Calls to shore up Connecticut’s health care workforce are getting louder, after the latest COVID variant placed heightened stress on the state’s nurses, physicians, behavioral specialists and other medical staff.
Advocates and lawmakers say programs they’ve long pushed for — workforce training, medical school loan forgiveness, higher nurse-to-patient ratios, simpler license transfers from other states and medical liability insurance reform, to name a few — are all on the table heading into the Connecticut General Assembly’s regular session, which begins Feb. 9.
Fallout from the pandemic, which has exhausted staffs and depleted resources across the state’s health care sector, could drive the change they’ve been seeking.
Sen. Heather Somers, R-Groton, ranking member of the Public Health committee, said she’s spent six years beating a drum for the state to boost recruitment and retention efforts for nurses, doctors, certified nursing assistants and other medical professionals.
“It has been somewhat falling on deaf ears until now,” Somers said.
The situation has become more urgent.
The Governor’s Workforce Council estimated the state’s annual workforce demand in health care has topped 7,000, “with significant shortages in nursing, certified nursing assistants, skilled technician roles, and long-term and home health care.” But since the start of the pandemic, the number of people employed in Connecticut’s education and health services sector has declined by 14,500.
“Those that we do have in the health care field are so burned out,” Somers said.
Charese Chery, chief human resources officer at Oak Hill, which runs group homes and classes for people with intellectual, developmental and physical disabilities, is seeing that first-hand.
“The impacts of the pandemic have been severe. We haven’t been able to fill our positions, and we have a crisis on our hands,” Chery said recently on the Metro Hartford Alliance podcast, “Pulse of the Region.”
Oak Hill typically employs a statewide staff of about 1,300, but during the pandemic, it’s been hard to maintain those numbers. “One day I was looking at the vacancy report, and we were up to 200 vacancies. I almost fell out of my chair,” Chery said.
Medical professionals say the situation is only going to get worse, given the approaching wave of retirements among the Baby Boomer generation. Not only will that deplete the ranks in the medical field, but those retirees will need medical care, too.
According to a report from the Connecticut Data Collaborative and the Center for Nursing Workforce, the number of nurses in the state aged 60 or over, 7,917, is currently nearly twice the number of those under 30.
Sherri Dayton, a registered nurse at the Plainfield Emergency Care Center, said, “We have to make this field more appealing. Right now, in the middle of a pandemic, it’s not very appealing.”
Dayton, who represents the health care division within the Connecticut chapter of the AFT union, said one way to ease the strain on nurses is to require fewer patients assigned to each nurse.
“Health care professionals aren’t allowed to have any work-life balance right now,” she said.
Relief on the way?
State and industry leaders have put forth some programs to provide relief to the medical workforce during the pandemic. Last fall, the governor signed an executive order allowing the certification of “temporary nurse aides” who had completed an 8-hour online course. Earlier this year, the state designated $70 million in federal American Rescue Plan Funding to short-term training programs in several sectors, including health care. Hartford HealthCare and Quinnipiac University recently announced a partnership to train the future health care workforce; as part of the partnership, Hartford HealthCare will donate $5 million to the university to support the program.
And on a recent visit to Torrington, U.S. Senator Chris Murphy, D-Conn., outlined his efforts to secure federal funding for workforce development in the health care and public health sectors.
“We are trying to stack a pipeline of young people, people transitioning from one career to the next, so that we can make sure that we fill this gap right now that we know we have,” Murphy said.
Incentives to stay
Training highly qualified medical professionals like nurses and doctors takes years — there’s no quick fix. And once they're trained, there's no guarantee they'll stick around Connecticut. According to the Connecticut State Medical Society, the state retains only roughly one-third of the residents and fellows who train here — well below the national median of 45%.
A proposal put forth during last year’s legislative session sought to establish a grant program for community health centers that could be used as a retention incentive to provide medical school loan repayment for doctors, nurses and mental health providers. The bill, which also included additional recruiting, retention and loan repayment programs targeted specifically for mental health specialists, didn’t pass.
Two existing Connecticut programs aimed at recruiting and retaining nurses and other primary care providers through loan forgiveness have gone unfunded. Meanwhile, dozens of other states offer a range of scholarship, repayment, loan assistance and forgiveness programs.
"We are competing with every other state for health care workers," said Rep. Jonathan Steinberg, D-Westport, co-chair of the Public Health committee. "We have the extra challenge of being a high cost-of-living state."
At a recent panel hosted by the Connecticut Business and Industry Association, Rep. Kerry Wood, D-Rocky Hill, said, “Connecticut is not a very business-friendly state for those that are entering the medical field.” Student loan assistance is critical, she said, “especially for the skilled workforce we’re desperately needing.”
Rep. Terrie Wood, R-Darien, also speaking on the panel, highlighted the issue of delays in health care licensing. One of her constituents, a nurse practitioner, recently had trouble getting her license transferred to Connecticut.
“That shouldn’t have happened,” Wood said. “Somebody who is a highly qualified nurse practitioner should not have to wait two months for her certification approval and license to practice in Connecticut.”
According to the Center for Nursing Workforce's study, among Connecticut's 86,483 licensed nurses, only roughly half are currently practicing in the state.
Movement on mental health
Lawmakers' efforts have already kicked off with several proposals targeting mental health services. Last week, the state Republican Party laid out its priorities on the issue, including increased access to mental health care; support for the mental health workforce; addressing the “youth mental health crisis” and improvements to screening and support for maternal mental health.
But, Somers said, “We’re not going to allow them to forget we need physicians, too.” Mental health services are one of many things the public health committee will be looking at this session, she said.
“When you talk to pediatricians, when you talk to primary care, they are dealing with people with mental and behavioral issues,” Somers said. “It needs to be all hands on deck looking at the most critical aspects in health care, with a primary look at behavioral health and mental health and a commitment to moving needle in the right direction.”
Steinberg said additional federal funding from the American Rescue Plan and other pandemic relief legislation presents an opportunity to put forth "extensive" proposals to rehabilitate the state's health care safety net.
"Children's mental health is the leading edge of the issue," he said.