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

Health Care Workforce Issues for Rural California The California State Rural Health Association Meeting . Beth Mertz December 5, 2006. Allied Health. The Allied Health Workforce in California- Critical Issues.

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

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  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. High Demand OccupationsSource: Conversations with RHORC Directors • Radiological Technicians & Technologists • Pharmacy Technicians • Respiratory Therapists • Medical Laboratory Technicians & Technologists • Medical Assistants • Physical Therapy Assistants

  5. 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 state’s urban areas. • Distance education and e-learning has made some progress but much more needs to be done

  6. Mental Health

  7. 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 California’s 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

  8. Pharmacy

  9. Trends in Pharmacy Employment Settings • 55% - Community Pharmacy (i.e. Walgreens) • 25% - Hospitals • 14% - Other community settings • 13% - Independent Settings From McRee, T (2002) “Pharmacy Staffing: A silent but critical concern” UCSF Center for the Health Professions.

  10. 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

  11. Dentistry

  12. MSSAs with a Shortage of Primary Care Dentists: California Counties, 1998

  13. General shortage in rural communities Policies must move beyond loan repayment, not sustainable for long term needs Private practice model difficult to sustain in rural areas, this will only get worse as dental incomes rise Community clinics have difficulty staffing Oral Health Workforce *MSSA=Medical 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

  14. Nursing

  15. 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

  16. 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

  17. Physicians

  18. Physicians to 100,000 US Population,1970-2000 • Source: BHPr/HRSA Factbook 2002

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

  20. 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

  21. Center for the Health ProfessionsUniversity of California, San Francisco3333 California Street, Suite 410San Francisco, CA 94118bmertz@thecenter.ucsf.eduhttp://futurehealth.ucsf.edu415-502-7934

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