California Hospital Association Allied Health Workforce Survey Report of Key Findings

Transcription

1 Critical Roles: Califoria s Allied Health Workforce Califoria Hospital Associatio Allied Health Workforce Survey Report of Key Fidigs February 2011

2 Critical Roles: Califoria s Allied Health Workforce Califoria Hospital Associatio Allied Health Workforce Survey Report of Key Fidigs Itroductio I December 2007, the Califoria Hospital Associatio (CHA) created the Healthcare Workforce Coalitio. The coalitio s missio is to create ad lead a statewide, coordiated effort to develop ad implemet strategic solutios to the shortage of specified o-ursig allied health professioals. Allied health icludes professios such as cliical laboratory scietist, radiological techologist ad respiratory therapist, amog may others. Members of this broad coalitio iclude CHA member hospitals ad health systems, as well as various stakeholders, icludig the Uiversity of Califoria (UC), Califoria State Uiversity (CSU), Califoria Commuity Colleges Chacellor s Office, Califoria Labor ad Workforce Developmet Agecy, UC Sa Fracisco Ceter for the Health Professios, Califoria Istitute for Nursig & Health Care, Califoria Health Workforce Alliace, Office of Statewide Health Plaig ad Developmet, ad Califoria Primary Care Associatio. The origial goals ad priorities of the coalitio were established usig data collected via a 2007 hospital survey. Sice the origial 2007 survey, deterioratig ecoomic coditios have caused may health care professioals to postpoe retiremet or icrease work hours, easig the demad for health care workers i the short term. I 2010, CHA agai surveyed hospitals statewide to gather up-to-date data regardig the effects of the ecoomy o the demad for allied health professioals i the short term, ad to idetify hospital workforce eeds ad cocers i the ext oe, three ad five years. This report highlights key fidigs from the 2010 survey ad recommeds strategies to address the log-term eed for these professioals. Summary of Recommeded Strategies Fudig for health sciece educatio ad health workforce preparatio at Califoria s commuity colleges ad uiversities must be a priority for the state. Hospitals are critical parters i developig a solid health care workforce, sigificatly ivestig i programs that educate ad trai health professioals. However, as gaps i fudig for educatio grow more severe, hospitals will ot be able to icrease ivestmets to fill these shortfalls. Fudig for health sciece educatio ad workforce preparatio must become a priority for the state. Health sciece curriculum must be more closely aliged with the eeds of employers. All too ofte, studets who have completed their educatio eter their professio eedig costly o-the-job traiig to alig their skills with the demads of workig i a hospital settig. Articulatio betwee Califoria s istitutios of higher educatio must be ehaced. Recetly passed legislatio partially addresses this issue by guarateeig studets admissio to a CSU if they have successfully completed the appropriate core uits at a commuity college. However, much work is still eeded to implemet this legislatio ad to address trasfer issues. Califoria s educatioal leaders ad policymakers must give cosideratio to iovative models of educatio that take ito accout the eeds of o-traditioal studets, such as the adult learer or the icumbet worker. Models offerig courses at ight, o the weekeds, durig the summer ad olie make it possible for these studets to obtai a degree or certificate i a allied health occupatio, while they remai i their commuity ad/or cotiue workig. Prerequisite courses must be stadardized across the health scieces so as studets trasfer from oe college to aother they are ot forced to retake courses they have already successfully completed at aother college. Stadardizatio will provide a clear pathway allowig studets to progress more efficietly ad mitigate capacity issues that are so prevalet with these courses. Barriers related to cliical traiig must be addressed. For example, the applicatio process for becomig a approved cliical laboratory traiig site is burdesome ad atiquated, requirig phoe calls ad paper documets. Istead, applicatio documets ad iformatio should be easily accessible olie. For details regardig recommedatios, please see page 9. 2 Critical Roles: Califoria s Allied Health Workforce Fe b r ua ry 2011

3 Critical Roles: Califoria s Allied Health Workforce Califoria Hospital Associatio Allied Health Workforce Survey Report of Key Fidigs Methods The 2010 CHA Allied Health Workforce Survey was prepared by the CHA Workforce Committee ad CHA staff. It was desiged to be a web-based survey targetig CHA member hospitals. The survey cosisted of 12 multi-part questios cocerig vacacies, impact of vacacies, chages i employmet status, hirig freezes, workforce age ad expected retiremets, ad log-term cocers about workforce supply. It was distributed to 200 hospitals statewide, ad 125 hospitals ad health systems respoded for a respose rate of 62.5%. The survey was distributed i Jauary 2010 ad held ope for resposes through May Survey aalysis was coducted by researchers at the UC Sa Fracisco Ceter for the Health Professios. Descriptio of Survey Respodets Survey respodets were assessed based o how represetative they were of the overall CHA membership. Amog the parameters used to assess this were geographic locatio, rural desigatio, bed size ad total full-time equivalets (FTEs). These assessmets idicated that the respodig hospitals ad health systems were geerally represetative of the CHA membership. However, hospitals ad health systems i selected regios of the Bay Area had a stroger respose rate tha hospitals ad health systems i the Sa Diego ad Imperial couties regio. More tha 80% of survey respodets were located i urba locatios ad approximately 20% i rural locatios. This is similar to the overall urba/rural distributio of the CHA membership (see Table 1). Approximately 65% of respodig hospitals had betwee 100 ad 399 occupied beds. This is similar to the overall membership of CHA, although respodig hospitals ad Table 1: Survey Respodets ad Member Hospitals by Rural ad Urba Locatio Locatio Survey Respodets (%) Total CHA Membership (%) Rural Urba/Suburba Number of Facilities* * Excludes facilities where rural vs. urba/suburba status is ukow. health systems i the bed size rage were slightly over-represeted, whereas respodig hospitals i the bed size rage were slightly uder-represeted (see Table 2). Table 2: Survey Respodets ad Member Hospitals by Bed Size # of Occupied Beds Survey Respodets (%) Total CHA Membership (%) Fewer tha or more Number of Facilities* * Excludes facilities where umber of total occupied beds is ukow. Surveyed Occupatios The followig 14 occupatios were icluded i the Allied Health Workforce Survey. Accordig to hospitals ad health systems statewide, these allied health positios are the most difficult to fill ad are critical whe it comes to health care delivery. Cliical Laboratory Scietist (CLS) Medical Laboratory Techicia (MLT) Radiologic Techologist Computed Tomography (CT) Techologist Positro Emissio Tomography (PET) Techologist Cardiovascular & Itervetioal Radiology (CVIR) Techologist Magetic Resoace Imagig (MRI) Techologist Ultrasoud Techologist Nuclear Medicie Techologist Pharmacist Pharmacy Techicia Physical Therapist Physical Therapy Assistat Respiratory Therapist CALIFORNIA HOSPITAL ASSOCIATION 3

4 Critical Roles: Califoria s Allied Health Workforce Califoria Hospital Associatio Allied Health Workforce Survey Report of Key Fidigs Why are these occupatios so critical? Whe most people thik about the health care workforce, they thik about doctors ad urses who provide care directly to patiets. There are may health care professioals, however, workig at the bedside ad behid the scees to provide laboratory, imagig ad other critical services eeded to diagose ad treat patiets. CLSs, for example, are a itegral part of the health care team. These professioals coduct a wide rage of diagostic assessmets, from simple blood tests to geetic testig, to help physicias determie treatmet plas. Workforce shortages i the cliical laboratory ca cause delays i diagosis ad icrease patiets legth of stay. The curret CLS shortage i Califoria is projected to grow more serious i the ext five years due to a sigificat umber of pedig retiremets. Imagig professioals, like radiological techologists ad diagostic soographers, use X-rays, MRIs ad ultrasoud equipmet to help health care providers view iside the huma body. The advaced techology used i diagostic imagig has eabled physicias to diagose ad treat patiets quickly ad efficietly. However, health care providers are challeged to fid eough qualified techical professioals to capture these images, especially i the special imagig modalities, such as CVIR. Key Fidigs FTEs by Occupatio Accordig to the survey results (111 respodets i this case), the five largest o-ursig health care professios, based o FTEs, are respiratory therapist, pharmacist, pharmacy techicia, radiological techologist ad CLS. These five occupatios accouted for roughly threequarters of all FTEs reported (76%) (see Figure 1). Figure 1: Total FTEs by Selected Allied Health Occupatio Respiratory Therapist Pharmacist Pharmacy Techicia Radiological Techologist Cliical Lab Scietist Physical Therapist Ultrasoud Techologist Medical Lab Techicia MRI Techologist Physical Therapy Asst CT Techologist Nuclear Med Techologist CVIR Techologist PET Techologist ,967 2,763 3,260 3,153 3,584 3,541 Respiratory therapists evaluate, treat ad care for patiets with breathig or other cardiopulmoary disorders. 1 Respiratory therapists provide complex therapy ad are vital i carig for patiets with respiratory illesses or who may be o life support i itesive-care uits of hospitals ,000 1,500 2,000 2,500 3,000 3,500 4,000 Total FTEs The occupatios described here, alog with the others icluded i the survey, make up the support system for health care delivery. Workforce shortages or skill gaps i these professioal areas impact hospital efficiecies ad threate timely access to care. Amog surveyed occupatios, respiratory therapists are the largest group i terms of workforce size, with 111 hospitals reportig 3,584 total full-time equivalet positios. 1 Health Jobs Start Here (2010). resources/job/respiratory-therapist.html 4 Critical Roles: Califoria s Allied Health Workforce Fe b r ua ry 2011

5 Critical Roles: Califoria s Allied Health Workforce Califoria Hospital Associatio Allied Health Workforce Survey Report of Key Fidigs Vacat Positios by Occupatio Vacacies were examied by professio i two ways: 2009 vacacies as a share of reported FTEs (a vacacy rate) ad absolute umber of vacacies. The 2009 vacacy rate raged from 3% to 8% for the selected allied health professios. The overall reported vacacy rate was 4.4% (total reported vacacies as a share of total FTEs for all surveyed allied health occupatios). Figure 2 shows that the vacacy rate was lowest for pharmacists ad pharmacy techicias ad highest for physical therapists. It is importat to ote that i relatively small professios (i terms of total FTEs), such as CVIR ad PET techologists, a small umber of vacacies results i a high vacacy rate. For example, the umber of PET techologists is small; oe vacacy per 18 FTEs results i a vacacy rate of 5.6%. Although physical therapists, CVIR techologists ad MLTs had the highest vacacy rates, 10 of the 14 occupatios surveyed have vacacy rates above the average of 4.4% for all occupatios combied (see Figure 2). The secod measure of vacacies is the absolute umber of reported vacacies. Table 3 shows the five occupatios with the greatest umber of vacacies are respiratory therapist, physical therapist, CLS, radiological techologist ad pharmacist. These occupatios are also five of the six largest i terms of total reported FTEs. Together, they accouted for 73% of the total umber of reported vacacies. These data, however, oly preset part of the picture. Vacacy rates by bed size were also aalyzed i order to determie whether small or large size hospitals were impacted differetly. Of the respodig hospitals ad health systems, 93 reported a total of 949 FTE vacacies (17 of the 111 facilities with usable FTE data did ot report ay vacacies at all). The smallest hospitals had the highest vacacy rates; more tha 7% for hospitals with less tha 100 beds. These vacacy rates were early twice as high as those i larger hospitals (see Figure 3 o page 6). Impact of Vacacies After idetifyig the umber of vacat allied health positios, it is importat to uderstad the impact of vacacies o hospital operatios. A survey item asked hospitals to respod to the followig statemet of (cotiued o page 6) Figure 2: 2009 Vacacy Rates by Occupatio Physical Therapist CVIR Techologist Medical Lab Techicia MRI Techologist PET Techologist Cliical Lab Scietist Physical Therapy Asst Ultrasoud Techologist CT Techologist Respiratory Therapist All Occupatios (Avg) Nuclear Med Techologist Radiological Techologist Pharmacist Pharmacy Techicia Occupatio 3.1% 2.9% 4.3% 3.8% 4.9% 4.5% 4.4% 5.3% 5.3% 5.0% 6.3% 6.2% 5.6% 6.8% 7.8% 0.0% 2.0% 4.0% 6.0% 8.0% 10.0% Table 3: 2009 Total Reported Vacacies by Occupatio Total Reported Vacacies Respiratory Therapist 162 Physical Therapist 151 Cliical Lab Scietist 146 Radiological Techologist 121 Pharmacist 109 Pharmacy Techicia 93 Ultrasoud Techologist 48 Medical Lab Techicia 31 MRI Techologist 25 Physical Therapy Asst 21 CT Techologist 19 Nuclear Med Techologist 16 CVIR Techologist 6 PET Techologist 1 CALIFORNIA HOSPITAL ASSOCIATION 5

6 Critical Roles: Califoria s Allied Health Workforce Califoria Hospital Associatio Allied Health Workforce Survey Report of Key Fidigs impact: Please rate from 1-5 the impact of vacacies i each occupatio o hospital efficiecies ad access to care (1 havig o impact ad 5 havig the greatest adverse impact). Figure 4 shows the impact score by allied health occupatio. For most of the selected allied health occupatios, vacacies were viewed as havig a sigificat impact o hospital efficiecies ad access to care. Overall, pharmacist vacacies were see as havig the greatest adverse impact whe vacacies exists (averagig a score of 3.75), while PET techologist vacacies were see as havig the least impact (a average score of 1.97). Data ot show here idicate that there were small differeces i how respodets viewed the impact of vacacies based o the geographic locatio (rural vs. urba/suburba) ad size of the hospital/health system. Vacacies for several of the techical occupatios (CT, CVIR, PET ad MRI techologist) were see as havig a greater impact at urba/suburba facilities compared to rural facilities (although all were see as havig a medium-low impact). Vacacies for CLS, radiological techologist, ultrasoud techologist, pharmacist ad respiratory therapist at very small facilities with fewer tha 50 occupied beds (which were also rural) were see as havig a greater impact by compariso to larger facilities. Hirig Freezes ad Coversio of Employmet Status Oly five facilities reported a hirig freeze of ay duratio; of those, two reported a year-log freeze. The others reported a hirig freeze of six moths or less. Covertig employees from part-time to full-time status was reported by 39 hospitals. There were a total of 171 employees who icreased hours from part-time to full-time. The occupatios most frequetly reported as icreasig hours from parttime to full-time were respiratory therapist (24 hospitals ad 59 employees), CLS (15 hospitals ad 23 employees) ad radiological techologist (14 hospitals ad 31 employees). Employee Average Age ad Projected Retiremets Across the health professios there is cocer about the agig workforce ad pedig retiremets. The CHA Allied Health Workforce Survey icluded two items askig about the average age of employees ad the umber expected to be eligible for retiremet (usig 62 as the age for eligibility) i the ext oe, three ad five years for each of the selected allied health occupatios. Figure 3: Vacacy Rate by Total Occupied Beds 8% 6% 4% 2% 0% Figure 4: Impact of Vacacies by Occupatio Pharmacist Physical Therapist Respiratory Therapist Cliical Lab Scietist Nuclear Med Techologist Ultrasoud Techologist MRI Techologist Radiological Techologist CT Techologist Pharmacy Techicia Physical Therapy Asst Medical Lab Techicia CVIR Techologist PET Techologist 7.5% 7.3% 3.7% 4.7% Fewer tha 50 Occupied Beds Occupied Beds Occupied Beds Occupied Beds 400 or More Occupied Beds 3.8% Table 4 o page 7 shows the average age of allied health workers across all respodig facilities for the surveyed occupatios. The resposes were disaggregated for urba ad rural hospitals i order to assess whether pedig retiremets are greater, less or the same whe comparig rural to urba/ suburba locatios. The data show that the average age i these occupatios raged from 36.9 years for pharmacy techicia i urba hospitals to 50.5 years for CLS i rural 6 Critical Roles: Califoria s Allied Health Workforce Fe b r ua ry 2011

7 Critical Roles: Califoria s Allied Health Workforce Califoria Hospital Associatio Allied Health Workforce Survey Report of Key Fidigs hospitals. For almost all occupatios there is a differece i the average age based o the geographic locatio of the facility: the rural workforce is almost uiformly older by compariso. For some occupatios, the differece is marked, icludig pharmacist ad pharmacy techicia, ad to a slightly lesser extet CT techologist ad MRI techologist. Table 5 illustrates retiremet eligibility for the surveyed occupatios. More tha 2,600 allied health employees i the selected categories are expected to be eligible for retiremet withi the ext five years; this traslates to roughly 12.5% of the total umber of FTEs reported by survey respodets. Retiremet eligibility figures for CLS, respiratory therapist ad pharmacist idicate that there will be a sigificat umber of vacacies i these occupatios should a majority of those eligible actually retire. Fidigs idicate that 844 CLSs will be eligible for retiremet i the ext five years. Califoria curretly oly graduates approximately 125 CLSs aually. Top Cocers of Hospitals Regardig Future Allied Health Workforce Supply Survey respodets were asked to idetify their top logterm cocer about the allied health workforce supply from a list of five factors. Not surprisig, give the data o workforce age, the top cocer expressed by 58% of the respodets was the agig workforce (see Figure 5 o page 8). The impact of health reform was see as the secod most importat log-term issue. It is importat to ote that the survey was ope Jauary through May A portio of this time pre-dated the passage of the Table 4: Average Age by Allied Health Occupatio (Urba/Suburba vs. Rural) Occupatio* Average Age of Employees by Occupatio Urba/ Suburba Hospital Rural Hospital Cliical Lab Scietist MRI Techologist CT Techologist Nuclear Medicie Techologist Medical Lab Techicia CVIR Techologist Respiratory Therapist PT Assistat Radiological Techologist Pharmacist Ultrasoud Techologist Physical Therapist Pharmacy Techicia * The average age for PET techologist (all facilities) was There were too few facilities reportig to calculate average age based o geographic locatio of facility. Table 5: Total Employees Eligible for Retiremet by Occupatio ad Eligibility Period (Age 62) Occupatio # Eligible for Retiremet Total Cliical Lab Scietist Respiratory Therapist Pharmacist Radiological Techologist Pharmacy Techicia Physical Therapist Medical Lab Techicia CT Techologist Nuclear Medicie Techologist Ultrasoud Techologist MRI Techologist PT Assistat CVIR Techologist PET Techologist Total Expected Retiremets ,597 2,659 CALIFORNIA HOSPITAL ASSOCIATION 7

8 Critical Roles: Califoria s Allied Health Workforce Califoria Hospital Associatio Allied Health Workforce Survey Report of Key Fidigs Patiet Protectio ad Affordable Care Act (ACA). A larger umber of respodets may have idicated a greater cocer about health care reform if data were collected durig the moths followig the passage of ACA. Makig the Case: New Strategies Needed for Developig Allied Health Professioals May reports regardig the ecoomy have focused o the health sector ad the fact that it is oe of the very few sectors addig jobs i today s challegig ecoomic climate. At the same time, coflictig reports i the media have brought attetio to workforce reductios withi hospitals. It is importat to ote that while the absolute umber of health care jobs atiowide may be icreasig across the broad health sector (which icludes commuity health ceters, other cliics ad private physicia practices, i additio to hospitals), Califoria hospitals have bee sigificatly impacted by the recessio. May factors, icludig a chagig payer mix, chages i patiet volume, ad a decrease i the umber of elective procedures takig place due to a ailig ecoomy, amog other factors, have required hospitals to egage i costreductio strategies that iclude workforce reductios or cosolidatios. These reports of workforce reductios otwithstadig, key fidigs from the Allied Health Workforce Survey support the eed to develop some ear-term, but especially logterm, strategies to icrease the supply of allied health professioals, particularly i critical areas. For example, of the top three occupatios havig the highest retiremet eligibility figures, the CLS pedig retiremet umbers idicate the most immediate risk i years Accordig to the survey, 217 CLSs will be eligible for retiremet i the ext year. Califoria curretly graduates approximately half that umber aually. Projectig beyod oe year, those eligible for retiremet withi this professio icreases to a staggerig 844. This represets early oe-third of the umber of the CLS FTEs reported by respodets. Figure 5: Top Cocer from Hospitals about the Allied Health Workforce Populatio Growth 5% Other 8% Cultural Diversity 8% Agig Health Workforce 58% Health Care Reform 21% Furthermore, rural hospital respodets rated CLS vacacies as havig the greatest adverse impact o hospital efficiecies ad access to care, while at the same time the CLS average age was highest i rural hospitals at 50.5 years. These fidigs validate logstadig claims that the shortage of cliical laboratory professioals must be addressed statewide, but the fidigs also brig about a ew urgecy for focusig o the eed to develop iovative solutios that will improve access to educatio ad traiig for rural commuities as well. Califoria recetly implemeted licesure for MLTs to help mitigate the impact of the CLS workforce shortage. I Califoria, MLTs ca perform phlebotomy ad moderately complex testig, ad supervise lower level laboratory workers. However, Califoria curretly has oly four approved MLT traiig programs i operatio. Physical therapists make up a relatively smaller compoet of the hospital workforce. However, they have the highest vacacy rate i respodet hospitals ad the secod highest impact score. This is cocerig because, begiig i 2015, physical therapists will be required to attai a doctorate degree (DPT) i order to become licesed i Califoria. This could exacerbate the shortage i Califoria because it will take studets loger to become licesed. Although legislatio was recetly eacted allowig the CSUs to offer the DPT so curret programs ca cotiue to educate physical therapists beyod 2015, this does ot address the overall eed for 8 Critical Roles: Califoria s Allied Health Workforce Fe b r ua ry 2011

9 Critical Roles: Califoria s Allied Health Workforce Califoria Hospital Associatio Allied Health Workforce Survey Report of Key Fidigs additioal physical therapy programs statewide. Logterm solutios for addressig the eed for physical therapists must be developed. Health care will cotiue to be a egie of ecoomic growth i the comig years as Califoria s populatio icreases ad ages. It is aticipated that the fastest growig area of health care employmet will be allied health, with a projected 63 percet icrease betwee 2010 ad Betwee ew job creatio ad the eed to replace workers who retire or otherwise leave the field, the state will eed to trai early 1 millio more allied health workers by Combie the challeges of a agig health care workforce, projected populatio growth i the state, ad a icreased demad ot oly for geeral health care service, but for customized cosumer-drive care as well, with the oset of health care reform, ad the result is a perfect storm that will threate access to timely health care for Califoria patiets. Recommeded Strategies Preserve ad Protect Fudig for Califoria s Public Istitutios of Higher Educatio The CHA Health Workforce Coalitio has examied the barriers to icreasig the supply of qualified, highly skilled allied health workers for almost three years. Oe particular barrier has repeatedly surfaced. Fudig for health sciece educatio i Califoria s commuity colleges ad uiversities is iadequate ad results i limited capacity for traiig health professioals. It is widely kow that Califoria s uprecedeted budget crisis is forcig policymakers to make very difficult decisios regardig fudig for programs ad services i the state. However, fudig for Califoria Commuity Colleges, CSUs ad UCs must be protected. These istitutios provide the bulk of accredited health professio educatio ad traiig opportuities for Califorias seekig a career i the allied health field. Most of these programs require a low studet-to-faculty ratio ad require a cliical compoet. The requiremets mea that these programs are more costly to operate, yet serve lower umbers of studets whe compared to other programs, leavig them vulerable to budget cuts. Oce allied health programs are closed dow, they are very difficult ad expesive to revive. Log-term plaig requires that budget cuts are prioritized i a way that will ot cripple Califoria s ability to educate ad trai allied health workers i the comig decade whe the eed will be most critical. Furthermore, these istitutios prepare the most diverse populatios of studets i the state. Ideed, these studets are represetative of Califoria s culturally diverse patiet populatio. It is imperative that the state preserve its ivestmet i these istitutios to esure the creatio of a culturally competet, well-qualified allied health care workforce that ca meet future demad. Protect Fudig for Califoria s Commuity College Workforce Preparatio Programs The Health Workforce Iitiative (HWI) is admiistered through the Califoria Commuity Colleges Chacellor s Ecoomic ad Workforce Developmet Program. The purpose of HWI is to promote the advacemet of Califoria s health care workforce through quality educatio ad services. This icludes providig educatio ad traiig programs to meet emergig demads for health care workers, determiig eeds, facilitatig developmet of iovative solutios ad securig resources to implemet plaed resposes. HWI s high-quality learig opportuities are offered to a diverse populatio of studets ad icumbet workers, ad directly lik educatio to the workplace ad health care employers. 3 Over the last two years, HWI has experieced sigificat budget cuts that have resulted i closures of several regioal ceters, icludig oe ceter located i Califoria s uderserved Cetral Valley. There is ackowledgemet that i this budget climate all programs must be scrutiized closely, but it should be oted that i this time of high uemploymet, programs such as HWI are vital to esurig that educatioal programs are aliged with health employers eeds so studets are educated ad prepared to eter ito a professio where there will be opportuities for 2 (2009) Help Wated: Will Califoria Miss Out o a Billio-Dollar Growth Idustry? 3 Califoria Health Workforce Iitiative, CALIFORNIA HOSPITAL ASSOCIATION 9

10 Critical Roles: Califoria s Allied Health Workforce Califoria Hospital Associatio Allied Health Workforce Survey Report of Key Fidigs employmet. Fudig for health sciece educatio ad workforce preparatio programs offered by Califoria s istitutios of higher educatio must become a priority for the state. Alig Programs With Idustry Demad Health sciece curriculum must be more closely aliged with the eeds of employers. All too ofte, studets who have completed their educatio eter their professio eedig additioal ad costly o-the-job traiig i order to brig their skills i aligmet with the demads of workig i a hospital settig. Also, i order to maximize employmet opportuities for ew graduates, it is critical that health professio programs ad fudig for such programs alig with the occupatioal demads of health employers. Stadardize Prerequisite Courses Prerequisite courses must be stadardized across the health scieces so that as studets trasfer from oe college to aother, they are ot forced to retake courses they have already successfully completed at aother college. Stadardizatio of prerequisites will elimiate curret barriers to certificatio ad licesure; provide a clear pathway allowig studets to progress more efficietly; ad mitigate capacity issues that are so prevalet with these courses. Improve Course Articulatio Betwee Califoria s Istitutios of Higher Educatio Studets pursuig a career i the health professios curretly do ot have a clear pathway for movig toward more advaced educatio ad traiig withi the Califoria istitutios of higher educatio. I additio to capacity issues that sometimes force studets to seek educatio outside of the public post-secodary istitutios, studets also face may obstacles as they try to avigate from oe commuity college district to aother, from private accredited to public istitutios, or o to a CSU ad/or UC from a commuity college. May times, due to the lack of articulatio agreemets betwee istitutios, studets are forced to retake classes or take additioal classes to complete their educatio. This ot oly presets a barrier to completio, it is a iefficiet use of resources. Articulatio issues, icludig those that occur betwee private accredited ad public istitutios, must be addressed i order to maximize resources ad efficietly educate studets i the state. Recetly eacted legislatio partially addresses this issue by guarateeig studet admissio to a CSU if they have successfully completed the appropriate core uits at a commuity college. However, much work is still eeded to implemet this legislatio ad to address trasfer issues. Develop Iovative Models for Educatig ad Traiig Allied Health Professioals New, iovative models of educatig ad traiig health professioals must be developed, especially if we are to build a solid health workforce to serve rural ad remote regios of the state. For example, techology has radically chaged how all studets lear ad access educatio. Expaded, iovative use of techology ca icrease access to allied health educatio ad provide opportuities for more studets to pursue a career i health. This is especially true whe it comes to accessig prerequisite courses, which have sigificat limited capacity, yet are i high demad because may are commo to all the health scieces. Techology also has the potetial to address some of the cliical portios of traiig as well, either through simulatio exercises or virtual access to cliical metors. Iovative programs must be developed ad evaluated so capacity issues ad geographic barriers ca be addressed. AB 2385, siged by the Goveror i 2010, authorizes the establishmet of iovative pilot programs for educatig urses ad allied health professioals. Although the fudig for these pilots has ot bee secured, authorizig commuity colleges to establish iovative pilot programs ad requirig that they be evaluated for effectiveess are importat steps toward developig models that ca be replicated throughout the state. I additio, may logstadig models of educatig ad traiig have become outdated. While perhaps effective for the traditioal studet, may models are ot as effective for o-traditioal studets, such as the adult 10 Critical Roles: Califoria s Allied Health Workforce Fe b r ua ry 2011

11 Critical Roles: Califoria s Allied Health Workforce Califoria Hospital Associatio Allied Health Workforce Survey Report of Key Fidigs learer ad icumbet worker. Califoria s educatioal leaders ad policymakers should give cosideratio to the developmet of traiig programs that take ito accout the eeds of these o-traditioal studets who typically have may competig priorities, such as a full-time job ad family. Educatioal models offerig courses at ight, o the weekeds, durig the summer ad olie make it possible for these studets to obtai a degree or certificate i a allied health occupatio, while they remai i their commuities, cotiue to work ad provide for their families. Lastly, rapidly chagig techology, shiftig demads for health professioals i respose to health care reform ad other factors, ad chages i delivery models of care require a educatioal ifrastructure that is flexible ad ca respod to rapidly chagig techology i both the educatioal ad health care eviromets. Alleviate Barriers Related to Cliical Traiig May allied health professios require completio of a cliical traiig compoet. The cliical requiremet varies i legth depedig o the professio. Geerally speakig, educatioal programs parter with hospitals ad other health care providers to provide the cliical traiig opportuities ecessary for studets to obtai certificatio ad/or licesure i a give professio. Hospitals provide cliical rotatios ad metors/preceptors for the cliical traiig, while the educatioal istitutios provide the curriculum ad accreditatio for the program. Despite these existig parterships, however, there are a isufficiet umber of cliical traiig opportuities to meet demad. The reasos for this may vary, but some specific issues iclude state approval requiremets for traiig programs to operate, ad metor/preceptor-tostudet ratio requiremets. without persoally cotactig a idetified idividual withi LFS. Istead, these documets should be easily accessible o the LFS website. Additioally, hospitals have to wait up to six moths or loger for approval. These ad other iefficiecies withi this departmet should be evaluated i order to streamlie the process for approvig traiig sites ad make better use of the departmet s limited resources. Coclusio To meet the log-term demads for health care services i the state, policymakers ad others must recogize the eed to develop a sufficiet supply of qualified, culturally competet allied health professioals. Hospitals are critical parters i developig a solid health workforce ad have bee doig their part to icrease the umber of traied urses, physicias ad allied health professioals by creatig ad heavily ivestig i workforce developmet parterships. Eve the most fiacially stressed rural hospitals havig sigificatly limited resources cotribute both fiacial ad i-kid support to help develop the health workforce eeded to serve their commuities. However, as gaps i fudig for educatio grow more severe, hospitals will ot be able to icrease ivestmets to make up for these shortfalls. Movig forward, ad especially i light of health care reform, it is more critical tha ever that all parters, icludig the state, Legislature, educatio ad idustry collaborate ad coordiate effectively aroud plaig ad resources. CHA looks forward to workig with policymakers ad the state, as well as other health workforce parters, as solutios are developed ad implemeted. For example, licesure as a CLS i Califoria requires obtaiig a bachelor s degree ad completio of a 12-moth itership traiig program that has bee approved by the Califoria Departmet of Public Health s Laboratory Field Services (LFS). The applicatio process for becomig a approved traiig site is burdesome ad atiquated. Hospitals caot obtai the applicatio paperwork for becomig a approved traiig site CALIFORNIA HOSPITAL ASSOCIATION 11

12 Ackowledgemets CHA thaks each member of the CHA Workforce Committee, Allied Healthcare Workforce Advisory Coucil, Imagig Services Workgroup ad Healthcare Laboratory Workforce Iitiative for all their time, commitmet ad dedicatio to the Health Workforce Coalitio ad its missio, ad the creatio of this report. Special thaks to Susa A. Chapma, PhD, RN, associate professor, Uiversity of Califoria Sa Fracisco (UCSF) School of Nursig, ad researcher for the UCSF Ceter for the Health Professios, ad Timothy Bates, aalyst for the UCSF Ceter for the Health Professios, for their work i aalyzig the data gathered from the Allied Health Workforce Survey. Their expertise ad kowledge were essetial to the developmet of this report. A special thak you as well to Teri Holligsworth ad Jamila Mayers of the Hospital Associatio of Souther Califoria for admiisterig the 2010 Allied Health Workforce Survey ad for their cosultatio as the results were aalyzed. This report would ot be possible without their valuable assistace ad iput. The developmet of this report is also made possible through a grat from The Califoria Edowmet. CHA is grateful for the Edowmet s fiacial support of the Healthcare Workforce Coalitio. For more iformatio, please cotact Cathy Marti, director, workforce, CHA Healthcare Workforce Coalitio at (916) or camarti@calhospital.org.