Report shows California health care jobs pay, but waitlists clog college on-ramp
AI-generated summary reviewed by our newsroom.
- PPIC finds community colleges produce high-pay health workers but face bottlenecks
- Long waitlists and limited clinical sites push students toward costly for-profits
- Policy fixes include higher faculty pay, more placements, and paid learn-and-earn
California’s health care industry is emerging as one of the state’s strongest on-ramps to the middle class for workers without a bachelor’s degree, but a sweeping report finds that many would-be entrants face barriers earning the credentials needed for those jobs.
Community colleges have struggled to offer enough spots in low-cost programs that lead to higher-paying positions, resulting in long waitlists and pushing many students into expensive, for-profit schools, according to researchers at the nonpartisan Public Policy Institute of California.
The report, “Training for Health Care Jobs in California: Opportunities for Workers Without a Four-Year Degree,” examines proposed solutions, including raising pay to attract more nursing instructors, expanding clinical training sites and experimenting with paid “learn and earn” models—though licensing rules complicate that approach.
PPIC researchers found that, within six years of earning associate degrees, respiratory therapists, radiologic technologists, dental hygienists and registered nurses typically earn two to three times California’s median hourly wage.
Wages for registered nurses and dental hygienists often exceed $60 to $70 an hour. Statistics show these graduates double their pay compared to pre-degree earnings — a larger increase than many bachelor’s degree holders achieve in other fields.
Students pursuing certificates in certain long-term programs also see significant wage gains — 37% for licensed vocational nurse training, 32% for paramedics and 43% for psychiatric technician credentials. Earnings are highest for those employed in hospital settings, the report found.
Shorter-term programs, such as medical assisting or certified nursing assistant training, offer limited immediate wage returns unless students advance into longer-term programs.
Few students manage to do so, said Shannon McConville, a PPIC senior fellow. During focus groups, program directors and career counselors said many students’ life circumstances shift while waiting to enter competitive programs like nursing, leading them to settle for short-term credentials or pursue other careers.
“Stacking credentials is especially important for those who initially earn a short-term health certificate, which confers little in terms of wage gains,” wrote McConville and her peers. “Earning a second health award increases earnings by 35%, and completing a third award adds another 20% to wage gains.”
While more than half of students who initially complete a short- or long-term certificate return to community college for additional coursework, only about 20% ultimately earn a higher-level credential, the report found.
Community college nursing programs have recently invested in better pathways from certificates to degrees, but the data so far show no clear payoff, researchers said. Some certificate holders may enter for-profit schools, but data from those institutions are less comprehensive than from public colleges.
Researchers said a new cradle-to-career data system could improve tracking across institutions.
California’s health care workforce continues to grow as the state’s population ages and more residents gain coverage. In 2024, the industry accounted for roughly 13% of all jobs in the state — more than 2.4 million positions, McConville said during a November briefing.
The state’s community colleges remain the main public provider of sub-baccalaureate health training, but capacity remains limited.
Registered nursing programs are the most impacted. Counselors told PPIC researchers that students often wait years to gain admission, even with top grades in prerequisite courses.
More than 60% of all sub-baccalaureate health credentials in California are awarded by private, for-profit institutions, especially in LVN, medical assisting, and dental assisting. These programs come at a steep cost:
- For-profit associate degree nursing programs cost seven times more than community colleges;
- LVN programs cost five times more;
- Medical and dental assisting programs average $17,500, often leading to high debt for jobs that barely exceed the median hourly wage.
Yet some students choose these pricier paths due to shorter program durations and flexible scheduling that better accommodate work and family responsibilities, McConville said.
Because of financial strain, geographic access and other barriers, Latino and African American students disproportionately shoulder the debt burdens from for-profit health programs. Women make up 70% of all health training enrollments, and nearly 90% of those in nursing, medical assisting and dental assisting.
In California, Los Angeles County and the Inland Empire have fewer community college health training slots per capita, while areas with higher enrollment rates include the Central Coast, Kern County, San Joaquin Valley and farther north state regions.
Program directors cited barriers including child care instability, prerequisite demands, financial hardship and a shortage of clinical training placements.
Some Los Angeles colleges have begun piloting guaranteed basic income stipends to help student parents stay enrolled.
If there were one change McConville could make to clear program bottlenecks, she said, it would be expanding capacity for qualified students seeking associate degrees in nursing from low-cost community colleges.
“They have difficulty finding faculty,” McConville said, “in large part because, for nurses, you can earn more money if you are in a hospital setting or working as a registered nurse or an advanced practice nurse as opposed to teaching.”
Increased pay for instructors and more clinical training sites are also key to expanding access, she said.
This story was originally published December 4, 2025 at 10:00 AM.
