part of the organization’s not-for-profit mission and mission to serve the community;
  • developing strong community partnerships to support the program;
  • offering participants training in communication, problem solving, and conflict resolution;
  • offering training for managers to ensure they know how to effectively manage and work with welfare-to-work program participants;
  • developing a mentoring program for the organization that fits the welfare-to-work program;
  • offering ongoing educational opportunities for program participants;
  • developing a career path for participants that encourages them to stay at work; and
  • developing an atmosphere that builds loyalty to the organization.

Among the barriers to creating such successful programs, the report notes the failure to address the significant child care, transportation, and socialization needs of program participants and the failure to offer affordable benefits options that bridge the transition from welfare to the time when the employees can afford the standard benefits offered by the employer.

For those still looking for a reason to consider starting a welfare-to-work program, consider these words from the report’s executive summary: "There is a business imperative to actively participate in welfare-to-work efforts. Not only is health care competing with retail, manufacturing and other industries for entry-level workers, it is competing with insurance and information technology for the nursing work force. If traditional recruitment processes are not yielding qualified, interested candidates, welfare-to-work gives the health care organization an opportunity to grow their own employee.’ [Participating] organizations have found that welfare-to-work participants’ additional training and soft-skills development make them more dedicated and informed employees. An added bonus is the ability to attract potential employees who better reflect the patient population."

The report includes descriptions of the nine programs and their outcomes, welfare-to-work resources, and information on wage reimbursement programs. For more information on the 2001 VHA Welfare-to-work report, contact Laura Murphy at (972) 830-0305 or lmurphy@vha.com.


  • Sister Melissa Camardo, program manager, Exempla HealthCare, 1835 Franklin St., Denver, CO 80218. Telephone: (303) 837 7744. E-mail: camardom@exempla.org