Healthcare Workforce Development: Where Are We Now

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GSETA 2011 Conference Presentation

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Healthcare Workforce Development: Where Are We Now

  1. 1. Health!Care!Workforce!Development:!!Where!are!we!now? 2011!GSETA!Conference Atlantic!City,!NJ September!14,!2011 Ashley!Conway,!SETC!Sr.!Policy!Analyst ashley.conway@dol.state.nj.us Sheryl!Hutchison,!SETC!Policy!Analyst sheryl.hutchison@dol.state.nj.us Janet!Moran,!Camden!WIB!Chairperson janetpmoran@gmail.com
  2. 2. Workshop!Agenda• An!overview!of!the!current!state!of!the!health!care!workforce!in!New!Jersey• What!does!the!future!hold!for!the!health!care!workforce?• NJ!Health!Care!Workforce!Council• Overcoming!barriers!to!work"based!training!programs!for! in"demand!health!care!occupations
  3. 3. What!are!your concerns!about!the!health!care!workforce?
  4. 4. Health!Care!is!unique:• Everyone!is!a!health!care!customer.• Government!is!a!big!player!in!the!health!care!industry:! ! Medicare/Medicaid!regulations!determine: o What!type!of!services!are!delivered! o Where!and!How!services!are!delivered o Reimbursement!rates!for!services ! 28!Health"Related!Licensing!boards!under!Division!of! Consumer!Affairs!(Law!&!Public!Safety,!Attorney!General),! each!with!its!own!rules!for!licensure,!depending!on!the! legislation!that!created!the!board.• Insurance!Payers!also!play!a!large!role!in!determination!of!types!of! services!provided.
  5. 5. Health!Care!is!a!growing!industry!in!New!Jersey.The!industry!shows!steady!employment!growth,!and!is!recession"proof.Mainly!service!sector,!not!goods"producing.Could!argue!that!the!growth/cost!of!health!care!is!a!drain!on!our!economy,!not!a!driver.Source:!NJ!Department!of!Labor!and!Workforce!Development,!Division!of!Labor!Market!&!Demographic!Research!
  6. 6. An!Aging!WorkforceIn!2009,!half (48.8%)!of!NJ!health!care!workers!were!45!or!older.And!of!those,!16.7%!were!already!at!retirement!age!(55!and!older).A!bad!economy!has!delayed!some!anticipated!retirements.
  7. 7. New!Jersey’s!Health!Care!Workforce!is!highly!educated,!and!slightly!surpasses!the!overall!NJ!population!in!degree!attainment:
  8. 8. New!Jersey!is!#1!in!health!care!spending!per!person,!for!the!last!2!years!of!life.! From!Dr.!Jeff!Brenner!– Camden!Coalition!Data!presentation Dartmouth!Atlas #1Inpatient and Part B spending per decedent during last 2 years of life Source: Dartmouth Atlas of Healthcare. 2006.
  9. 9. NJ!could!be!called!the!Acute!Care!State!
  10. 10. Current! Unemployed "ment Medical! Consumer! homes expectations! &!preferences Nurse! Faculty! Shortages Some!US!Health!Care!System!facts: Focus!on! primary! care Emerging! health! • US!spends!more!money!per!person!than! problems any!other!nation!in!the!world Aging! Workforce Economic! • Medical!debt!contributes!to!46.2%!of! Health! Care! Crisis all!personal!bankruptcies Reform • Life!expectancy!is!ranked!42nd – below! most!developed!nations Existing!System! Problems Population! Demographics • Higher!infant!mortality!rate!than!most!of!the world’s!developed!countries Accountable! Care!Act! Transforming!the!health!care!workforceBureau!of!Labor!Statistics:!www.bls.gov/news.release/ecec.nr0.htmWorld!Health!Organization:!“World!Health!Statistics!2009”.Wall!Street!Journal:!"Consumers!Cut!Health!Spending,!As!Economic!Downturn!Takes!Toll”.
  11. 11. Health!Care!Industry!Trends Moving!from!acute! With!mass! Baby"boomers! 450,000!newly! New!knowledge! All!of!these! care!to! retirements,! retire!and!more! insured!Health! and!training! changes!are! community"based! expertise!leaving! people!need!more! Care!consumers!in! needed!in!a!rapidly! happening!during!a! care the!workforce care NJ!by!2014!– or! changing! time!of!record! Medical!and!Technological! Health!Care!Reform Advances Economic!EnvironmentDeinstitutionalization Aging!Workforce Aging!population not environment!e.g.! level! Health!Information! unemployment! Technology and!a!stagnant! economy Uncertainly!that!threatens! A!dangerous! Organizational!Crisis high"priority!goals opportunity. Robert!Ulmer,!“Effective!Crisis!Communication:!!Moving!from!Crisis!to!Opportunity”.
  12. 12. Health!Care!Workforce!Council Employers Education WorkforceGoals:!• Recommend!policy!to!address!health!care!workforce!issues• Formulate!strategies!to!address!problems!or!implement!change
  13. 13. Overarching!needs:!!Geriatrics!and!Mental!Health Tier!I!Priority!Occupations Primary!Care! Physician! Nurses Physicians Assistants Terminal! Advanced! Degree Practice! Nurses Nurses Frontline/Direct! Radiography Care!Personnel Registered! Registered! Technicians! Nurses!– Nurses!– Baccalaureate! Associate! Degree Degree! (4!year) (2!year) Certified! Nursing! Home! Registered! Licensed! Assistants! Health Nurses!– Practical! (and!other! Aides Diploma! Nurses job!titles) Program (1!year) (3!year) Nurse Tier!2!Priority!Occupations Aides,! Patient!Care! Orderlies,! Technicians! Physical,! Attendants Social!Occupational,! Community! Pharmacists Dentists Workers! Speech!&! Health! (add!Pharm! (add!Dental! (LCSW!&! Respiratory! Workers Techs?) Hygienists?) MSW) Therapists
  14. 14. The!NJ!Health!Care!Workforce!Council!identified!health!care!workforce!issues. Need!for!shared,!coordinated!Primary!care!physician!shortages!! state!health!care!data. Training!and!education!to!fit!and!needs:• Reimbursement current!and!future!jobs!• Retention!in!NJ! Alignment!of!• Quality!of!life!issues Transition!from! training!&! Train!and!educate!from!• Able!to!specialize acute!care!to! education!with! generic!to!specific!!through! community" workplace! work"based!trainingNeed!for!greater!use!of!APNs: based!care needs• Reimbursement• Physician!collaborating!agreements• Nursing!faculty!shortages Coordination!of! patient" Implementation!of!!a!meaningful,! centered!care! Need!for!greater!collaborative! replicable,!statewide!!Health!Care! provided!by! learning!!&!training!and!education! model!– a!template!for!a!NJ! effective!teams that!links!fields/disciplines!and!! Accountable!Care!Team! transcends!the!isolation!of!silos. Organization
  15. 15. Training!&!Education!to!fit!current! and!future!jobs• What!are!those!jobs?!!Docs?!!Nurses?• For!Workforce!Investment!Boards!/!One!Stop! Career!Centers – Nursing!Assistants• Given!the!transition!to!Accountable!Care! Organizations!– we’re!not!quite!sure!what!the! jobs!will!look!like – Will!assistive!personnel!(very!broad!definition)! administer!non"controlled!meds?
  16. 16. Generic!to!specific!by!work"based! training!• Where!should!the!training!occur?• If!the!Accountable!Care!Organization!is!not!in! place,!should!training!occur!at!the!One!Stop! Career!Center?• If!the!jobs!are!better!defined,!can!the!training! occur!in!the!community,!out"patient!or!in" patient!setting?
  17. 17. Collaborative!training!that! transcends!silos• Once!jobs!are!defined,!can!the!One!Stop! Career!Centers!work!with!the!colleges!and! health!organizations!to!provide!qualified! candidates!to!be!trained!and facilitate! training?• One!organization’s!barrier!to!providing! training!– a!real"life!lesson.
  18. 18. Action!Items: Change!and! Legislation Data Innovation Gather!employer!input! and!ideas!to!understand!Clarify!health!care!roles what!future!demand Identify!short,!mid,!and! may!be long"term!health!system! needs!for!making! recommendations Map!jobs!and!required! job!skills!and!identify! Gather!supply and!how!the!two!are!aligned! education!capacity data! – or!not to!identify!critical! shortages!for!high! demand!occupationsIdentify!workable!models Select!one!council! recommendation!to! become!model! legislation Explore!establishing!a!Explore!what!a!NJ!model! central!repository!for! for!an!accountable!care! state!health!care!andteam!would!look!like!and! workforce!data how!it!would!work
  19. 19. DATA!MATRIX for!Selected!Health!OccupationsSupply!+ Education =Demand Current!Projections,! Current!Number!in! weighted!by!Trends: Number!in!school!now Occupation Changes!to!Delivery!and! Staffing!ModelsMinus!Exits!(retirement,! More!Community!Careleft!field,!moved!out!of! Minus!Number!NOT! state) Retained in!New!Jersey Population!Demographics Epidemiologic!/Chronic! Disease!Rates Note:!Number! Unemployed Aging!and!Long"Term!Care Note:!Program!Capacity! and!Number!Waitlisted Charity!Care!PressuresNote:!Current!Salaries Medicare/Medicaid
  20. 20. Data!Plans• Baseline!Supply!Data!=!What!we!have!now – Current!number!employed:!Labor!Data – Number!Unemployed:!Labor!Data – Replacement!Rate:!Labor!model – Education!Pipeline:!!Labor!gets!Higher!Education! and!training!provider!data!• Licensing!Data!– Trends!in!licensure!rates• Mapping!New!Jersey!– Find!gaps!in!workforce/services
  21. 21. A!Few!Workforce!Data!Issues• Data!collected!by!many!groups,!at!different!times – State!Agencies!" Labor,!Health,!Human!Services,!Education,!Higher! Education – Division!of!Consumer!Affairs!(Licensing) – Medicaid/Medicare – Employer!Associations!" NJHA,!NJCTH,!Primary!Care!Association – Community!Based!Organizations – Unions!and!Employee!Organizations• Licensing!data!does!not!necessarily!match!up!with! employment!data – Licenses:! 120,000!nurses!(RNs!and!LPNs) – Labor:! 91,700!nurses!employed!• Demand!is!an!unknown – we!are!in!a!time!of!change!
  22. 22. Data!Dream• Minimum!Data!Set!of!survey!questions! administered!to!all!health!care!professionals! when!they!renew!their!licenses. – Demographic!(age,!zip!code) – Practice!information!(type!of!services!provided,! accept!Medicaid,!etc.) – Retention/Retirement!plans
  23. 23. NJ!Health!Care!Workforce!Data!Center• Data!is!more!useful!when!you!have!the!whole!picture – Employment!and!Wages " Practice!Information – Licensing " Location!and!Types!of!Care – Demographics " Billing!Information – Education " Plans!for!the!Future• Economy!of!Scale!– more!efficient!to!have!data!for!all!health! care!occupations!housed!together,!rather!than!separate! centers!by!occupation!(more!silos,!more!cost)• Share!information!freely!amongst!stakeholders,!across!state! agencies• Make!informed!policy!decisions!as!a!state,!improve!quality!of! care!and!benefit!our!economy.!!Use!to!apply!for!grants.• Benefit!to!having!state"driven!center,!no!self"interest
  24. 24. To!perform!the!collection,!analysis!of!multiple!data!sources,!and!comprehensive!reporting!on!health!workforce!supply!and!demand!trends*.!! State!and! Federal! Agencies NJ!Center! for!Health! NGOs/CBOs Employers Workforce! Planning Education! Institutions *New!Jersey!Council!of!Teaching!Hospitals:!!“New!Jersey!Physician!Workforce!Task!Force!Report”.
  25. 25. Discussion

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