A Healthcare Employer Guide to Hiring People with Arrest and Conviction Records SEIZING THE OPPORTUNITY TO TAP A LARGE, DIVERSE WORKFORCE

SEPTEMBER 2016 Contents

A. Executive Summary ______5 B. How to Use this Toolkit ______12 C. Myth-Busters: Hiring People with Records ______13 D. Access an Untapped Workforce of People with Records for Bottom-Line Results ______17

E. A Step-by-Step Guide to Hiring People with Arrest or Conviction Records ______29

F. Chart New Territory ______39 Model Employer Practices for Hiring People with Records Johns Hopkins Hospital & Healthcare System: An Employer Model for Hiring People with Records ______39

Mount Sinai Health System Institute for Advanced Medicine Coming Home Program: An Employer Model for Hiring Community Health Workers ______42 Roseland Community Hospital: Hiring for Healthcare Career Pathways ______44

G. Leverage Community Intermediaries ______47 How to Build Partnerships to Source & Develop Diverse Talent Creating Value through Intermediaries ______47

Preparing to Meet Future Needs: Workforce Development Best Practices for Employers ______51 H. Conclusion ______57 Appendices

REFERENCES ______58

RESOURCES ______62

KEY LAWS REGULATING EMPLOYMENT BACKGROUND CHECKS ______64

1 NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 2 The National Employment Law Project (NELP) is Law Employment The National research a non-profit organization and advocacy that partners with local communities secure to the promise workers. of economic opportunity for today’s has been supporting Safer Foundation 44 years, For the efforts of people with arrest and conviction members become to records of the commu- employed and as a result recidivism. reduce nity,

Asawari SodhiAsawari Safer Public Policy & LegislativeCoordinator, Affairs Foundation Michelle Natividad Rodriguez Rodriguez Michelle Natividad NELP Attorney, Senior Staff Anthony Lowery Anthony Safer Foundation of PolicyDirector & Advocacy, Ronald Jones Ronald Public Policy & Law Safer Foundation Intern, Maurice Emsellem NELP Project Director, Beth Avery Beth Avery NELP Attorney, Staff Sodiqa Williams Foundation Safer Vice President of External Affairs, Contributing Writers: AUTHORS Lead Writer: ACKNOWLEDGMENTS made possibleThis toolkit was with the generous support NELP and the Safer of JPMorgan Chase & Co. a number also to are of individ- grateful Foundation their exper- who contributed uals and organizations tise help shapetoolkit, of the and time to the content Gertzincluding Emily for Advanced of the Institute Medicine, Diane Williams and Victor Dickson of the Gibson Michael Safer Foundation, of Alameda County Emergency Medical Services, Linda Mellgren, retired Department of Health Human and the U.S. from Services, Maureen O’Donnell Clark of and Paulette Roseland Ernesto Community Hospital, Melody Young, and Clinic Network, of Transitions Diaz, Shira Shavit Michele Sedney and Joseph Phelps Hopkins of Johns also Bowe are Andrew indebted to Health We System. contribu- NELP for their valuable Eng of and Norman the project.tions to

NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT

PAMELA PAULK business rationale, it’s not just just not it’s rationale, business Former Senior V.P. of Human Resources, Resources, of Human Senior V.P. Former May 7, 2015 7, May

healthcare is almost insatiable. insatiable. almost is healthcare If we only look at the population the population at look only we If

Johns Hopkins Hospital & Health System & Health Hospital Johns Hopkins the perfect background, we we background, the perfect the perfect physical abilities, abilities, physical the perfect that has a perfect education, education, that hasa perfect philanthropic or just a mission.” just or philanthropic

can’t meet [demand]. It’s a It’s [demand]. meet can’t “Our need for workers in in workers for need “Our NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 4 This toolkit avoids the use of stigma- tizing labels, like or “ex-offender” “felon,” in favor of the term “people records,” with which seeks to decouple an past individual’s from mistakes his or her future potential. You may have already observed already have may You 1 A disproportionate number of people with records 2

increased services demand for healthcare as a result of changes the made by Act To Care Affordable and the demographicby aging baby shift ledboomers. develop- workforce need appropriate implement to meet you’ll this demand, workers.ment strategies in qualified and invest are people of color, who have mostly been charged crimes. with non-violent who have peopleare of color, these a second taken part individuals give to in programs who have Employers and loyalty. praised ethic, worth their enthusiasm, chance have opportunities limited employment in the healthcare have People with records attitudesindustry misper- and of reasons, including employer for a myriad stringent checks for occupa- required background overly ceptions; the often tional certifications and licenses; hiring lack of guidance in properly people legal mechanisms that and the underutilization of rehabilitative with records; people hire to hospitals with records. allow and other employers healthcare the burgeoning services market for healthcare Given and the forecasted consider quali- fully to encouragecompetition you we for skilled workers, fied when filling records people job healthcare with openings. The singular An Undiscovered Pool of of Pool An Undiscovered Talent and Valuable Diverse and underutilized overlooked An often pool is eager individuals of talented meet increased and help you demand. becometo workforce a part of your people society reenter they incarceration; from 700,000 nearly Every year, an arrest who have among the estimatedare million adults in the U.S. 70 record. and conviction A Growing Need for Healthcare Workers Healthcare for Need A Growing jobs healthcare in growth is projected aware, well are As employers healthcare in the far exceed employment with otherto the next decade, industries over and socialhealthcare million jobs assistance become to sector the adding 3.8 largest sector employment in the nation. A. Executive SummaryA. Executive NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 5 on e with Expected release: late 2016. LEADERSHIP AT THE FEDERAL THE LEADERSHIP LEVEL AT Look for an upcoming report from the U.S. Department of Health and Human Services (HHS), Office of the Assistant Secretaryfor Planning and Evaluati The with records. people sector for healthcare the (ASPE), in employment on report is part of a national initiative improve to opportunities for peopl arrest and conviction records. demand for workers combined with the nation’s recognition of the need for combined nation’s with the workers demand for presentscriminal justice reform in previously invest an opportunity to for you untapped talent pools, people including with arrest records. or conviction the Opportunity Seize Let’s an opportunity have employers As industry the healthcare continues grow, to strategies assure a diversified development to workforce launch innovative to pipelineworkers. of qualified healthcare Businesses of all sizes and types come and go in the communities they serve. communities afloat and organizations help keep healthcare many However, financial and uncertain in hard times. even steady, Adopting your policy a hiring achieve for people can help you with records Consult serve missionto the public. your business objectives while advancing this toolkit for people hiring program for guidance on implementing a with records. and trainersSeveral featured providers healthcare at the in the toolkitare underserved in in workforces invest to communities. of a movement forefront their experiences can all learn from policies developing in and practices We that work. in recruiting can be proactive in the toolkit, you With the guidance provided Please this toolkit with your share community. people your from with records good And HR and talent acquisition teams. journey! begin your luck as you A. Executive SummaryA. Executive NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT EMPLOYER | A HEALTHCARE FOUNDATION & SAFER NELP Melody Young: A Success Story

A large part of Melody Young’s life is service to others. As a nurse, she devotes her time at work to meeting the needs of her patients. She volunteers her free time as an anti-violence community activist and participates in local government. She believes that change and growth are possible for anyone and always asks youth the million dollar question: “What do you want to be in life?” For Ms. Young, the answer to that question was simple, but achieving her dream of becoming a nurse was a bit more complicated.

Photo used with permission of Melody Young Ms. Young began her career in healthcare years ago as a home health aide. After a drug offense, however, she was sent to prison. It was a frightening place, and she quickly realized that she didn’t belong there and decided to turn things around. She earned an early release based upon her outstanding behavior.

Upon release, Ms. Young found a job at a restaurant. But she wanted to accomplish more. She took a chance and entered the CNA training program at a nursing home. Three months later, she was hired by the Rehabilitation Institute of Chicago, but her time there was cut short. Without a “healthcare waiver,” Illinois law prohibited her from working in a healthcare setting. The hospital terminated her, losing a reliable, loyal, and passionate employee who was beloved by both patients and staff.

“ I have confidence not Ms. Young was not deterred. With the help of the Safer arrogance. I live by how I can Foundation, she secured a healthcare waiver.3 She set out to accommodate the person earn her nursing degree, first receiving her associate degree with quality patient care. I do in nursing and later her LPN degree.4 all that I can for my patients. It’s not just a job.” Ms. Young’s first nursing position was at a nursing home, where she was hired after sharing her story of struggle and perseverance. Her commitment and professionalism were rewarded when she became a nurse at the nursing home. A skilled worker, her certifications include CPR instruction, wound care, IV therapy, and medical surgery geriatrics.

Today, Ms. Young is employed by the U.S. Department of Veterans Affairs. She approaches every new opportunity by asking what she can do to accommodate and bond with patients and co-workers. “I have integrity, and that leads to advancement,” she explains.

Ms. Young was pardoned by the governor in 2015.

6 A Look at the Numbers We are all affected when millions of Americans— TOOLKIT EMPLOYER | A HEALTHCARE FOUNDATION & SAFER NELP both men and women, particularly people of color—are locked out of jobs because of an arrest or conviction record.

70 MILLION PEOPLE in ONLY 4.5% of U.S. arrests the U.S. have a record. involved violent crimes in 2014.6 That’s nearly 1 IN 3 ADULTS.5 4.5%

Incarceration of WOMEN grew 700% from 1980–2014.7 215,332 202,089 205,190

164,221

119,786

81,023

42,176 26,378

1980 1985 1990 1995 2000 2005 2010 2014

7 A Look at the Numbers NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT EMPLOYER | A HEALTHCARE FOUNDATION & SAFER NELP

MEN with a CRIMINAL RECORD 28% of ALL 2010 account for about 34% of the ARRESTS were of UNEMPLOYED prime working age MEN.8 AFRICAN AMERICANS, despite African Americans comprising ONLY 14% of 34% the U.S. POPULATION.9 28% 14%

Only 34% of TEXAS WOMEN were employed 8–10 months after release from prison (compared to 60% of MEN).10 2010 Arrests U.S. Population 34% vs. 60%

NEARLY HALF of U.S. children have at least one parent with a record.11

8 A Look at the Numbers NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT EMPLOYER | A HEALTHCARE FOUNDATION & SAFER NELP The stigma of a record is devastating to employment prospects.

9 IN 10 employers conduct CRIMINAL BACKGROUND CHECKS.12

HALF of the records in the FBI database are INACCURATE.13

Background checks for employment using FBI DATA grew 600% from 2002–12 (17 million total).

A criminal record 27,254 RESTRICTIONS REDUCES the in state laws may limit someone with a record from obtaining an likelihood of a job 15 occupational license.14 callback by 50%.

9 A Look at the Numbers NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT EMPLOYER | A HEALTHCARE FOUNDATION & SAFER NELP When given a fair chance to work, people with records make good employees, whose employment helps improve our economic health and public safety.

Putting 100 formerly incarcerated people back to work could increase their lifetime earnings by $55 million, MORE increase their income tax contributions PRODUCTIVE by $1.9 million, and boost sales tax revenue by $770,000. And it would Studies have found save $2 million in criminal justice workers with records to expenditures.16 be MORE productive than other workers and have Harvard researchers observed LESS job turnover.17 that MILITARY MEMBERS with felony convictions are promoted FASTER and were NO MORE likely to be discharged.18 $78 –$87 BILLION LOST

America’s GDP lost an estimated $78 BILLION– Employment is the $87 BILLION in 2014 #1 most important because people with felony records could not factor for decreasing participate in the labor 19 recidivism. market.20

10 NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 11 offers and Section G www.nelp.org of this toolkit further hiring explain how equips you with a step-by-step equips or you you help guide to explores best practices used model by healthcare

LEARN FROM OTHER EMPLOYERS OTHER LEARN FROM Section F successfully people to hire and details with records, employers the key steps they take in their hiring protocols. people with records can improve your bottom line and help your people can improve with records your mission and community for patient care better fulfill health outcomes. This toolkit also provides guidance on building critical top-down support for implementing an initia- people hire as staff. to with records tive PROGRAM HIRING EFFECTIVE AN TO STEPS SIX Section E human resources process the hiring your personnel navigate and federal, state, while ensuring compliance with the relevant the balance the factors that and effectively govern local laws screening of people with an arrest record. or conviction collaborate with trainers to and community guidance on how and candidates connect to intermediaries employers who work and resilient pipeline of reliable, a robust, develop to in order workers. qualified, diverse MAKING CASE THE BOTTOM-LINE FOR RESULTS Sections C and D

his toolkit will equip you with the knowledge you need and recruit to with the knowledge you his toolkit equip will you implement best your community, in records workers with qualified hire practices people for employing organization and establish with records, your strategies the health and promote to workforce as a leader in using innovative community. safety of your www.saferfoundation.org Materials in this toolkit are available for download at for download available in this toolkitMaterials are T B. How to Use this Toolkit Use to B. How NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 12 Check whether whether Check your state also provides specific against protection negligent hiring when liability people hiring with records by the consulting in Resources Appendix B of this toolkit. 21

Negligent hiring liability is not a substantial Negligent risk. Most people with aking decisions based assumptionson inaccurate does a disservice to This section addresses some business common and community. your misperceptions HR about hiring people and your so with records that you informedstaff decisions. can make fully myth #1: I willmyth #1: substantial be to exposed if I hire someone liability negligent-hiring with a record. FACT: records have offenses that do not pose have records the “foreseeable” of harm that risk you negligent hiring. As employer, a healthcare prove to required is legally both the applicant and potential evaluating risk of liability by can avoid job opening—taking of the account the age the nature of the offense, into position,and the degree of on-the-job supervision other In employees. by policy business for peoplecontrast, hire” instead if your adopts a blanket “no your business in violation of the federalfind civil well may you with records, hiring discrimination. that protect from workers rights laws violence is generally “[n]o research that workplace has shown Moreover, ex-offenders employee or that hiring ex-offenders to attributed is causally increasedlinked violence.” to workplace M C. Myth-Busters: Hiring People with Records Hiring People C.Myth-Busters: NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 13 For For

23 le, le, an an 25 an an 24 26 and have been than other employees. at a higher rate promoted and have While federal and state laws often require background checks of many checks of many background require often While federal laws and state Workers with records have been shown to have higher retention on higher retention been have to shown have records with Workers 22 THE FACTS ABOUT RECIDIVISM ABOUT FACTS THE recidivism decline of chances person’s that a clear makes research latest The examp For records. felony with people for including time, over significantly is crime another will commit individual that an record risk the with burglary a no greater than the risk for any other person in the general population after likelihood The that offense. individual’s the years passed3.8 have since th greater no is crime another will commit individual withassault record an the likelihood of any other person in the general population after 4.3 years offense. individual’s the passedhave since myth #3: Federal and state laws regulating laws and state Federal myth #3: from me prevent employment healthcare withhiring records. people FACT: myth #2: People with records won’t be won’t with records myth People #2: reliable employees. FACT: categories of healthcare workers, the laws do not prohibit hiring anyone with hiring anyone do not prohibit categories the laws workers, of healthcare list Instead, specific for certaina record. occupations, healthcare the laws offenses, from being such as the individual serious felonies, that prevent regulations allow and laws licensed In addition, many or certifiedby the state. and appeal processes that allow rehabilitation,” of “certificates for “waivers,” that she does demonstrate with a disqualifying to record an individual not becausepose of the signifi- Moreover, a risk of safety or security on the job. cant racial impact of wholesale on people exclusions record criminal of color, Opportunity Equal Employment Commission (EEOC) has cautioned the U.S. in defense hiring practices. of their laws on state rely not to employers the job example, a three-year Hopkins Hospital of a Johns tracking study example, program nearly 500 peoplethat hired the Baltimore from area resulted with records in with a record. of employees terminations zero “problematic” C. Myth-Busters: Hiring People with Hiring Records People C. Myth-Busters: “Cultural competency is crucial to closing disparities in health and education. Services that are respectful of and responsive to the beliefs, practices, and cultural and linguistic needs of diverse communities are needed to help bring about positive outcomes. Communities and their education and health care systems must be able to address the needs of their diverse populations without cultural differences hindering the conversation and delivery of services.”

From: Investing in Boys and Young Men of Color: The Promise and Opportunity Rhonda Bryant, Linda Harris, and Kisha Bird at Center for Law and Social Policy 27 NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 15 Interested in the signing pledge? Visit https://www. whitehouse. gov/issues/ criminal-justice/ business-pledge . The has an arrest or Fair Chance Business Pledge Fair If properly leveraged, these leveraged, If properly million people 70 can 28

early one in three American adults of working age American adults of working one in three early conviction record. conviction

pledge symbolizes economic opportunity a dedicatedto providing effowrt embracing fair-chancefor all, by hiring of people and setting with records an example for other businesses. A moral case can be made for hiring underrep- resented groups, but hiring people is also with records good business. enhance your workforce. This untapped talent pool workforce. being is already soughtenhance your by In 2016, industry in a global economy. leaders competitive looking remain to Hospital Hopkins Johns and Health joined System 200 major nearly corpora- tions, including American Airlines, the Coca-Cola Google, PepsiCo, Company, and Facebook, House in signing the White N

with Records Bottom-Line for Results Records Conviction or Arrest with People The Benefits Hiring of D. Access an Untapped Workforce of People People of Workforce an Access Untapped D. NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 16

29 WHITE HOUSE FAIR CHANCE BUSINESS PLEDGE: HOUSE FAIR WHITE Johns Hopkins Hospital and Health System and Health Hospital Hopkins Johns The Johns Hopkins Hospital and Health System’s (JHHS) practice of Hopkins HospitalThe Johns and Health System’s accessproviding and opportunity citizens returning the Baltimore of to is not conduct our business. we a strategic but part of the way a charitable endeavor, not just are that conducts an organization business but an in Baltimore, We and connected partintegral for 126 of the community—interwoven and years counting. the Hospital, he recognized Hopkins endowed that the service When Mr. we lasting a positive impact if all members of the commu- have can only provide Hopkins’ keep Mr. to made sure have a partnity are of JHHS mission. We Chance Business at Pledge, the Fair mirror ways which in many directives, This is evidenced which hiring practice, in our do. of all that we the forefront embraces our community's citizens who meet our hiring requirements— citizens.including returning an established banned the box in our hiring process prac- and have have We a criminal background. applicants that have reviewing tice of individually returning a strong This thoughtful, detailed process have enabled has us to the years. over citizen rate hire Our long standing partnerships based with community partners, particularly those that serve citizens, returning and understand our organization and the our share provides us with a pipeline applicants. of talented We do, we work practices with other Baltimore City companies and encourage dialogue on the importance of engaging all of our citizens process. in the employment Baltimore commitment to City and our organization[’]s unwavering Lastly, managerial and super- leadership, Maryland is reflected in our Institution’s a lot of talented people in our visorywe have who understand that staff, to let recognizeaway— good cannot afford that we talent get We community. especially talent that might need a second chance. D. Access an Untapped Workforce of People People of Workforce Access an Untapped D. with Records Bottom-Line for Results NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 17 Health Outcomes Qualified Candidates Qualified with Employment Laws Reduce Recruiting Costs Recruiting Reduce Improve Quality Care & of Improve Cost-Free Employee Insurance Employee Cost-Free Advance Your Corporate Social Corporate Your Advance Access Significant Tax & Credits Significant Access by Hiring Loyal, Committed Personnel Committed Hiringby Loyal, Responsibility, Diversity & Compliance & Compliance Diversity Responsibility,

with Pool Local Talent Your Enlarge Productivity & Increase Turnover Reduce

of hiring people arrest with or conviction records from community: your Bottom-Line Benefits NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 18 - - - For more information on working with intermediary with on working information organizations, more For see Section G of this toolkit. Increased output of services services outputIncreased of resources of expenditure the same For Equating profit more to

» » » Intermediary candidates. with organizations connect They provide employers servicestraining and employment for those seeking and are employment essential Community-based partners for employers. nonprofits, training job centers, and agencies,organizations, governmental government-funded examples boards are of intermediary development can groupsworkforce you region. identify in your Community intermediaries candidates recruit demands and based on your then trained candidatesVetted based are your on the needs of qualifications. for interviews. then sent Successful you directly to company candidates are supportprovided services being after and unsuccessful hired, candidates assistance address follow-up being to them from issues receive that prevented hired. All of these essential services with a community partner provided are costs. employer and reduce 1. Enlarge Your Local Talent Pool with Pool Local Talent Your 1. Enlarge Candidates Qualified 70 million overlook companiesCompetitive potentialto cannot afford This is especially backgrounds. of diverse employees true with the skills cultural competency deliv where is key to shortage industry, in the healthcare responds that healthcare ering quality and effective to the needs of the commu programs, simple and efficient such as employee-led Through training nity. and robust recruiting, talent pool this accessible can strengthen and driven business better and leadyour health to outcomes. Community intermediaries can help streamline hiring processes vetting, by training, recommending, and supportingcontinuously applicants. These partners decrease costs deliv by your ering qualifiedneeds. applicants specifically to suited Costs Recruiting 2. Reduce but finding them canQualifiedto growth, be expensive. vital applicants are Community peopleintermediaries for employ- that prepare with records reduce these ment can significantly costs. These partnersyou in can assist for hard-to-fill skilled individuals more recruiting positions. The result? D. Access an Untapped Workforce of People People of Workforce Access an Untapped D. with Records Bottom-Line for Results NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 1919 30 COLUMBUS Middle-skill healthcare percent of 14 job growth projected 2013 between and 2018; approximately annual openings for 2,051 middle-skill jobs healthcare 2013 and 2018. between NEW YORK CITY NEW YORK 14 percent projected growth rate for for percent rate projected growth 14 require lessrequire degree. than a bachelor’s positions in five that areas occupation positions in five DALLAS-FORT WORTH online job postings for 32,990 2013-June 2014; jobshealthcare July annual job growth percent average 5.5 projected middle-skill for healthcare jobs 2013 and 2018. between 37 percent occupations37 of healthcare are healthcare sector between 2014 and 2019; and 2019; sectorhealthcare 2014 between middle skilled; over 25,000 postings across 25,000 middle skilled; over CHICAGO jobs wage. earning least at a living 10 percent healthcare job growth projected10 percent job healthcare growth More than 410,000 total healthcare jobs in 2014; jobs healthcare total 2014; in More than 410,000 23 percent of middle-skill online job postings for between 2014 and 2019; healthcare jobs healthcare comprise and 2019; 2014 between

SAN FRANCISCO / BAY AREA / BAY FRANCISCO SAN 23 to 21 percent jobs of healthcare are middle skilled; jobs healthcare requiring less expected degree than a bachelor’s are a and pay percent in 10 years 16 grow to of $29.32. wage median hourly

LOS ANGELES LOS jobs; healthcare 596,000 23 middle percent are median skilled; $37.51 29,500 wage; hourly middle-skill healthcare job postings between 2014. 2013 July and July Opportunities in Healthcare & Middle-Skill Jobs in Healthcare Middle-Skill & Opportunities NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 20 Diverse compa- Diverse 32 One major advantage of diversity is of diversity One major advantage 31 38 Strengthen the local economy by reducing unemployment reducing by the localStrengthen economy which supports strong Increase economic self-sufficiency, families and healthy the health and safety of the community with lower Improve of employment increasing by rates of crime and recidivism those with prior convictions. Please see Appendix information. C for more • • • COMMUNITY VALUE OF HIRING PEOPLE WITH RECORDS WITH OF HIRING PEOPLE COMMUNITY VALUE innovation, which spurs growth. In response spurs which growth. a Forbes survey to of largeinnovation, firms, innovation. driving 85 key to is percent opined diversity that 4. Reduce Turnover & Increase & Increase Turnover 4. Reduce Committed Hiring Loyal, by Productivity Personnel within the sectorto growth Qualified vital meeting and are the employees can but finding them be expen- demand for a skilledincreasing workforce, is essential of skilled employees Retention the success to of the health- sive. which faces of 19.2 rate the challenges of an annual turnover industry, care 3. Advance Your Corporate Social Corporate Your Advance 3. and Compliance Diversity, Responsibility, with Employment Laws disproportionatelyPeople represented of color are those among arrest with or And diver- population making that records, particularlyconviction diverse. McKinsey companiesthat diverse found perform & Company sity pays. 35 percentbetter than industry averages. nies stand ready to capitalize on a progressively diverse society. diverse nies capitalize to stand on a progressively ready resulting the increased from diversity innovation, driving In addition to comply to hiring people employers also records with better positions private with the anti-discrimination mandatesaction and the and affirmative minority-owned business federal contractors, to that apply preferences as has been emphasized both by Opportunity the Equal Employment Commission (EEOC) and the Department of Labor’s Federal Contract Office of Compliance in a good are employers healthcare position Programs (OFFCP). Similarly, legal challenges the federal with comply taking steps fully by to avoid to checks for employment background regulating consumer protection laws number of “banand the growing private to apply the box” that now laws employers. A growing number of “ban the box” laws now apply to private employers. D. Access an Untapped Workforce of People People of Workforce Access an Untapped D. with Records Bottom-Line for Results NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 21 34 . In addition, the Social IMPACT In addition, the Social IMPACT One-third those of who partici- 36 37 Evolv, a data provider that studies a data provider Evolv, found that workers retention, employee than productive more were with records those an arrest without or conviction the CEO, Evolv’s to According record. increased to related productivity is likely sense of loyalty feeling “a the employees the companies to hire that took the risk to them.” Research Center researched a transitional peoplejob facing that employed program barriers and reportedemployment that The retention rate for people rate surpassed with records The retention 35 21 percent of an employee’s salary percent of an employee’s 21 Lost productivity and other factors associated typi- with turnover 33 the rate for similarly-situated without an arrestthe rate employees or conviction people with involved terminations In addition, zero “problematic” record. records. cally cost an employer costcally an employer 5. Improve Quality Care & Health of Improve 5. Outcomes engaging communities bottom through line, your increasing In addition to Employees quality of care. your hiring people can also with records improve understanding envi- cultural, a distinctive of how the community have from and localronmental, resources life- influence health outcomes healthy and styles. As more can create records workers a result, with qualified community links vulnerable effective between system. populations and the healthcare quality patient strong compassion in delivering These also display individuals pated in the program were people released recently and with records were in the program pated from years). the lastprison two (within percent. committed be themselves to loyal, proven have People with records A three-year Hopkins employees. Johns of a program at study tracking Hospital nearly 500 people that hired the Baltimore from area with records target of their rate and high retention rate documented turnover low the 40 months. after group employers supportedemployers because the program the cost “lowering of hiring it was business and increasing new employees finan- productivity [and] improving satisfaction.” and customer cial well-being D. Access an Untapped Workforce of People People of Workforce Access an Untapped D. with Records Bottom-Line for Results NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 22 Moreover, employing employing Moreover, 39

Work Opportunity Tax Opportunity Tax Work and wage subsidies and wage to related The government incentivizes hiring The government these qualified records applicants with the through Credit federal job-training and other work- The tax programs. development force credit offers $1,500between and $2,400 for eachper qualified candidate year hired, depending on the number of hours Some states and year. in the firstworked cities offer additional tax credits. minimizes risks of hiring these perceived Review the ResourcesReview in Appendix information. B for more employees andpatients employees Increased knowledge by healthcare Increased by knowledge healthcare care to access Improved vulnerablefor communities Better outcomes health effectiveMore disease prevention

Federal Bonding Program Federal » » » » people with records, who are historically underrepresentedpeople historically in the job who are market, with records, of socioeconomic a variety contributes to and health benefits for those indi- viduals and their families. The result? Healthier communities with less crime economic climate. and an improved and recidivism care to those in their community. What is the tangible impact? What is the those to care in their community. reentry the local example, hired from health community commu- workers For nity increase and prescription appointment-keeping adherence regimen measures for high-risk preventive otherwhile facilitating several high-value and health education. care, populations, rehabilitative 6. Access Significant Tax & Credits Significant Access 6. Insurance Employee Cost-Free qualified applicants. for employees “fidelity provides The program bonds” against losses employers histories insure with conviction to caused any by the bond of charge free for receive dishonest Employers acts of an employee. at least the first six months of employment. The D. Access an Untapped Workforce of People People of Workforce Access an Untapped D. with Records Bottom-Line for Results NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 23 onic lready face ions? Chronic illness The success of the TCN model 41 40 CHW Ronald Sanders (right) assists patient TCN

Over time, Transitions Clinic Network has observed has observed Transitions Clinic Network time, Over . In a randomized trial, the patients controlled of the TCN program Did you know that, 157 by million 2020, people in the U.S. are expected to have one chr condition while 81 million are expected to have multiple chronic condit especially impacts people of color and those with low incomes, both of whom a poorer health outcomes than the general population. general the than outcomes health poorer (TCN) of a national network is primary clinics care that address the needs released of recently pris- medicaloners condi- with chronic the clinics a decade, over tions. For health community employed have with a history of (CHWs) workers cultur- provide to incarceration In healthcare. appropriate ally such hiring, facilitate to order TCN successfully worked clinics have with human resources departments of healthcare in the wide variety settings in which TCN clinics county hospital including operate, systems and public universities. Improved Health Outcomes by Employing Employing by Outcomes Health Improved Community Health Workers Network Transitions Clinic with expe- compared their patients, when health outcomes for improved with convinction CHWs primarydited facilities that do not employ care histories reduced their emergency department 12 about by utilization 50 percent over months, thus also costs. healthcare reducing demonstrates people that employing settings in healthcare with records is feasiblenot and cost-effective, only necessary but healthto ensuring positive outcomes for our country’s most marginalized communities. D. Access an Untapped Workforce of People with Records for Bottom-Line Results

A Snapshot of Healthcare Workers

FRONTLINE HEALTHCARE WORKERS According to the Frontline Health Workers Coalition, “frontline workers” are “often based in the community and come from the community they serve and play a critical role in providing a local context for proven health solutions, and they connect families and communities to the health system. They are the first and the only link to health- care for millions of people, are relatively inexpensive to train and support, and are capable of providing many life-saving interventions.”42

Responsibilities: First point of contact when answering phones; arranging transpor- tation for patients; arranging appointments; patient follow-up; and taking vital signs.

Roles: Customer service; administrative support; direct care in health education, chronic disease, rehabilitative care, and preventive services.

Examples: Medical assistants; medical records & health information technicians; administrative assistants; home care aides, and community health workers.43

ENTRY-LEVEL HEALTHCARE JOBS Entry-level positions generally require a GED or high school diploma as well as limited training and experience.

Examples: certified nursing assistant; home health aide; personal care aide; food service assistant; transporter; environmental services assistant; health information clerk; and emergency medical technician.

MIDDLE-SKILL HEALTHCARE OCCUPATIONS Middle-skill jobs do not require a bachelor’s degree, but these skilled positions require some education and training (e.g., associate degree/certifications) beyond high school and more experience.

Examples: licensed practical nurse; certified medical assistant; and phlebotomy technician.44

24 “Th[e] new [U.S. Department of Justice, Office of Justice Programs] policy statement replaces unnecessarily disparaging labels with terms like ‘person who committed a crime’ and ‘individual who was incarcerated,’ decoupling past actions from the person being described and anticipating the contributions we expect them to make when they return. We will be using the new terminology in speeches, solicitations, website content, and social media posts, and I am hopeful that other agencies and organizations will consider doing the same.”

KAROL MASON U.S. Assistant Attorney General, Head of the Office of Justice Programs, Department of Justice45 NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 26

ignore a large talent poolignore . safety , and that can reduce his or her chances his that can reduce of a callback or job offer quality 46 , But employers also lose But employers out if they 47 fairness

2: Eliminate blanket bans against blanket hiring Eliminate 2: e’ve already highlighted how a huge number how highlighted already of job-seekerse’ve held are an arrest or adults one in three nearly have their record: back by

by 50 percent. by people with records and adopt fair screening fair screening and adopt with records people standards step for an open of the hiring criteria blanket exclusions positionReview and remove Doapplicants with a record. not assume someone disqualified is automatically solely healthcare in because employment from that person State has a record. nuanced usually are checks workers of healthcare background requiring laws restrictions protections moderate employment broad providing to by and may step 1: Adopt humanizing language when humanizing language when Adopt 1: step with records people describing When describing this population on job postings, internal applications, “ex-offender”terminology such as avoid or assessments, and among staff, can be incarcerated” stigmatizing “formerly the term Even “ex-convict.” been incarcerated— because have criminal record with a not all individuals termi- such been of an offense. even convicted Moreover, never some have identity notnology on their capabilities focuses but on former a person’s be to would in the criminal justice A better system. alternative involvement adopt language on the person, that centers such as a person with an arrest or as opposed record, conviction or ex-offender. ex-felon to conviction record conviction by prematurely discounting applicants with an arrest prematurely record. by or conviction tap this talent pool to learnUse how guide to implementing the following by compliance with fair hiring policiesinto bias, bring employers that reduce in demon- assist employers rights and consumer protectionfederal civil laws, strating their due diligence in adopting best practices, and strike a balance between W

with Arrest or Conviction Records E. A Step-by-Step Guide to Hiring People Hiring People to Guide E. A Step-by-Step NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 27 id- 48 increase increase . Delaying arrest and conviction . Delaying Eliminate criminal history inquiries inquiries criminal history Eliminate The age of the offense age of The the offense of nature The the job to directly related is record theWhether individual’s rehabilitation of Any evidence

» » » » THE 2012 EEOC GUIDANCE IS HAVING AN IMPACT ON ON AN IMPACT EEOC IS HAVING GUIDANCE 2012 THE PRACTICES. HIRING EMPLOYER In a 2015 survey, 72 percent of employer respondents asserted that they with records—an candidates assessments” of perform “individualized from 64 percent of respondents in 2014—thus indicating that “the gu EEOC’s impact practices.” hiring growing a employer have on to continues ance record inquiriesrecord is necessary reasons. for several such questions Including on effect” on applicantspotential with a crim- a “chilling an application can have applying. even might be ideal from candidate deterred Your inal record. 3: step the box”) (“ban applications job from until the end of the hiring should wait a fair process, you ensure To record process ask about to an applicant’s Finally, limit your background check to those check to background and aspects limit your relevant that are Finally, be Depending it may on the state, whose law. by consideration is allowed screenillegal to out people based consider convic- on arrest and to records tions older than a specifiedyears. number of By strictly with these complying avoid rights protections, civil employers discouraging potential applying, candidates from which helps expand the talent pool for recruitment. healthcare employers and jobseekers (e.g., Illinois’ healthcare waivers). Only and jobseekers waivers). healthcare employers healthcare Illinois’ (e.g., when necessary include in the job posting should you the specific convictions and arrests and arrests) (or class disqualifying of convictions statutorily that are to hiring an applicant. a significant barrier form or may Rights (Title Actthe Civil VII of of rightsAs laws the federal civil by required checks because criminal background which regulate 1964), of their dispro- the account must take into employers portionate impact on people of color, guide- of the job to applicant, notbackground According just the record. Opportunity Equal Employment Commissionlines issued in 2012U.S. the by must(EEOC), consider the employer E. A Step-by-Step Guide to Hiring People with Hiring Arrest to People Guide or E. A Step-by-Step Conviction Records E. A Step-by-Step Guide to Hiring People with Arrest or Conviction Records

By removing criminal history inquiries from applications, employers are able to draw from a wider talent pool, while still conducting a background check later in the hiring process. Even employers and HR professionals with good intentions may be affected by unconscious bias and inadvertently exclude qualified applicants with a record. Without early access to record information, employer callback decisions won’t be based on arrest or conviction history— but rather on the strength of the applicant’s qualifications.

BAN THE BOX—GIVING PEOPLE WITH RECORDS A FAIR CHANCE FOR EMPLOYMENT

“Banning the box” means removing criminal history inquiries from job appli- cations and delaying background checks until after an interview or condi- tional offer of employment. Such delayed inquiries prevent the stigma of a criminal record from overshadowing a job candidate’s qualifications.

Ban-the-box policies have been embraced by 24 states and over 130 locali- ties, covering more than half of the nation’s workforce. In 2015, President Obama directed federal agencies to ban the box. A number of corporations— including Starbucks, Facebook, and Koch Industries—and philanthropies have also adopted fair-chance hiring policies.

State and local ban-the-box policies cover government employers, including many public healthcare delivery providers. In addition, nine states and many of the nation’s largest cities (including Baltimore, Chicago, New York City, Philadelphia, San Francisco, Seattle, and Washington, D.C.) expressly cover not just public employers, but private employers as well. Some ban-the-box laws exempt certain healthcare positions from coverage. Fair-chance policies have proven effective; for example, since banning the box, Durham County, North Carolina has nearly tripled the number of applicants with criminal records who are recommended for hire.49

step 4: Avoid making suitability decisions based on self-disclosure

To employers, self-reporting questions during interviews or on applications can be a test of a candidate’s integrity. The expectation of self-disclosure, however, undermines the goal of fair chance hiring policies, which were developed to highlight what matters most—qualifications, work experience, and competence.

28 NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 29 Employers and commercial reporting and commercial Employers back- agencies that conduct private checks the with mustground comply called federal consumer protection law, Reporting Credit Act (FCRA), the Fair checkswhich regulates for background employment. Before check, obtaininga background FCRA requires that the applicant be a disclosureprovided document that: 50 If a background check is necessary, analysis—not an impulsive rejection. Capitalize employment opportunities rational a with employment Capitalize Obtains the candidate’s written consent perform written to a background Obtains the candidate’s check. Conspicuously check indicates is for employ- that the background ment purposes; and

» • • step 5: step provide firm screening and a reliable use the verify an to opportunity the applicant the information of accuracy Besides, self-disclosure questions do not make for quick and simple responses.rap sheet The document, a complicated is of and the reliability applicants/candi- Well-intentioned checksthird-party is spotty. background history be of their conviction the details recall to unable out of dates may hiring rather than consciousconfusion or misinformation omission. Or, check report background in hand an inaccurate that does have managers may account. not a candidate’s corroborate Many background check companies background produceMany out-of-date or inaccurate criminal history information. When selecting a screening firm, ask about of the firm. their process the reliability reliability of Some indicators verify to include policies the FCRA. with comply that demonstrably When generating reports, screening reliable the court firms use from records of a candidate’s of residencecounty or state and not database searches A firm should alone. use pieces at least of birth—to two generate a of information—name and date and report an organization such match from Accreditation record. a positive Associationas the National of Professional Background also Screeners be may of reliability. a helpful indicator E. A Step-by-Step Guide to Hiring People with Hiring Arrest to People Guide or E. A Step-by-Step Conviction Records E. A Step-by-Step Guide to Hiring People with Arrest or Conviction Records

step 6: Send a “pre–adverse action” notice with High Road Employers a copy of the background report and allow the applicant to produce evidence of rehabilitation Employers who provide If the employer decides to deny employment based on the background check meaningful jobs with report, the applicant must also be provided a “pre–adverse action” notice, which provides the applicant an opportunity to review the report and challenge the living wages and accuracy of the information. The pre–adverse action notice should include a favorable benefits copy of the background check, a summary of the candidate’s rights under FCRA, and a reasonable timeline within which a candidate should respond.51

As required by many “ban the box” laws and consistent with the EEOC’s criminal background check guidelines, employers should also notify the applicant of the EQUALS specific offense that is considered disqualifying and provide an opportunity to Higher retention + High present evidence of rehabilitation before making a final hiring decision. productivity In addition, the EEOC urges employers to consider the following mitigating evidence as part of an “individualized assessment”:

LEADING TO • The facts or circumstances of the offense; • Evidence of work history; An overall stronger • Rehabilitation efforts such as education and training; and • Employment or character references52 bottom line as companies reduce recruitment costs Some states also issue evidence of rehabilitation (e.g., Illinois’ Certificates of and increase productivity Relief from Disability) that reaffirms a person’s successful rehabilitation. By providing room for mitigating evidence, employers help protect themselves against liability for violations of civil rights laws. step 7: HIRE THE CANDIDATE or formally rescind the offer

After considering the additional information, if you still deem the candidate unfit for the job, notify him or her in writing that you are rescinding the offer and explain the reasons for your decision.

But if you consider the candidate qualified for the job after assessing the miti- gating evidence, hire the applicant.

30 E. A Step-by-Step Guide to Hiring People with Arrest or Conviction Records NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT EMPLOYER | A HEALTHCARE FOUNDATION & SAFER NELP KAISER PERMANENTE’S BACKGROUND CHECK PROCESS

To apply for a position at Kaiser Permanente, the individual creates an account online that includes his or her profile, qualifications, and skills. When a partic- ular position of interest to the individual is posted, he or she provides a “submis- sion of interest” for the position. In 2014, Kaiser Permanente ended the practice of requesting criminal history information from the applicant as part of the “submis- sion of interest” process. The criminal background check does not take place until Kaiser Permanente has extended a conditional offer of employment to the individual.

Consistent with the requirements of the consumer laws regulating employers and background check companies, Kaiser Permanente provides the individual with a consent form to sign because the criminal background check is initiated by an outside vendor. The form also describes the individual’s right to receive a copy of the criminal history report and the other requirements of the consumer laws. Consistent with the California law that regulates background checks prepared by private compa- nies for employers, Kaiser Permanente limits the background check to convictions that occurred within the past seven years and does not include arrests that did not lead to conviction (pending cases are included), infractions, or cases that have been dismissed. Background checks required by state law for licensing or certification are conducted by the State of California Department of Justice.

Because Kaiser Permanente is a recipient of federal funding, it must also check the Fraud and Abuse Control Information System (FACIS) to determine if care providers are prohibited from receiving federal funds because of sanctions or disci- pline imposed by a government body. Importantly, Kaiser Permanente recruiters review the background check report provided by the vendor—it is not reviewed by the hiring managers. Kaiser Permanente does not apply a specific “matrix” of disqualifying offenses as part of the screening process, and instead it evaluates each applicant’s information individually and takes into account the job functions of the specific position. Kaiser Permanente seeks to screen out individuals with a violent offense or a conviction that would be a risk to its members or patients. Depending on the nature of the position, more minor offenses like drunk or disorderly conduct or driving under the influence (DUI) are often not considered disqualifying, depending upon the circumstances.

If there is a conviction of concern to the recruiter or an open arrest, the recruiter follows a structured process to engage with the individual about the nature of the offense and to solicit other explanatory information. As required by the consumer protection laws, if the offense disqualifies the individual from the position, Kaiser Permanente will issue an “adverse action” letter, allowing the individual to chal- lenge the accuracy of the information.

31 NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 32 Have a few years passed a few years without incident? (The likelihoodHave Will the nature of the job sought,Will the nature such as easy access to How careful and accurate is their process? and accurate careful How pieces of information do they match many What and how they lifetime bars? Are does the law i.e., they mandatoryAre discretionary, or of re-offending declines with time; a significantly person the pastwho has not an offense committed over several else commit a crime than anyone to likely is no more years in the general population.) medications or patient information or direct patient-care responsibilities, a particular allow pastrecur? offenseto before issuing of birth report? a positive and date (Name should be the baseline.) people not hire with a disqualifying that employers require or can hiring managersoffense, discretion? exercise * * * * * * Has the person taken rehabilitative steps since the conviction? stepsHas the person since the conviction? taken rehabilitative Does the nature of an offense have any bearing on the any Doesjob of an offense the nature have long ago how of the job, the nature to is related If the conviction Is the disqualifying offenseto the related directlyposition? particular the statutory position,For hiring bars any to there are Who will have access the record? to Who will have If a consumer reporting the record? agency: Who will provide (For instance, did she obtain an education or gain work experi- did she obtain an education instance, or gain work (For she steps thoseway reflectedence?) And are in the rehabilitative explains her history of arrest or conviction? sought? did the offense occur? people with a certain conviction? If so:people with a certain conviction? policy on the use checks, review consider: of background including a record-based a job on posting, exclusion consider: • • • • • • • extending a conditional offer of employment and receiving the receiving and employment a conditional offer of extending A Hiring Manager’s Key for for Key A Hiring Manager’s with anArrest Hiring or People Conviction Record DURING BEFORE AFTER consider: history, background applicant’s E. A Step-by-Step Guide to Hiring People with Arrest or Conviction Records NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT EMPLOYER | A HEALTHCARE FOUNDATION & SAFER NELP Ernesto Diaz: A Success Story 53

For the past six years, Ernesto Diaz has been a hard-working employee of Royal Ambulance in Northern California. He has filled multiple roles at the company, progressing from an entry-level position to management.

Mr. Diaz’s interest in healthcare began during a low point in his life. As a teenager in Berkeley, California, he became involved with gangs, sold drugs, and got into fights. He cycled in and out of jail, was expelled from high school, and even- tually ended up in juvenile detention for assault with a deadly weapon and battery. While there, he took a first-aid class with a visiting firefighter, and “it sparked an interest in helping people,” he says. Through a program that later evolved into the nationally recognized Alameda County EMS Photo used with permission of Ernesto Diaz Corps,54 Mr. Diaz was able to begin first responder training while incarcerated, and later obtained his EMT certification after his release. He soon began working at Royal Ambulance, and that’s when “something clicked,” he says. “Friends around me continued to go to jail. But I was so fed up with it. I felt proud of myself—I had a job and responsi- bility... I needed to put that other stuff behind me.”

Mr. Diaz began as an intern; at only 18, he didn’t yet satisfy Royal’s age require- ment for EMTs. Instead, he worked with the billing and operations departments and was soon hired as a biller. Desiring more responsibility, he later transitioned into the marketing department, where he quickly proved himself as a successful account manager. The company promoted Mr. Diaz to his current position as regional manager. He trains and supervises account managers and teaches classes to employees at skilled nursing facilities on topics such as administering CPR and recognizing the signs of a stroke. One of his favorite aspects of the job is client inter- action—transporting patients to medical appointments and checking in on how they’re doing.

Still only in his 20s, Mr. Diaz aspires to climb even higher: “My biggest goal is to get back into school.” He has his sights on a college diploma.

33 “ We have a philosophy that Johns Hopkins is ‘of the community’ of Baltimore. We need to do something about creating opportunities. This community has disproportionately high rates of unemployment, dysfunctional families, crime, abandoned homes, etc. It is in our best interest to take constructive steps to introduce the people of East Baltimore into the workforce.”

RONALD R. PETERSON President of Johns Hopkins Hospital & Health System

34 NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 35 - 56

Johns Hopkins launched an initiative to hire those hire to in the Hopkins launched an initiative Johns 55 An Employer Model for Hiring for Model Employer An

numbers to prove it.” numbers prove to SPOTLIGHT: CHAMPION OF CHANGE OF CHAMPION SPOTLIGHT: was honored as a 2014 White House Champion of Paulk Pamela Change for leading the Johns Hopkins initiative to hire people with arrest or conviction records while serving as senior vice president of human resources. She was appointed president of Johns Hopkins Medicine International in January 2015. These are good, loyal, solid workers. And I have the These solid good, And I have are workers. loyal, “First and foremost, this is a good business decision. Baltimore community with records after recognizingBaltimore after the hospital with records community had a need to fill entry-level, higher-turnover positions.reliable employees find stable, to its this population, missionBy hiring from to hospital the advanced system The program has been recognized widely as abetter serve the local community. national leader the hiring of people in promoting with records. care system with more than 40,000 employees. As employees. the second-largest employer than 40,000 with more system care applicants per and hires month 1,800 12,000 to in Maryland, it attracts 9,000 people per year. 1. Johns Hopkins Hospital & Health & Health Hospital Hopkins 1. Johns System: Hopkins Hospital Johns and Health the leadership under System, President of Peterson and SeniorRonald Director of Central Services Recruitment Michele successfully hiring model is the premier employer of a healthcare Sedney, entry-levelpeopleand middle-skill the community into from with records positions. acclaimed hospital and nationally and health is a worldwide Hopkins Johns

F. Chart Territory New F. Records with People Hiring for Practices Employer Model NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 36

that of 3-6 YEARS . THOROUGH after 40 months. individuals were still employed and still employed individuals were

are ruled out based on conviction conviction on based out ruled are 73 25% . of each year’s total hires have had a record, and a record, had have hires total year’s each of 57 RETENTION OUTMATCHED RATE 5% are hired; hired; are are ruled out for other reasons. other for out ruled are With or without a record, not all people are well suited suited well are people all not With a record, without or attributes Hopkins Johns healthcare. in a career for to success its of program’s much SCREENING 25% 50% was involuntarily terminated. involuntarily was

of their candidates have their background checked after offer an checked background their have candidates their of OF ENTRY-LEVEL HIRES HAVE HAD A RECORD HIRES HAVE OF ENTRY-LEVEL ONE ONE

20% background; background; a decade, over For is extended: 100% What about those with higher-level offenses? Johns Hopkins conducted conducted Hopkins Johns offenses? with higher-level those What about for records serious with more employees 79 of a study after their hiring date. only only At the end of the study period period study the of end the At CAREFUL SCREENING CAREFUL NO PROBLEMATIC TERMINATIONS PROBLEMATIC NO EMPLOYEES WITHOUT RECORDS WITHOUT EMPLOYEES A 2009 study at John Hopkins of about 500 hires of people with people of hires 500 about of Hopkins John at study A 2009 their showed records BETTER RETENTION What do the numbers show? the numbers What do F. ChartF. New Territory NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 37 l ment ons in IT echnician,

Job and dutiesJob and number of convictions nature, Time, Circumstances between convictions and relationship hire and decisionTime between to conviction the applicant by at rehabilitation Attempts of rehabilitation judge the extent to before and after Employment Age at time of the conviction Whether applicant disclosed information security to and safety of Impact and relevance of conviction patients, and visitors employees, COMMON POSITIONS: POSITIONS: COMMON While many people with records at Johns Hopkins are hired into entry-leve positions, food such as service environmental technician, services t and clerical positions, some are placed in middle- or high-skill positi and clinical roles. Johns Hopkins staff also have access career to develop opportunities additional certification for funding and and training. • • • • • • • • • of arrests convictions) or check is conducted the background offer, the conditional After investigator/screener If an applicant is hired, his or her background file is kept confidential his or her background If an applicant is hired, notified HR, and the manager is only by if necessary. When needed, transition a coach is assigned support to an applicant’s When assessing the relevance of an applicant’s background, Johns Hopkins Johns background, When assessing of an applicant’s the relevance factors:considers the following 1. Typical application and interview process (no questions about history 2. If selected, a conditional offer is made 3. the human resources by reviewed checkResults are of background 4. HOW DOESHOW JOHNS HOPKINS DIFFICULT? DO IT? IS IT process. application a regular like much it’s No, 5. 6. F. ChartF. New Territory NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 38 from formerly formerly from 58 From left to right: Beth Hribar, CHP Program Director; Emily Gertz, Director of Special Projects; Debra Barnes, CHP Peer; Iris Bowen, CHP Coordinator; Edwin Lopez, CHP Peer; Mary Research Nyamu, Director; Sylviah Clinical CHP Johnson, Home Coming the of permission with used Assistant. Photo Program. ongoing training from incarceration through reentry through incarceration from An Employer Model for Hiring Hiring for Model Employer An continuity of care targeted counseling and supportive servicestargeted counseling and supportive Identify and collaborate with reputable localIdentify and collaborate with reputable intermediaries build the pre-hire help referrers to curriculum for referrals; specificmeet needs your support security from for program Receive staff Screen closely internships Provide Utilizejob coaches employment into for transition top-downHave leadership support • • • • • • and beyond incarcerated staff incarcerated Provide Provide Offer with formerly work effectively to able all clinic staff are Ensure peopleincarcerated through JOHNS HOPKINS’ TOP FACTORS LEADING TO SUCCESS TO LEADING FACTORS TOP HOPKINS’ JOHNS • • • 2. Mount Sinai Health System, Institute Institute System, Sinai Health 2. Mount for Advanced Medicine, Coming Home Program: Community Health Workers The Mount Sinai Health Institute System, Coming Home Medicine’s for Advanced City. York Program is located in New inception in 2006, Since the program’s patients it has served than 3,000 more prison home from and jail and returning nine formerly has successfully employed staff members.incarcerated The Coming (CHP) oper- Home Program ates out of a hospital-based clinic (part of of hospital and commu- network a six-site nity clinics than 13,000 caring for more HIV/AIDS). for patients with or at-risk the physical improve missionCHP’s is to and mental health and emotional and social of people well-being with a history during their transition of incarceration prison their communities.from or jail to objectivesThe threefold to: are F. ChartF. New Territory NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 39 SAMPLE COMING HOME PROGRAM JOB POSTING JOB PROGRAM HOME COMING SAMPLE Community Health Advocate Medicine a Community (IAM) is recruiting for Advanced The Institute Health (CHA). The CHA will supportAdvocate patients who are of the Institute engagement and other in healthcare promote social to incarcerated formerly services prison/jail the community. from during the transition to Coming (CHP) Home Program in the Institute’s key role a The CHAs play will health social and the mental and physical and improve to which strives emotional of people well-being with a history providing by of incarceration counseling, offering supportive care, linkage to and implementing staff knowledgeable are about all IAM employees that ensure the expe-training to rience of incarceration. The CHA will perform a number tasks including: visiting patients of at their meeting with patients in the IAM, accompanying home or in the community, medicalpatients other and to appointments, supportive coun- providing seling, educating patients about disease chronic management, conducting collaboratingoutreach, and tracking all activities. team, the healthcare with with at least will beThe ideal incarcerated candidate years three formerly of professional should be The candidate experience. change, adaptable to Candidates should also and diplomatic. solve, problem able to mature, good skills and a communication verbal time management, excellent have sensestrong boundaries. of appropriate The position requires organizational and the capacity to learn a desire and grown, to literacy, skills, computer of people group and with a diverse providers including healthcare well work administrators. experienceThe shared between the Community and the Health Advocate a direct this role; and personalpatient is critical to understanding of incarcer- the challenges to ation and sensitivity of reentry A willingness required. are discloseto personal your experience with staff and patients of incarceration is also required. F. ChartF. New Territory NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 40

the lynchpin Advice from Emily Emily from Advice INDIVIDUAL STAFF EXPERIENCES STAFF INDIVIDUAL Depending some experience, need on their incarceration staff members may supportmore address and training to the impact has had on them. incarceration Implementing a program within a hospital takes time. But as long as you a hospital within Implementing a program But as long as you takes time. and build can grow the program champions leading the initiative, have momentum. IDENTIFY SAME IN THE WAY STAFF ALL NOT formerly or who are records arrest or conviction be staff who have may There if their job does self-identify to and do not want incarcerated not require disclosure of their justice involvement. WHAT TO KEEP IN MIND WHEN YOU’RE TRYING TO START A A START TO KEEP TRYING TO IN MIND WHEN YOU’RE WHAT ORGANIZATION?: PROGRAM YOUR WITHIN Gertz, for Advanced Director Projects Institute for the Special of Medicine IS KEY PATIENCE HOW DOES SINAI’SHOW MOUNT COMING HOME PROGRAMRECRUIT STAFF? INCARCERATED FORMERLY RETAIN AND which emphasizes Hopkins, Johns Unlike confidentiality and keeps all crim- filesresourcesinal background within the human department, of the Coming is staff Home Program about transparency their criminal justice history effec- more to and use of incarceration background of their serve patients. tively of intermediaries and relies the program for referrals a network on However, processthe vetting staffhistories. without criminal identical to is nearly All potential hires the corporate go human resources through process. The notified applicants is that are in approach major that they will difference be expected history their incarceration share with other to staff memberswell as as patients. F. ChartF. New Territory NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 41 60 As safety net hospital, a non-profit, 59 3. Roseland Community Hospital: Hospital: Community Roseland 3. Pathways Career Healthcare for Hiring Roseland Community has served Hospital (“RCH”) the residents of Chicago’s far South85 than for more Side years. Roseland been has long serving dedicated to the fullest the community to the hospital leadership recognized however, possible. extent More recently, opportunities an that providing was records with conviction for workers says important part of that mission. “People make mistakes. Things happen,” turn “If people to want human resources Clark,Paulette manager. Roseland’s coming After do that.” like to then we’d can help, we and around their lives of the hospital CEO, obtained the HR team that realization, to the approval them with top-downwhich provided support for hiring those with records. Roseland as part workers decided of a hire with Safer Foundation, to Working posi- start The employees program. in lower-level pathway career healthcare patient- into advance Roseland, training from and eventually tions, receive positions. helpedcare find qualified Safer Foundation applicants, and the HR looking for indications resumesteam examined applicants’ the holistically, their pasts behind them. The managers making efforts who to leave they were interviewed the applicants, of the new employees oversee the work would the applicants and, when the results of those interviews came back favorably, offered Roselandpositions.well, and were Things hopesgoing are to continue As program. Clark seeshiring people it, “People as a part of this pathway them opportunities.” open giving to deserve a second We’re chance. F. ChartF. New Territory NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 42

Increase diversity of workforce of diversity Increase quality to access Increase talent shortage frontline of Overcome and middle-skill workers service deliveryImprove and health outcomes Maintain high standards skill of among frontline and middle- up freeing staff,skill thereby work their own for physicians providing by retention Increase opportunity career for entry-level from advancement positions costs recruiting Decrease with working by community intermediaries GOALS Lack of diversity in in diversity of Lack pool talent your Low quality staff Shortage frontline of and middle-skill workers Difficulties ensuring care patient quality productivity Reduced in a rise and costs associated among turnover High workers frontline of cost High new recruiting employees CONCERNS CAREER PATHWAYS HELP EMPLOYERS HELP PATHWAYS CAREER for people pathways in career benefit investing from employers Healthcare entry-level positions. into hired develop- are who with records This workforce ment strategy is essential costs reducing and to patient care while improving vacanciespositions. in higher-level filling TALENT OWN YOUR GROW & LINE BOTTOM STRENGTHEN YOUR WORKERS ENTRY-LEVEL FROM OVERCOME STAFFING CHALLENGES STAFFING OVERCOME F. ChartF. New Territory “Criminal justice reform efforts are sweeping across the nation; from the halls of Congress in Washington, D.C. to Safer Foundation’s home state Illinois and beyond. As our nation faces the reality that mass incarceration has been a failure, we are now moving to reduce the number of people in our jails and prisons. The next big issue we face is how we will integrate those coming out of our jails and prisons into our communities in a productive way. Opening career opportunities in industries with explosive growth must be one of the key success factors for successful reentry.”

VICTOR DICKSON President & CEO, Safer Foundation NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 44 . at reduced costsat reduced

for developing and building lasting, for developing successful, and

Seven Tips Seven cross the nation, key factors in healthcare have converged to create a create to converged cross the nation, key factors have in healthcare skilled positions picture that has many goingworkforce unfilled, while at the same time, thousands of working-age people thousands of working-age the same should be time, with records gain- but cannot find jobs. employed fully old or minor offenses,While most million people of the 70 have a record with interactions recent with the criminal justice more system. In have some may partnersuch cases, has a promising in development the need for workforce develop- with reentryPaired workforce programs, prison “reentry” policy. ment for people serves with records skill short- goal the dual of overcoming ages community health outcomes. and improving Local community-based intermediary groups connect the surging employer needsdemand with the employment of this target population. These partners assist businesses in finding qualified candidates tip #1: Conduct preliminary research of preliminary of research Conduct #1: tip that are region in your players the key were who with people working successfully an arrest or have or incarcerated formerly conviction record. with people with records. exclusively notSome work intermediaries may partners, they can serve especially as valuable if they focus on However, opportuni- training and employment and providing development workforce ties. sourcing partners The preferred community organizations reputable are Creating through Value Intermediaries Below are mutually beneficialrelationshipsmutually local with partners.sourcing A

G. LeverageG. Community Intermediaries Talent Diverse Develop and Source to Partnerships Build to How NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 45 - You may find out there is one community find out there may You intermediary in educa- that can assist you tion, job-readiness training, and employ- for people exclusively ment referrals perhaps Or with records. is a group there that focuses on soft-skills training for offering a seamlesshealthcare, and effi- that in healthcare pathway cient career includes education, training, and employ ment services. #3: Develop points of contact and build and build contact of points Develop #3: #2: Reach out to the identified the identified to out Reach #2: These partnerships intermediaries become critical in allowing to are familiar specific organization and understand hiring needs. your with your Develop communication strategies competency around needs, demand planning, and shared goals. analysis, talent-flow tip relationships. that work with people job and for vocational that work readiness with records training services, related and employment ongoing while also support providing for candidates. referred tip and begin to the conversation intermediaries offer. to have they what see The closer the collaboration in intermediaries among community working the pipeline talent, the better of healthcare build and diversify tandem to connect organization—so to the results these for your seek groups. For ways is an intermediary if there focusingexample, on training and employment opportunities for people focusing and another group with records on training a three- try develop to populations career pathways, in key healthcare at-risk and workforce trainer, healthcare fold collaboration the employer, where closelyintermediary working development together. are G. Leverage Community Intermediaries Leverage G. NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 46 #5: Share open positions with positions open Share #5: #4: Provide your contacts with a pre-hire with a pre-hire contacts your Provide #4: Tip #7: Track & evaluate referred candidates. referred & evaluate Track #7: Tip Collecting will help you with records employees certain your data regarding make informed decisions about strategies. recruitment future Moreover, Tip #6: Keep an open line of communication. of line an open Keep #6: Tip Communication and feedback is the assuring that intermediarieskey to the training and skills for the provide need. Betalent you are honest if you noticing missing competencies among candidates. Intermediariesreferred need their candi- this feedback improve to screening,date support, and training processes. intermediaries your Give feedbackregular quality on referral calls (we email or conference through suggest bi-weekly). tip intermediaries. contacts upon agree to with your a notification process for suitable Work obtainopen and assess to a system positions. should develop In addition, you intermediaries. Ask your your organization through candidates sent your to contacts whether job descriptions needed. are tip existing and future your meet curriculum to organization’s your achieve and to needs objectives. intermediary and certifications; credentials of required Inform your educa- training and experience; required or preferred tional requirements; any and other necessary skills, desiredbehavior, employee certificateswaivers; or requirements. reference qualities; any and G. Leverage Community Intermediaries Leverage G. NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 47 From Left to Right: Pamela Paulk, former VP of Human Resources, Victor Dickson, System; Healthcare & Hospital Hopkins Johns Davis, 7th Danny Congressman Foundation; Safer CEO, & President District, IL; Melody Young, LPN Helping candidates apply for an Illinois healthcare worker waiver worker for an Illinois healthcare Helping candidates apply Developing relationships employers with healthcare trainings on hiring people develop with records Helping employers Identifying qualified candidates with an interest in healthcare trainersreputable healthcare with qualified, Finding and working organizations and referral • • • • • CHALLENGES IN ASSISTING HEALTHCARE EMPLOYER PARTNERS: PARTNERS: EMPLOYER HEALTHCARE ASSISTING IN CHALLENGES Opportunities in Chicago involved executives healthcare together 30 high-level The 2015 forum brought a firstin hiring decisions. in facilitating increased It was step hiring of people healthcare in the Chicago Ten area. employers healthcare by with records organizations, including a major hospital network, qualified federally health and safetycenters, net hospitals, expressed with Safer interest in working response, the positive increaseto hiring of people Safer Given with records. 2016, Asexpanded challenge. take on this critical its of July programming to for retained people ten Safer has referred of whom were with records—nine qualified federally health a major centers, hospital than 90 days—in more network, and local community hospitals. The positions include: house- keeping, CNA, CMA, counsellor. treatment transporter, Venture: Paving the Way to Healthcare Healthcare to the Way Paving Venture: 43 Safer Foundation over years, For has helped people arrest with become records or conviction members productive of employed, observing After the growth society. Safer industry, of the healthcare announced the Safer Demand Skills Collaborative—at its 2015 forum, co-sponsoredhealthcare Congressman Davis. by Danny the DemandThrough Skills public Safer develops Collaborative, partnerships among and private trainers, and industryemployers, experts demand skills create to living-wage training that leads to careers for candidates in high-need communities. A Close Look at One Intermediary’s Intermediary’s One at Look A Close G. Leverage Community Intermediaries Leverage G. NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 48 Their focus on primary emphasizes care 61 Retention and turnover rates turnover and Retention termina- “problematic” and terminations of involuntary Number an incident) those involving tions (i.e., satisfaction Employee Cost savings productivity and job performanceEmployee candidates of Number internships placed and the number into of those permanent into hired positions interns entry-level, of placements middle-skill, into Breakdown and more positions ; advanced higher-skill to advance that with records employees of Number positions; • • • • • • • • FILL FRONTLINE AND MIDDLE-SKILL JOBS THROUGH LOCAL AND LOCAL MIDDLE-SKILL JOBS THROUGH FRONTLINE FILL RECRUITMENT Health that help meet centers the needs of underserved communities have to Act. Care the Affordable According through stimulus payments received Department of Health and Human Services,the U.S. health centers serve one in seven people in poverty. living patient education, and self-care care, coaching. The task of patient preventive Preparing to Meet Future Needs: Future Needs: Meet Preparing to Best Practices for Development Workforce Employers some Anticipating changes the sector, to trainers, providers, and servicehealthcare developed strategies have providers partnerships,that leverage path- career service improve and coaching to ways, and community health outcomes. Their management strategiestalent-pipeline networked advancement, combine career of job-readyrecruitment and workers, customized educationemployer-driven some are of and training. The following busi- can help your you ways the proven the commu- within ness and thrive grow serve. nity you sharing tangible successessharing tangible your organi- throughout build confidence will help get started,zation about identify and commit hiring people To with records. tracking key successto measures such as the following: G. Leverage Community Intermediaries Leverage G. NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 49 al evel- pital ). With). intervention and outreach to 62 : The Baltimore Alliance Careers for in Healthcare is a (BACH) community-based organizations in distressed neighborhood, d BACH oped the a network to lay local groundwork for healthcare training. IMPLEMENT EMPLOYER-LED TRAINING PROGRAMS TRAINING EMPLOYER-LED IMPLEMENT all post-secondaryNot designed are training programs meet employers’ to job-readyneeds who are for workers upon of critical graduation and capable also need non-clinical may you thinking and multitasking. As an employer, not be which may skills, such as knowledge in health information technology, partnerships accessiblea readily Three-way credential. between employers, colleges,and community-based intermediaries can address this misalign- the right talent pipeline creating demand by and ment between for supply demands. workforce your Partnerships whose members aligned in their expectations, are methods, resources marshal and mission effectively to train for careerjob placement, progression, quality service and provision. education is increasingly being delegated to frontline workers who enjoy beingeducation workers is increasingly frontline delegated to significant direct patient interaction. positions in frontline hinders high turnover the primary goal of However, skill, and experience erodingknowledge, the by healthcare levels preventive neededin these health positions outcomes. in turn, This, enable improved to of clinicians and reduces their productivity. the work adds to patient interaction,and primary goals, can meet improve care your You partnerships leveraging by increase local for retention Several recruitment. a long history of servingintermediaries have distressed communities. In addi- the servicestion to the knowledge these intermediaries they provide, have neededand credibility a locally based create to talent pipeline. Example consortium development workforce that serves a dual customer train- of role ing frontline healthcare high-growth, for workers high-shortage hos jobs and creating a talent pipeline at all entry-level positions through loc partnerships. In an effort overcome to shortagethe of frontline staff,BACH undertook a gap analysis to determine local demand and characteris- supply tics. They that found local recruitment and training would be an important tool in meeting staffing demandsand addressing high local unemployment percent city(43 of residents ages the of out and and were workforce 16 31 over percent lacked a high school diploma G. Leverage Community Intermediaries Leverage G. NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 50 g des, nd nd g or g or Some employer members of BACH have developed career members have BACH of Some employer path- : The Allied Health Care Career (AHCCN) Network in Chicago is ways to recruit and train entry-level incumbent frontline for employees job vacancies. In so doing, the cost employing of can new workers be reduced if incumbent undertaking employees career advancement choose to hold their job while they train and with employers the capacity are to provide able necessary support. The supportscan covering include the cost trainin of logistics assuch transportation until an incumbent is trained employee a qualified a for frontline to apply job. TAILOR TRAININGS TO THE EMPLOYEE THE TO TRAININGS TAILOR Community-based intermediaries equipped comprehensive are provide to wrap-around support services new recruits and trainees to in need of extra services. their knowledge and referral development, Coupled with workforce a stable pipeline can create that meetsnetwork demands both workforce the and training needs As of employees. partners,of employers they can help you expendituresreduce on screening and those and recruitment resulting from high turnover. Example: Example comprised seven diverse of training partners. Each the of partners provides a different service as parta of rangewide of training—from language and basic educationremediation, to training lower-skill for jobs like health home ai to professional training and credentialing middle- for to high-skill nursin positions. Partners in the process are in the AHCCN soft-skillsof implementing a training that uses self-sufficiency psychological to build a talent pipeline that possesses not but also technical only career skills crit- ical for on-the-job success. Agreements membersamong network consist of goalsshared and practices. Mutual through accountability is enforced memoranda of understanding that define conditions of participation. The network’s policy annually. governance is reviewed G. Leverage Community Intermediaries Leverage G. NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 51

Assesses, plans, STEP #4 AA – BS Nurse Registered (RN) Duties: implements, and evalu- ates of nursing care admissionpatients from discharge. through Other Requirements: RN license; some Valid clin- related previous be ical experience may required.

63 Obtains accurate Obtains accurate Under the direct Under MAPS: Medical Assistant Duties: patient information and creates office a positive respondingimage by all professionally to and other patients, staff, customers. Other Requirements: of medical One year office experience; basic experience. computer STEP #3 – AAHS/GED Licensed Practical Nurse Duties: supervision of an RN, provides direct patient an assigned for care group of patients. Other Requirements: Graduation from practical approved nursing education license. program; current Under the direct Under Under the direc- Under NAVIGATING CAREER NAVIGATING technician), includesEach position a category administrative, (patient care, education, and salary experience, series right. Generally, of steps left to from is there step, Within a given right across the to the map. move increase as you sometimes an increase experience in the required and education/training as you of the page. the bottom the top from to move Nursing Assistant Nursing Duties: supervision RN, of an performs delegated functionspatient care of nature. an uncomplicated Other Requirements: assistantNursing certifi- cation in some states. STEP #2 HS/GED Extender Nurse Duties: provides a tion of an RN, of environmental, variety nutritional, clinical support,transporta- and tion services and activi- patient ties promote to comfort and satisfaction. Other Requirements: Certified nursing assistant license in some required states; six months of acute experience;care training that teaches the following skills: IV starts, EKGs, blood catheters, Foley therapy, drawing, oxygen NG tubes, suctioning, drain managements, and care. wound CAREER MAP FOR PATIENT CARE POSITIONS CARE PATIENT CAREER FOR MAP Performs a variety Performs a variety Transports and Prepares HS = high school GED = high school equivalency AA = associate degree (2 yrs.) yrs.) BS = bachelor’s degree (4 KEY Duties: of cleaning functions. Environmental Environmental Services Assistant Food ServiceFood Assistant Duties: patients, equipment, and supplies. serves food patients, to and visitors. staff, Transporter Duties: STEP #1 GRADE8TH – HS/GED G. Leverage Community Intermediaries Leverage G. EXAMPLE OF CAREER PATHWAY: Content used with permission of the Baltimore Alliance for Careers in Healthcare. NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 52 ee e. By ized d bridging 65 As a result, training 64 Entry-level workers at MEDSTAR Good Samaritan Hospital Good Samaritan MEDSTAR at workers Entry-level development. career their in next step the take (Baltimore) Graduating cohort of CNAs. Photo used with permission of BACH. The AHCCN strives to accommodate in adult workers career various roles throughout your organization that entails comparing and your roles throughout various better to identify paths of requirements connecting competency/skill advancement. employee defined by the U.S. Department“a part of of a Laborsequence of as by the defined build up an individu- time to credentials that can be over accumulated or up pathway along a career to move qualifications and help them al’s jobs.” and higher-paying different potentially ladder to a career 2. Utilizing competency-based of mapping—an evaluation career FORGE CAREER PATHWAYS Demand for post-secondary education in the meet minimum qualifying to order In sectorhealthcare continues grow. to high-skill for mid- to standards positions, an applicants must at least have of Medicine the Institute recom- associate or bachelor’s In 2010, degree. 80 percent of nurses a Bachelor hold of Science 2020, mended that by degree. positions either being ladder are along the career eliminated Simultaneously, creep”). increasedor their qualifications are (“credential Example: training. The network includes partnersthat utilize contextualize in basic education individuals for testing 8th below grade. Contextual bridging combines remedial training with basic job-specific knowledg making training job-relevant basic and for education, even train employer needs are simultaneously addressed. the opportunity Reducing cost of career is crucial to training and advancement engaged an and traineddeveloping work- adults records, with low-income For force. quitting a job advancement for a career opportunity can be straining. Trainers partnerwith the AHCCN also develop college-approved that is curriculum condensed and scheduled relatively to adults allowing accommodate working hold their jobs,them to support their families pursue simltaneously and career opportunities.advancement costs can increase dramatically, reducing both accessibility and economic costs can increase dramatically, the talent pipeline dry. mobility and leaving ladder are: in the career steps restore to ways Two 1. credentials”— “stackable Optimizing attainment through credential G. Leverage Community Intermediaries Leverage G. NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 53 or- ta- Some employers involved with involved assignSome employers BACH coaches to their AHCCN also provides a transition coordinator imple- helps who Effective career pathways allow for stackable, industry-recognized for stackable, allow creden- pathways career Effective tials; multiple entry training. and exit points;work-based flexible options; and identifying and strategizing by Partnerships pathways implement career can periodic and long- emerging occupations short- dynamic, around through laborterm market analyses connecting and by jobs different to develop pathways. multiple career MENTORSHIP PROVIDE pays training eventually Although training can beHealthcare time intensive. skilled in highly jobs, employment off through these jobs require an often associate or bachelor’s Necessary degree. training steps high- leading up to Mentorship is key skill opportunities paying. shorter and lower typically are keepingto traineesengaged all stages throughout of their training. Mentors realistic expectations providing by can gain trainee buy-in about training with short-term of work intervals alternate timelines to suggesting and ways increases both skill and pathways career onto training. Helping employees workforce. within your retention Example: incumbent worker-trainees. Coaches providebasic career guidance and co dinate between and the theemployer trainee, checking in frequently during training and bringing specificchallenges such as financialand transpor tion challenges attention. to the employer’s Example: trainingsment that lead to career pathways and job a placement. merely not In addition to identifying needs client and making referrals, transition coordinators interest gauge worker match and those competency, interests and skills with demands, employer and advise both process on and timeline. Transition coordinators also to a year job clients up retention. monitor for for G. Leverage Community Intermediaries Leverage G. “As a country, we have to make sure that those who take responsibility for their mistakes are able to transition back to their communities. It’s the right thing to do. It’s the smart thing to do.”

BARACK OBAMA President of the United States66 NELP & SAFER FOUNDATION | A HEALTHCARE EMPLOYER TOOLKIT 55 , you can help improve can help improve , you

potential of the 70 million Americans with records with records Americans million the 70 of potential patient care. costs and improving reducing while It’s time to exercise your hiring power to unlock the the unlock to power hiring your exercise to time It’s

» your local economy, increase public safety, and achieve better health and achieve increase safety, public local economy, your neighbors.outcomes for your face intense competition shortage and a significant employers Healthcare of and middle-skillfrontline neglect implement new If employers to workers. and hiring strategies,recruitment the industry chal- will face tremendous lenges workforce. meet to the rising demand for a diverse in Use organization for investing become this toolkit to a champion in your bottom leading line and efforts your while improving with records employees recidivism. reduce to to ready that’s both together to build a skilled workforce work Let’s economic century meet the demands of the 21st ensure and economy opportunity all Americans. for The changing landscape of healthcare signals that it’s time to re-think time to the The changing landscape that it’s signals of healthcare historical perception that hospitals and primary facilities solely care are acute-care institutions. entities Healthcare not do generally re-locate and serveoften as the largest and economic engines. local As employers such, marginalized economically can help elevate institutions” these “anchor underserved in surrounding communities investing by neighborhoods. By community your from hiring people with records

Conclusion Today Impact an Make Appendix A References

1. U.S. Bureau of Labor Statistics, News Release: Employment 19. Mark T. Berg & Beth M. Huebner, Reentry and the Ties that Bind, 28 Projections—2014-24 (Dec. 8, 2015), http://www.bls.gov/news.release/pdf/ Justice Quarterly 382 (2011), http://www.tandfonline.com/doi/abs/10.108 ecopro.pdf. 0/07418825.2010.498383?journalCode=rjqy20#preview. 2. NELP, Research Supports Fair-Chance Policies (June 2016), http://www. 20. Cherrie Bucknor & Alan Barber, Ctr. for Econ. & Pol’y Research, The Price nelp.org/publication/research-supports-fair-chance-policies. We Pay: Economic Costs of Barriers to Employment for Former Prisoners and People Convicted of Felonies (2016), http://cepr.net/publications/ 3. Such healthcare waivers are specific to Illinois. reports/the-price-we-pay-economic-costs-of-barriers-to-employment- 4. Also called an “LVN” degree in some states. for-former-prisoners-and-people-convicted-of-felonies.

5. NELP, Research Supports Fair-Chance Policies (June 2016), http://www. 21. Susan Gauvey & Tom Webb, A New Look at Job Applicants with Criminal nelp.org/publication/research-supports-fair-chance-policies. Records, Soc’y for Human Res. Mgmt. (Oct. 22 2013), https://www.shrm. org/legalissues/federalresources/pages/applicants-criminal-records. 6. FBI, Crime in the United States 2014: Table 29—Estimated Number aspx. of Arrests (2015), https://www.fbi.gov/about-us/cjis/ucr/crime-in- the-u.s/2014/crime-in-the-u.s.-2014/tables/table-29 (percentage 22. Pamela Paulk, V.P. of Human Resources, Johns Hopkins Hosp. & Health calculated using data from Table 29). Sys., presentation for NELP & Cmty. Legal Servs. of Phila. webinar, titled “Understanding the EEOC’s New Criminal Records Guidance” (May 30, 7. The Sentencing Project, Incarcerated Women and Girls 1 (2015), http:// 2012), available at https://www.youtube.com/watch?v=7QnMW2glErk. www.sentencingproject.org/wp-content/uploads/2016/02/Incarcerated- Women-and-Girls.pdf. The increase of incarcerated women outpaced 23. Jordan Yadoo, Ex-Cons May Outperform You in the Workplace, that of men by over 50%. Id. Bloomberg Markets (May 5, 2016), http://www.bloomberg.com/news/ articles/2016-05-05/ex-cons-may-outperform-you-in-the-workplace 8. Binyamin Appelbaum, Out of Trouble, but Criminal Records Keep (citing the research of Devah Pager). Men Out of Work, N.Y. Times (Feb. 28, 2015), http://www.nytimes. com/2015/03/01/business/out-of-trouble-but-criminal-records-keep- 24. Pamela Paulk, V.P. of Human Resources, Johns Hopkins Hosp. & Health men-out-of-work.html (citing Kaiser Family Found./N.Y. Times/CBS Sys., presentation for NELP & Cmty. Legal Servs. of Phila. webinar, titled News Non-Employed Poll (Dec. 2014), http://kff.org/other/poll-finding/ “Understanding the EEOC’s New Criminal Records Guidance” (May 30, kaiser-family-foundationnew-york-timescbs-news-non-employed-poll). 2012), available at https://www.youtube.com/watch?v=7QnMW2glErk.

9. EEOC, Enforcement Guidance on the Consideration of Arrest and 25. Alfred Blumstein & Kiminori Nakamura, Potential of Redemption in Conviction Records in Employment Decisions Under Title VII of the Civil Criminal Background Checks 23-24 (Sept. 2010), https://www.ncjrs.gov/ Rights Act of 1964, as amended, 42 U.S.C. § 2000e et seq. (Apr. 25, 2012), pdffiles1/nij/grants/232358.pdf. http://www.eeoc.gov/laws/guidance/upload/arrest_conviction.pdf. 26. EEOC, Enforcement Guidance on the Consideration of Arrest and 10. Nancy G. La Vigne, et al., Urban Inst. Justice Policy Ctr., Women Conviction Records in Employment Decisions Under Title VII of the Civil on the Outside: Understanding the Experiences of Female Prisoners Rights Act of 1964, as amended, 42 U.S.C. § 2000e et seq. (Apr. 25, 2012), Returning to Houston, Texas (June 2009), http://www.urban. http://www.eeoc.gov/laws/guidance/upload/arrest_conviction.pdf. org/research/publication/women-outside-understanding- 27. Rhonda Bryant, et al., Ctr. for Law & Soc. Pol’y, Investing in Boys and experiences-female-prisoners-returning-houston-texas/view/ Young Men of Color 14 (Feb. 2013), http://www.rwjf.org/en/library/ full_report. research/2013/02/investing-in-boys-and-young-men-of-color.html. 11. Rebecca Vallas, et al., Ctr. for Am. Progress, Removing Barriers 28. NELP, Research Supports Fair-Chance Policies (June 2016), http://www. to Opportunity for Parents with Criminal Records and Their nelp.org/publication/research-supports-fair-chance-policies. Children 1 (2015), https://cdn.americanprogress.org/wp-content/ uploads/2015/12/09060720/CriminalRecords-report2.pdf. 29. Press Release, The White House, Fact Sheet: White House Launches the Fair Chance Business Pledge (Apr. 11, 2016), 12. Soc’y for Human Res. Mgmt., Background Checking—The Use of Criminal https://www.whitehouse.gov/the-press-office/2016/04/11/ Background Checks in Hiring Decisions 2 (2012). fact-sheet-white-house-launches-fair-chance-business-pledge. 13. Madeline Neighly & Maurice Emsellem, NELP, Wanted: Accurate FBI 30. JPMorgan Chase & Co., New Skills at Work Skills Gap Reports, available Background Checks for Employment 8 (2013), http://nelp.org/publication/ at https://www.jpmorganchase.com/corporate/Corporate-Responsibility/ wanted-accurate-fbi-background-checks-for-employment (most recent new-skills-reports.htm. available data on accuracy is from 2006). 31. Vivian Hunt, et al., Diversity Matters 2 (2015), http://www.mckinsey.com/ 14. Michelle Natividad Rodriguez & Beth Avery, NELP, Unlicensed & business-functions/organization/our-insights/why-diversity-matters. Untapped: Removing Barriers to State Occupational Licenses for People with Records 1, 6 (Apr. 2016), http://www.nelp.org/publication/ 32. Jonathan Becher, Diversity Drives Innovation, Forbes (Oct. unlicensed-untapped-removing-barriers-state-occupational-licenses. 10, 2012), http://www.forbes.com/sites/sap/2012/10/10/ diversity-drives-innovation/#552bc35c6f90. 15. Devah Pager, The Mark of a Criminal Record, 108 Am. J. Soc. 937 (2003), http://scholar.harvard.edu/files/pager/files/pager_ajs.pdf. 33. Compdata Surveys, Rising Turnover Rates in Healthcare and How Employers Are Recruiting to Fill Openings, (Sept. 17, 2015), http://www. 16. Econ. League of Greater Phila., Economic Benefits of Employing Formerly compdatasurveys.com/2015/09/17/rising-turnover-rates-in-healthcare- Incarcerated Individuals in Philadelphia (2011), http://economyleague. and-how-employers-are-recruiting-to-fill-openings-2/. org/uploads/files/712279713790016867-economic-benefits-of-employing- formerly-incarcerated-full-report.pdf (based on results of a 2011 study). 34. Heather Boushey & Sarah Jane Glynn, Ctr. for Am. Progress, There Are Significant Business Costs to Replacing Employees 1 (Nov. 2012), https:// 17. Vivian Giang, Why Criminals Might Make Better Employees, cdn.americanprogress.org/wp-content/uploads/2012/11/16084443/ Business Insider (Dec. 4, 2012), http://www.businessinsider. CostofTurnover0815.pdf. com/a-criminal-record-might-increase-productivity-2012-12. 35. Pamela Paulk, Vice President of Human Resources, Johns Hopkins 18. Jordan Yadoo, Ex-Cons May Outperform You in the Workplace, Health System & Hospital, presentation for “Understanding the Bloomberg Markets (May 5, 2016), http://www.bloomberg.com/news/ EEOC’s New Criminal Records Guidance: Education and Enforcement articles/2016-05-05/ex-cons-may-outperform-you-in-the-workplace Opportunities,” Webinar hosted by Community Legal Services of (citing research by Devah Pager). Philadelphia and National Employment Law Project (May 30, 2012).

56 Appendix A References

36. Vivian Giang, Why Criminals Might Make Better Employees, Business Rights Act of 1964, as amended, 42 U.S.C. § 2000e et seq. (Apr. 25, 2012), Insider (Dec. 4, 2012), http://www.businessinsider.com/a-criminal- http://www.eeoc.gov/laws/guidance/upload/arrest_conviction.pdf. record-might-increase-productivity-2012-12. According to the press 53. Telephone Interview with Ernesto Diaz, Regional Manager, Royal accounts, Evolv is still in the process of analyzing the results and Ambulance (May 5, 2016). “exploring what it means for other industries.” 54. Emergency Med. Servs. Corps (EMS Corps), Alameda Cnty. Pub. Health 37. Margaret Schultz Patel, Social IMPACT Research Ctr., Michigan Earn Dept., http://www.acphd.org/ems-corps.aspx (last visited June 22, and Learn: An Impact, Outcome & Implementation Evaluation of a 2016); Patricia Leigh Brown, Opinion, A Chance to Go From Hard Lives Transitional Job and Training Program 70 (May 2015). to Healing, N.Y. Times (Sept. 18, 2014), http://opinionator.blogs.nytimes. 38. Safer Found., Improving Public Safety, Reducing Incarceration Rates com/2014/09/18/a-chance-to-go-from-hard-lives-to-healing/?_r=0. & Costs By Lowering Recidivism in Illinois, (Aug. 2014), http://www. 55. Senate Presidents’ Forum, Employment Opportunities at the Johns saferfoundation.org/files/documents/FINAL-White-Paper---Improving- Hopkins Health System, http://www.senpf.org/johns-hopkins- Public-Safety--Reducing-Incarceration-Rates--Costs-by-Lowering- opportunities.html (last visited May 27, 2016). Recidivism-in-Illinois-8-8-14--2-.pdf. 56. Press Release, Johns Hopkins Medicine, Johns Hopkins Medicine Senior 39. Anne Witmer, et al., Community Health Workers: Integral Members of the Vice President for Human Resources Honored as Champion of Change Health Care Work Force, 85 Am J. of Pub. Health 1055 (1995), http://www. (July 2, 2014), http://www.hopkinsmedicine.org/news/media/releases/ ncbi.nlm.nih.gov/pmc/articles/PMC1615805/pdf/amjph00446-0017.pdf. johns_hopkins_medicine_senior_vice_president. 40. Emily A. Wang, et al., Engaging Individuals Recently Released From 57. Pamela Paulk, V.P. of Human Resources, Johns Hopkins Hosp. & Health Prison Into Primary Care, 102(9) Am. J. of Pub. Health e22 (2012), http:// Sys., “The Johns Hopkins Hospital Success in Hiring Ex-Offenders,” www.ncbi.nlm.nih.gov/pmc/articles/PMC3482056/. presentation at Chicago healthcare forum co-sponsored by 41. John E. Snyder, Dept. of Health & Human Servs., ASPE Issue Brief— Congressman Danny Davis and the Safer Foundation (May 2015). Community Health Workers: Roles and Opportunities in Health Care 58. Emily Gertz, Dir. of Special Projects, Mt. Sinai Inst. of Advanced Med., Delivery System Reform (Jan. 2016), https://aspe.hhs.gov/sites/default/ “Recruiting, Retaining and Integrating Formerly Incarcerated Staff files/pdf/168956/CHWPolicy.pdf. through the Coming Home Program,” presentation at the U.S. Dept. of 42. Who They Are, Frontline Health Workers Coalition, http://www. Health & Human Servs. listening session (March 2016). frontlinehealthworkers.org/frontline-health-workers/who-they-are/ (last 59. Our History, The New Roseland Community Hospital, http://www. visited May 27, 2016). roselandhospital.org/about/ (last visited Apr. 27, 2016). 43. Kavita Patel, et al., Engelberg Ctr. for Health Care Reform at Brookings, 60. Telephone Interview with Paulette Clark, Human Res. Manager, Redesigning the Care Team 6 (March 2014), http://www.brookings.edu/~/ Roseland Cmty. Hosp. (Apr. 13, 2016). media/research/files/papers/2014/03/19-frontline-health-worker-toolkit- aco-patel/final--hitachi-toolkit-32014.pdf (citing BLS data from 2013). 61. U.S. Dept. of Health & Human Servs., What is a Health Center?, http:// www.bphc.hrsa.gov/about/what-is-a-health-center/index.html (last 44. Particular jobs may vary between entry-level, middle-, and high-skill visited June 23, 2016). depending on the education and certifications required by employers in each geographic region. 62. Rebecca Klein-Collins & Rebecca Starr, Advancing in Health and Health Care Careers—Rung by Rung 3 (2007), http://www.jff.org/sites/default/ 45. Karol Mason, Guest Post: Justice Dept. agency to alter its terminology files/publications/RungbyRung.pdf. for released convicts, to ease reentry, Wash. Post (May 4, 2016), https:// www.washingtonpost.com/news/true-crime/wp/2016/05/04/guest-post- 63. Baltimore Alliance for Careers in Healthcare, Career Map: Patient Care justice-dept-to-alter-its-terminology-for-released-convicts-to-ease- Positions, http://www.baltimorealliance.org/career-maps/4589807325 reentry/. (last visited Aug. 30, 2016).

46. NELP, Research Supports Fair-Chance Policies (June 2016), http://www. 64. Randall Wilson, CareerSTAT, Implementing the Patient Protection and nelp.org/publication/research-supports-fair-chance-policies. Affordable Care Act 30 (2014), http://www.jff.org/sites/default/files/ publications/materials/Implementing-The-Affordable-Care-Act_030414. 47. Devah Pager, The Mark of a Criminal Record, 108 Am. J. Soc. 937, 957-60 pdf. (2003), http://scholar.harvard.edu/files/pager/files/pager_ajs.pdf; Devah Pager, et al., Discrimination in a Low-Wage Labor Market, 74 Am. Soc. 65. Evelyn Ganzglass, Ctr. for Law & Soc. Pol’y, Scaling “Stackable Rev. 777, 777-79 (2009), http://scholar.harvard.edu/files/bonikowski/files/ Credentials”: Implications for Implementation and Policy 2 (2014), http:// pager-western-bonikowski-discrimination-in-a-low-wage-labor-market. www.clasp.org/resources-and-publications/files/2014-03-21-Stackable- pdf. Credentials-Paper-FINAL.pdf

48. EmployeeScreenIQ, Employment Screening 2015: Background Screening 66. Barack Obama, “A Nation of Second Chances,” May 5, 2016, https://www. Trends & Practices 14 (2015). whitehouse.gov/blog/2016/05/05/nation-second-chances.

49. NELP, Research Supports Fair-Chance Policies (June 2016), http://www. nelp.org/publication/research-supports-fair-chance-policies.

50. Lawyers’ Comm. for Civil Rights, Nat’l HIRE Network & Nat’l Workrights Inst., Best Practices Standards: The Proper Use of Criminal Records in Hiring 11-12 (2013), http://hirenetwork.org/sites/default/files/Best- Practices-Standards-The-Proper-Use-of-Criminal-Records-in-Hiring. pdf.

51. Cabrini Green Legal Aid & Morgan, Lewis & Bockius LLP, The Role of Criminal Records in Hiring (2015) (presented at a Chicago training session organized by Cabrini Green Legal Aid, Safer Foundation, and Morgan Lewis).

52. EEOC, Enforcement Guidance on the Consideration of Arrest and Conviction Records in Employment Decisions Under Title VII of the Civil

57 57 Appendix B Resources

1. COLLATERAL CONSEQUENCES OF A RECORD New York: https://www.jpmorganchase.com/corporate/ Corporate-Responsibility/document/54841-JPMC-GAP- NELP, A Healthy Balance, Expanding Healthcare Job REP-AW6.pdf. Opportunities for Californians with a Criminal Record San Francisco: https://www.jpmorganchase.com/corpo- While Ensuring Patient Safety and Security rate/Corporate-Responsibility/document/54841-jpmc- http://www.nelp.org/content/uploads/2015/03/Healthy- gap-san-francisco-aw7.pdf Balance-Full-Report.pdf

Community Health Workers Illinois Dept. of Public Health, Facts About the Waiver U.S. Dept. of Health & Human Services, ASPE Issue Brief: Application for Health Care Workers Community Health Workers: Roles and Opportunities in http://www.idph.state.il.us/nar/WAIVER_APPLICATION_ Health Care Delivery System Reform (2016) Facts.pdf https://aspe.hhs.gov/sites/default/files/pdf/168956/ CHWPolicy.pdf American Bar Association, National Inventory of the Collateral Consequences of Conviction 3. GUIDANCE TO RELEVANT LAWS http://www.abacollateralconsequences.org

EEOC & Federal Trade Commission (FTC), Background NELP, Unlicensed and Untapped: Removing Barriers to Checks: What Employers Need to Know State Occupational Licenses for People with Records https://www.eeoc.gov/eeoc/publications/background_ http://www.nelp.org/publication/unlicensed-untapped- checks_employers.cfm removing-barriers-state-occupational-licenses/

EEOC, Enforcement Guidance on the Consideration of The National Employment & Reentry Committee, Arrest and Conviction Records in Employment Decisions Federal Policy Recommendations to Increase Job under Title VII of the Civil Rights Act of 1964 Opportunities for Justice-Involved Workers https://www.eeoc.gov/laws/guidance/arrest_conviction. http://hirenetwork.org/sites/default/files/The%20 cfm National%20Employment%20and%20Reentry%20 Committee%20Recommendations.pdf FTC, A Summary of Your Rights Under the Fair Credit Reporting Act 2. HEALTHCARE WORKFORCE NEEDS https://www.consumer.ftc.gov/articles/pdf-0096-fair- credit-reporting-act.pdf JPMorgan Chase & Co. Skills Gap Reports: Chicago: https://www.jpmorganchase.com/corporate/ Corporate-Responsibility/document/54841-jpmc-gap- 4. EMPLOYER INCENTIVES chicago-aw3-v2-accessible.pdf\ Federal Bonding Program Columbus: https://www.jpmorganchase.com/corporate/ http://www.bonds4jobs.com/ Corporate-Responsibility/document/54841-jpmc-gap- columbus-aw4-online.pdf U.S. Dept. of Labor (DOL), Employment & Training Dallas-Fort Worth: https://www.jpmorganchase.com/ Administration (ETA), Employer’s Guide to the Work corporate/Corporate-Responsibility/document/335911- Opportunity Tax Credit jpmc-gap-dallas-aw5-online-2.pdf https://www.doleta.gov/business/incentives/opptax/ Los Angeles: https://www.jpmorganchase.com/corporate/ PDF/WOTC_Employer_Guide.pdf Corporate-Responsibility/document/54841-jpmc-gap- los-angeles.pdf

58 Appendix B Resources

U.S. DOL, ETA, WOTC Application Submission Processes by State https://www.doleta.gov/business/incentives/opptax/pdf/ WOTC_Submission_Processes_by_State.pdf

U.S. DOL, ETA, WOTC Tax Credit Amounts https://www.doleta.gov/business/incentives/opptax/ benefits.cfm

U.S. DOL, ETA, WOTC Tax Credit Calculation Chart https://www.doleta.gov/business/incentives/opptax/ PDF/WOTC_TAX_CREDIT_CALCULATION_CHART.pdf

IRS, Form 5884: 2015 Work Opportunity Credit https://www.irs.gov/pub/irs-pdf/f5884.pdf

5. WORKFORCE DEVELOPMENT

U.S. Chamber of Commerce Foundation, Building the Talent Pipeline: An Implementation Guide https://www.uschamberfoundation.org/reports/ building-talent-pipeline-implementation-guide

U.S. DOL, Employment & Training Administration, The Workforce Innovation and Opportunity Act https://www.doleta.gov/WIOA/eta_default.cfm

New York Alliance for Careers in Healthcare http://nyachnyc.org/about-us/vision-mission/

Kentucky Health Career Center http://kcc.kentuckianaworks.org/JobSeekers/ KentuckyCareerCenterLocations/ KentuckyHealthCareerCenter.aspx

59 59 Appendix C Key Laws Regulating Employment Background Checks

Fair-Chance Laws delay employer inquiries about employer has considered the convictions in light of busi- a job applicant’s conviction record until later in the ness necessity and established that its exclusions target hiring process. In their simplest form, ban-the-box specific conduct that would compromise the require- laws (a subset of fair-chance laws) prohibit employers ments of the job and there are no alternatives to such from including such questions on their job applica- exclusions. tions. More robust fair-chance laws require an employer to first extend a conditional offer of employment, or at Federal & State Occupational Licensing Laws regulate least conduct an in-person job interview, before asking licensed professions. Requirements for most licensed about the applicant’s record. They may also include occupations vary by state, as do the specific occupations other measures to ensure the accuracy and reliability of that are licensed. All states require a background check the background check process. Fair-chance policies are when licensing certain professions, including many gaining momentum across the nation and have been healthcare positions, including long-term care workers, adopted in numerous states and over 100 cities and registered nurses, and certified nurse assistants. Some counties. Most existing policies apply to only govern- states have strict standards limiting employment of ment employers, but laws governing the hiring practices people with records for certain health care occupations of private employers are also spreading to new states and (e.g., many nursing boards will not certify anyone with localities. Visit www.nelp.org/campaign/ensuring-fair- a felony record), and others provide special “waivers,” chance-to-work/ for more information. “certificates of rehabilitation,” and appeal processes allowing people with records to produce mitigating The Fair Credit Reporting Act (FCRA) regulates back- information and evidence of rehabilitation. Thus, health ground checks obtained from a third-party consumer care employers and workers need to be well informed reporting agency. In order to be in compliance, about their rights and responsibilities under the law of employers must follow FCRA guidance before obtaining the state where they are located. a background check (obtaining written authorization from a candidate) as well as before and after taking adverse action (providing candidate with pre–adverse action notice with a copy of her background report with summary of rights under FCRA and adequate response time; a notification as to the decision and reasoning in the event of a denial).

Title VII of the Civil Rights Act of 1964 prohibits discrimination—both direct and disparate impact—in employment on the basis of race, color, religion, national origin, or gender. People with arrest or conviction records are protected under Title VII because the use of criminal background checks has a significant “dispa- rate impact” on people of color. In 2012, the EEOC issued detailed guidelines regulating criminal background checks for employment under Title VII, precluding blanket restrictions against hiring people with records and requiring a case-by-case review of the individu- al’s application. However, a policy resulting in dispa- rate impact will not necessarily violate Title VII if the

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