Across two rounds of grants from 2010 and 2021, the Health Profession Opportunity Grants (HPOG) Program aimed to provide education and training to Temporary Assistance for Needy Families (TANF) recipients and other adults with low incomes for occupations in the healthcare field that pay well and are expected to either experience labor shortages or be in high demand.

This report presents findings from the systems study component of the National Evaluation of HPOG 2.0. It describes the local service delivery systems in which 15 of the 38 second-round HPOG programs selected for the study operated, explores both how these systems influenced the HPOG programs, and how the HPOG programs influenced these systems, from the perspectives of program operators and their partners on their local systems. The study also seeks to understand how the economic and policy contexts and existing training and support services within the local system may have influenced HPOG program design and implementation.

Key Findings

Collaboration and Partnership

• The HPOG 2.0 programs appeared to be an inflection point for new or enhanced collaboration within the system. No one program operator in this study could bring about change alone.
• The selected programs reported engaging an average of 20 partners per program.
• Local program operators and partners perceived that offering robust support services helped improve the quality of healthcare training and services.
• The presence of articulated career pathways did not appear to help support advancement in healthcare careers.
• Nearly all HPOG 2.0 programs engaged multiple employers that played different roles to support participant success in the workforce

Quality Improvement and Sustainability:

• Data sharing for improving healthcare training and local systems seemed to be a more limited aspect of HPOG. HPOG encouraged data sharing for managing the HPOG programs, but it did not always support systems activities such as building cross-system processes and strategies.
• Reflecting the intent of the grant, HPOG program operators and partners planned to sustain the programs, including the training and services, in some form.
• Recommendations for future similar initiatives include continued encouragement for new and strengthened partnerships and robust wraparound services to improve access to training and address barriers to training completion and post-training employment. In addition, the study recommends encouraging a greater focus on advancement in healthcare careers and emphasizing strong employer relationships.