ALLIED HEALTH: PROFESSIONAL SHORTAGE

Texas Public Health Association, 16apr09

Eldon L. Nelson, Ph.D.Professor and Dean, School of Health Sciences

The University of Texas at Brownsville and Texas Southmost College

Shortage: Allied Health Workforce AH makes up 60% of healthcare

workforce 15 of the 30 fastest growing occupations

are Allied Health A need for 5.3 million AH workers

through departures and new positions (2010)

1.6 to 2.5 million vacant positions (2020)

HRSA, Bureau of Labor Statistics

HRSA – Report to Congress, 2002

The Allied Health Program plays a crucial role providing a rapid transition of students with a baccalaureate degree into the health-related sciences. Allied health professions encompass about 30 percent of the total health care workforce and projections are that by 2010, 5.3 million new allied health workers will be needed. Already there are shortages in critical allied health fields.

HRSA Report to Congress 2002, Allied Health Shortage

12 Nov 2006

“Laboratory sciences are just critical to our delivery of healthcare in an acute-care hospital, but they are out of sight, out of mind.”

Roger E. Seaver, CEO, Henry Mayo Newhall Memorial Hospital, Valencia, CA (Los Angeles Times, July 27, 2008)

nationally, 77% of academic health center CEO’s declared AH shortages to be a problem

Who are Allied Health Professionals ? More than 100 separate

disciplines/occupations AMA 2008-09 Health Careers Directory

77 Health Professional groups; 8000 training programs Physicians, nurses, radiologic technologists…. Many others

Definition: Allied Health Professionals

HRSA – Health Resources and Services Administration

U.S. Code 42USC Sec. 295p Association of Colleges of Allied Health

Who are Allied Health Professionals ? HRSA* (2000) - Allied Health Professionals:

2,672,000 made up of:

Dental hygienists/assts/lab techs Dieticians/dietetic technicians EMT / Paramedic Health Information Admin / Tech Occupational Therapists Orthotics and Prosthetics Physical Therapists

*Health Resources and Services Administration

HRSA – Allied Health (cont.)

Radiologic service workers Respiratory Therapy workers Speech Pathologist /audiologists Other:

Dietetic assistants Genetic assistants Operating room technicians Ophthalmic / optometric medical assistants Medical transcriptionists Vocational rehab counselors Other rehabilitation workers Other social and mental health workers

US Code Definition (42 USC Sec. 295p):

Allied Health Professionals … a health professional (other than a registered nurse or other than a registered nurse or

physician assistantphysician assistant) who has received a certificate, an associate's degree, a

bachelor's degree, a master's degree, a doctoral degree, or

post-baccalaureate training, in a science relating to health care;

who shares in the responsibility for the delivery of health care services or related services, including -         (i) services relating to the identification, evaluation,

and prevention of disease and disorders;         (ii) dietary and nutrition services;         (iii) health promotion services;         (iv) rehabilitation services; or (v) health systems management services…

42USC Sec. 295p (continued)

… and, who have NOT received a degree of: doctor of medicine doctor of osteopathy doctor of dentistry doctor of veterinary medicine doctor of optometry doctor of podiatric medicine bachelor or doctorate of science in pharmacy graduate degree in graduate degree in public healthpublic health doctor of chiropractic graduate degree in health administration doctoral degree in clinical psychology degree in social work degree in counseling

Allied Health Professionals

“… are involved with the delivery of health or related services pertaining to identification, evaluation and prevention of diseases and disorders; dietary and nutrition services; rehabilitation and health systems management, among others.

Allied health professionals, to name a few, include dental hygienists, diagnostic medical sonographers, dietitians, medical technologists, occupational therapists, physical therapists, radiographers, respiratory therapist and speech language pathologists.”

The Association of Schools of Allied Health Professions

Summary Definition:Allied Health Professionals

“Allied Health” … typically excludesexcludes : Physicians AND most doctorate level health

professionals Nurses and Physician Assistants Public Health, Counseling and Social Workers Healthcare Administration

All Others having credentials in the Healthcare professions:

Allied Health ProfessionalsAllied Health Professionals

Among the Most Recognized Allied Health Disciplines

Occupation 1970 1990 2000 (% change)

Total Allied Health 750,000

1,831,000

2,672,000 (256)

Dental Hygienists 40.000 81,000 112,000 (180)

Dieticians 17,000 57,000 90,000 (429)

EMT - Paramedic 36,000 93,000 125,000 (247)

Health Information Admin /Tech

52,000 87,000 101,000 (100)

Clinical Laboratory 135,000

297,000 337,000 (150)

Occupational Therapists 6,000 42,000 72,000 (1100)

Physical therapists 30,000 92,000 130,000 (333)

Radiologic workers 87,000 157,000 220,000 (153)

Speech Pathologists/audiologists

19,000 65,000 121,000 (537)

HRSA, Bureau of Health Professions, National Center for Health Workforce Analysis

Occupation

Employment Number*Total job openings

Growth & net replacement 2006-16*2006 2016

Graduate Degree level Occupational therapists 99 122 37 Physical Therapists 173 220 68 Speech-Lang Pathologists 110 121 33

Baccalaureate Degree Dieticians / Nutritionists 57 62 19 Med & Clinical Lab Tech 319 362 92

Associate Degree Dental Hygienists 167 217 82 Med. Records / HIT 170 200 76 Radiologic techs 196 226 56 Respiratory Therapists 102 126 38

* thousands, Data from S.N. Collier, 2007 Health Workforce Articles, BLS projections to 2016

Allied Health Professions: Projections 2006-2016

Causes for the Shortage? - Demand exceeds Production

Growing population Lag of educational AH programs to meet need

Limited enrollment (small) programs Lack of AH faculty Lack of students (many AH programs are not known) Limitation of Clinical Sites

restricted student / faculty ratio Attrition rates are high

Retirement of aging AH professionals AH Programs advancing entry-level to higher

degree Some occupations have limiting salary attraction

(e.g., EMS, MLT)

Texas: Shortage of Allied Health Professionals

Texas: Shortage of Allied Health Professionals 764,000 health care workers

8.2% of total workforce Population grew 26%, 1988-2000

Health worker employment, 51% Population expected to increase 23%, 2000-

2020 The Hispanic patient population will increase

Texas projected to have a majority Hispanic pop. 2030 Need for bilingual health care providers

Texas: Job Openings VS. Number of Graduates 2004-2014

Profession # Annual Openings

(1)

# Graduates*Minus 10%

(2)

#/Percent Unfilled

Positions (1)

Clin Lab Scientist 610 246 364 / 60%

Dental Hygienist 465 322 143 / 31%

EMT/Paramedic 560 276 284 / 51%

Occupational Therapy

340 131 209 / 39%

Physical Therapy 480 155 325 / 68%

Physician Assist 270 230 40 / 15%

Respiratory Care 460 363 97 / 21%

Speech /Lang Pathology

445 171 274 / 62%1. Texas Workforce Commission, Data Link, Future Job Growth by Occupation 2004-2014. http://www.tracer2.com/cgi/dataanalysis/AreaSelection.asp?tableName=Occprj 2. AMA. Health Professions Career and Education Directory 2007-08. Chicago, IL

[Modified from M. Harrington, Dean, College of Health Professions UTHSCSA]

Allied Health Education Programs: Texas

In 2008: 379 AH Programs in Texas (2008)

264 programs in community/technical colleges 115 programs in universities

127 programs are CAAHEP accredited programs representing 20 of the AH disciplines

Expected AH 8,000 Graduates Job Openings – 12,000*

* Estimated based on the average shortage (52%) of the most recognized AH professions

Allied Health Data: Border Region of South Texas

Allied Health Workforce Projections- South Texas 200

7Jobs

2012Jobs

Openings

New

Replace

Total (%)

Med. & Clinical Lab. Tech

619 710 91 46 137 (22)

Radiology Technology

1068

1273

205

72 277 (26)

Physical Therapy 1348

1686

338

73 411 (30)

Dental Hygiene 456 560 104

43 147 (32)

Respiratory Therapy 679 810 131

64 195 (29)

Speech Path/Audio 937 1110

173

81 254 (27)

Occupational Therapists

486 597 111

30 141 (29)

Surgical Technology 473 583 110

72 182 (38)

Source: Texas Workforce Commission and Comptroller report, Texas in focus: South Texas, Aug 2008

Allied Health Programs: Border InstitutionsFaculty, Enrollment, and Graduation

Allied Health Programs

Cert./ Assoc.

Bachelor Master Master/

PhD

Number of Programs

29 8 7 2

Faculty FT/PT

Current

73/39 18/11 43/7

Needed FT/PT 40/30 5/1 10 3

Enrollment Data

AY 2007 974 2294 123 15

AY 2008 1010 2456 131 16

Change 4% 7% 7% 7%

Graduate Data

2007 386 116 92 pending

2008 415 131 85 pending

Change 8% 13% -8%

•Laredo CC, South Texas College, Texas State Technical College - Harlingen, UT-Brownsville /TSC, UT-El Paso, UT-Pan American

Programs along the Border *- 22 Allied Health Disciplines

Dental Assistant Dental Hygiene

Cancer Information Management

1 Clinical Laboratory Science

1

Dental Assistant 1 Dental Hygiene 1

Diagnostic Medical Sonography

1 Dietetics 1

Emergency Medical Services

4 Health / Medical Administration

1

Health Promotion 1 Medical Assistant 3

Medical Laboratory Technology

3 Occupational Therapy 1

Occupational Therapist Asst.

2 Pharmacy Technology 1

Phlebotomy 1 Physical Therapy 1

Physical Therapist Assisting

2 Polysomnography 1

Radiology Technology 3 Respiratory Care/Therapy 2

Speech – Language Pathology

2 Surgical Technology 1

* Laredo CC, STC, TSTC, UTB/TSC, UTEP, UTPA

High Demand Allied Health Professions in LRGV*

Laboratory Technologists /Medical Laboratory Technicians

OR/Surgical Technologists Pharmacists / Pharmacy Technicians Phlebotomists Radiologic Technologists (AART certified) Respiratory Technologists (Registered or Certified) Physical Therapy / PTA Occupational Therapy / OTA

*employment practices vary among hospitals; regular employment, use of PRN

Mitigation of AH Shortage

Federal Legislation

Federal: Allied Health Reinvestment Act, 110th

Congress, 2007-08 Title VII of the Public Health Service Act

PART G – Allied Health Professionals AH portion of Section 799C - Not passed

Funding for Allied Health Professions in the Stimulus Package (Amer. Recov. & Invest. Act)

Allied Health may take advantage of: DOL - $4 billion – focused on training workers for high

demand professions Workforce Investment Act (WIA) - $750M – worker training WIA - $3B – Training & Employment, Displaced Worker Formula

funding

Pell Grants – funding needy students into college - $15B

(derived from J. Colbert, Allied Health- Moving Forward, AAHP Annual Meeting, St. Petersburg, FL, 19mar09; and S. N. Collier, Where is Allied Health in Stimulus Funding?, Trends, March 2009)

HRSA Funding :• $500M for health professions Workforce Shortage• $200 million for health professions training programs

Current Texas Legislation: Allied Health Professions

SB 706 - Incentives to Recruit and Retain Allied Health Education Program Faculty (Davis; Harris, Hinojosa, West)

Tuition exemption/reduction for children of AH Faculty Tuition reduction for AH Clinical Preceptors Grants for recruiting/retaining AH Faculty

SB 290 - Creation and Implementation of the Health Professional Education Grant Program (Nelson; Zaffarini)

Grant for expanding AH education programs

Current Texas Legislation: Allied Health Professions

SB 706 - Incentives to Recruit and Retain Allied Health Education Program Faculty (Davis; Harris, Hinojosa, West)

Tuition exemption/reduction for children of AH Faculty Tuition reduction for AH Clinical Preceptors Grants for recruiting/retaining AH Faculty

SB 290 - Creation and Implementation of the Health Professional Education Grant Program (Nelson; Zaffarini)

Grant for expanding AH education programs

Partnering in the Valley:

UTB/TSC partnering with: UTPA … to expand needed AH programs to

Brownsville OT Program Speech Pathology Program

South Texas College... To initiate programs in Brownsville OTA Program PTA Program

TSTC… to initiate new programs Vocational Nursing Cancer Information Management

ALLIED HEALTH: PROFESSIONAL SHORTAGE

Texas Association of Public Health, 16apr09

Eldon L. Nelson, Ph.D.Professor and Dean, School of Health Sciences

The University of Texas at Brownsville and Texas Southmost College

Thank you,!...... Questions?