March Update – Highlights:
- Legislature introduces wave of new health workforce bills: Health workforce issues remain a top priority as the state continues to respond to COVID-19. After the Governor proposed a variety of workforce investments in his January budget, the Legislature has introduced a wave of bills aimed at closing shortages of health professionals, increasing diversity among health workers, and expanding successful state programs like PRIME and the Health Careers Opportunity Grant Program (HCOP).
- Poll finds providers experiencing high levels of burnout, frustration: A poll released in February by the California Health Care Foundation found health workers are reporting rising levels of burnout, ongoing staffing shortages, and growing frustration with the public.
- Two new state reports highlight home care gaps, challenges facing low-wage health workers: A newly released state audit of the In-Home Supportive Services Program found widening gaps between the number of home care recipients and caregivers—with low wages making it difficult to recruit additional workers. Another report released in March by the Governor’s Future of Work Commission highlighted the need for wage support for home care providers—recommending setting a state goal to raise wages for home caregivers to at least 75% of an indexed, regional living wage measure.
- UCSF oped highlights “urgent need to increase diversity among California physicians:” With COVID-19 exposing deep inequities in California’s health system, a new oped by UCSF professors Janet Coffman and Alicia Fernández highlights strategies the state can use to close these gaps—including several Commission recommendations around preparing, admitting, and training more medical students committed to caring for California’s underserved patient populations.
- Applications open for new online training program for PMHNPs: The UCSF School of Nursing, in collaboration with the UC Davis and UCLA Schools of Nursing, has launched a new remote-access training program that will prepare 300 psychiatric mental health nurse practitioners (PMHNPs) over the next five years. Applications are open through April 15 to join the January 2022 cohort.
Legislature introduces wave of new health workforce bills
Only a few months after the passage of legislation promoting adoption of community paramedicine programs and allowing nurse practitioners to practice independently, the Legislature has introduced another wave of bills aimed at addressing health workforce issues.
Some notable health workforce bills include:
- AB 240 (Rodriguez): Requires the State Department of Public Health to conduct an evaluation of the adequacy of local health department infrastructure and make recommendations for future staffing and workforce needs.
- AB 1015 (Rubio): Requires the Board of Registered Nursing to incorporate regional forecasts in its biennial analyses of the nursing workforce and to develop a plan for addressing regional shortages.
- AB 1130 (Wood): Establishes a new Office of Health Care Affordability within OSHPD and requires the office to set priority standards for various health care metrics, including health care quality and equity and health care workforce stability.
- AB 1204 (Wicks): Requires hospitals to submit an annual equity report to OSHPD that includes an analysis of access to care and employment disparities based on race, ethnicity, and gender and plans for addressing those them.
- SB 40 (Hurtado): Creates the California Medicine Scholars Program, a 5-year pilot program that would establish a regional pipeline for community college students to pursue premedical training and enter medical school, in an effort to address the shortage of primary care physicians.
- SB 395 (Caballero): Extends Proposition 56 tobacco taxes to e-cigarettes and directs a percentage of revenues to the Health Careers Opportunity Grant Program Fund for the purpose of improving access to the state’s health profession programs by underrepresented students from disadvantaged backgrounds.
- SB 441 (Hurtado): Adds geriatric medicine to the list of primary care specialties supported by the Song-Brown Health Care Workforce Training Act.
- SB 787 (Hurtado): Establishes a PRIME program for the California State University system, requiring the university to create a Doctor of Medicine program with the goal of addressing access to medical care in underserved, disadvantaged areas.
Poll finds providers experiencing high levels of burnout, frustration
A new survey from CHCF finds health care providers are experiencing rising levels of weariness and frustration as the COVID-19 pandemic wears on. With the pandemic entering its second year, providers continue to report significant shortages in PPE, clinical staff, and other resources. Almost half (45%) are reusing PPE, and 39% say they do not have enough medical-grade N95 masks to meet their needs. Six in 10 agree that staffing shortages are hampering their ability to respond to the pandemic.
Half or more providers feel frustrated at their job (50%), overworked (57%), burned out (59%), or emotionally drained (68%). And frustration with the public is climbing: A total of 91% of providers agree with the statement: “I am frustrated by the public’s behaviors and attitudes related to COVID-19.” When asked if they believe “the public is doing their part to stop the spread of COVID-19,” 86% said they disagree, with 60% “strongly” disagreeing.
Two new state reports highlight home care gaps, challenges facing low-wage health workers
A newly released audit of the state’s IHSS program finds the program helps more than 591,000 lower-income elderly or disabled Californians access health care, but concludes that a shortage of workers and low wages are preventing the program from keeping pace with demand. The audit notes that the number of recipients statewide who lack care has grown to more than 40,000 each month, a number that is expected to climb as the senior population grows by two million people in the next decade.
With many care workers earning close to the state’s $12-per-hour minimum wage, the audit recommends modifying the compensation system for home care workers to improve recruitment. In 2019, the Commission proposed addressing growing shortages of home care workers by developing a robust “universal home care” family of jobs, career ladders, and associated training that would boost earnings and provide more workplace stability.
Governor Newsom’s Future of Work Commission, in its final report released this week, recommended setting a state goal to raise wages to at least 75% of an indexed regional living wage measure for 50% of workers in home care and other “vulnerable” sectors.
UCSF oped highlights “urgent need to increase diversity among California physicians”
COVID-19 has revealed serious flaws in California’s health system, say UCSF professors Janet Coffman and Alicia Fernández in a new CalMatters oped, but none is more distressing than the deep racial and ethnic inequality exposed by the pandemic. “There is no easy solution to these problems,” the authors write. “But the evidence shows the need for at least one urgent response: Doing everything we can to create a health system—and a physician workforce in particular—that looks a lot more like the people it serves.”
Coffman and Fernández highlight the potential of a series of successful programs that have helped increase diversity in California’s medical schools—including UC PRIME, which boosted the number of Latinx students at UC med schools by 21% and Black students by 25% in the first four years after it was launched 2004. The program, also highlighted by the Commission in its final 2019 report, has now expanded to six UC campuses.
The oped highlights the need for investments in programs that prepare students for medical school, as well—noting the Commission’s recommendations and 10-year cost estimates for expanding advising and mentorship programs for low-income college students ($159 million) and funding postbaccalaureate training programs for people from disadvantaged backgrounds ($26 million).
Applications open for new online training program for PMHNPs
With California facing a growing shortage of mental health professionals, the UCSF School of Nursing, in collaboration with the UC Davis and UCLA Schools of Nursing, has launched a new remote-access training program that will prepare 300 psychiatric mental health nurse practitioners (PMHNPs) over five years.
Applications are open now and will close April 15, 2021 for the cohort beginning January 2022.
The first remote-learning, post-master’s certificate of its kind in California, the new Multi-Campus PMHNP Post-Master’s Certificate training is a 12-month hybrid that combines remote-access education with three in-person sessions and regional clinical training across California. Students can stay in their communities to complete their training. Upon completion, students will sit for the American Nurses Credentialing Center national certification to become a PMHNP.
