Hawaii’s healthcare system continues to face the double strain of the COVID-19 pandemic and a significant labor shortage. A recent report of the University of Hawaii (UH) John A. Burns School of Medicine has seen a shortage of 1,000 statewide physicians – a deficit that the report said would be “difficult to manage” even without the pandemic preventing providers from working full time.
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Nicknamed by a doctor the “most hostile sanitary environment to practice, ”Hawaii’s low reimbursement rates relative to the cost of living, an aging workforce, and compound health taxes also continue to fuel the provider shortage.
The dilemma not only spurred the creation of Hawaii Physician Shortage Task Force, but concentrated recruitment efforts in state health education systems. Lisa Radak, dean of university health programs at Kapi’olani community colleges, said healthcare facilities aren’t the only places feeling the impacts of the labor shortage.
“From an educational point of view, the barriers that we currently have attract [faculty members]. We cannot attract or find capable instructors [to teach] because there is a shortage. They stay in the industry where they are needed.
To both respond to the public health crisis and bring more people into the health workforce during the pandemic, the UH System and Kapi’olani Community Colleges worked in conjunction with the Department of Health (DOH) to to create contact search and community health worker programs. More than 600 contact tracers and 130 community health workers completed their training by the end of 2021.
Ensuring that recruitment efforts were as broad and diverse as possible was key to developing the programs. According to Radak, the community health worker program received a additional grant of the DOH to specifically increase recruitment from neighboring islands.
“We realized that community health workers are the ones who are going to be in the communities, on the ground, to support people.”
Recruitment efforts also included matching the acceptance rates of each county zip code’s programs to their percentage of the state’s population and partnering with local high schools to provide the training through coursework. English as a second language (ESL).
Another solution included a training program for people looking to make the transition to new jobs. For example, Hawaii’s leisure and hospitality industry lost nearly 35,000 jobs due to the pandemic, according to the Hawaii and Budget Policy Center. UH Community Colleges (UHCC) have worked with the city and county of Honolulu to provide subsidized vocational training opportunities, according to UHCC’s associate vice president for academic affairs. Tammi Oyadomari Chun.
“It was more entry-level openings and short-term training. People would move from their pre-pandemic jobs to different health care professions. “
So far, the program has trained hundreds of participants for positions as a certified practical nurse (CNA), pharmacy technician, phlebotomy and patient services.
The education system is also considering longer-term solutions, such as strengthening health education for the workforce. Jean Blanc, the health worker liaison for UHC, said that even with targeted recruitment and retention efforts, they had not “created the kind of bottom line we would like to have.”
“[We’re] think about “Why is that?” And try to develop the root causes. Then [we’ll] see if we can go back to both the colleges and send them to the employees and see if there’s anything to adjust or sort out that is going to help these people find jobs and keep the jobs.
White referred to a report from the Healthcare Association of Hawaii which detailed pre-pandemic healthcare worker shortages across the state, including about 450 CNA openings. He suspects that number has likely doubled due to the pandemic.
White is working to publish a survey in the coming weeks that analyzes motivation in light of the pandemic, particularly the workforce decisions people make when they have to move to different jobs. As 2022 marks another pandemic year, White stressed the importance of silo partnership and flexibility in creating a sustainable healthcare workforce in Hawaii.
“I think the pandemic has opened people’s minds to change, that they have stepped out of their traditional roles and are thinking more about training…. “