At Craft, we think a 25-bed Critical Access Hospital that hires about two surgical techs a year is right to question whether it can build an apprenticeship program alone. The math is not pessimism. It is a clear-eyed view of what one employer would have to carry.
We heard exactly that question during our July webinar, Travelers or Talent: The Math of Healthcare Staffing. An attendee asked whether a 25-bed Critical Access Hospital hiring maybe two surgical techs a year had reached the point where a grow-your-own model stopped making sense.
The panelists said no. Michael Backus, president and CEO of Oswego Health, said the approach can help hospitals across the healthcare ecosystem. A Baylor Scott & White Health panelist went further, arguing that these programs can be even more important in smaller and rural markets. But the question deserves a second look: what if one hospital should not have to carry the entire program alone?
Nearly 1,400 Critical Access Hospitals operate across the United States. We see the same challenge across many of them. A hard-to-fill role matters deeply to patient care and to the community, but annual hiring volume is too low to justify building an entire talent-development system from scratch.
We think the better question is not whether one hospital can justify one program. It is whether several hospitals in the same region can justify one shared structure.
The problem is not training. It is everything around training.
When we talk about “apprenticeship,” we are not only talking about an employee learning on the job while completing the classroom portion of a credential. A Registered Apprenticeship also needs someone to administer the program, coordinate the work, and maintain the records that come with it.
Under federal guidance, a program sponsor can be an employer, an association, a consortium of businesses, or another organization. A sponsor can also work with an outside provider for related technical instruction, the educational portion of the apprenticeship. That flexibility matters because it means a small hospital does not have to become a sponsor, a school, and an administrative office all at once.
Still, the work does not disappear. Someone must own registration and ongoing administration. Someone must provide the curriculum. Someone must make sure training, progress, hours, and pay are documented. We do not expect a hospital hiring two surgical techs a year to carry all of that alone simply because it is committed to growing local talent.
For us, that is a reasonable conclusion.
The three legs belong to a region
A Baylor Scott & White Health panelist described the work as a three-legged stool: health systems, academic partners, and an intermediary.
We see the health-system leg as the jobs, supervisors, and workplace learning. The academic leg brings the instruction and credential pathway. The intermediary holds the relationships together and helps carry the coordination that no single employer wants to own by itself.
In the panelist’s view, the intermediary is the most important leg. Baylor Scott & White’s workforce partners helped carry the relationships and administrative work behind its sector partnerships. Registered Apprenticeship intermediaries exist precisely to connect employers with education and workforce partners, provide technical assistance, and help build talent pipelines.
For a large health system, all three legs may already sit inside one organization or its existing partnerships. The panelist described a Greater Austin sector partnership involving multiple health systems, and a Central Texas healthcare academy being built with hospital systems, community colleges, and regional workforce boards.
The webinar did not present a ready-to-join shared-sponsorship model for independent rural hospitals. It did show us why regional collaboration is worth exploring: a Critical Access Hospital does not need to assume it must replicate the entire structure by itself.
Change the unit of analysis
This is the regional math we want rural healthcare leaders to consider.
Instead of asking a hospital to sponsor and administer a surgical-tech program for two apprentices, we can help a region explore one shared sponsorship structure with several participating hospitals. Each employer still has its own hiring needs, workplace learning, and local decisions. But the sponsor and instruction partner do not have to be rebuilt from zero for every hospital.
Federal apprenticeship guidance explicitly allows a sponsor to be a consortium of businesses or a workforce intermediary. That does not guarantee that a shared model will work in every place. It does make the structure possible, and it gives us a practical structure to examine with regional partners.
That is where Craft fits. We help rural hospitals build, register, fund, and manage allied health apprenticeships, bringing the sponsorship and compliance infrastructure, a national curriculum partner, and the reporting support needed to run them. Hospital teams retain control over which employees participate and how workplace learning happens.
We are now exploring whether that same infrastructure can serve several small hospitals in one region rather than asking each to build it alone. It is not a ready-made program, and no hospital should assume that a shared approach guarantees funding or a viable cohort. If you are weighing that question for your region, talk with our team about the roles you are trying to fill and the partners already around the table.
What a region needs before it starts
We start with a convener that has enough credibility to bring employers, education partners, and workforce organizations into the same conversation. That might be a workforce development board, a hospital association, or another regional intermediary.
Then we look for shared demand. Hospitals do not need identical hiring plans, but they do need enough common need in roles such as surgical technologist or sterile processing technician to explore a common pathway.
We also look for an instruction partner that fits those occupations and a practical plan for workplace learning. Who will supervise apprentices? Where will training happen? What will each participating employer own?
Finally, we keep the funding conversation local and specific. Workforce Innovation and Opportunity Act resources may support eligible training, on-the-job learning, support services, or recruitment, but funding decisions are made at the state and local levels. Our approach is to map what may be available, not promise that a source will cover a particular cost.
A better answer than “no”
Rural and smaller hospitals have been especially affected by reliance on contract labor, according to the American Hospital Association’s Costs of Caring report. We know that pressure does not make every apprenticeship plan viable. It does make it worth looking for talent pathways that do not require every small employer to solve the same infrastructure problem alone.
If your organization serves several rural hospitals, start with the demand that already exists. Which roles recur? Which hospitals could participate? Who can convene the health-system, academic, and intermediary legs of the work?
The first step may not be launching a program. It may be changing the question from “Can one hospital justify this?” to “What could this region build together?”
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