Webinar Tackles Staffing Shortages and State Policy Amidst COVID-19

On February 24, 2021, California Competes hosted a webinar, “Critical Care: Increasing the Capacity of Allied Health Training Programs,” featuring subject experts, leaders from government and higher education, and critical new research funded by Futuro Health.

California Competes Senior Policy and Research Analyst Gail Yen shared findings from the report, Meeting California's Demand for Allied Health Workers. For allied health professionals, California’s demand for their skills far outstrips their numbers. The state faces a shortage of up to 35,754 workers annually, even before taking into account extra strains from the COVID-19 pandemic.

Yen explained, “There are many reasons why there’s such a large gap between the supply and demand of allied health professionals. One of the big contributors to the gap—and the one that we focus on—is the lack of access to and availability of clinical training hours.”

Though the number of clinical hours required for licensing varies in different fields, the report concludes that, to meet staffing needs, the state needs to offer as many as 6.5 million more training hours per year than it currently does. That is, this issue is not just a lack of students; there are simply not enough slots available for each of those students to fulfill the clinical hours requirements their graduation depends upon.

The report proposes three solution areas: changes to collective stakeholder efforts, changes to education programs, and changes to employer practices.

Stakeholders, Yen said, must come together to do what needs doing. Strengthening regional consortia composed of educational institutions, employers, and community-based organizations will be a key avenue for increasing clinical training opportunities, as well as building upon sector-specific improvements.

Within higher education, technology is part of the solution, and the report strongly recommends increasing the use of various simulation modalities and telehealth. But there are other important ways students can advance, too, like increasing the use of competency-based education and offering credit for prior learning.

As for employers, they simply need to offer more training opportunities. The report recommends incentives for training sites and expanding the use of nonacute healthcare sites to put more students in clinical settings.

In all of these areas, the report argues, a multi-prong regional approach is largely feasible—and California cannot wait any longer to take action.

Following Yen’s presentation, the webinar turned to its expert panel discussion, moderated by California Competes Executive Director Dr. Su Jin Gatlin Jez and focusing on how to advance the report’s proposed solutions and accelerate their uptake across the whole state.

The discussion featured state Assemblymember Evan Low (D-28), Futuro Health CEO Van Ton-Quinlivan, Commission on Accreditation of Allied Health Education Programs Vice President Dr. Stacey Ocander, and Sacramento City College Director of Nursing and California Board of Vocational Nursing and Psychiatric Technicians President Dr. Carel Mountain. As the webinar was hosted live on Zoom, attendees were able to submit questions for the panelists to answer in real time.

Dr. Mountain praised the report’s recommendations and noted how well education–employer alignment can work in practice. “We’re really fortunate in the Sacramento area. We have developed a consortium of all the nursing schools—whether it’s community college or private schools and all of the leaders from all the various facilities—so that we can coordinate our efforts and be collegial,” she said.

I think more collaboration between industry and education will move us forward in the way we want to go.

Dr. Carel Mountain, Director of Nursing, Sacramento City College; President, California Board of Vocational Nursing and Psychiatric Technicians

She added, “One of the things that I’ve seen over the past year, especially with the pandemic, is how flexible people have been and how willing they are to share sites, give up sites, and make sure that people are meeting their hours. So I think more collaboration between industry and education will move us forward in the way we want to go.”

Dr. Ocander argued for the legitimacy of competency-based education and credit for prior learning, especially in the face of reduced available clinical hours. She explained, “We make it way too difficult. We try to find all the reasons to say no before we say yes, which is ridiculous behavior…For example, no one will ever convince me that a military medic is not as well-trained as my EMT students, because they’ve been trained in real life!” She also pointed out the importance of flexibility in competency-based education, noting that, “It just comes back to, let’s stop making things so difficult and just use common sense to be able to say yes.”

Assembleymember Low, who last year authored Assembly Bill 2288 to increase flexibility for nursing programs, discussed the difficulties policymakers often face in trying to legislate effectively while not being subject-matter experts themselves. “What’s important,” he concluded, “is to build consensus around this for the regulatory framework so we can address this big hurdle… we rely on your expertise, but when we go to industry and there's no consensus, it becomes that much more difficult to figure out. These conversations can be circular in nature, and the focus can be counterintuitive.”

Ton-Quinlivan tackled the big question of the day: Why are allied health workers so important, and why are clinical bottlenecks such a problem? “Working with California Competes, one of the things we were able to identify was that through the deployment of the mass vaccination sites…[we had] an opportunity for students to have direct patient care.” she said. “So we proposed that to Kaiser Permanente and other health systems, and they said yes.”

The more that we’re actively thinking about the opportunity and how we systematically create the opportunity, I think collectively we have a better chance at closing the gap on some of these very large numbers.

Van Ton-Quinlivan. CEO, Futuro Health

She also recalled her previous experience in the private sector and how valuable simulations can be in training, for instance in preparing for an airline crash. “The more that we’re actively thinking about the opportunity and how we systematically create the opportunity, I think collectively we have a better chance at closing the gap on some of these very large numbers.”

All the panelists emphasized the importance of providing quality training as well as flexibility, noting the frustrations students had faced throughout the pandemic as expectations and opportunities have shifted frequently.

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