Health Profession Opportunity Grants; Past Successes and Future Uses

WM: Worker and Family Support, Health Profession Opportunity Grants; Past Successes and Future Uses, March 10, 2021

These remarks rely on my experience in a wide variety of positions in and out of government. These include:

• Program Analyst in the Office of the City Administrator in Washington, D.C. government in the late 1990s,

• Contracted grants office technical representative with the H-1B Technical Skills Training Grant Program in the early 2000s with the Department of Labor,  

• Proposal coordinator for Graduate School USA in the late 2000s and early 2010s, including submitting Grant Applications for this program,

• Contracted research on the results of welfare reform in the same time period, including reviews of academic literature and government reports, 

• Submitting comments for the record to the Ways and Means Committee on these issues for the past decade (which have been consolidated into book form),

• Exploring options on how to lift workers from the bottom tiers of the workforce to a more cooperative economy.

When President Clinton and Speaker Gingrich ended welfare as we knew it, I had a front row seat in the D.C. government on how Temporary Aid for Needy Families was to be structured.  The race was on to provide adults, usually women, with jobs in the medical and hospitality industries, as well as channeling those who needed it into basic literacy programs. 

The H-1B program expanded its reach from technical skills training to this program, although such training was beyond the scope of the authorizing legislation. This led to the current program, including the site bid for by Graduate School, USA. Budget cuts to meet baseline requirements happened in the interim, leading me into an early retirement after a period of low wage work. These remarks are made without funding.

I am not a fan of this program. It only leads to higher wage work in unions where the Service Employees International Union is open for business. In right to work states, wages are less and working conditions are harder for graduates of these programs.  These are some of the worst jobs there are and the training provided can only take graduates so far up the career ladder. I would be shocked if many, indeed any, program graduates have climbed the career ladder to medical school. A true career ladder would lead there.

This program and those like it channel people into different forms of poverty. Women, in particular, are tracked into what is considered “women’s work.”  While there are more male nurses and physician’s assistants, they are the exception, not the rule. When entrance into medical school requires nurse’s training, plus a period of practice, I will believe that a career ladder exists.

Accidents of birth and deliberately bad urban education leave workers unprepared for an escape from our dirtiest jobs. No job is dirtier than being a nurse’s aide in a hospital. Members of the Subcommittee should try it sometime.

Before people enter these programs, they must first be offered not only remedial education as necessary, but should be paid to pursue it. This should include English as a Second Language and be given regardless of immigration status. The minimum wage should be paid for attendance and homework so that the opportunity costs of the students are met. Students with academic promise should be tracked toward higher education, which should also be paid - both in terms of tuition and salary.

If they are not entirely repealed, an exception to right to work laws must be enacted for this type of work. Dignified work is also well-paid. On top of this, the child tax credit should be expanded and made refundable so that mothers and fathers with children can participate in both literacy and training programs. This should include intact families. Individuals receiving unemployment compensation, or any benefit, should be included in this funding stream. 

The CTC would be paid by government pensions and benefits, educational programs and employers. The CTC would be paid with wages with employers deducting these payments from either an employer-paid subtraction VAT or from current quarterly payments to income and FICA taxes. Tax rates should be high enough to also include either private health benefits, Affordable Care Act benefits and Medicare and Medicaid. A separate credit invoice value-added tax would fund discretionary government (both military and civil) and possibly the employer share of FICA. Please see the attachment further detailing our tax reform proposals.

Attachment – Comprehensive Tax Reform, March 4, 2021