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Health Care Workforce Issues for Rural California The California State Rural Health Association Meeting

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Many allied health professions projected to reach or have reached ... Psyche Techs. Innovative solution to some shortages. LVN trained in specialty. Pharmacy ... – PowerPoint PPT presentation

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Title: Health Care Workforce Issues for Rural California The California State Rural Health Association Meeting


1
Health Care WorkforceIssues for Rural
CaliforniaThe California State Rural Health
Association Meeting
  • Beth Mertz
  • December 5, 2006

2
Allied Health
3
The Allied Health Workforce in California-
Critical Issues
  • Many allied health professions projected to reach
    or have reached critical shortages
  • Lack of awareness/visibility/advocacy for allied
    professions
  • Lack of reliable data on supply and demand
  • Like other health professions, California lags
    behind the U.S. in proportion of allied health
    workers to population in
  • Allied health technical occupations
  • Allied health support occupations

4
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5
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6
High Demand OccupationsSource Conversations
with RHORC Directors
  • Radiological Technicians Technologists
  • Pharmacy Technicians
  • Respiratory Therapists
  • Medical Laboratory Technicians Technologists
  • Medical Assistants
  • Physical Therapy Assistants

7
Challenges for the Allied Health Workforce in
Rural California
  • Access to educational programs is limited maps
    show that programs in high demand allied health
    professions are concentrated in the states urban
    areas.
  • Distance education and e-learning has made some
    progress but much more needs to be done

8
Mental Health
9
Mental Health Workforce
  • Demand and distribution of workforce
  • 54 of providers employed in Bay Area and Los
    Angeles, only 9 in North county and Central
    Valley regions
  • Statewide by 2010, demand for services may grow
    16-30, absence of comprehensive workforce and
    education/graduation data make it difficult to
    assess Californias ability to produce enough
  • Rural communities are less competitive in
    hiring/retaining qualified personnel
  • In California, mental health providers were only
    made eligible for NHSC loan programs in late 2002
  • Psyche Techs
  • Innovative solution to some shortages
  • LVN trained in specialty

10
Pharmacy
11
Trends in Pharmacy
  • Employment Settings
  • 55 - Community Pharmacy (i.e. Walgreens)
  • 25 - Hospitals
  • 14 - Other community settings
  • 13 - Independent Settings

Ratio Pharmacists per 100,000 Population Ratio Pharmacists per 100,000 Population Ratio Pharmacists per 100,000 Population Ratio Pharmacists per 100,000 Population
Year 1973 1991 1998
CA 52.8 70.9 51.3
US 54.7 68.1 65.9
From McRee, T (2002) Pharmacy Staffing A silent
but critical concern UCSF Center for the Health
Professions.
12
Pharmacy Policy Issues
  • Rural communities are simply less competitive for
    pharmacy employment due to smaller economies of
    scale, yet have a larger over 65 population which
    is in most need of pharmaceuticals
  • Staffing shortages result in limiting services,
    increasing job dissatisfaction and stress, and
    potential for errors impacting patient safety
  • Very limited pharmacy availability in FQHC and
    community settings, difficulties educating,
    recruiting and retaining staff in these systems

13
Dentistry
14
MSSAs with a Shortage of Primary Care Dentists
California Counties, 1998
15
Oral Health Workforce
  • Private practice model difficult to sustain in
    rural areas, this will only get worse as dental
    incomes rise
  • Community clinics have difficulty staffing
  • General shortage in rural communities
  • Policies must move beyond loan repayment, not
    sustainable for long term needs

MSSAMedical Service Study Area- Rational
service area for the delivery of health care
services From Mertz et al. The Geographic
Distribution of Dentists in California Center
for California Health Workforce Studies, UCSF.
January 2000
16
Nursing
17
RN-to-Population Ratios, January, 2006
400-500 RNs/100,000 500-650 RNs/100,000 650-800
RNs/100,000 800-1000 RNs/100,000

Under 400 RNs/100,000
More than 1000 RNs/100,000
18
Nursing Issues in Rural California
  • Rural nurses are older and will retire sooner
  • 31 of rural nurses are age 55
  • 26 of urban nurses are age 55
  • There is not enough growth of new nurses in rural
    counties
  • There are not many nursing education programs in
    rural counties
  • General trend of young people migrating out of
    rural regions
  • Solutions?
  • Distance education video conferencing of
    education
  • Scholarships for students to travel for school

19
Physicians
20
Physicians to 100,000 US Population,1970-2000
  • Source BHPr/HRSA Factbook 2002

21
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22
California, 2000
  • 100,000 MDs
  • 65,000 active, patient-care MDs
  • Access-limiting
  • Mal-distribution

23
Themes
  • Market driven health care solutions tend to
    disadvantage rural communities
  • Staffing issues will dominant the health care
    landscape for years to come, critical shortages
    of allied health, pharmacists and nurses,
    maldistribution of mental health, dentists and
    physicians
  • Public health safety net left to fill the gap
    are under resourced
  • Technology revamped educational programs may be
    where innovations solutions arise to meet the
    needs of rural communities

24
Center for the Health ProfessionsUniversity of
California, San Francisco3333 California Street,
Suite 410San Francisco, CA 94118bmertz_at_thecenter
.ucsf.eduhttp//futurehealth.ucsf.edu415-502-793
4
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