JUNE 2007: SPECIAL REPORT, THE FUTURE OF HEALTH CARE
Elaine Echmann at work
in a medical lab technician class at PCC.
PHOTO BY MICHAEL G.
HALLE.
|
The workforce worry
Community colleges struggle to keep up with the demand for
health-care workers.
By Jon Bell
During the 2004-05 school year, Oregon community colleges
graduated 573 students from registered nursing programs;
colleges and universities contributed another 524, for a total
of 1,097 graduates.
Sounds like a pretty good chunk of RN change, no?
In reality, however, those numbers still fell short of the
1,200 new registered nurses the Oregon Employment Department
(OED) projected the state would need every year between 2004
and 2014 to keep up with workforce demand.
Similar scenarios played out in other health-care occupations,
from cardiovascular technologists and technicians —
which, because there is no training program in Oregon, came
nowhere close to getting the 23 new workers it needed —
to dental hygiene, which graduated just 76 of the 129 students
necessary to slake annual demand.
Other fields, such as respiratory therapy and licensed
practical nursing, appear to have adequate supply for current
and future demand. But for the most part, the notorious
health-care workforce shortage in Oregon is already very
real.
And despite the fact that the state’s educational
institutions continue to produce new health-care graduates each
year — OED logged nearly 8,500 postsecondary health- care
program graduates in 2004-05 — the struggle to meet
increasing workforce demands for a larger and older population
is shaping up to be a long and frustrating slog.
Nowhere is that more evident than at the state’s 17
community colleges.
“We’ve got a workforce crisis heading our
way,” says David Goldberg, executive director of the
Oregon Healthcare Workforce Institute. “It’s not
unique to Oregon, but we’ve got our share. And the 17
community colleges are the absolute backbone of our training
and education system for health care.”
Though they annually train more than half of the state’s
registered nurses and 75% of allied health workers, community
colleges are apparently not keeping pace with Oregon’s
growing need.
“Community colleges are not training enough health-care
workers to meet current and future need,” summed up a
2006 plan for health-care education from Allied Healthcare for
Oregon: Seeking Solutions through Technology.
Acutely aware of projected shortages, community colleges have
responded with new programs and partnerships, distance learning
opportunities and other capacity expansions to help boost the
state’s supply of health-care workers. But funding
constraints, faculty shortages and even geographic divides are
doing their part to make sure they don’t have an easy
time of it.
“Community colleges understand that there will be
increasing workforce needs,” says Dr. Mary Jeanne Kuhar,
an instructional dean at Central Oregon Community College
(COCC).
“We’re really doing our part to anticipate those,
but to do that you have to have programs in place, you have to
have space and you have to have faculty and funding.”
THE HEALTH-CARE WORKFORCE SHORTAGE is expected to be
particularly acute in Oregon because of a growing and aging
population, which will put increased demands on health-care
services. In addition, aging workers are expected to retire or
leave the field faster than they can be replaced.
“When you start to look at the demographics and the
challenge of the aging boomers and then the flat production of
providers over the last three decades, it’s
sobering,” says Lesley Hallick, vice president for
academic affairs at Oregon Health & Science University.
In a 2006 health-care workforce assessment, OED reported that
17 of the 71 direct health-care occupations faced certain or
likely shortages between 2004 and 2014. Examples included
medical and clinical laboratory technologists and mental-health
counselors.
The assessment found that health-care oc-cupations make up
about 8% of Oregon’s overall employment. Ten of the 25
fastest-growing jobs in Oregon between 2004 and 2014 will be in
direct health care and, over the same time period, employers
are expected to need 59,000 new workers.
The state may be producing nearly 8,500 health-care graduates
a year, but out-of-state migration, occupational deficits and
surpluses and other factors render that number inadequate to
meet projected demand, according to OED.
Nor is educational capacity in Oregon sufficient to train all
the workers necessary to keep a shortage at bay. In 2005, the
Oregon Center for Nursing found that there were two to three
times more qualified applicants than there was room in nursing
programs. At COCC, for example, 150 applicants apply for 36
positions in the school’s nursing program every year.
Similar educational limitations can be found for most of the
shortages identified by the OED.
“There is still a real problem of capacity throughout
the state,” says Cyndi Andrews, director of the nonprofit
Community College Healthcare Action Plan.
PARTLY AS A RESULT OF THESE TROUBLING ISSUES, community
colleges statewide are forming partnerships with other academic
institutions and private-sector medical institutions.
They’re streamlining courses and curriculum based on
workforce needs, employing technological advances and exploring
distance-learning opportunities.
Because it can be expensive for a community college to
establish its own health-care programs — and because in
smaller communities there may not be enough students or
potential jobs to merit them — some schools have indeed
turned to their regional counterparts.
COCC, for example, has partnered with Linn-Benton Community
College to give students access to the Albany school’s
radiologic technology program. Students at COCC take
prerequisite courses in Bend and online rad tech courses from
Linn-Benton; they also travel to Albany for further
instruction.
“They’re thrilled to not have to move somewhere
else to make it happen,” Kuhar says, adding that students
trained in their communities tend to stay in their
communities.
In another example, Portland Community College (PCC) has made
its medical laboratory technology program available online to
both Lane and Rogue community colleges.
“It’s all for extending the education programs
here to other parts of the state without having to develop
entire new programs at these other community colleges,”
says Larry Clausen, dean of allied health and science at
PCC.
A $2.9 million federal Department of Labor grant awarded in
2005 is helping fund PCC’s effort and that of nine other
community colleges to expand capacity via online courses.
In a self-sustaining move, private industry is partnering with
community colleges, providing student training, tuition
reimbursement and faculty for health-care courses.
“Our hospitals and labs have bent over backward to make
this happen,” says Karen Hill, marketing director at Blue
Mountain Community College. As an example, she says, two
hospitals in Pendleton and Hermiston have each ponied up
$10,000 to help train students in Blue Mountain’s
associate nursing program.
Other partnerships have found Clackamas Community College and
Kaiser Permanente working to establish an entire new nursing
class, and two hospitals in Eugene provide annual funding for
16 of Lane’s 72 nursing students.
Technology also is helping community colleges through programs
such as the Oregon Simulation Alliance, which trains future
workers at 23 sites around the state on high fidelity,
programmable mannequins that simulate real-world scenarios. The
added training capacity has helped ease the burden on
overloaded community college instructors.
Other initiatives include the Oregon Con-sortium for Nursing
Education’s implementation of a more universal nursing
curriculum. It allows students to take prerequisites at their
community college with local faculty; then instructors from
OHSU teach the upper- level courses on the students’
campuses.
Hallick says OHSU is pressing the Legislature to fund several
program enhancements that would be collaborative with community
colleges. Among those: $1.7 million for the Oregon Consortium
and a $1 million expansion of OHSU’s graduate nursing
program, which could result in desperately needed nursing
instructors for the state’s community colleges.
ALL THESE EFFORTS LEAD to one simple question: Are they
working?
Jessica Nelson, an OED employment economist, says it’s
too early to tell from a data standpoint. She says she
wouldn’t be surprised, however, to find noticeable
differences in some occupations when the department does
another workforce assessment in a few years.
“There may be some [jobs] where there have been enough
efforts to train people to make a difference,” she says,
“but some where there haven’t been.”
In some areas, community college efforts do seem to be
yielding tangible results.
At Providence St. Vincent Medical Center in Portland, for
example, clinical imaging manager Lorri Jacobs has all but two
of her radiologic technologist positions filled — a big
improvement from just a few years ago.
She attributes the improvement in part to the hospital’s
long-standing training affiliation with PCC and a recent
doubling of the school’s radiography program from 28 to
48 students.
Also at PCC, the first four students to re-motely take the
medical laboratory technology program are set to graduate this
year; Clausen says the next group will contain 12 students, and
next fall’s class should bring in 20. And Lane Community
College in Eugene recently received a $1.9 million Department
of Labor grant to expand its dental hygiene program into a
multimedia online program.
Nursing programs statewide have made sizable gains, too.
Oregon Coast Community College recently added an associate
nursing degree program for 20 students, and Mt. Hood Community
College has been able to quadruple the size of its program to
160 students.
While gains have been made in some areas, others have not
fared so well. The state still lacks training programs for some
specialized technicians, and externally funded, one-time
programs, such as a distance-learning nursing course offered at
Central Oregon a few years ago, only highlight the need for
consistent if not increased state funding.
“We’re having huge budget challenges be-cause of a
disinvestment by the state,” says Mary Spilde, Lane
Community College president. “We’re hoping they
will invest more because we do respond to workforce
challenges.”
Whether legislators will be mindful of that is yet to be seen.
As of mid-May, the Legislature’s Joint Ways and Means
Committee had proposed $458 million for community colleges in
the next biennium — $25 million less than the governor
proposed and $71 million less than the schools would like to
see.
Have an opinion? E-mail feedback@oregonbusiness.com
