Recognizing the importance of adult education in health literacy, CAAL recently attended the annual New Jersey Health Literacy Summit at Mercer County Community College.  The goal of improving communications between healthcare providers and patients is at the heart of health literacy. This communication is key to improved access to and use of healthcare services.  Many intriguing topics were presented at the Summit -- e.g., the technique of "Teach Back" to overcome the problem of different vocabularies between patients and healthcare professionals; health literacy as a roadmap to behavioral change; the power of health literacy to fix our "broken" healthcare system; and how health literacy by its nature leads to an integrated approach in healthcare. 

But one of the most stimulating presentations of the day was by widely-published pharmacist John Colaizzi, Jr., Supervisor of Pharmacy at Walgreens, adjunct faculty member at Rutgers University, and former Chair of the New Jersey Pharmacists Association.  Active in health literacy for many years, his topic was "Improving Communications Around Medication: Labeling, Adherence, and Health Outcomes." 

Colaizzi said that failure to fill and properly take prescription drugs is one of the biggest reasons so many patients are readmitted to the hospital or do not recover as fully or quickly as they could.  As they fill prescriptions and interact with patients, pharmacists gather extensive data and monitor drug use closely. Colazzi observed that this data reveals a "leaking bucket" so far as health care results are concerned.  Consider just these few facts:  Of every 100 Rx's written by doctors, only 50% are ever delivered to a pharmacy, and of these, 4% are not covered by insurance and as a result not picked up by the patients.  Of prescriptions filled, only 25% are taken properly, and only 15% are ever refilled as prescribed.  If patient behavior regarding prescriptions could be improved, Colaizzi stressed, so would the outcome of health care services.

The point is that pharmacists are in a unique position to contribute to health literacy and the goal of improved healthcare.  They can, and already often do, follow up with patients regarding their use, non-use, or misuse of prescribed drugs.  And, according to Colaizzi, much more of this outreach should be done. Pharmacists have a special vantage point from which to "educate" patients and communicate with medical personnel.  The potential is huge -- considering that pharmacists generally work mostly with older patients, where there are apt to be more serious ongoing health issues, and that by 2020, about one-third of all Americans will be aged 65 or older.  

FEATURE: WE NEED WIA IN OUR FUTURE

[The following article was prepared for CAAL as an op ed piece to urge reauthorization of WIA early in the new Congress.  But because WIA is in imminent danger of being seen by policymakers as irrelevant to our job training and adult education needs, we decided to cast a wider net now by offering our essay in this E-News format.  Please feel free to use it as a resource in your letters and contacts with your elected officials in Washington, local legislators, the local media, and other constituent groups.  The basic message is that we urgently need reauthorization of WIA, including the Adult Education and Economic Growth Act within it -- and the U.S. needs a robust Adult Education enterprise in order to meet its needs in the 21st century economy.]  

by   

Morton Bahr, President Emeritus, Communications Workers of America

Samuel Halperin, Founder, American Youth Policy Forum

Ray Marshall, former U.S. Secretary of Labor

Gail Spangenberg, President, Council for Advancement of Adult Literacy

One strategy is not enough when it comes to preparing workers for 21st century jobs and a more competitive economy.  Our nation needs to invest in several.  That's because not all businesses or workers have the same needs or the same educational foundation to start with.  Business and labor leaders understand this.  So do many state and federal legislators, community college visionaries, workforce development experts, and adult educators.  They also know that we need to do much more than we're doing now.

America's job training system should meet the nonacademic and academic needs of adult learners and make them job and college ready.  This includes GED or diploma programs for high school dropouts, community college and postsecondary programs, career and technical education, ESL services for immigrants, and skills upgrading programs of all kinds. And it means comprehensive federal and state planning to make the overall effort efficient.

Millions of out-of-school adults, 16 and older, make up the current and potential workforce, and a huge part of our workforce needs upgraded basic and language skills to attain job and college readiness.  If we're to achieve the country's employability and competitiveness goals, we must rise to the challenge.  A vibrant, adequately funded adult education system should be an integral part of our job training effort. We will otherwise condemn many workers to idleness or underemployment.

Many states are poised or moving in the right direction. But worker preparedness also requires federal action and Washington is stalemated.  An essential workforce bill to meet the needs of America's workers, the Workforce Investment Act (WIA), is stalled in its enactment in both the House and Senate-despite the efforts of dozens of national leaders and organizations that have contributed to the dialogue and to WIA's language and intent.

According to the National Commission on Adult Literacy, more than 93 million Americans, some 60 percent of the workforce, "lack literacy at a level needed to enroll in postsecondary education or job training that current and future jobs now require."  But the stark reality is that our adult education programs-for which federal funding is the core-are reaching fewer than 3 million adults a year, the tip of the iceberg.

The Commission's report, Reach Higher, America: Overcoming Crisis in the U.S. Workforce, concludes that our current adult education system fails to meet 21st century needs.   It found that:

• Existing programs do not and at current funding levels cannot meet the needs of our nation's changing demographics.
• Postsecondary institutions need to develop more programs and degree strategies appropriate for working adults.
• In the decade ending in 2014, 24 of the 30 fastest-growing occupations will require workers with postsecondary education or training and about 40 percent of job openings will soon require these skills. 
• Fifty-seven percent of children whose parents have a high school diploma but no college education live in low-income families, and children's learning achievement improves in proportion to their parents' level of education. 
• In 2008, more than 18 million Americans lacked a high school diploma, more than 51 million adults had a high school diploma but no college, and 18.4 million had limited English skills.

Clearly, if we are to remain globally competitive we must invest adequately in our adult education system, and we must take the essential steps to enable employability, self-sufficiency, and job mobility.  But it will take more than money to meet the challenge.

Adult education programs are trying to find ways to meet the new 21st Century demands placed on them.  But the involvement and commitment of business leaders is also needed, along with state agencies and workforce/economic development leaders.  And strong federal leadership is vital-in particular a continuing commitment by federal legislators to enact the reforms built into the pending WIA, as well as other workforce development bills.   

These reforms reflect input and analysis from dozens of national and state leaders and the energy of many House and Senate leaders.  The long-pending WIA is remarkably nonpartisan in nature.  Ideological differences and contentious political debate should not stand in its way as we move into the future.  Amendments proposed for WIA would strengthen adult education and workforce development, while providing greater coordination of goals and outcomes.

We also need incentives for business to improve and invest in employee skills.  States should increase the participation of incumbent workers in their workforce and adult education programs.  Federal funding formulas should be flexible enough that states can direct funds to their greatest needs. We should deploy the far greater use of technology to increase access and improve economies of scale. WIA recognizes these imperatives.  

America is losing its place as a world leader in education and becoming less educated. We need to reverse that tide urgently.  Enactment of the Workforce Investment Act, as an early priority of the new Congress, would be a big step in the right direction.  We urge Congressional leaders to re-dedicate themselves to this goal.  For four years, adult education and workforce development leaders have been working hard, right along with Congress, to enact a reformed WIA.  We may be WIA-weary at this point, but we still have our eyes on the target and intend to stay the course.   

Graduating to College: Three States Helping Adult Education Students Get a College Education, by Tom Hilliard, Summer 2012, is a new policy brief by The Working Poor Families Project (WPFP).  WPFP has a strong interest in building educational opportunities for low-skilled adults to improve their employability through successful transitions to postsecondary education and job training. The report reviews some of key national demographics that relate to this need.  It also considers obstacles to serving low-skilled adults who aspire to college as well as policy, service, and funding trends.  A major section of the brief is profiles the leadership activities and achievements of three states: Kentucky, Maine, and Minnesota. 

The Kentucky Council on Postsecondary Education, starting with its "Go Higher Kentucky" marketing campaign, is credited with getting adult and young audiences to understand the importance of attending college in that state.  The Council is presently implementing Common Core Standards, and is a part of the national Accelerating Opportunity initiative of Jobs for the Future.  The effort sets clear goals and holds providers accountable.  Between 2006 and 2010, the adult education students continuing on to college in KY increased from 19 to 26 percent. 

In Maine, College Transitions is the driving force.  In 2006, the Maine State Legislature provided funding to expand this program to 22 adult education/community college partnerships around the state.  In 2008, it was found that some 85 percent of students went on to enroll in college after finishing the state's transition program for adults lacking college readiness. 

In Minnesota, through the FastTRAC Adult Career Pathway effort, and in partnership with public higher education and workforce groups, low-skilled adults are moved from lowest literacy and ESL levels up to the Associate degree level.  Students are tracked longitudinally from adult education into college.  A January 2012 evaluation report found that students who enter college from adult education programs have a significantly higher persistence rate than other freshmen (70 and 63 percent respectively).

The WPFP brief discusses many other features also important to these three successful state initiatives. It concludes with a set of recommendations to help other states work more fully and effectively on transitions from adult education to college.  The recommendations include setting and clearly articulating goals and benchmarks, forming partnerships to plan and evaluate (in terms of workforce, human service, and economic development need), and aligning data systems to measure student progress and generate innovation.