In the coming years, the Nation faces shortages of critical health care workers, including nurses and long-term care providers. In addition, all health care workers will need to be flexible and responsive enough to act on new challenges and maximize the potential of new technologies. In addition to strategies to develop its own workforce, HHS is committed to helping the field recruit and retain, as well as train, develop, and support, a competent professional and paraprofessional health care workforce. Among the operating and staff divisions contributing to the achievement of this objective are AoA, ASPE, CMS, HRSA, IHS, OPHS, and SAMHSA.
HHS, in the health care programs it operates, faces the same recruitment and retention challenges encountered by health care providers nationwide. The first performance indicator measures HHS’s success in meeting its goal to recruit and retain the Commissioned Corps members needed to provide ongoing health care. The second measures the Corps’ readiness to rapidly respond to medical emergencies and urgent public health needs.
Commissioned Corps. The mission of the Commissioned Corps of the United States Public Health Service (USPHS; Commissioned Corps) is protecting, promoting, and advancing the health and safety of the Nation. The Commissioned Corps achieves its mission through rapid and effective response to public health needs, leadership and excellence in public health practices, and the advancement of public health science. As one of the seven Uniformed Services of the United States, the Commissioned Corps is a specialized career system designed to attract, develop, and retain health professionals who may be assigned to Federal, State, or local agencies or international organizations. The Commissioned Corps will continue to offer two excellent opportunities for students through the highly competitive Junior Commissioned Officer Student Training and Extern Program and Senior Commissioned Officer Student Training and Extern Program.
Indian Health Service. The Indian Health Care Improvement Act of 1976 (Public Law 94-437), as amended, authorized IHS to administer interrelated scholarship programs to meet the health professional staffing needs of IHS and other health programs serving Indian people. In addition, IHS administers a Loan Repayment Program for the purpose of recruiting and retaining highly qualified health professionals to meet staffing needs. The Indian Health Professions Program provides scholarships, loans, and summer employment in return for agreements by students to serve in health facilities serving American Indians and Alaska Natives in medically underserved areas. As a matter of law and policy, IHS gives preference to qualified American Indians in applicant selection and in career development training.
National Health Service Corps. Currently, 35 million people live in communities without adequate access to primary health care because of financial, geographic, cultural, language, and other barriers. Since its inception, the National Health Service Corps (NHSC), managed by HRSA, has placed more than 27,000 primary care clinicians, including dental, mental, and behavioral health professionals, in underserved areas across the country including communities with Health Centers. In FY 2007, field strength for the NHSC is estimated to be more than 3,400 people.xiv Approximately half of NHSC clinicians are assigned to service in Health Center sites.
Nurses. The Bureau of Labor Statistics estimates that by 2020 the Nation will have a shortfall of up to 1 million nurses, which includes new jobs and “replacement” jobs that are open when today’s nurses retire and leave the field.xv As the population continues to grow and age and medical services advance, the need for nurses will continue to increase. A report developed by HHS, What is Behind HRSA’s Projected Supply, Demand, and Shortage of Registered Nurses, predicted that the nursing shortage is expected to grow to more than 1 million by 2020. In 2007, HHS nursing programs will support recruitment, education, and retention of nursing students, emphasizing new loan repayments and scholarships.
Workforce Support Efforts
Cultural Competence. OPHS’s OMH is mandated to develop the capacity of health care professionals to address the cultural and linguistic barriers to health care delivery and increase access to health care for people with limited English proficiency. The Center for Linguistic and Cultural Competence in Health Care was established in FY 1995 as a vehicle to address the health needs of populations with limited English proficiency.
National Standards on Culturally and Linguistically Appropriate Services. These standards have been developed and are primarily directed at health care organizations; however, individual providers also are encouraged to use the standards to make their practices more culturally and linguistically accessible. The principles and activities of culturally and linguistically appropriate services should be integrated throughout an organization and undertaken in partnership with the communities being served. The standards are organized by three themes: Culturally Competent Care, Language Access Services, and Organizational Supports for Cultural Competence.
Mental Health and Substance Use Disorders Prevention and Treatment. SAMHSA supports efforts to identify and articulate key workforce development issues in the mental health and substance use disorders prevention and treatment fields and to encourage the retention and recruitment of an effective compassionate workforce. These efforts include support for programs that train behavioral health professionals to work with underserved minority populations, training for mental health and substance abuse providers, and leadership training programs.
Support to Family Caregivers. The National Family Caregiver Support Program, developed by AoA, calls for all States working in partnership with local area agencies on aging, faith- and community-service providers, and tribes to offer five direct services that best meet the range of family and informal caregivers’ needs: information about available services; assistance in gaining access to supportive services; individual counseling, organization of support groups, and training to assist caregivers in making decisions and solving problems relating to their roles; respite care to enable caregivers to be temporarily relieved from their caregiving responsibilities; and supplemental services, on a limited basis, to complement the care provided.
Direct Support Workforce. To address the emerging “care gap” between the number of long-term care workers and growing demand, providers, policymakers, and consumers are likely to consider a broad range of strategies: improving wages and benefits of direct care workers, tapping new worker pools, strengthening the skills that new workers bring at job entry, and providing more relevant and useful continuing education and training. A key strategy in this mix will be a focus on workforce development—providing workers with the knowledge and skills they need to perform their jobs. In addition, ASPE and its partners in and outside HHS are engaged in a series of research projects aimed at more accurately enumerating the long-term care workforce, describing the types of tasks performed and assessing the impact of workforce development programs.