INSIDE THE ISSUE

> Creating Nursing Educators
> Out-of-State Nurses
> Post-Acute Backups
> Board Focus on DHE&I
> Serious Illness Summit Nov. 3
> Transition

MONDAY REPORT

U.S. Department of Labor Looks to Expand Nursing Workforce

The U.S. Department of Labor (DOL), under the direction of Secretary Marty Walsh, the former mayor of Boston, on Monday announced an $80 million grant program to support nurse training programs.

The grant program’s first track will increase the number of clinical and vocational nursing instructors by training new nurses, or “upskilling” experienced current or former nurses into advanced postsecondary credentialing necessary for them to become clinical and vocational nursing instructors and educators. The second track will train frontline healthcare professionals and paraprofessionals, including direct care workers, to advance along a career pathway and attain postsecondary credentials needed for middle- to high-skilled nursing occupations. For the second, “Nursing Career Pathway Track,” DOL is looking for applicants that can develop training partnerships between clinical settings and education.

“Each training track places an emphasis on training individuals from historically marginalized and underrepresented populations, which will also have an impact on addressing the health equity gap in underserved communities,” DOL writes in the application document. “The promotion of a diverse nursing workforce is a key strategy towards improving health equity in the U.S.”

Currently across Massachusetts, numerous hospitals are partnering with community colleges and other education institutions to create education-internship-job development programs for the healthcare workforce. The challenge often encountered with such partnerships, MHA members report, is that there are not enough clinical educators to match the applicants for such programs.

An MHA report issued this summer showed that more than 5,100 registered nurses (R.N.) would be needed to fill current full-time vacancies at Massachusetts acute care hospitals, and that hospitals already had spent $445 million halfway through Fiscal Year 2022 on temporary nurses to fill the void. That shortage and traveler expense has not abated since the report was released; the full FY2022 staffing cost for temporary R.N.s in Massachusetts could approach $1 billion if this trend continues, compared with an estimated $133 million in 2019.

State Recognizes Workforce Crisis; Extends Staffing Flexibility

Last week, the Baker Administration once again extended a COVID-19 Public Health Emergency Order that had first been put into effect in June 2021 – namely, allowing registered nurses, licensed practical nurses, and advanced practice registered nurses who are licensed in another state to practice in Massachusetts through December 31, 2022, once they present their credentials to the state’s Board of Registration in Nursing. The previous cut-off date for the nurses to practice was September 30, 2022. MHA and its members have identified COVID-imposed flexibilities as especially critical in addressing workforce shortages and capacity constraints.

Workforce Shortages Mean Some Patients Have Nowhere to Go

The workforce crisis is not just affecting acute care hospitals; post-acute facilities, which include inpatient rehabilitation facilities, long-term acute care hospitals, skilled nursing facilities, assisted living residences, and home care services, are also severely short staffed. The lack of post-acute staff is just one reason that acute care hospitals are unable to transfer patients to them. Patients who have received the appropriate level of care at an acute care hospital, but now need specialized care often cannot receive it because the post-acute doesn’t have the necessary staff. The patient therefore remains at the hospital, occupying a bed that other arriving patients need.

The most recent MHA survey (September) of just 41 of the state’s 65-plus acute care hospitals found that 967 patients were waiting to be discharged: 625 were waiting for a skilled nursing facility bed; 77 were awaiting discharge to an inpatient rehabilitation facility or long-term acute care hospital; and 265 were awaiting home health services. Of those patients, 184 were waiting 30 days to six months; 37 patients were waiting more than six months.

MHA Continues its Efforts on Diversity, Health Equity

As part of MHA’s ongoing commitment to leading on diversity, health equity, and inclusion (DHE&I) efforts, the association is offering members’ governing boards a custom training program entitled “The Role of Governance in Advancing Health and Racial Equity.”

“Boards have the power to support a sustainable equity vision for leadership, staff, patients and communities,” said MHA President & CEO Steve Walsh. “Informed board members can leverage their governance role to ask key questions, set expectations for progress and reporting, and define measures of success to advance DHE&I values.”

The four-month program will run from January through April 2023 and consists of a pre-training self-assessment, two asynchronous trainings focused on Recognizing and Responding to Implicit Bias and Advancing Racial Health Equity; and a live training session on Understanding Board Accountability for Health Equity.

MHA’s Senior Vice President and Chief Innovation Officer Valerie Fleishman is coordinating the MHA offering in partnership with Health Resources in Action.

Coalition for Serious Illness Care Holds Summit on November 3

The seventh annual summit from the Massachusetts Coalition for Serious Illness Care takes place virtually on Thursday, November 3 from 1 to 3:30 p.m. Part of the summit is dedicated to the rollout of the Coalition’s first ever strategic plan. Register for the free summit by visiting here.

Transition

Dr. Michael Wagner, former CEO of Tufts Medical Center and most recently Chief Physician Executive for Tufts Medicine, has been named the president & CEO of Rhode Island-based Care New England, effective December 1, 2022. Care New England is the parent organization of Butler Hospital, Kent Hospital, Women & Infants Hospital of Rhode Island, Care New England Medical Group, the VNA of Care New England, The Providence Center, and the Integra ACO. The system has 970 licensed beds and 216 infant bassinets. Wagner replaces James Fanale, M.D., who is retiring after five years at the helm of Care New England. Fanale was previously COO of Jordan Hospital, now known as Beth Israel Deaconess Hospital-Plymouth.

John LoDico, Editor