Public-Private Partnerships Help Train Health Care Work Force

by George Lauer, California Healthline Features Editor

Health care workers at every level of the industry -- from physician to billing coder -- are needed now and will be needed in the next few years, as the country moves deeper into health care reform and baby boomers age and become frail.

In California, students are willing and waiting in the wings. Hospitals, clinics, laboratories and physician offices are ready to hire now -- or will be in the near future. It's that middle stage -- the training -- that may prove problematic in California.

A new survey released last week indicates California community colleges are turning away qualified applicants for health worker training programs because schools lack the capacity to teach them. The survey, conducted by Goodwin Simon Strategic Research and funded by the California Wellness Foundation, indicates that health care training tracks are among the most popular fields of study at community colleges but that only a few colleges in the state are able to accept all qualified applicants.

"These are highly sought after fields for young people," said Amy Simon, partner in the research firm. ."It's frustrating that so many genuinely qualified applicants are not able to get training."

Simon said the problem boils down to three main areas. "Partly it's about a straight-up lack of budget, partly it's about lack of space and scarcity of instructors, and partly it's a lack of partnerships with health care providers who can help with the first two problems," Simon said.

Partnerships With Providers May Help

Community college officials don't have much hope for good budget news anytime soon in a state facing a $25.4 billion budget deficit. But there is hope that more schools can forge successful partnerships with health care providers who can offer clinical space and expertise -- and even funding in some instances -- with the expectation of benefiting from a well-trained work force.

In Northern California, a partnership between Sutter Health and Yuba Community College District is keeping afloat the only accredited X-ray technician training program between San Francisco and the Oregon border. They're working on a similar arrangement for ultrasound technician training at Cosumnes River College in Sacramento.

"We have quite a few partnerships in our region and more in development," said Anette Smith-Dohring, work force development manager for Sutter's Sacramento-Sierra region. "With the Affordable Care Act before us, we're able to predict our needs and we're doing what we can to fill them," Smith-Dohring said.

Sometimes that means money. Sutter's Sacramento Sierra region has donated $25 million toward education over the past seven years, Smith-Dohring said. Sometimes it means expertise. "We have staff on loan as faculty at several colleges," Smith-Dohring said. Sometimes it means clinical and lab space. Partnering colleges sometimes use Sutter facilities for training.

In Southern California, MemorialCare Health System, a not-for-profit company with five hospitals in Long Beach and Orange County, has several partnerships in place, including nursing support programs at Long Beach State University, respiratory therapy programs at Orange Coast College in Costa Mesa and lab technician and imaging technician programs at other schools.

"We've been working on these kinds of partnerships for six or seven years now," said Barry Arbuckle, MemorialCare president and CEO. "It started back in the days when we were having so much trouble getting nurses we had to bring them in from a dozen different states. We were going through placement agencies and it was costing us a lot of money." Over lunch one day seven years ago, the president of Long Beach State told Arbuckle the school was going to have to reduce its nursing program because of lack of instructors and lack of laboratory facilities.

"It occurred to us that we have exactly the two things he needed and that was the start of these kinds of partnerships," Arbuckle said.

With instructors and clinical facilities provided by MemorialCare, Long Beach State's School of Nursing -- which was scheduled to go from 74 training slots a year to "somewhere in the 40s" -- now is training "in excess of 100 nurses a year," Arbuckle said.

Through a partnership with Orange Coast College, MemorialCare provides and pays for a respiratory therapist instructor and helps with student recruitment and financial aid.

"These kinds of private-public partnerships haven't been replicated as much as I might have guessed they would be," Arbuckle said, "but that may change. I think more forward-thinking institutions are going to start looking for things like this."

Residency Program Gets Federal Boost

While the community college survey focused on programs for allied health professions -- laboratory and X-ray technicians, nursing aides, respiratory therapists and medical secretaries -- that account for 60% of all health jobs, California is lagging in training other health care workers as well.

A UC-Berkeley School of Public Health report released in the fall predicted California would be unable to train enough health care workers at all levels -- especially primary care physicians -- to keep up with demand over the next several years. But there are signs that prospects may be picking up in some regions.

The physician-training program in Stanislaus County -- another kind of public-private partnership -- landed $3.2 million in funding and designation as a "Teaching Health Center" through a federal program to train primary care doctors.

The Valley Consortium for Medical Education in Modesto is one of 11 programs in the country -- and the only one in California -- to receive the community-based teaching designation from HHS.

The funding, which comes as part of the Affordable Care Act, will cover salaries, benefits and other physician-training costs in regional clinics.

Last summer, the Valley Consortium -- which includes Stanislaus County, Memorial Medical Center and Doctors Medical Center -- launched the Valley Family Medicine Residency Program, replacing a previous residency that had trained medical school graduates in Stanislaus County since 1975.

If the grant is renewed, the residency program potentially could receive as much as $11 million over the next five years.


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