| 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.
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