Experts discussed the various components—including childcare and housing availability, pay, and education/training options—that affect the state’s healthcare workforce at the 2024 State of Reform Health Policy Conference on Jan. 4th.
Sue Skillman, senior deputy director at the Center for Health Workforce Studies at the University of Washington, said the department reaches out to healthcare employers throughout the state to request input about their workforce issues twice a year.
“Often policymakers and others turn to the education and training system and say, ‘We need to ratchet up production,’” Skillman said. “We can’t educate our way out of the problems we have. Education and training (are) critical. We have to have that pipeline. But we have to make sure we’re paying equal or more attention to workforce retention, reducing staff turnover, and making that work environment conducive to keeping them there. We also need to look at community and societal factors that provide barriers to retention and recruitment.”
Skillman discussed findings from the department’s most recent Health Workforce Sentinel Network data collection, which was gathered last fall. One of the questions posed to providers asked them about their organization’s workforce experiences in regard to childcare and housing availability, transportation options, and how violence in the workplace affects their staff, she said.
“Childcare is an issue for more than half of the facilities responding; similarly housing and transportation (are issues). Workplace violence is growing in frequency. These are some of the overarching community issues that I think we have to keep in mind. It’s not just about putting more seats in the schools. We have to work simultaneously on all of these issues.”
— Skillman
Crisis Connections CEO Michelle McDaniel discussed Washington’s behavioral health workforce. The organization has a 24-hour crisis line, which received 675,000 calls, texts, and chats from people seeking behavioral health support in 2023, she said.
“In 2019, we had about 280,” McDaniel said. “That gives you a sense of where we’re at as far as substance use disorder and the mental health crisis that we’re trying desperately to respond to. And we’re dealing with the fact that there’s not as many people able to do this work.”
Crisis Connections staff analyzed its workforce data, and realized the organization was losing a lot of workers within their first 90 days of employment, Skillman said. So a group of human resources workers there held three four-hour work sessions to analyze its job postings and hiring process.
“We went painstakingly through and white boarded the process, and put in red pen areas that we needed to either change or add (to),” McDaniel said. “We found out we (had) a long list of things we can do better. We found out we weren’t moving fast enough. People were getting [other job] offers before we could get them through the process.”
Crisis Connections then made several workforce changes, including implementing a 27 percent wage increase last fall, McDaniel said.
“We literally had staff saying, ‘I was thinking about leaving this organization, and now I’m staying.’ Pay is really important. We know that’s not the only reason people are going to stay with an organization, but we had to address that.”
— McDaniel
Crisis Connections also started offering referral bonuses of $1,000 for staff who were able to refer workers to the organization, McDaniel said.
“That has been effective,” she said. “All those things came together to help with retention.”
Washington State Nurses Association President Justin Gill said the nursing sector faces challenges in attracting enough nurses to teaching positions.
“We still have an issue in nursing on getting nurses that want to teach, to teach at the community college level, as well as four-year universities,” Gill said. “Part of that is an economic issue for a lot of them. Many of them will make more money in a setting where they are caring for patients rather than teaching.”
Northwest Regional Primary Care Association CEO Bruce Gray said the new national Equitable Long-Term Recovery and Resilience model could be a useful tool in workforce improvement. The model lays out an approach for federal agencies to cooperatively strengthen the vital conditions necessary for improving individual and community resilience and well-being nationwide.
“It’s really looking at the vital conditions,” Gray said.