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

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 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 other than a registered nurse or  … a health professional (other than a registered nurse or physician assistant physician 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 public health  graduate degree in public 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 excludes  “Allied Health” … typically excludes :  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 Professionals

Among the Most Recognized Allied Health Disciplines Occupation (% change ) Total Allied Health750,0001,831,0002,672,000 (256) Dental Hygienists ,000112,000 (180) Dieticians17,00057,00090,000 (429) EMT - Paramedic36,00093,000125,000 (247) Health Information Admin /Tech52,00087,000101,000 (100) Clinical Laboratory135,000297,000337,000 (150 ) Occupational Therapists6,00042,00072,000 (1100) Physical therapists30,00092,000130,000 ( 333) Radiologic workers87,000157,000220,000 (153) Speech Pathologists/audiologists19,00065,000121,000 (537) HRSA, Bureau of Health Professions, National Center for Health Workforce Analysis

Occupation Employment Number* Total job openings Growth & net replacement * Graduate Degree level Occupational therapists Physical Therapists Speech-Lang Pathologists Baccalaureate Degree Dieticians / Nutritionists Med & Clinical Lab Tech Associate Degree Dental Hygienists Med. Records / HIT Radiologic techs Respiratory Therapists * thousands, Data from S.N. Collier, 2007 Health Workforce Articles, BLS projections to 2016 Allied Health Professions: Projections

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

 764,000 health care workers  8.2% of total workforce  Population grew 26%,  Health worker employment, 51%  Population expected to increase 23%,  The Hispanic patient population will increase Texas projected to have a majority Hispanic pop Need for bilingual health care providers

Texas: Job Openings VS. Number of Graduates Profession# Annual Openings (1) # Graduates* Minus 10% (2) #/Percent Unfilled Positions (1) Clin Lab Scientist / 60% Dental Hygienist / 31% EMT/Paramedic / 51% Occupational Therapy / 39% Physical Therapy / 68% Physician Assist / 15% Respiratory Care / 21% Speech /Lang Pathology / 62% 1. Texas Workforce Commission, Data Link, Future Job Growth by Occupation AMA. Health Professions Career and Education Directory 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 2007 Jobs 2012 Jobs Openings NewReplaceTotal(%) Med. & Clinical Lab. Tech (22) Radiology Technology (26) Physical Therapy (30) Dental Hygiene (32) Respiratory Therapy (29) Speech Path/Audio (27) Occupational Therapists (29) Surgical Technology (38) Source: Texas Workforce Commission and Comptroller report, Texas in focus: South Texas, Aug 2008

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 AssistantDental Hygiene Cancer Information Management1Clinical Laboratory Science1 Dental Assistant1Dental Hygiene1 Diagnostic Medical Sonography1Dietetics1 Emergency Medical Services4Health / Medical Administration1 Health Promotion1Medical Assistant3 Medical Laboratory Technology3Occupational Therapy1 Occupational Therapist Asst.2Pharmacy Technology1 Phlebotomy1Physical Therapy1 Physical Therapist Assisting2Polysomnography1 Radiology Technology3Respiratory Care/Therapy2 Speech – Language Pathology2Surgical Technology1 * 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, 110 th Congress, 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 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 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 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 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?