In a recent analysis of the state’s healthcare workforce, the Alaska Hospital and Healthcare Association found that job vacancies are increasing, and not enough people are entering the workforce to make up for it.
Leaders in Alaska discussed the pressing healthcare workforce crisis in the state and ways to support and retain providers at the 2023 Alaska State of Reform Conference last month.
John Solomon, chief executive officer at the Alaska Behavioral Health Association, discussed the issue of burnout and how it negatively affects workforce retention.
“One of the biggest things that affects burnout in our workforce is, we come into the field to help people and then [we] consistently are running up against barriers that aren’t about clinical work. They’re about these administrative barriers, payment barriers, the social determinants of health … if only I [could] get my client food, we could start talking about trauma.”
— Solomon
Sylvan Robb, director of the division of corporations for business and professional licensing at the Department of Commerce, Community, and Economic Development with the State of Alaska, discussed how obtaining a license to practice is one such administrative barrier.
During the height of the pandemic, it was especially difficult to get a license in a timely manner. Robb said for a time, the department was only 65% staffed. “At one point it was taking us almost 12 weeks to start looking at a nursing application after we’d received it,” she said.
Now, the department is almost fully staffed again, which Robb said has made the process much quicker. They are also working to get all of their license applications online so it’s easier for applicants to access them. Currently, about 100 of more than 300 license, endorsement, and certificate applications are available online, as well as all renewal applications.
Robb emphasized the importance of state health leaders fulfilling their primary mission—keeping the public safe—but they need to streamline the process as much as possible so qualified individuals can start providing care quickly.
Robb identified two pieces of legislation she hopes will pass in next year’s legislative session. The first is a Universal Temporary Licensure bill, which would allow licensed individuals to gain a temporary license for another position as long as they had substantially equivalent qualifications, so they can begin practicing in that position while going through the longer process of obtaining a permanent license.
The second piece of legislation would have Alaska join the interstate Nurse Licensure Compact (NLC). Nurses in states that are part of the NLC are able to practice nursing in any other NLC state without obtaining a different state license.
Xiomara Owens, PhD, director of tribal education and training at the Alaska Native Tribal Health Consortium, spoke about education as a barrier in workforce development, explaining how this especially impacts rural communities.
She listed two positions within the Tribal healthcare system that do not require higher education degrees and are able to help to support people, especially those living in remote communities: community health aides (CHA) and behavioral health aides (BHA).
“Most of these positions, they don’t require a degree but they do require a substantial amount of training, education, and regular continuing education,” Owens said.
CHAs and BHAs are supervised by people with higher education degrees, but often the supervisors are not from Alaska, and not connected to the culture, she said.
Owens also believes it is important to care for the existing workforce just as much as the prospective workforce in order to prevent the burnout that causes so many individuals working in healthcare to leave.
“What are we doing to take care of the workforce that’s taking care of our people?”
— Owens
Gloria Burnett, director of the Alaska Center for Rural Health at the University of Alaska Anchorage, said in many school districts there are career technical education (CTE) programs that allow children still in school to specialize in a healthcare career path earlier on. Sometimes this is an alternative to a college education, or a supplement for those who choose to pursue higher education.
Trish Zugg, the CTE program administrator in the Mat-Su Borough District, cited the variety of programs her district offers for healthcare training including for biomedical science, dental assistants, emergency medicine, health informatics, pharmacy technicians, and pre-nursing.
The Mat-Su school district has the advantage of being in and near Anchorage, and therefore more resources and instructors to have a successful CTE program. Burnett said many rural schools, on the other hand, do not have qualified instructors. She said her organization has a program where they send qualified instructors out to rural areas so kids can get similar CTE programs as those living in an urban area.
“[We] try to bridge those gaps by providing instructors to go out into these communities.”
— Burnett
Karen McIntire, vice president of workforce at Southcentral Foundation (SCF)—an organization focused on Native health in Alaska—said SCF has financial benefits and internship opportunities for students wanting to enter healthcare, eliminating barriers to entering the field.
“One thing I’m really proud of is our scholarship program,” McIntire said. “We have a new clinical initiative program that has already offered over half a million dollars in scholarships and stipends to students so they can get their clinical degree.”
Jennifer Nixon, director of health equity and workforce development at the Alaska Primary Care Association, discussed the issue of retention, and the reality that there are not enough people entering the healthcare workforce. Initiatives are good, she said, but the ongoing healthcare workforce shortage is a serious issue.
“We also need to look at short-term strategies right now,” Nixon said. “… We need to start thinking about these programs that we have that are underutilized that could use more visibility.”
She cited the Strengthening Healthcare Access Recruitment Program as an example, which looks to support students and workers in healthcare through financial incentives.