Oregon Lawmakers Eye Workforce Crisis In Health Care Industry

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Clouds hover over the Oregon Capitol building.

Oregon health care providers face obstacles as they seek to fill vacancies and bolster the ranks of the workforce nearly two years after the start of the COVID-19 pandemic. 

The problems run the gamut. Workers are burned out and want fewer hours instead of more. Other workers don’t want to enter the field due to high child care costs. In rural areas, it’s a challenge to keep long-term care facilities open with a lack of qualified workers. 

State legislators on the House Health Care Committee heard testimony Tuesday from health care industry groups about the workforce crisis that outlined these challenges. 

They said the COVID-19 pandemic has exacerbated a workforce shortage in the health care industry, burned out staff and increased demand for health care. These conditions have forced policymakers and the industry to look for solutions in the February 2022 legislative short session and beyond. 

Rep. Rachel Prusak, D-Tualatin/West Linn and a nurse practitioner, said the views reflect what she’s heard, and she said the committee will do what it can to tackle the issue in the short session.

Industry leaders underscored the urgency of the situation. In some health care sectors, such as long-term care and behavioral health, facilities are on the brink of closure, they said. 

“Quite frankly, the single biggest crisis that long-term care faces today is the workforce shortage,” said Libby Batlan, senior vice president of government relations for Oregon Health Care Association, which represents the long-term care industry.

Batlan warned that some facilities in rural parts of the state are in danger of closing. 

To lure more people into the workforce and keep them in the industry, Batlan asked lawmakers to consider incentives such as student loan forgiveness programs and tuition assistance for trainees. She also suggested that the state modify the training requirements for certified nursing assistant programs so licensed practical nurses could be program directors or instructors. Currently, that role is limited to registered nurses. 

“Expanding that pipeline is really really important,” Batlan said.

Affordable child care is another barrier to entry into the field, Batlan said. 

Amid the shortage, long-term care providers are squeezed. Temporary staffing agencies that health care providers increasingly rely upon have increased their rates amid heightened demand. Batlan said that route is “unsustainable from a financial standpoint.”

Behavioral health faces similar challenges but is in a slightly different place compared to other sectors of the health care industry, said Heather Jefferis, executive director of the Oregon Council for Behavioral Health. The statewide group represents more than 50 provider organizations. 

For example, the industry has “long-standing parity issues” and gets low reimbursement rates, Jefferis said. Lower reimbursement rates, such as through Medicaid, can leave providers strapped and contribute to the low wages in the industry. Entry-level workers in the field, such as caregivers, routinely earn less than $20 an hour.

In congregant care settings, which require a high level of care, the lack of adequate nursing staff can cause the closure of an entire program, Jefferis said. 

Chris Guastaferro, executive director of Area Health Education Center of Southwest Oregon, works with rural communities on health and education programs to encourage people to enter the field. He said the state’s capacity to expand the workforce, such as for teaching faculty for nursing programs, is one challenge.

He recommended the state look at incentives to encourage qualified nurses to teach, such as matching their salary.

Matthew Calzia, a registered nurse, spoke on behalf of the Oregon Nurses Association. He said professionals across the health care industry are exhausted. For nurses, that means many want to leave the profession or cut back their workload — even amid a heightened demand.

“The vast majority are looking to leave the bedside or at least reduce their hours,” Calzia said.

For example, this means some nurses want to go from three 12-hour shifts a week to just two 12-hour shifts. Among his suggestions for lawmakers: ensure that nurses get adequate break periods during shifts. There’s pent-up demand for health care, he said, that cannot simply be put on nurses. 

Traveling nurses from out-of-state agencies have helped, but now “we need to start figuring out how we wean ourselves off traveling nurses,” Calzia said.

It’s also critical that nurses and other frontline health care workers have access to mental health services without any stigma if they need help, he said.

You can reach Ben Botkin at [email protected] or via Twitter @BenBotkin1.

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