What difference could a once-in-a-century pandemic in three years and a century make to Hawaii’s healthcare workers?
LOT, according to the 2022 Healthcare Workforce Initiative report assessing healthcare staffing and education needs in the Aloha State. The report is a follow-up to the inaugural 2019 report commissioned by the Healthcare Association of Hawaii, which represents assisted living and skilled nursing facilities, home care companies, hospices and hospitals.
Key findings include the need to enhance the entry-level health certification pipeline, attract and retain the healthcare workforce through glide paths, and expand nurse residency and transition-to-specialty registered nurse programs.
Recognizing the growing need for more healthcare workers, HAH launched the Healthcare Workforce Initiative in 2018 to better understand current employment needs across the state’s healthcare continuum. HAH President and CEO Hilton R. According to Raithel, collaborations in the state’s education, health care and community-based sectors share a common goal of increasing the locally trained and educated health workforce.
Growing need for health workers
The 2022 report identified nearly 3,900 open positions in 89 public-facing occupations, a 76% increase over 2019’s figures. Respondents included assisted living communities and other long-term care settings, hospitals, health system clinics, physician officers, federally qualified health centers, physical therapy providers and health insurers.
In assisted living, the overall healthcare vacancy rate increased from 11% in 2019 to 14% this year. According to Hilton, entry-level open certified nursing assistant positions are slated to grow in 2022 with a 15% vacancy rate, while the vacancy rate for licensed practice nurses is 32%. Oahu has the most open assisted living positions among all the islands.
Overall, across all settings, 17% of positions for health organizations surveyed are vacant – up from 10% in 2019. By profession, compared to 2019, there was a 78% increase in the number of CNA openings across all providers surveyed, a 47% increase in LPN openings, a 417% increase in Personal Care Assistant openings, and a 116% increase in RN open positions growth.
Hilton told McKnight’s Senior Living Reasons that remain open include net out-migration of working adults due to burnout, retirement and high cost of living in Hawaii, as well as net inward migration of older adults in need of service.
“It means we need more people in our healthcare workforce,” he said.
Wesley Lo, CEO of Ohana Pacific Health and Hale Makua, told McKnight’s Senior Living Assisted living communities and nursing homes cannot compete for RNs from a reimbursement perspective, so the focus turned to increasing LPN programs across the state.
“The industry is now realizing that we need to work together,” Lo said. “Employers need to take a position in people’s development. They can’t just rely on the education system.
At the core of the Healthcare Workforce Initiative, Hilton said, is education and employers working together “to better match supply and demand and ensure that we pivot and adjust over time.”
running the needle one program at a time
Some successes have come from collaborative partnerships, including a partnership between HAH and the University of Hawaii Community College System to create an entry-level certification pipeline for CNAs and other healthcare positions. To date, over 28 groups and 250 students have completed the Health Certificate Training program with an 80% placement rate.
In 2021, HAH convenes the Collaborative LPN Innovation Team to design an LPN pilot program to train employed CNAs to become LPNs. The program prioritizes entry for working CNAs and enables an earn-and-learn — or glide path — approach through an online course and clinical education at the current workplace. The program will launch in 2023.
Another new program coming next year is a pilot of a high school healthcare certificate program for students in underrepresented public schools. The effort will focus on a transition-to-employment model by offering career search, mentoring and employment opportunities.
“We are still behind the curve because of the pandemic, which has exacerbated staff shortages,” Hilton said. “We have a lot of work to do, but we know what we have to do and where we have to invest over the next few years. I am optimistic about the future.”
HAH plans to conduct the survey every two years. Access to the 2022 Healthcare Workforce Initiative Report is available on the HAH website.