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We Will Inform You About:• Northern Virginia Health Care Workforce
Alliance• PricewaterhouseCoopers Study• GWBOT Health Care Task Force• NoVaHealthFORCE Strategies & Action Plan• GWBOT Study Recommendations• Northern Virginia Workforce Investment Board
Why the Northern Virginia Health Care Workforce Alliance?
Regional health care worker shortage
• Current regional shortage obvious but not quantified
• Projections call for worker demand to continue growing over next 30 years
• Current capacity of training & education system inadequate to meet projected demands
What is the Northern Virginia Health Care Workforce Alliance?• Private sector, business, government,
community, health care and educational leaders
• Mission: establish a long-term, business-driven, sustainable strategy to address the Northern Virginia health care worker shortage
Outcome: A Business-driven Sustainable Strategy• Concept of “business-driven” is key
• Businesses must see themselves as having a vested interest
• Health care workforce shortage must be seen as more than a hospital problem
Outcome: A Business-driven Sustainable Strategy• Solution must provide upward mobility
for “New Americans” and underemployed
• The solution must address workforce utilization in health care industry
• Solution must be self-perpetuating and out-live the Alliance
What Did The Alliance Do:• Commissioned
PricewaterHouseCooper Study
• Develop comprehensive regional
strategies
• Changed Name to NoVaHealthForce
PricewaterhouseCoopers was engaged by the Northern Virginia Health Care Workforce Alliance, a Coalition of business, academic, and community leaders to:
•Identify the issues
•Analyze the scope and impact of the health care
workforce shortage on Northern Virginia.
Objectives and ApproachThe objectives were to identify:
• current and future Northern Virginia health care workforce needs for 24 selected health care professions
• current and future gaps in the health care workforce and the driving forces leading to these gaps
• training and education, recruitment, and retention best practices within Northern Virginia and other regions of the country.
The approach included:
• a quantifiable independent survey of a sample of health care providers in Northern Virginia• interviews with local health care providers, academic institutions and economic development authorities• a literature search
Health Care Professions Studied
Professions Studied
RNs Nursing AidesMedical Records/ HIT Dental AssistantsMedical and Nurse Managers Home Health AidesDental Hygienists EMTs/ParamedicsRadiologic Techs LPNsPhysical Therapists Physical Therapist AssistantsOccupations Therapists Respiratory TherapistsCT Scanning Techs Medical and Lab TechnologistsMRI Techs Speech Language PathologistsPharmacy Techs PharmacistsSurgical Technologists Medical and Lab TechsPhlebotomists Surgical Techs
Demographics pose specific challenges and solutions:• High growth rate• Low unemployment rate • Highly educated • High levels of employment• High salaries (comparatively)• Ethnically diverse• Large percent of foreign born • Growing focus on life sciences• Large information technology focus
Northern Virginia is a Dynamic Community
Ad
van
cem
ent
Intellectual Property Protection
Private Capital/Gov. Funding
Technology/Science DiscoveryRes
earc
h
Government• National Institutes of Health• National Science Foundation• Defense Advanced Research
Projects AgencyPrivate Sector• Think Tanks• Technology Councils• IT Industry• Pharmaceutical Industry
• Life Sciences IndustryUniversity• Academic Medical Centers
• Teaching Hospitals• Specialty Research• Health Sciences
Community Colleges/Universities Technical SchoolsHigh Schools
Education Graduate Schools
Entrepreneurial Spirit
“The greater DC Metro Area and Northern Virginia are poised to be the one of the world’s primary centers of biotechnology. The region sits at a crossroads between world class education and research with a foundation of drivers to advance discovery and the implementation of new technologies.”
-- President - Large Northern Virginia Medical Technology Foundation
Northern Virginia: A Medical and Health Care Information Technology Incubator
• A shortage of health care workers exists in Northern Virginia
• Estimated shortage of about 2,800 professionals in the 24 occupational categories
• Average vacancy rate of about 10 percent
• Without interventions, vacancy rate is anticipated to grow to over 41% by 2020
Key Findings
Key Findings (cont)• Anticipated vacancy percentages are estimated to range
from 27 - 56% depending on the profession
• RNs dominate the current and projected shortage, with more than 1,000 current vacancies
• Other hard hit professions are medical records and health information technicians and imaging
• The forecasted growth will continue to put immense strain on the availability of health care workers through 2020. Without interventions, vacancies will increase to 16,600 positions with a total demand of over 40,000 positions
Future Demand is High
Occupation Current
EmploymentCurrent
ShortageCurrent Demand
Demand 2010
Demand 2020
Estimated Shortage
2010
Estimated Shortage
2020
Registered nurses (includes CRNAs, nurse practitioners and nurse midwives)
9,100
1,000
10,100
12,100
15,400 3,000 6,300
Nursing aides, orderlies, certified nurse assistants, attendants
3,200
300
3,500
4,300
5,400 1,100 2,200
Medical records and health info technicians
1,300
200
1,500
1,900
2,500 500 1,200
Dental assistants 1,100
20
1,120
1,400
1,900 300 800
Medical and nurse managers
1,100
100
1,200
1,300
1,700 200 600
Note: “Estimated Shortage” calculation assumes no change related to increased retirements, etc.
Current and Estimated Demand by Health Care Occupation Through 2020
Vacancies Could Increase by 2020 Without Intervention
Anticipated Growth in Vacancy Rates for Select Occupations
`39%22%6.7%Medical and nurse managers
47%29%11.4%Medical records and info techs
42%26%12%Radiologic, CT, MRI techs
42%33%26%LPNs
41%25%10.3%RNs
`39%22%6.7%Medical and nurse managers
47%29%11.4%Medical records and info techs
42%26%12%Radiologic, CT, MRI techs
42%33%26%LPNs
41%25%10.3%RNs
2004 Vacancy Rate
2010 Estimated
Vacancy Rate
2020 Estimated
Vacancy Rate
Other Key Findings• Access to health care, quality of care, and quality of
life may be negatively affected as a result of the shortages
• Increased demand for services due to the aging population
• Concurrent aging of the health care workforce and resultant retirements
• Shortage of nursing and allied health profession faculty, schools, and clinical experience sites and the inability to find replacements
Other Key Findings (cont)
• Concurrent aging of clinical faculty and the resultant retirements
• Difficulties with having market competitive salaries for clinical faculty
• Nature of the profession
• Low unemployment rates and high cost of living
0
1
2
3
4
5
6
7
8
9
10
Decreased Stay the Same Increase
Last 12 months Next 12 months
All of the Northern Virginia hospitals surveyed expected to either retain their current workforce or hire additional workers.
Nine hospitals reported that they would grow their health care workforce in the year ahead.
Hospitals Expect Biggest Future Difficulties in Hiring Staff Change in Workforce Needs
for Hospitals
Source: PwC Analysis of Northern Virginia Workforce Survey
Num
ber
of r
espo
nses
Gaps Will Be Exacerbated by Lower Supply
Occupation
Current Vacancy
Rate
Expected Increase Demand (2004-2010)
Future Demand Scenario
Registered nurses 10% 51% More than 1,000 vacancies currently; retirements expected to widen the gap; shortages could lead to more burn-out and raise current vacancies rates.
Nursing administration 7% 51%
Occupational therapist 16% 51% Large vacancy rate combined with drop in graduates could affect access to therapy.
Physical therapist 17% 51%
Physical therapist asst. 26% 65%
Dental hygienist 4% 64% Trend toward more hygienists per dentist leads to more demand for these positions.
Medical records/info tech
11% 64% Coders and other IT professionals currently in short supply. As hospitals and clinics move to electronic medical records, need for coders may slow, but demand for other IT professionals will increase.
Occupations with High Demand and Low Supply
Medical Records and Health Information Technicians
• Rising health care demand
• Increased scrutiny of medical documentation
• Continued emphasis on the electronic medical record
• Growth will be primarily distributed among physician offices/clinics, hospitals, and long-term care facilities
Increased demand for medical records technicians will be fueled by:
Medical Records and Health Information Technicians (cont)• Third-party payers and government regulators
are expected to add to the demand
• Issues with quality of the available medical records staff surfaced repeatedly in the interviews
More Medical Records/IT Technicians Will Be Needed
0
500
1,000
1,500
2,000
2,500
3,000
Current Supply CurrentDemand
2010 Demand 2020 Demand
1,200 Positions
Medical Records and Health Info Technicians
Additional Demand for Workers (Current and Future)
An 11% shortage of medical records technicians or 172 open positions was reported. To eliminate the shortage and keep up with anticipated demand and population growth, Northern Virginia will need to add over 363 technicians by 2010 and another 675 by 2020.
An average of seven medical records technicians graduated each year from colleges between 1999 and 2003. At this graduation rate, an additional 49 technicians will be added to the workforce by 2010, 314 below market demand estimates.
Current Supply
Current Gap
Additional Gap by 2010
Additional Gap by 2020
Lack of awareness about certain occupations
• While students may be aware of what a nurse or pharmacist does, many are not familiar with the role of a surgical technologist, speech pathologist or CT scanner.
Misconception about the occupations
• Students don’t realize that many health care careers are “high-tech.” Said one hospital executive: “Technology is a large aspect of health care jobs and will continue to increase. This is not a particular awareness that students or teachers have.”
Low pay• While some positions pay well,
many lower-level jobs pay poorly.
Poor hours• These are “labor intensive jobs
with too much responsibility and unattractive work hours.”
High turnover• High turnover becomes a self-
fulfilling prophesy. Most employers interviewed cited burnout as a common problem. Often, other workers must take up the slack when their co-workers quit. This burns them out and leads to more turnover.
• When asked about the consequences of vacancies, one employer said: “Nursing staff must work more hours.”
Inability to RetainOccupation Awareness Access to TrainingMany training programs are at
capacity• “There will be a critical shortage of
faculty as the programs scale up. Presently there is a serious faculty constraint,” said one education leader.
• A shortage of clinical training sites is a critical element in increasing the number of nursing and allied health student graduates.
• Educators said that more of their students are foreign-speaking. Providing instructors in a multiplicity of languages is expensive and difficult.
Recruitment and Retention Challenges
Education and Training
Providing health care training to persons new to health care or encouraging advanced training to persons inside of health care. Most programs achieve this through free training and education, paid training and internship opportunities, and accelerated training programs.
• Recruitment
Initiatives aimed at recruiting new workers into the field of health care. Strategies include awareness programs, enhanced benefits, loan forgiveness, increased marketing of health care careers, and flexible work hours. Focus on English as a Second Language.
• Retention
Retention tools often include innovative benefits such as employee driven scheduling, development of clinical specialist and manager positions, market rate adjustments, career ladders, child care job satisfaction, focus on the over-40 worker among others.
Specific challenges are retaining the experienced employees who are so important in training and mentoring the less experienced employees. Without mentors, the less experienced professionals are apt to leave.
Creative compensation.
Workforce Best Practices
Expand best practices:Create awareness of the professionsProvide specialized training and on-site trainingFocus on retention and job satisfaction
Encourage new innovative ways to provide health care services
Develop a synergy among the health care providers, the educational institutions, and the economic development authorities and workforce planning commissions
No. Virginia Health Care Providers Adopt Innovative Ways to Maintain a Strong Health Care Workforce
Who Cares? Report Objectives
1. Review national health care workforce shortages and strategies to address them.
2. Assess Greater Washington’s health care workforce shortages, current workforce training efforts, and best practices.
3. Develop recommendations to strengthen Greater Washington’s health care workforce.
Greater Washington: The Region
• Northern Virginia - Arlington, Fairfax, Fauquier, Loudoun, Prince William, Stafford and Spotsylvania (7 counties); Alexandria, Fairfax City, Falls Church, Leesburg, Manassas, Manassas Park, Fredericksburg, Vint Hill (7 cities)
• Suburban Maryland - Anne Arundel, Calvert, Charles, Frederick, Howard, Montgomery, Prince George’s and Saint Mary’s (8 counties).
• Washington, DC
Methodology Gathered Primary and Secondary Data (i.e. Bureau
of Labor Statistics, Dept. of Labor Occupational Employment Statistics, Maryland Higher Education Commission and State Commission on Higher Education for Virginia, survey Data, etc.)
Conducted Interviews and focus groups with over 40 individuals throughout the region from the business, government, academic, and nonprofit sectors.
Identified 23 occupations in high demand, required less than B.A. degree, potential for career ladders.
Educational Supply & Industry Demand
Scan of public and private 2- and 4-year institutions and private education/training providers in targeted area.
Graduate numbers are based on 2003-2004 data from MHEC and SCHEV and self-reported data from individual institutions.
Data on number of graduates is only an estimate for this scan; they should be systemically validated in future studies.
Washington PMSA: Top 10 Occupational Projections 2000-2010
(By Annual Total Openings)Health Care-Related Health Care-Related
OccupationsOccupationsProjected Projected
Employment 2010Employment 2010Estimated Annual Estimated Annual Percent ChangePercent Change
Annual Total Annual Total OpeningsOpenings
Registered Nurses 43,859 1.8% 1,461
Nursing, Aides, Orderlies, and Attendants
21,856 2.2% 655
Licensed Practical and Licensed Vocational Nurses
12,302 2.0% 482
Medical Assistants 7,474 3.8% 371
Dental Assistants 6,075 3.2% 242
Home Health Aides 5,708 3.1% 203
Pharmacy Technicians 4,528 2.8% 197
Dental Hygienists 3,784 3.1% 141
Medical Records and Medical Records and Health Information Health Information TechniciansTechnicians
2,8782,878 3.3%3.3% 126126
Medical and Clinical Laboratory Technologists
3,714 0.9% 111
Greater Washington Health Care Workforce:
Educational Supply & Industry DemandHealth-care Health-care
Related Related OccupationsOccupations
Projected Projected Annual Annual
OpeningsOpenings
# of # of Programs Programs in Regionin Region
Estimated Estimated Annual # of Annual # of GraduatesGraduates
NotesNotes
RNs 1,461 DC: 10MD: 19VA: 7
1,444
Mix of offerings, AssociatesLPNBSN, and MSN
Nursing Aides,
Orderlies, and
Attendants
655 DC: 4MD: 11VA: 1
208+
Mostly non-credit certificate; Private career schools
LPNs 482 DC: 6MD: 6VA: 1
403+
Certificate; Private career schools; Decentralized data collection
Greater Washington Health Care Workforce:
Educational Supply & Industry DemandHealth-care Health-care
Related Related OccupationsOccupations
Projected Projected Annual Annual
OpeningsOpenings
# of Programs # of Programs in Regionin Region
Estimated Estimated Annual # of Annual # of GraduatesGraduates
NotesNotes
Medical Assistants
371 DC: 1MD: 12VA: 3
43++
Certificate; Private career schools; Decentralized data collection
Home Health Aides
203 DC: 2MD: 2VA: 0
100-150+
Certificate and non-credit certificate levelPrivate Career Schools
Pharmacy Technicians 197 DC: 0
MD: 4VA: 1
33+ Certificate
Greater Washington Health Care Workforce:
Educational Supply & Industry DemandHealth-care Health-care
Related Related OccupationsOccupations
Projected Projected Annual Annual
OpeningsOpenings
# of # of Programs in Programs in
RegionRegion
Estimated Estimated Annual # of Annual # of GraduatesGraduates
NotesNotes
Dental Hygienists 141 DC: 1MD: 1VA: 1
50+
Associate and Bachelor’s degrees
Medical Records Medical Records & Health & Health
Information Information Technology Technology
126 126 DC: 4DC: 4MD: 8MD: 8VA: 5VA: 5
42+ 42+
Mixed Mixed educational educational offerings, but offerings, but most are at most are at certificate certificate level level
Medical and Clinical Lab
Technologists
111 DC: 1MD: 1VA: 1
?
All programs are Bachelor’s degrees
NoVaHealthForce Strategies:
Goal 1: Increase capacity within the health care education and training system
Goal 2: Develop and sustain an ongoing supply of persons interested in entering
health care career fields
Goal 3: Nurture Innovation
NoVaHealthFORCE Action Plan:• Action plan developed by eight working
groups
• Working groups consisted of stakeholders from: education, healthcare industry, local, state and federal government, social service agencies and economic development authorities
Capacity:• Address the lack of nursing and
allied health faculty
• Address the need for additional clinical training sites and clinical faculty
Capacity (cont):• Address the projected increasing
population in the western and southern portions of Northern Virginia.
• Ensure optimal resource utilization to increase capacity and output of Northern Virginia educational health care institutions.
Pipeline:• Increase awareness of the healthcare career
fields
• Improve healthcare career preparedness in the school systems
• Provide upward mobility opportunities
• Facilitate foreign trained healthcare personnel to enter the workforce
Innovation:• Enhance the adoption in Northern Virginia of
Information Technology
• Harness the potential of the healthcare consumer
• Create innovative approaches in healthcare human resource management
Innovation (cont):• Nurture the career fields of tomorrow
• Develop a forum to share best practices
• Designate an organization to coordinate the implementation of these actions
Study Recommendations
• Raise Awareness: Educate stakeholders throughout Greater Washington regarding health care workforce challenges, issues, and potential ways to solve them.
• Convene the Region: Provide a forum for all stakeholders to address the region’s health care workforce shortage.
• Advocate for Change: Develop a policy agenda that supports regional efforts to increase recruitment, training, and retention of health care workers.
Next Steps
• Working to develop a cross-sector, regional initiative to create a robust, sustainable health care workforce.
• Hold a series of focus groups with providers, educational/training institutions, workforce investment agencies, and social service organizations to garner input, build support. (Fall 2005)
The Role of the Northern Virginia Workforce
Investment Board in Responding to Our
Regional Healthcare Workforce Shortage
Goal of the Public Workforce Investment System and Local
Workforce Boards• To support business hiring and workforce
retention needs
• To increase the employment, retention, and earnings of participants, and increase occupational skill attainment by participants
• As a result, the quality of the regional and national workforce will improve and enhance the productivity and competitiveness of the nation
Structure of The Public Workforce System
• 643 state and local Workforce Investment Boards (WIBs) appointed by local elected officials, chaired by business leader
• Each board has a majority business membership (51% ) and includes public workforce partners
• Overseen nationally by the U.S. Department of Labor and funded primarily by the Workforce Investment Act
Local WIBs: Composition
• Established in each local workforce investment area
• Appointed by the Chief Local Elected Officials (LEOs) using criteria established by Governor and State Board
• Chair must be private sector/business
• 17 mandatory public partners must also provide services at the Career Center
Roles of Local Workforce Investment Boards (WIBs)
• Administer and operate the local public employment and training system
• Convene public partners (MOU’s) & businesses to create coordinated responses to the community’s workforce issues
• Operate nationwide network of One-Stop Career Centers
NOVA Workforce Board Vision and Mission
Vision:A region where every business can attract and retain highly skilled workers and where every worker gains the skills they need to become employable.
Mission:A system that is demand-side led, meeting business demands for a highly skilled workforce and assisting business in sustaining economic growth. The system offers world-class preparations to every Northern Virginia resident throughout his or her lifetime.
Our Region’s Unemployment Challenge
As of June 2005
5.2%
5.6%
5.1%
4.5%
5.3%
4.4%
4.6%
4.4%
2.8%Northern VA
Research Triangle
Boston
San Diego
Denver
Austin
Seattle
Silicon Valley
United States
Northern Virginia Public Utilization of One-
Stop CentersNVWIB has experienced continued strong public utilization of One Stop Centers throughout region. While data represents multiple visits, it offers an order of magnitude ‘snapshot’ of Center use.
2003 2004 2005
59,018 50,513 49,063
One Stop Centers offer universal access to the public, in addition to specific employment services for eligible job seekers.
NOVA Workforce Board Policy Direction
• NVWIB sets policy in areas including:
– Local area’s workforce investment strategic plan– Developing budget to carry out duties of WIB– Coordinate workforce investment with economic
development– Promote private sector involvement– Select One-Stop Center Operators– Appoint Youth Council Members along with Chief Elected
Officials – Identify eligible training providers– Provide program oversight– Negotiate local program performance measures
Value of Local Workforce Boards
• Sets strategic direction for use of public workforce resources
• Creates the infrastructure of the network of approximately 3,000 One-Stops throughout U.S.
• Access to political leadership, training and other human capital resources
• Board can be a neutral convener that represents key community partners addressing workforce development in a community
• Can leverage strategic resources for workforce development and training
How Can Healthcare Businesses Engage Their Local Workforce Boards?
• Make a tangible “ask” for resources and support
• Create a Value proposition – share data
• Volunteer to serve on the Local Workforce Board of Directors
• Help local elected officials understand what systematic and policy changes are needed to support local healthcare business workforce needs
• Share case studies and best practices with private sector members
• Publish and disseminate business testimonials about the value to the business bottom line
• Show you understand the big picture of workforce development
• Know the difference between operations and policy-making
How Can Healthcare Businesses Engage Their Local Workforce Boards?
Opportunities to Link with the Region’s Economic
Development Initiatives• Federal WIA funding can be utilized to support new
business attraction and existing business retention. Moreover, the Healthcare Industry is identified as a National High Growth Industry:
– Worker Training Grants (ITA’s)
– On-The-Job Training (OJT) Wage Subsidies
– Incumbent Worker Training Grants
– Regional and National Labor Market Data
Online Resources To Link Your Business With Free
Workforce Services– National Association of Workforce Boards
www.nawb.org– U.S. Department of Labor One Stop Center
Directory http://www.servicelocator.org/– U.S. Department of Labor Workforce One Initiative
http://www.workforce3one.org– NOVA HealthForce
http://www.novahealthforce.com/– Northern Virginia Workforce Investment Board
http://www.myskillsource.org
For More InformationDavid HunnExecutive DirectorNOVA Workforce Investment Board(703) 752-1606(703) 752-1609 (fax)[email protected]
Reference and Contact Information:
www.NoVaHealthFORCE.com
http://healthcare.pwc.com
www.potomacconference.org/healthcare.html
www.futureworks-web.com
www.myskillsource.org/Home/nvwib/index.asp
www.nvcc.edu/medical