Summary - Increasing Supply by Tapping Retirees and Other Health Practitioners
As cases of COVID-19 continue to rise around the United States, health care leaders are struggling to assure that the nation has the capacity of caregivers to treat those in need. Increasing Supply by Tapping Retirees and Other Health Practitioners provides a broad framework of state policies to increase workforce capacity and takes a closer look at the New York State experience. Moderated by Edward Salsberg, Director of Health Workforce Studies at the Mullan Institute, this webinar’s speakers include Lauren Block, Program Director for the National Governors Association (NGA) Center for Best Practices’ Health Division, and Jean Moore, Director of the Health Workforce Technical Assistance Center.
Since the onset of the COVID-19 pandemic, states have taken a variety of approaches to expand the workforce through executive action, Ms. Block explains (minute 03:30). These actions include easing licensure requirements, expanding telehealth within and across state lines, and authorizing temporary scope of practice. Also included among these actions is reactivating licenses for retired clinicians. Ms. Block also notes that in addition to expanding the workforce, states are also prioritizing personal protective equipment for workers. “In order for health care workers to do their jobs, they need those protections,” she adds. Memos summarizing these key priority areas are available from the NGA.
With respect to licensure, Ms. Block points to increased reciprocity with other states and expedited licensing as actions states can prioritize (minute 19:38). Some states also participate in interstate compacts allowing nurses to practice across state lines. Similarly, the Emergency Medicine Assistance Compact (EMAC) enables states to share resources, including health workers, through license reciprocity and also provides protection for those personnel. EMAC is state law in all 50 states, the District of Columbia and U.S. territories but requires activation by the governor during times of emergency.
As the epicenter for the outbreak in the U.S., Governor Cuomo in New York State placed the call early for additional health professionals to supplement current workforce capacity (minute 10:55). According to Dr. Moore, outreach first began with retirees and those with inactive licenses, then expanded to all actively licensed individuals and to professional associations. As of April 3rd, over 80,000 individuals had responded with vetting and deployment of these healthcare workers currently underway. The state has also been mindful of the increased risk posed to older individuals and has identified other supportive roles allowing them to assist without being on the front lines (minute 16:00).
New York State is also experiencing regional variation with the New York City metropolitan area experiencing a high volume of cases while upstate New York is seeing significantly fewer cases (minute 24:50). This has led to furloughing of some health care workers who could potentially get deployed to high-needs areas though this is still being explored. As the pandemic is expected to peak in different areas at different times, Ms. Block adds that actions being done by executive order now such as cross-state licensing could help to facilitate movement of health workers across state lines (minute 27:35).
Based on the experience so far in New York State, Dr. Moore advises other states to have a plan for collaboration across state agencies (minute 26:10). “We put down our turf issues and worked collaboratively to figure out a way to get this done as rapidly as possible because we just don’t have the time to do otherwise,” she says.
When surveying potential health workers, she recommends collecting a variety of information in addition to the health profession the applicant represents (minute 18:30). This includes status of license, last date of practice, availability, prior experience in infectious disease, emergency medicine, or intensive care, and prior experience with respirators. She also notes that logistical information such as need for childcare, transportation and lodging are helpful when deploying individuals to high needs hospitals.
As other states prepare for the pandemic and continue to build workforce capacity, Ms. Block recommends creating new administrative flexibility and removing barriers to allow providers to participate in the critical areas (minute 29:40). Similarly, understanding current inventory and needs is also important.
While still very early in the pandemic, both speakers recognize the opportunity to learn from this experience and to share lessons across state lines. “It’s clear to me that we have no choice but to learn from this experience and build strategies and approaches that allow us to respond to something like this a whole lot more quickly [and] a whole lot more efficiently,” Dr. Moore says.
Since the onset of the COVID-19 pandemic, states have taken a variety of approaches to expand the workforce through executive action, Ms. Block explains (minute 03:30). These actions include easing licensure requirements, expanding telehealth within and across state lines, and authorizing temporary scope of practice. Also included among these actions is reactivating licenses for retired clinicians. Ms. Block also notes that in addition to expanding the workforce, states are also prioritizing personal protective equipment for workers. “In order for health care workers to do their jobs, they need those protections,” she adds. Memos summarizing these key priority areas are available from the NGA.
With respect to licensure, Ms. Block points to increased reciprocity with other states and expedited licensing as actions states can prioritize (minute 19:38). Some states also participate in interstate compacts allowing nurses to practice across state lines. Similarly, the Emergency Medicine Assistance Compact (EMAC) enables states to share resources, including health workers, through license reciprocity and also provides protection for those personnel. EMAC is state law in all 50 states, the District of Columbia and U.S. territories but requires activation by the governor during times of emergency.
As the epicenter for the outbreak in the U.S., Governor Cuomo in New York State placed the call early for additional health professionals to supplement current workforce capacity (minute 10:55). According to Dr. Moore, outreach first began with retirees and those with inactive licenses, then expanded to all actively licensed individuals and to professional associations. As of April 3rd, over 80,000 individuals had responded with vetting and deployment of these healthcare workers currently underway. The state has also been mindful of the increased risk posed to older individuals and has identified other supportive roles allowing them to assist without being on the front lines (minute 16:00).
New York State is also experiencing regional variation with the New York City metropolitan area experiencing a high volume of cases while upstate New York is seeing significantly fewer cases (minute 24:50). This has led to furloughing of some health care workers who could potentially get deployed to high-needs areas though this is still being explored. As the pandemic is expected to peak in different areas at different times, Ms. Block adds that actions being done by executive order now such as cross-state licensing could help to facilitate movement of health workers across state lines (minute 27:35).
Based on the experience so far in New York State, Dr. Moore advises other states to have a plan for collaboration across state agencies (minute 26:10). “We put down our turf issues and worked collaboratively to figure out a way to get this done as rapidly as possible because we just don’t have the time to do otherwise,” she says.
When surveying potential health workers, she recommends collecting a variety of information in addition to the health profession the applicant represents (minute 18:30). This includes status of license, last date of practice, availability, prior experience in infectious disease, emergency medicine, or intensive care, and prior experience with respirators. She also notes that logistical information such as need for childcare, transportation and lodging are helpful when deploying individuals to high needs hospitals.
As other states prepare for the pandemic and continue to build workforce capacity, Ms. Block recommends creating new administrative flexibility and removing barriers to allow providers to participate in the critical areas (minute 29:40). Similarly, understanding current inventory and needs is also important.
While still very early in the pandemic, both speakers recognize the opportunity to learn from this experience and to share lessons across state lines. “It’s clear to me that we have no choice but to learn from this experience and build strategies and approaches that allow us to respond to something like this a whole lot more quickly [and] a whole lot more efficiently,” Dr. Moore says.