May Update – Highlights:
Stay tuned for more information soon about a new date for the Commission’s rescheduled one-year anniversary convening! In the meantime, health workforce issues continue to be a primary focus of the state and federal response to COVID-19, with noteworthy activity on a number of fronts:
- Expanding the health workforce: Governor Newsom’s new California Health Corps initiative has mobilized almost 90,000 new health professionals to help combat the pandemic. The Administration has also issued temporary waivers from some licensing requirements to boost the state’s number of trained health workers. The Office of Statewide Health Planning and Development has also released details on grant applications for $40 million in Workforce Education and Training regional partnership funds.
- Preparing for the next phase: Two legislative hearings this month focused on the importance of health workforce planning—including an Assembly budget hearing on how workforce policies can support the state’s economic recovery and a Senate special committee hearing on the need for additional workers to conduct testing and contact tracing.
- Tracking health workers’ views: A new weekly polling series from the California Health Care Foundation has been tracking front-line health workers’ views on the state’s response to the coronavirus.
Newsom Executive Orders aim to boost state’s numbers of trained health professionals
Governor Newsom issued two executive orders in March to expand the state’s health workforce in response to the COVID-19 emergency. “California’s health care workers are the heroes of this moment, serving on the front lines in the fight against this disease,” Governor Newsom said. “If you’re a nursing school student or medical school student, we need you. If you just retired in the last few years, we need you. If you are looking to expand your scope of practice … we need you.”
One of Newsom’s executive orders created a new California Health Corps, a major initiative to recruit health care professionals by streamlining licensing requirements for doctors, nurses, paramedics, pharmacists and other frontline providers needed to combat a surge in coronavirus cases. Within a few weeks, more than 86,000 people applied to join the Health Corps.
Another executive order signed in March sought to temporarily expand the health care workforce by giving the Department of Consumer Affairs (DCA) the ability to grant waivers for existing provider supervision and licensing requirements. To date, DCA has issued six waivers on license renewals, reinstatement of licensure, nursing student clinical hours, and supervision requirements for Physicians Assistance, Nurse Practitioners, and Certified Nurse-Midwives.
Finally, OSHPD recently announced $40 million in regional partnership grant opportunities for workforce education and training. Within the next two weeks, OSHPD will be releasing an additional $18 million for psychiatry education capacity expansion (psychiatry residencies and psychiatric mental health nurse practitioners students) for training institutions, traditionally hospitals and universities.
California legislative hearings highlight health workforce needs
With the state budget facing significant deficits as a result of COVID-19, Assemblymember Joaquin Arambula (D-Fresno), chair of the Assembly Budget Subcommittee on Health & Human Services, held an informational hearing last week on the pandemic’s impact on providers and the role of California’s health workforce in stabilizing and regenerating the state’s economy.
State officials representing the Department of Health Care Services (DHCS), the Department of Managed Health Care (DMHC), and the Legislative Analyst’s Office (LAO) all noted a significant volume increase in telehealth, which has benefited from flexibility provided by the Centers for Medicare and Medicaid Services that now allows telehealth visits to be paid at the same rate as in-person visits. A Health Access representative noted that additional consumer protections are still needed to ensure patients can receive the care they need without unexpected bills.
Bradley Gilbert, Director of DHCS, cited the Commission’s work in reminding legislators that physician access remains an issue in regions like the Central Valley, Inland Empire, and rural areas, which faced shortages of health professionals before COVID-19. (The Commission’s recent fact sheet series highlights some ways the state can address shortfalls of behavioral health and primary care providers.)
Several speakers expressed growing concern with the increasingly dire financial situation facing many providers—leading to layoffs and furloughs and threatening access to care, especially for low-income patients. Experts testified that these issues will become more acute as providers maintain surge capacity, prepare for a possible second wave, and continue to purchase personal protective equipment.
Health worker representatives also noted the need for investments in historically underfunded local public health departments, which saw many of their positions eliminated between 2008 and 2017. An SEIU spokesperson reminded legislators about the series of targeted investments the Commission recommended for training the next generation of public health professionals—and expanding health equity.
As the state prepares to move into the next phase of its response to the pandemic, experts testified in another May hearing before the Senate Special Committee on Pandemic Emergency Response on the status of testing and contact tracing—two critical indicators identified by the governor for safely reopening the economy. According to the California Department of Public Health, approximately 800 workers are currently conducting contact tracing, with an anticipated additional 2,200 local health department employees being redirected to assist. The state is seeking to redirect a total of 10,000 state employees to this effort and has worked with UCLA and UCSF to establish a virtual training academy that is now providing 20 hours of online and in-person training for selected employees.
CHCF polling series capturing front-line health workers’ shifting views on the response to COVID-19
The California Health Care Foundation has been conducting a series of weekly polls since the beginning of the COVID-19 emergency, asking front-line health workers about the availability of medical supplies—and how their hospitals are coping with the surge in patients.
Among the key findings in recent polls: 89% of critical care doctors surveyed now say they have adequate access to PPE (up from 70% in early April), and 86% say patients and health workers can get tests if they need them (up from 74% a month earlier). Less than 5% of physicians report being “extremely worried” about getting the resources they need.
Still, 29% of physicians say their stress has increased “slightly” or “significantly” in the past week—down from 51% when posed the question was posed two weeks ago. A greater share of physicians both in and outside the safety net say their stress level is “about the same” compared to those who reported no change two weeks ago.