The looming crisis in rural healthcare
Health care is one of the largest industries in the country, including Nebraska, employing a vast number of workers. Still, many rural communities experience health care workforce shortage problems, with the most severe being in rural health professional shortage areas and medically needy and underserved population groups.
Over half of Nebraska's counties (49 of 93) were federally designated, either in full or in part, as primary care health professional shortage area. Seventy-one (71) Nebraska Counties are designated as Medically Under-served Areas.
Rural health care workforce shortages carry a negative impact on health care quality, through reduced health care access as well as through increased stress on providers. Shortages not only contribute to higher costs by raising compensation levels to reflect increased demand but also by increasing the use of overtime pay and expensive temporary personnel.
Health care workforce shortage problems are prominent in rural areas due to several reasons. These include:
* An aging workforce population
* High retirement eligibility
* Difficulty in retention of workers
* Difficulty in recruitment of workers
* Lack of educational and training opportunities
* High vacancy rates
* High turnover rates
* Lack of opportunities for career advancement
* Financial concerns including lower pay as well as lack of benefits
* Increased work load demand
Many health care professions are facing workforce shortages. These include but are not limited to primary care physicians, nurse practitioners, licensed practical nurses, physician assistants, dentists, registered nurses, certified nursing assistants, home care aides, lab technicians, pharmacists, opto-metrists, chiropractors, allied health personnel, public health personnel, and radiology technicians.
The State of Nebraska and rural communities must continue to develop new strategies to help reduce and address the problems of workforce shortages in rural health care. Short-term and long-term approaches that the state and local communities can take to help remedy the shortage might be -
* promoting educational opportunities
* providing professional training
* partnering with educational institutions
* increasing pay, benefits and flexibility
* marketing public health careers
* using information technology
* training future health care workers
Strategies include encouraging individuals to pursue education in health profession fields by offering programs that provide assistance for repayment of educational loans and to assist with the cost of education.
These programs can take the form of grants, loans, fellowships, scholarships, state loan repayment programs, and faculty loan repayment programs. Some programs have special conditions such as a specified term of service in an underserved area.
Another strategy is to assist in recruitment and retention of health care workforce professionals. Rural areas often experience health care workforce difficulties in the recruitment and retention of primary care physicians. Having quality physicians is essential to providing healthcare in rural communities. Many communities turn to the recruitment of foreign medical graduates with http://www.raconline.org/info_guides/hc_providers/j1visafaq.php Visa Waivers to fill their physician vacancies. Other communities use the http://www.raconline.org/info_guides/hc_providers/j1visafaq.php \l conrad30 Conrad 30 program, a program designed to provide each of the 50 U.S. states up to 30 waivers for physicians each fiscal year.
Attracting, recruiting, and http://content.healthaffairs.org/cgi/content/full/23/3/78 retaining foreign nurses is another strategy many institutions are looking towards to fill current registered nurse staffing vacancies.
The Immigration and Naturalization Service gave the recruiting industry a boost at the end of 2004 by issuing for the first time clear guidelines for using a http://www.h1base.com/page.asp?id=312 H1-B visa for a nurse. For an explanation of the H1-B Visa as well as further information, please visit the H1-B section on the http://www.raconline.org/info_guides/hc_providers/j1visafaq.php \l visa J1-Visa information guide.
Rural providers can promote retention and advancement through incentives, training, loan repayment programs, and supportive services including helping spouses find work, providing continuing educational training opportunities, reducing stress, and providing adequate pay and benefits. Incentive programs can reward work-related milestones like sustaining employment over a specified period of time, or work-related achievements regarding productivity or new ideas that can be implemented.
These incentives do not have to be financial but could include flexible work hours, time off from work to attend work-related training, special privileges such as VIP parking, or tuition assistance. Employers may also consider providing customized on-the-job training during working hours to help employees upgrade their skills.
Other support systems that encourage a positive workforce would be providing on-site child care and transportation services to and from work.