1. The Health Care Workforce Shortage: An Analysis of the Scope and Impact on Northern Virginia Northern Virginia Health Care Workforce Alliance Draft

2. 1 Objectives and Approach Study objectives - identify: current and future Northern Virginia health care workforce needs for 24 selected health care professions current and future gaps in the health care workforce and the driving forces leading to these gaps training and education, recruitment, and retention best practices within Northern Virginia and other regions of the country. Study approach: a quantifiable independent survey of a sample of health care providers in Northern Virginia interviews with local health care providers, academic institutions and economic development authorities a literature search

3. 2 Northern Virginia Health Care Workforce Alliance Draft Health Care Job Professions Studied Professions Studied RNsNursing Aides Medical Records Dental Assistants Medical and Nurse ManagersHome Health Aides Dental HygienistsEMTs/Paramedics Radiologic TechsLPNs Physical TherapistsPhysical Therapist Assistants Occupations TherapistsRespiratory Therapists CT Scanning TechsMedical and Lab Technologists MRI TechsSpeech Language Pathologists Pharmacy TechsPharmacists Surgical TechnologistsMedical and Lab Techs PhlebotomistsSurgical Techs

4. 3 Northern Virginia Health Care Workforce Alliance Draft This Study Analyzes the Health Care Workforce Needs of Northern Virginia Counties and Cities Represented in Study Arlington County Fairfax County Loudoun County Prince William County City of Alexandria City of Fairfax City of Falls Church City of Manassas City of Manassas Park The study attempts to forecast the future health care workforce needs of Northern Virginia for 2010 and 2020. Source: Northern Virginia Regional Commission Website

5. 4 Northern Virginia Health Care Workforce Alliance Draft A shortage of health care workers exists in Northern Virginia. There is an estimated shortage of about 2,800 professionals in the 24 job categories. An average vacancy rate of about 10 percent exists. Without interventions, this vacancy rate is anticipated to grow to over 41 percent by 2020. The anticipated vacancy percentages are estimated to range from 27 to 56 percent depending on the profession. RNs dominate the current and projected shortage, with more than 1,000 current vacancies. Other hard hit professions are medical records and health information technicians and imaging. The forecasted growth will continue to put immense strain on the availability of health care workers through 2020. Without interventions, vacancies will increase to 16,600 positions with a total demand of over 40,000 positions. Key Findings

6. 5 Northern Virginia Health Care Workforce Alliance Draft Key Drivers: Growth Rate of over 33% by 2020 - Twice National Rate Northern Virginia Population Growth Projections 200420102020 Projected Growth (2004-2020) Growth in % (2004-2020) Arlington County197,858214,177244,42146,56223.5% Fairfax County1,013,9241,113,8511,273,924246,29324.0% Loudoun County217,056283,799416,247190,71684.6% Prince William County326,480368,031449,362122,88237.6% City of Alexandria139,725153,889180,75741,03229.4% City of Fairfax22,86223,05023,3675052.2% City of Falls Church11,28812,19713,8772,58922.9% City of Manassas38,15643,23053,23215,07739.5% City of Manassas Park12,47614,37818,2155,73846.0% Combined Northern Virginia2,002,0082,226,6022,673,401671,39333.5% US16.5% Source: April 1, 2000 Census, July 1, 2001 Estimate, July 1, 2002 Estimate and Provisional 2003 based on Census figures as provided by the Weldon Cooper Center, University of Virginia, February 2, 2004. Projections developed by calculating the compound annual growth rate between the estimated 2002 and projected 2007 population by ethnicity data provided by Solucient. Using the July 1, 2002 estimate data as a base year 2003 through 2020 were projected by applying the compound annual growth rate to calculate the growth estimate.

7. 6 Northern Virginia Health Care Workforce Alliance Draft Other Key Drivers Inpatient Days - Concentrated in the Over 65 population cohort per National Data Sources: National Hospital Indicators Survey, 2003, CMS; Indicators of Healthy Communities 2003—Northern Virginia Region, Inpatient days per 1,000 population, 2000 n Increased demand for services due to the aging population n Concurrent aging of the health care workforce and resultant retirements n Shortage of nursing and allied health profession faculty, schools, and clinical experience sites and the inability to find replacements n Concurrent again of clinical faculty and the resultant retirements n Difficulties with having market competitive salaries for clinical faculty n Nature of the profession n Low unemployment rates and high cost of living Inpatient Days by Age Cohort

8. 7 Northern Virginia Health Care Workforce Alliance Draft Nearly Half of Health Care Employers Expanded Their Staffs and Found Recruiting Somewhat Difficult Change in Size of the Workforce Last 12 Months Source: PwC Analysis of Northern Virginia Health Care Workforce Survey Ease of Recruiting Health Care Personnel

9. 8 Northern Virginia Health Care Workforce Alliance Draft In the next 12 months, all of the Northern Virginia hospitals surveyed expected to either retain their current workforce or hire additional workers. Nine hospitals reported that they would grow their health care workforce in the year ahead Two said it would stay the same Hospitals Expect Biggest Future Difficulties in Hiring Staff Change in Workforce Needs for Hospitals Source: PwC Analysis of Northern Virginia Workforce Survey Number of responses

10. 9 Northern Virginia Health Care Workforce Alliance Draft Estimated Demand for Health Care Workers Through 2020

11. 10 Northern Virginia Health Care Workforce Alliance Draft Retirement Rate Increases Will Contribute to Higher Shortages Average age of registered nurses in Virginia is over 45, according to the Virginia Hospital and Healthcare Association. The increasing age of the registered nurses is a concern because it is anticipated that a greater than average number of registered nurses will be retiring over the next several years. The physically demanding nature of the nursing occupation contributes to the need to retire or change careers. Registered Nurse Shortage Assuming Increasing Retirement Rates Source: Where We Stand: Projected Nurse Demand and Supply in Virginia, 2000-2020, Virginia Hospital and Healthcare Association, April 2004 Northern Virginia’s Future Health Care Workforce Needs Retirements are increased by 1% of the labor force each year.

12. 11 Northern Virginia Health Care Workforce Alliance Draft Northern Virginia - positioned to be a leading innovator for health care workforce solutions. Experiencing an acute shortage in many of its professional and occupational health care employment categories. Northern Virginia’s demographics pose specific challenges and solutions. n Low unemployment rate n Highly educated n High levels of employment n High salaries (comparatively) n Ethnically diverse n Large percent of foreign born n Growing focus on life sciences n Large information technology focus n Creating an alliance of educators, providers, business, and economic authorities. Northern Virginia is Well-Suited to Be a Leading Innovator for Health Care Workforce Solutions

13. 12 Northern Virginia Health Care Workforce Alliance Draft Education and Training n providing health care training to persons new to health care or encouraging advanced training to persons inside of health care. Most programs achieve this through free training and education, paid training and internship opportunities, and accelerated training programs. Recruitment n initiatives aimed at recruiting new workers into the field of health care. Strategies include awareness programs, enhanced benefits, loan forgiveness, increased marketing of health care careers, and flexible work hours. Retention n Retention tools often include innovative benefits such as employee driven scheduling, development of clinical specialist and manager positions, market rate adjustments, career ladders, child care among others. n Specific challenges are retaining the experienced employees who are so important in training and mentoring the less experienced employees. Without mentors, the less experienced professionals are apt to leave. Workforce Best Practices