alaska’s allied health workforce: a statewide assessment · the estimated $80,000 in program...

Alaska’s Allied Health Workforce:A Statewide Assessment

Alaska Center for Rural HealthUniversity of Alaska Anchorage

3211 Providence DriveAnchorage, Alaska 99508

March 2001

PROJECT SPONSORS

University of AlaskaAlaska State Hospital and Nursing Home Association

PROJECT DEVELOPMENT TEAM

Alaska Center for Rural Health (ACRH)Denny DeGross, Director

Beth Landon, Assistant DirectorJanice Troyer, Research Associate

Institute of Circumpolar Health Studies (ICHS)Brian Saylor, Director

Bette Rutan, Research CoordinatorCathy Rowe-Dishman, Research Assistant

University of Alaska Anchorage (UAA)Community and Technical College

Robin Wahto, Program Director, Medical Assisting DepartmentAnn Hook-Baker, Assistant Professor, Health Education and Training

Alaska State Hospital and Nursing Home Association (ASHNHA)Laraine L. Derr, President/CEO

Judy Nyman, Workforce Development Project Director

Alaska Native Health Board (ANHB)Cynthia J. Navarrette, President/CEO

Trudy Anderson, Executive Administrative AssistantSandra Pearson, Special Projects Manager

Alaska Native Tribal Health Consortium (ANTHC)Kim Smith, Program Manager

Terri Fitka, Professional Recruiter

Alaska Primary Care Association (APCA)Marilyn Walsh Kasmar, Executive Director

Bill Tucker, Market Place AnalystRobyn Newby, Program Assistant

Alaska Mental Health Trust Authority (AMHTA)Mary Elizabeth Rider, Planner

Heather Ireland, Intern

Alaska Mental Health BoardMargo Waring, Health and Social Services Planner

Advisory Board on Alcoholism and Drug Abuse, DHSSPam Watts, Executive Director

Governor’s Council on Disabilities and Special Education, DHSSMillie Ryan, Executive Director

PROJECT DEVELOPMENT TEAM (cont.)

Substance Abuse Directors Association (SADA)Mary Rosenzweig, Executive Director

Alaska Association on Developmental Disabilities (AADD)Emily F. Ennis, Vice-President

Alaska Department of Administration, Division of Senior ServicesKay Burrows, Director

Kay Branch, Associate Coordinator of Rural Long-term Care Development

Alaska Department of LaborChris Miller, Chief, Research and Analysis

Jack Cannon, Labor EconomistBruce McHardy, Labor Economist

Yukon-Kuskokwim Health Corporation (YKHC)MaryAnn Schaffer, Patient Care Services Administrator

Alaska Community Mental Health Services Association (ACMHSA)Ron Adler, Chair

PROJECT IMPLEMENTATION TEAM

Beth Landon, ACRHJanice Troyer, ACRH

Bette Rutan, ICHSCathy Rowe-Dishman, ICHS

Judy Nyman, ASHNHATrudy Anderson, ANHBSandra Pearson, ANHB

Bill Tucker, APCAMaryAnn Schaffer, YKHC

Ron Adler, ACMHSA

PROJECT EVALUATION TEAM

Beth Landon, ACRHJanice Troyer, ACRHStacy L. Smith, ICHS

Bette Rutan, ICHSRobin Wahto, UAA

Judy Nyman, ASHNHABill Tucker, APCA

Heather Ireland, AMHTHAMary Rosenzweig, SADA

Pam Watts, Advisory Board on Alcoholism and Drug AbuseMargo Waring, Alaska Mental Health Board

Millie Ryan, Governor’s Council on Disabilities & Special Education

Alaska Center for Rural Health Allied Health Workforce AssessmentUniversity of Alaska Anchorage March 2001

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EXECUTIVE SUMMARY

The health care industry is one of the largest employers in Alaska. Health care workers, rangingfrom physicians and administrators to public health workers and allied health professionals, aredistributed across the state. For this project, allied health workers are defined as thoseprofessions and occupations that provide physical and behavioral health support in the healthcare field.

The purpose of the Allied Health Workforce Assessment is to determine the current andprojected training needs of the Alaskan allied health workforce. This information will enable theUniversity of Alaska to plan future training programs in the health care field. This assessmenttook a “snapshot view” of the Alaskan allied health workforce in terms of number of employees,vacancies, annual turnover, projected future needs and recruitment difficulties – to determinethe areas of greatest need. It also collected qualitative information regarding training needs,cross training, general trends and suggestions to the University of Alaska for planning healthrelated coursework and programs.

Working in collaboration with staff and representatives of health care industry organizations,Project Team members developed a data collection instrument and generated a list of 74occupations in October 2000. Pilot surveys were conducted in four sites across the state duringNovember 2000. Based on feedback from these pilots, the survey instrument was revised andfinalized.

Survey participants were identified using membership lists from:

1. Alaska State Hospital and Nursing Home Association (ASHNHA)2. Alaska Primary Care Association (APCA)3. Alaska Native Health Board (ANHB)4. Alaska Mental Health Trust Authority (AMHTA)5. Substance Abuse and Directors Association (SADA)6. Alaska Community Mental Health Services Association (ACMHSA)7. Infant Learning programs8. Long-term care and assisted living facilities9. Developmental disability providers

Surveys were mailed in November 2000 along with a survey tip sheet and appropriate coverletters from these organizations. Staff members of ASHNHA, APCA, ANHB, ICHS and ACRHtelephoned respondents to discuss the survey and collect data. ACRH staff conducted surveyswith school districts, a sampling of EMS organizations, and the Alaska Department ofCorrections.

In addition to the above mentioned organizations, other health care providers were identifiedusing the “yellow pages” of Anchorage, Fairbanks, Juneau, and Kenai Peninsula phone books.ACRH staff contacted pharmacies, vision clinics, rehabilitation offices (including physicaltherapy, occupational therapy, speech pathology, audiology, and orthopedics), and imagingclinics. They also sampled medical clinics, dental clinics, and behavioral health organizations.No surveys were mailed to these organizations, but the same survey instrument was used torecord information.

369 organizations out of 384 responded for an overall response rate of 96%. The project teamreconvened in early February 2000 to review data and draft recommendations for the Universityof Alaska's Planning & Budgeting Advisory Committee (PBAC) on Health.


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RECOMMENDATIONS

ACRH staff presented the Project Team’s findings and recommendations to the Planning &Budgeting Advisory Committee (PBAC) on Health on February 22nd, 2001. The PBAC, withrepresentation from each of the University of Alaska’s three major academic units (Fairbanks,Anchorage, and Southeast), transformed the findings into a proposed implementation strategyfor Fiscal Year 2002 funding. If these recommendations are included in the FY02 Universitybudget and funded by the Alaska State Legislature, the following will occur:

Pharmacy Technician

Expansion of pharmacy technician training at UAF using instructional models developed atUAA. Sixty thousand dollars in FY02 general fund, coupled with $20,000 in tuition, would coverthe estimated $80,000 in program expenses.

Radiologic Technicians

Continuation of current efforts to develop radiological health training including the FY03proposal to increase faculty appointments from 9 to 12 months. Additional assessments of theprogram should be conducted for possible inclusion in FY04 initiatives.

Behavioral Health

The recommendations in the Allied Health Workforce Assessment emphasized the need for anadditional review of behavioral health professions. The PBAC recommends an extension of theexisting Allied Health Services contract with the Alaska Center for Rural Health to provide aninitial $10,000 for the study of behavioral health efforts. This money has been taken from theFY01 pool and therefore will not affect the FY02 Allied Health set-aside.

Additional activities to be included are as follows:

• Behavioral Health Personnel Analysis - $50,000• Associated Travel - $10,000• Curriculum Development in Cross-Cultural and Intergenerational Mental Health Issues -

$5,000• Curriculum Development in Substance Abuse - $5,000

Rehabilitation Services

The Allied Health Workforce Assessment found a strong need for more rehabilitation staff inAlaska, but the Project Team recognized that starting new programs in Alaska may beunrealistic at this time. The Project Team recommended dedicating staff to advise students onoptions for completing rehabilitation degrees in programs outside Alaska in the areas ofoccupational, physical, recreational, and speech therapy, and to endorse current affiliations withWICHE programs. They also urged the development of aggressive advising services, including800 numbers, and support for professional student exchange programs.

The PBAC recommends that a full-time equivalent faculty member be hired with related traveland incidental costs not to exceed $120,000.


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Other Allied Health Professions

The PBAC found common themes in the study’s discussion of the need for coordination of otherAllied Health professions, including coding and billing specialists, dental assisting, entry levelhealth occupations, and some emergency medical services training. The committee discussedthe need for distance delivery of many of these programs and the need for qualified personnelat each Major Academic Unit (MAU) to assist students in:

• Service coordination• Instruction• Distance education• Preceptorship site development and management• Student placement

The PBAC recommends hiring an Allied Health Coordinator for each MAU. These coordinatorswould assure that students enrolled in various Allied Health Distance Education courses ofstudy would receive the support required for successful completion. High school studentrecruitment into health careers (especially of minority students) would be another criticalelement in this initiative. It was estimated that the cost would not exceed $200,000.

The PBAC recommends that the chair contact individuals who could put together a moredetailed proposal for the expenditure of the FY02 Allied Health resources in line with theserecommendations.

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TABLE OF CONTENTS

EXECUTIVE SUMMARY ........................................................................................................... iRECOMMENDATIONS............................................................................................................. ii

TABLE OF CONTENTS ...........................................................................................................iv

I. PROJECT RATIONALE ...................................................................................................... 1

II. METHODOLOGY................................................................................................................ 2A. Project Collaborators.................................................................................................... 2B. Instrument Development .............................................................................................. 2C. Pilot Survey.................................................................................................................. 3D. Identification of Survey Participants ............................................................................. 4E. Implementation of the Survey....................................................................................... 5

III. RESULTS .......................................................................................................................... 6A. Overview of Quantitative Findings ................................................................................ 6B. Results Organized by Occupation ...............................................................................13

1. Health Information Management ...........................................................................14Analyst ..................................................................................................................15Health Information Technician ...............................................................................16Health Information Administrator ...........................................................................17Medical Transcriptionist .........................................................................................18Records Clerk........................................................................................................19Coder ....................................................................................................................20Biller ......................................................................................................................21Combined Coder/Biller...........................................................................................22

2. Behavioral Health..................................................................................................23Human Service Worker/Entry-Level.......................................................................24Human Service Worker/2-Year Degree .................................................................25Human Service Worker/4-Year Degree .................................................................26Psychiatric Nurse Assistant ...................................................................................27Marriage And Family Therapist/Licensed...............................................................28Marriage And Family Therapist/Unlicensed ...........................................................29Licensed Professional Counselor ..........................................................................30Mental Health Counselor .......................................................................................31Psychological Associate ........................................................................................32Clinical Psychologist..............................................................................................33Social Worker/4-Year Degree (BSW) ....................................................................34Social Worker/6-Year Degree (MSW)....................................................................35Licensed Clinical Social Worker.............................................................................36Substance Abuse Technician ................................................................................37Substance Abuse Counselor 1 ..............................................................................38Substance Abuse Counselor 2 ..............................................................................39Substance Abuse Clinical Supervisor ....................................................................40School Counselor ..................................................................................................41School Psychologist ..............................................................................................42

3. Ancillary Services..................................................................................................43Biomedical Equipment Technician.........................................................................44

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ECG/Treadmill/Holter Technician ..........................................................................45Cardiovascular Technician ....................................................................................46Cardiac Sonographer ............................................................................................47Registered Dietitian ...............................................................................................48Dietetic Technician ................................................................................................49Radiologic Technologist.........................................................................................50Diagnostic Medical Sonographer ...........................................................................51Nuclear Medicine Technologist..............................................................................52Imaging- MRI.........................................................................................................53Imaging - CAT .......................................................................................................54Mammographer .....................................................................................................55Phlebotomist..........................................................................................................56Clinical Lab Assistant ............................................................................................57Clinical Lab Technician/2-Year Degree (MLT) .......................................................58Clinical Lab Technician/4-Year Degree (MT) .........................................................59Patient Advocate/Interpreter ..................................................................................60Pharmacist ............................................................................................................61Pharmacy Technician ............................................................................................62Surgical Technician ...............................................................................................63Physician Assistant................................................................................................64

4. Long-term Care.....................................................................................................65Certified Nursing Assistant ....................................................................................66Medical Foster Care Provider ................................................................................67Personal Care Attendant .......................................................................................68

5. Rehabilitation ........................................................................................................69Audiologist.............................................................................................................70Occupational Therapist..........................................................................................71Occupational Therapy Technician/Assistant ..........................................................72Orthotist/Prosthetist ...............................................................................................73Physical Therapist .................................................................................................74Physical Therapist Assistant ..................................................................................75Respiratory Technician..........................................................................................76Respiratory Therapist ............................................................................................77Speech Pathologist................................................................................................78Therapeutic Recreation Specialist .........................................................................79

6. Miscellaneous Occupations...................................................................................80Community Health Aide.........................................................................................81Community Health Representative ........................................................................82Dental Assistant ....................................................................................................83Dental Hygienist ....................................................................................................84Environmental Health Technician ..........................................................................85Health Educator.....................................................................................................86Home Health Aide .................................................................................................87Medical Assistant...................................................................................................88Licensed Optician ..................................................................................................89Apprentice Optician ...............................................................................................90Optometric Technician...........................................................................................91

7. Emergency Medical Services ................................................................................92Emergency Medical Technician I (EMT I) ..............................................................93Emergency Medical Technician II (EMT II) ............................................................94Emergency Medical Technician III (EMT III) ..........................................................95

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Paramedic .............................................................................................................96EMS Instructor.......................................................................................................97

C. Summary of Qualitative Comments.............................................................................981. Dental Clinics (N= 41) ...........................................................................................982. Medical Clinics (N= 32) .........................................................................................983. Pharmacies (N= 27) ..............................................................................................994. Vision Clinics (N= 29)............................................................................................995. School Districts (N= 38) ........................................................................................996. Rehabilitation Offices (N= 27) .............................................................................1007. Emergency Medical Services (N= 11) .................................................................1008. Behavioral Health (N= 105) .................................................................................1009. Large Health Care Organizations (N= 59) ...........................................................100

IV. DISCUSSION AND RECOMMENDATIONS...................................................................102A. Billing and Coding .....................................................................................................102

1. Findings and Recommendations .........................................................................1022. PBAC Proposed Implementation Strategy...........................................................102

B. Dental Assisting Program..........................................................................................1021. Findings and Recommendations .........................................................................1022. PBAC Proposed Implementation Strategy...........................................................103

C. Pharmacy Technician Program .................................................................................1031. Findings and Recommendations .........................................................................1032. PBAC Proposed Implementation Strategy...........................................................103

D. Radiologic Technology Program ...............................................................................1031. Findings and Recommendations .........................................................................1032. PBAC Proposed Implementation Strategy...........................................................104

E. Rehabilitation ............................................................................................................1041. Findings and Recommendations .........................................................................1042. PBAC Proposed Implementation Strategy...........................................................104

F. Behavioral Health Programs......................................................................................1051. Findings and Recommendations .........................................................................1052. PBAC Proposed Implementation Strategy...........................................................105

G. Emergency Medical Services....................................................................................1061. Findings and Recommendations .........................................................................1062. PBAC Proposed Implementation Strategy...........................................................106

H. Entry-Level Occupations ...........................................................................................1061. Findings and Recommendations .........................................................................1062. PBAC Proposed Implementation Strategy...........................................................107

I. Other Allied Health Professions ..................................................................................107

Appendices

Appendix A: Survey Instrument

Appendix B: Tips Sheet

Appendix C: Cover Letter

Appendix D: Campus Categories

Appendix E: Data Limitations

Appendix F: Detailed Analysis of Open-ended Questions


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I. PROJECT RATIONALE

Health care is a major employer. Nationally, the health workforce represents 10.5% of allAmerican workers (State Health Workforce Profile 2001, Health Resources and ServicesAdministration). In Alaska, Providence Alaska Medical Center is the second largest privateemployer, behind Safeway/Carrs. Many health care providers, such as the Norton SoundHealth Corporation in Nome and the Yukon-Kuskokwim Health Corporation in Bethel, are thelargest employers in their regional areas. The Department of Labor states in the August 2000issue of Alaska Economic Trends, “Health care is a labor-intensive industry that providesaround-the-clock and year-round services.”

To keep the health care delivery system functioning efficiently within Alaska, it is important tohave an adequate supply of allied health workers. According to the statewide industryemployment estimates from 1995 to year 2000 (http://www.labor.state.ak.us/research/emp_ue/ak95prs.htm), health care services are on the rise. During 1995, an estimated monthlyaverage of 13,200 people were employed in health services. 1999 shows an estimated averageof 15,600, and the 2000 figures report an estimated average of 16,650 health service workersemployed each month. These numbers do not include additional behavioral health occupationsthat might be listed under “social services.” This sector also shows a steady increase from anestimated 6,300 people employed in 1995 to over 8,000 employed in 2000.

Alaska must “grow its own.” The September 2000 Alaska Economic Trends notes that, “Alaska’sper capita personal income and average earnings are currently hovering at the nationalaverage, providing little economic incentive for workers from high wage areas in western statesto choose Alaska. Training Alaska workers may be the best and least expensive solution formany employers.”

The University of Alaska seeks to expand and maintain training programs for allied healthworkers. This could include planning new courses and programs, or potentially re-engineeringexisting curricula. To facilitate this process, the University of Alaska invited the Alaska Centerfor Rural Health (ACRH) to conduct an assessment of the current and projected needs of theallied health workforce. ACRH designed the project as a collaboration with health care industryorganizations. The purpose of the survey was to take a “snapshot view” of the Alaskan alliedhealth workforce in terms of number of employees, vacancies, turnover rates, projected futureneeds, and recruitment difficulties – and to determine the areas of greatest need. For thisproject, allied health workers are defined as those professions and occupations that providephysical and behavioral health support in the health care field. They are an essential partof Alaska’s growing health care workforce.

The format of this report reflects its customer, the University of Alaska's Planning & BudgetAdvising Committee (PBAC) on Health. The PBAC sought information on allied healthoccupations on the statewide level. In addition, the data were also sorted by geographiccorrespondence to major academic units (UAF, UAA, UAS) and by correspondence to mainversus branch University of Alaska campuses. Thus, Section III “Results” has threecomponents. First is “Overview of Quantitative Findings”– providing an overview of respondents,comparing occupations, and selected data organized by major academic unit. Second is“Results Organized by Occupation.” Each occupation under study has its own page thatincludes a summary of findings, survey responses, comparisons by location, and an abbreviatedoccupation description. Where possible, the occupations are also clumped and have categoryoverviews (behavioral health, rehabilitation, etc.). This format enables faculty for theseoccupations, and employees in these occupations, to read the pages of interest to them rather


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than gleaning occupation-specific information from other sections. Finally, part three of theResults section is a “Summary of Qualitative Comments.” Due to the range of organizationsthat participated in the survey, the analysis is separated into categories that are often difficult tocompare within the Occupation results. The quantitative and qualitative findings converge later,to form Section IV “Discussion and Recommendations.”

II. METHODOLOGY

A. Project Collaborators

The Alaska Center for Rural Health (ACRH) sought active partners on this project for three keyreasons. First, the assessment’s timeline of 4.5 months made it nearly impossible for a singleorganization to effectively implement the project. Second, ACRH wanted the depth and breadthof experienced health leaders – organizations that understood the allied health workforce andhow health employers organize their staff. Finally, ACRH recognized the need for a highresponse rate, and knew allied health employers would respond to letters and phone calls fromthese visible and respected health organizations.

To this end, the ACRH worked in collaboration with the Alaska State Hospital and NursingHome Association (ASHNHA), the Alaska Primary Care Association (APCA), the Alaska NativeHealth Board (ANHB), the Alaska Native Tribal Health Consortium (ANTHC), the MedicalAssisting Department of UAA, the Institute for Circumpolar Health Studies of UAA, the AlaskaMental Health Trust Authority (AMHTA), the Alaska Mental Health Board, the Department ofHealth and Social Services (including the Advisory Board on Alcoholism and Drug Abuse andthe Governor’s Council on Disabilities and Special Education), the Substance Abuse andDirectors Association (SADA), the Division of Senior Services, and the Department of Labor.Representatives from each organization were invited to participate in developing the surveyinstrument, review preliminary data, and make recommendations to the University of Alaska fortraining programs. In practice, they all participated in instrument development. Staff fromASHNHA, APCA, ANHB, and ICHS assisted in the implementation phase – conducting phoneinterviews with member organizations. Final recommendations were developed in collaborationwith the staff and representatives of ASHNHA, APCA, ANTHC, AMHTA, the Medical AssistingDepartment of UAA, ICHS, the Alaska Mental Health Board, the Substance Abuse and DirectorsAssociation, the Governor’s Council on Disabilities and Special Education, and the AdvisoryBoard on Alcoholism and Drug Abuse.

B. Instrument Development

Members of the collaboration team met in a series of meetings in October and November 2000.During this time, they discussed common goals and outcomes of the project, developed a list ofallied health occupations to be assessed, and assisted in the development of the surveyinstrument. Initially, ACRH had planned to assess only those occupations for which theDepartment of Labor (DOL) had no data. However, because DOL did not have the level of detailthe University needed for planning curricula,1 the entire spectrum of allied health workers wasexamined. To better determine the need for particular education programs, the allied healthteam decided to identify occupations in terms of educational backgrounds. In addition, the team

1 In some cases, occupations were lumped into larger categories. For example, social worker is considered onecategory in the DOL data. A social worker, however, can be someone with a bachelor’s degree, a master’s degree, ora master’s degree and a state license.


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felt identifying turnover rates and recruitment difficulties within occupations were importantcomponents when planning for Alaska’s needs – information not included in the DOL data.

Physicians and dentists were not included in the survey since they are not considered alliedhealth workers. Nurses, above the certified nursing assistant level, were also excluded due toprevious assessments that have been recently completed (Alaska Colleagues in Caring RN andLPN relicensure survey partially funded by Robert Wood Johnson Foundation). It was felt thattheir inclusion would have been redundant at best. Physician assistants were not in the originalinstrument. After survey printing, however, ACRH was reminded of the need for collecting harddata on physician assistants in Alaska. Phone interviewers manually added physician assistantsto their surveys during implementation.

While drafting the list of allied health occupations, members of the collaboration team made adecision to exclude alternative health occupations including massage therapists, chiropractors,and acupuncturists; some highly specialized occupations such as radiation therapy; andoccupations within public health management. In addition, because of the ambiguous nature ofsome behavioral health occupational titles, specific educational degrees were identified formany occupations, especially in the behavioral health section. A total of 74 occupations2 wereidentified on the survey (see Appendix A). Occupations were grouped into general categories onthe survey instrument to make it more user-friendly. Categories included health informationmanagement, behavioral health, hospital ancillary services, long-term care, and rehabilitation.

In order to maintain consistency in the identification of employees within occupations,descriptions for each occupation were compiled and made available on the ACRH web site(http://www.uaa.alaska.edu/ichs/acrh/). Several sources were used to compile the list ofoccupation descriptions. These include the ACRH web site, the Montana AHEC ResourceCenter’s web site (http://healthinfo.montana.edu/natahec/Ahecedu.htm), the North CarolinaHealth Careers on-line manual (http://www.med.unc.edu/ahec/hcm2000/frame.html), theAmerican Medical Association’s Health Professions Career and Education Directory 2000-2001(28th Edition), and, in some cases, job descriptions and professionals in the field.

C. Pilot Survey

The Allied Health Workforce Assessment was piloted in four sites: the Yukon-Kuskokwim HealthCorporation (YKHC), Bartlett Regional Hospital in Juneau, the Anchorage Neighborhood HealthCenter, and the City of Ketchikan Gateway Center for Human Services. Representatives ofASHNHA, APCA, and the Alaska Community Mental Health Services Association eachimplemented a pilot survey, with MaryAnn Schaffer running one at YKHC. Upon completion ofthe field test, the collaboration team reconvened to discuss the survey instrument and issuesrevolving around its implementation. Two major changes to the survey resulted from thismeeting: 1) rather than using the more traditional method of counting full-time equivalents, unitsare represented by the number of people who must be trained to do the work and 2) turnoverrates are identified. The rationale for counting bodies rather than full-time equivalents is that theUniversity is interested in the number of individuals who need to be trained to get the workdone, independent of a worker’s status as part-time, full-time, or contractor. Turnover is definedas the number of people that need to be “turned over” or hired each year. Adding thisinformation to our assessment provides a clearer picture of how many people need to be hiredeach year within a particular occupation.

2 In addition, information was collected on the following occupations that were not listed on the final surveyinstrument: physician assistants, school counselors, school psychologists, and apprentice opticians.


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D. Identification of Survey Participants

A list of survey participants was compiled using membership lists from ASHNHA, APCA, ANHB,and the Alaska Mental Health Trust Authority. In addition, membership lists were obtained fromthe Substance Abuse and Directors Association (SADA); the Alaska Community Mental HealthServices Association (ACMHSA); Infant Learning Programs; long-term care and assisted livingfacilities; and developmental disabilities providers. Once the major list was sorted and compiled,duplicate programs were identified and deleted. In many cases, larger organizations may havesatellite programs. For example, Providence Hospital has facilities in Anchorage, Kodiak, andSeward. When appropriate, information for satellite programs within an organization wascompiled and counted within one survey. Surveys were also sent to 38 school districts thatemploy allied health workers, and one survey was given to the Department of Corrections thatincludes all allied health employees for its facilities statewide.

In addition to Native health corporations and federal, state, and municipal funded healthfacilities/organizations, private practices also employ a large sector of the allied healthworkforce. Due to the short timeframe for this project, ACRH selected a sample of privatepractices in three regions of the state: Interior, Southcentral, and Southeast. The regions looselycorrespond to the University of Alaska Fairbanks, Anchorage, and Southeast campuses. Yellowpages from the current Fairbanks, Anchorage, Kenai Peninsula, and Juneau phonebooks wereused as a sampling frame, since the Division of Occupational Licensing did not organize theirdata by employer (i.e. hospital, native health corporation, private practice), nor did the medical,dental, or other professional associations. All businesses listed under the following headings inthe “yellow pages” were contacted: pharmacies, audiologists, speech pathologists, occupationaltherapists, physical therapists, orthopedics, ultrasound, mammography, opticians, andoptometric technicians. Businesses that were composed of only one employee (i.e. an opticianor a physical therapist) were excluded. The rationale behind this decision was that our surveyinstrument is composed of questions for employers of allied health workers and not employeesthemselves. It would be impossible to ask a sole proprietor what their personal turnover was; itwas necessary to ask an office manager about turnover for employees of the organization.

A sample of dental clinics, medical clinics, and behavioral health practices across the state werealso surveyed. Once again the yellow pages from the Anchorage, Kenai Peninsula, Fairbanks,and Juneau phonebooks were used as a sampling frame. Identifying unique organizationswithin these phonebooks proved to be a time consuming and sometimes difficult task due to thetremendous number of entries (over 1000) and the nature of phonebook listings. Many practiceshave duplicate or multiple listings, often under different names. In order to narrow the list ofpotential survey contacts to a more manageable sample that could be done in the timeframeallowed for this project, a decision was made to sample only practices with more than onephysician, dentist, or behavioral health worker.

Medical clinics were identified under the phonebook headings of physicians and medical clinicsand dental clinics were identified under the listings of dentists. The following headings wereused to identify behavioral health practices: mental health services, mental health agencies,counselors-human relations, mental health clinics, home health service, marriage and familycounselors, and psychologists. Alphabetical lists were created for each of the four phonebooksand a systematic sampling of 50% was taken from each list.

Limiting the sample to offices that contained more than one dentist excluded the Southeastregion, since no group clinics are found in the Juneau phonebook. As a result, an additionalsample of 30 single dentist practices was surveyed. To get a representative sample across the


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three regions of the state, we contacted the Alaska Dental Society. They currently have 325members that represent approximately 76% of the practicing dentists in the state. Of these 325members, percentages were calculated of those that reside in the Southeast, Southcentral, andInterior regions of the state. These percentages were then used to decide how many offices tosample in each region for a total of 30 surveys. Systematic samples were taken from eachphonebook. (Note: to get a more representative sample of Southeast, besides the Juneauphonebook, one office in Sitka was selected and one office in Ketchikan.)

E. Implementation of the Survey

Once the initial list of 136 organizations was identified, collaborating organizations providedcover letters for their member organizations. For example, ASHNHA wrote letters to all non-Native hospitals and nursing homes, ANHB wrote letters for all Native health corporations, etc.These letters encouraged survey completion by outlining benefits of the project to the alliedhealth workforce in their own terms. Surveys were mailed November of 2000. Included in thesurvey packet was an Allied Health Survey Tips sheet (see Appendix B), the aforementionedcover letter from the participating organization, and a cover letter from the University of Alaska(see Appendix C). The enclosed Tips Sheet included a pointer to the ACRH web site whereboth the survey and occupation descriptions were posted. Cover letters instructed participantsthey would be contacted by phone from a representative of the appropriate organization – andthe name and contact information for that person was provided. In general, survey packets weresent to executive and program directors with a request to pass the survey on to an appropriateperson within their organization who would best be able to compile the information.

Information was collected over the phone by staff members of ASHNHA, ANHB, APCA, ICHS,and ACRH. Initial contact was made to all survey participants shortly after surveys were mailed,to provide an introduction of the interviewer and identify the appropriate contact person. Inaddition, questions were answered about interpretation of the survey components and, ifpossible, times were scheduled for actual collection of data over the phone. Occasionally,surveys were mailed or faxed to ACRH. In these instances, the surveys were reviewed andfollow-up calls made if any numbers or comments needed clarification.

Additional surveys were conducted with school districts, EMS organizations, and the AlaskaState Department of Corrections. Eleven EMS organizations were identified through the EMSweb site (http://chems.alaska.gov/ems_contacts.htm). All school districts were contacted, 38 ofwhich were found to employ allied health workers. One survey was used to cover all alliedhealth employees working in correction facilities across Alaska.

For those participants selected from the yellow pages, phone surveys were conducted by ICHSand ACRH staff. Though surveys were not mailed to these businesses, information wasrecorded on the same survey instrument as those mailed. When possible, contact was madewith the individual who was in charge of recruiting and hiring within the organization.

A total of 198 phone surveys were attempted from businesses identified within the yellow pages.190 surveys were completed, while 8 businesses refused to participate. In some cases,businesses listed in the yellow pages were no longer in operation or were connected to a largerorganization that had already participated in the survey process. No tally was kept of thesebusinesses and they are not included in the total number of surveys attempted.


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III. RESULTS

A. Overview of Quantitative Findings

369 surveys were completed out of 384 surveys attempted, for an overall response rate of 96%.Response rate can be further organized by type of employer. Specific response rates are shownin Table 1.

Table 1. Response Rate by Employer

Member Organizations Attempted/Completed

ResponseRate

Hospitals/Health Clinics/Native Health Corporations 58/61 95%Behavioral Health (mental health, substance abuse,developmental disabilities, long-term care, infant learning)

71/75 95%

School Districts 38/38 100%Corrections (statewide) 1/1 100%EMS (sampled) 11/11 100%

Yellow Pages (Anchorage, Fairbanks, Juneau, Kenai Peninsula)Pharmacies (all) 27/28 96%Eye Clinics (all) 29/29 100%Rehabilitation (physical therapists, occupational therapists,audiologists, speech pathologists, orthotists, prosthetists) (all)

27/27 100%

Imaging (all) 2/2 100%Medical Clinics (sampled) 30/32 94%Dental Clinics (sampled) 41/43 95%Behavioral Health Organizations (sampled) 34/37 92%

Organizations varied tremendouslyin size, with over half of the respon-dents employing 15 or fewer staff.

Figure 1

Number of Employees per Organization

501-70005%

101 to 50013%

16 to 10032%

1 to 1550%


7

As Figure 2 demonstrates, respondents are fairly proportional to the population statewide(Alaska Population Overview: 1999 Estimates). This suggests data collection is geographicallyrepresentative of the population, and allied health employers are as well. Sixty-two percent(62%) of the surveys came from the southcentral and southwest regions, where approximately68% of the population resides. Fifteen percent (15%) of the surveys came from southeastAlaska, where approximately 12% of the population resides. Twenty-two percent (22%) of thesurveys came from the interior and northern regions, where approximately 20% of the popula-tion resides.

Figure 2

The following table is a compiled summary of the results for annual turnover, 3-5 year hiringprojections, recruitment difficulty and recruitment difficulty, because of training. Each arrowindicates that the number in the column to its left is from a sample and is conservative. That isto say, if it were possible to get 100% of the population, the number would be higher. Twoarrows reflect the number is underrepresented in two samples.

KEY

900Statewide (facilities whichreported results statewide)

995 and 996Southcentral/Southwest regions(includes Anchorage)

997Interior & Northern regions(includes Fairbanks)

998 and 999Southeast region


8

Table 2. Compiled Occupational Results

*See page 92 for EMS statewide numbers and comments.

Reason for recruit difficult: number of orgs reporting because of TRAINING

Total number of orgs employing occupation

Analyst 1.00 4 2 4 13Audiologist 3.00 1 2 1 13Biller 39.25 24 9 18 75Biomedical Equipment Technician 4.00 6 2 2 14Cardiac Sonographer 2.00 3 4 2 5Cardiovascular Technician 0.00 1 3 1 3CAT 0.50 4 4 7 11Certified Nursing Assistant 299.00 18 13 19 37Clinical Lab Assistant 12.00 5 1 2 12Clinical Lab Technician/2 yr (MLT) 6.00 4 1 7 15Clinical Lab Technician/4yr (MT) 14.50 6 11 12 23Clinical Psychologist 2.00 7 18 15 44Coder 9.00 17 16 21 41Combined Coder/Biller 36.45 24 14 27 97Community Health Aide 56.50 7 9 11 23Community Health Representative 19.50 3 3 5 22Dental Assistant 30.50 13 11 16 57Dental Hygienist 13.75 10 10 19 49Diagnostic Medical Sonographer 6.50 10 14 13 19Dietetic Technician 1.00 1 1 2 6Dietitian registered 8.20 4 4 4 27ECG/Treadmill/Holter 6.00 1 1 4 7EMS Dispatcher* 1.00 2 1 7EMS Instructor* 0.00 1 4 3 14EMT1* 12.00 2 2 3 12EMT2* 2.00 1 12EMT3* 2.00 1 10Environmental Health Technician 44.00 2 2 1 12Health Educator 4.00 3 2 5 19

Annual turnover per year (positions)

3-5 yr hiring projection: number of organizations expecting an INCREASE in staff

Recruitment difficult: number of organizations reporting VERY DIFFICULT


9

Table 2. Compiled Occupational Results (cont.)



Health Information Administrator/4yr 7.00 3 6 6 17Health Information Technician/2 yr 7.25 6 8 12 20Home Health Aide 21.50 4 2 2 12Human Services Worker/2yr 59.75 8 7 9 25Human Services Worker/4yr 71.50 12 15 18 39Human Services Worker/Entry Level 119.25 8 6 10 27Licensed Professional Counselor 21.20 10 15 18 38Mammographer 4.50 8 10 11 21Marriage & Family Therapist/Licensed 4.00 6 9 12 25Marriage & Family Therapist/Unlicensed 2.00 1 3 3 8Medical Assistant 32.50 14 6 8 32Medical Foster Care Provider 13.00 1 1 1 1Medical Transcriptionist 17.50 6 9 14 56Mental Health Counselor 34.50 15 21 18 49MRI 5.50 8 7 5 9Nuclear Medicine Technologist 2.50 4 7 5 8Occupational Therapist 21.25 13 20 27 61Occupational Therapy Technician 0.25 3 2 5 11Optician/Apprentice 16.50 3 3 3 20Optician/Licensed 9.00 9 10 13 24Optometric Technician 9.25 4 3 5 18Orthotist/Prosthetist 0.00 1 1 1 3Other-Behavioral Health 45.00 5 8 7 17Other-Other 0.50 1 2 4Other-Rehab 1.00 1 1 1Paramedic 12.00 2 6 7 12Patient Advocate/Interpreter 3.00 3 9Personal Care Attendant 145.00 14 7 11 25Pharmacist 33.60 18 36 28 57





10

Table 2. Compiled Occupational Results (cont.)



Pharmacy Technician 78.50 20 7 18 48Phlebotomist 21.00 5 2 7 20Physical Therapist 34.25 25 20 30 74Physical Therapist Assistant 6.75 11 4 8 33Physician's Assistant 15.50 8 9 8 34Psychiatric Nurse Assistant 42.00 1 2 3 7Psychological Associate 2.70 3 9 11 27Radiologic Technologist 33.00 12 17 17 28Records Clerk 66.75 21 7 19 87Respiratory Technician 3.00 2 5 7Respiratory Therapist 20.50 4 3 4 13School Counselor 13.30 5 8 12 27School Psychologist 9.80 4 15 16 28Social Worker/ Licensed Clinical 18.50 13 23 28 54Social Worker/4 yr degree 32.60 9 10 15 39Social Worker/6 yr degree 12.70 13 12 17 49Speech Pathologist 27.25 12 37 30 58Substance Abuse Counselor 1 22.00 8 13 15 35Substance Abuse Counselor 2 22.50 11 16 17 40Substance Abuse Supervisor 14.00 5 16 10 27Substance Abuse Technician 33.00 7 10 8 28Surgical Technician 4.00 2 2 1 9Therapeutic Recreation Specialist 13.10 5 3 5 17





11

The following two tables organize selected occupations by geography and major academic unit (MAU). For purposes of analysis,current employees and vacancies are summed in the tables. This is because the summation of current staff and vacant staff reflectsthe actual number of people needed for the facility to operate at the time of the survey. Annual turnover is abbreviated as “Turn” andshown in parentheses with the employees/vacancies number. The reader can thus see what proportion “turns over” in each category.

Table 3. Occupations Organized by Geography and MAU

Total Curr +Vacancy

ANC, JNU,FBX

Curr+ Vac(Turn)

BranchCampus*

Curr+ Vac(Turn)

No campusnearby

MAU ANC

Curr+ Vac(Turn)

MAU FBX

Curr+ Vac (Turn)

MAU JNU

Curr+ Vac(Turn)

Billers and Coders 509 311 (58) 168 (19) 30 (7) 223 (45) 60 (10) 28 (4)

Dental Assistant 242 158 (22) 74 (8) 10 (1) 119 (12) 36 (9) 3 (1)

PharmacyTechnicians

525 341 (54) 180 (25) 4 (0) 261 (43) 45 (13) 35 (5)

RadiologicTechnologist

178 121 (20) 52 (12) 5 (1) 89 (14.5) 28 (5.5) 4 (0)

Speech Pathology 235 145 (17) 81 (10) 10 (0) 123 (12.25) 6 (2) 16 (3)

Human Services/Entry Level

515 202 (40) 286 (69) 27 (10) 195 (33.25) 7(7) - -

2 yr 210 170 (52) 33 (7) 7 (1) 86 (31.75) 31 (10) 53 (10)

4 yr 411 302 (58) 104 (13) 5 (1) 191 (39.5) 47 (7) 64 (11)

Substance Abuse /Tech

194 75 (13) 92 (6) 27 (14) 55 (10) 15 (2) 5 (1)

SA Couns 1 122 60 (8) 48 (11) 14 (3) 28 (4) 25 (4) 7 (0)

SA Couns 2 148 95 (13) 39 (7) 14 (3) 74 (12) 8 (1) 13 (0)

*See Appendix D for a list of University of Alaska branch campuses.


12

Table 4. Occupations Organized by MAU and MAU Branches

Total Curr +Vacancy

MAU ANC

Curr+ Vac(Turn)

ANC branch*

Curr+ Vac(Turn)

MAU FBX

Curr+ Vac(Turn)

FBX branch*Curr+ Vac

(Turn)

MAU JNU

Curr+ Vac (Turn)

JNU branch*

Curr+ Vac(Turn)

Billers and Coders 509 223 (45) 95 (13.25) 60 (10) 56 (3) 28 (4) 17 (3)

Dental Assistants 242 119 (12) 20 (5) 36 (9) 30 (?) 3 (1) 24 (3)

PharmacyTechnicians

525 261 (43) 133(20) 45 (13) 30(2) 35 (5) 18(2)

RadiologicTechnologist

178 89 (14.5) 31 (8) 28 (5.5) 16 (2) 4 (0) 5 (2)

SpeechPathologists

235 123 (12.25) 62 (4.5) 6 (2) 12 (4.5) 16 (3) 7 (1)

Human Svs / EntryLevel

515 195 (33.25) 67 (7) 7(7) 218 (62) - - 1 (0)

2 yr 210 86 (31.75) 14 (7) 31 (10) 13 (?) 53 (10) 6(0)

4 yr 411 191 (39.5) 84 (13) 47 (7) 7 (?) 64 (11) 13 (0)

Substance Abuse /Tech

194 55 (10) 24 (1) 15 (2) 58 (3) 5 (1) 10 (2)

SA Couns 1 122 28 (4) 22 (8) 25 (4) 12 (0) 7 (0) 14 (3)

SA Couns 2 148 74 (12) 23 (5) 8 (1) 5 (0) 13 (0) 11 (2)

*See Appendix D for a list of University of Alaska branch campuses.


13

B. Results Organized by Occupation

In this section, you will find a page for each occupation which includes:

• Summary of findings• Statewide Employment Results of the 369 surveys implemented• A breakdown of numbers by campus category• An occupational description

Occupations are grouped by sections with an introductory page that notes highlights and datalimitations for the occupations within that section (see Appendix E for an overall summary ofdata limitations). Sections are divided into the following categories: Health InformationManagement, Behavioral Health, Hospital Ancillary Services, Long-term Care, Rehabilitation,Emergency Medical Services, and Miscellaneous Occupations. Below is a more detaileddescription of how to interpret the tables and graphs on the following pages.

Statewide Employment Results Table

Each table includes total number of positions by occupations counted on 369 surveys for thefollowing: A) current number employed, B) current vacancies, C) estimated annual turnover, andD) 12-month projection of number of employees.

In addition, the last three columns of the table include the number of organizations reporting forthe following: E) hiring projection for the next 3-5 years (increase, decrease, stay the same,position eliminated, or don’t know); F) recruitment difficulty (very difficult, somewhat difficult, notdifficult) and G) suspected reasons for difficulty in recruiting (pay/benefits, relocation, training).

It should be noted that not all organizations answered all questions on the survey, so numbersof organizations that reported for a particular variable are noted as “N” in the bottom row of eachcolumn. More than one answer could be provided for the last column “Reasons for Difficulty,” sono “N” number is reported for that column.

Number of Organizations Employing this Occupation by Campus Category bar graph

To get a better idea of training needs in rural Alaska versus urban Alaska, and thinking in termsof potential educational course/program delivery systems, the data were sorted into three sets.Organizations located in Anchorage, Fairbanks, or Juneau were included in the “Main Campus”data set. Those organizations located in communities with a University of Alaska branchcampus or center were lumped under “Branch Campus” and all other organizations withincommunities that were not near a main or branch campus were lumped into “No CampusNearby.” See Appendix D for a list of these communities.

Total Number of Positions and Annual Turnover by Campus Category bar graph

Note: total number of positions in this bar graph includes current number of employees pluscurrent vacancies by the three campus categories. Turnover is the estimated annual number ofpositions that must be recruited each year.

Additional Note: In a few instances an organization may not currently have employees orvacancies, but projects employment for a particular occupation in the future. This may causesome discrepancies in numbers.


14

1. Health Information Management

Occupations include: Analyst, Health Information Technician, Health Information Administrator,Medical Transcriptionist, Records Clerk, Coder, Biller, Combined Coder/Biller.

Coders and Billers can be found in large hospitals, clinics, Native health corporations, as well asmost of the smaller private practices. When compared to other allied health occupations, codersand billers consistently rose to the top of the lists in terms of total numbers employed, highturnover, difficulty in recruiting and plans to hire more in the future.

For the purposes of this assessment, staff could be categorized as Coders, Billers, or CombinedCoder/Billers. The latter recognizes that in small organizations people often have bothresponsibilities.

Coding was the most frequently mentioned training need in hospitals, Native healthcorporations, clinics and private medical practices. Several organizations expressed an interestin some level of training in coding for all staff. Other areas of training requested includedinsurance billing, medical terminology, computer training, grant writing, legal issues andcustomer service.

Trends in the health information management field include the use of electronic medical records(as opposed to paper), increased emphasis on documentation and the increased regulation andcomplication of both coding and insurance billing. Several behavioral health organizationsmentioned that changes in Medicaid policies and insurance laws have impacted service deliveryand content.

Cross training between front desk staff such as receptionists, billing clerks, medical records staffand coders is common. For example, it can become essential in small offices that cannot affordto hire both a coder and biller. But even in larger hospitals and Native health corporations crosstraining among clerical staff has become necessary to help meet patient needs, staff turnoverand scheduling demands towards a more efficient office.

It should be noted that the medical clinics were sampled (see Methodology, p.4). Numbers forcoders and billers reported on the following pages are thus conservative.


15

ANALYST

Summary:Analysts ranked relatively low on survey variables, most likely because so few are employed inthe industry (large hospitals and two community mental health centers). Nevertheless, nearlyone third of responding organizations that employ analysts project to hire more in the next 3-5years.

Statewide Employment Results

Totalcurrentlyemployed

Totalvacancies

Estimatedannualturnover

12 monthprojection

3-5 year hiringprojection(organizations)

Recruitmentdifficulty(organizations)

Reasons fordifficulty(organizations)

4 Increase 2 Very difficult 3 Pay/benefits

8 Stay thesame

5 Somewhatdifficult

1 Relocation

0 Decrease 5 Not difficult 4 Training47

positions3

positions1

position50

positions

1 Don't know

N=13 N=12 N=9 N=12 N=13 N=12

* N= number of organizations reporting for that variable

(Note: See Appendix D for a list of communities nearthe “main” or “branch” University of Alaska campuses.)

OCCUPATIONAL DESCRIPTION

An Analyst processes medical records and interprets contents of medical records according toa variety of regulatory and department procedures in accordance with the Joint Commissionfor Accreditation of Hospitals. This position serves as an information resource for hospital staff,medical staff, and others.

Number of Organizations Employing this Occupation by Campus Category

0

8

5

0

2

4

6

8

10

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s Main Campuses

Branch Campuses

No Campus Nearby

Total Number of Positions & Annual Turnover by Campus Category

33

1

17

00

10

20

30

40

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


16

HEALTH INFORMATION TECHNICIAN

Summary:The Health Information Technician is one of the 20 occupations in rural Alaska that rankedhighly on 4 variables:1) highest turnover; 2) most difficult to recruit; 3) most difficult to recruitbecause of training; and 4) the largest number of organizations expecting an increase in hiringin the next 3-5 years.



Totalvacancies


12 monthprojection





10 Stay thesame

6 Somewhatdifficult

6 Relocation


positions0

positions7.25

positions29

positions

3 Don't know

N=20 N=17 N=14 N=20 N=19 N=17



The daily operations of the medical records department may be handled by the HealthInformation Technician. This person reviews medical records for completeness and accuracy,sees that all information on a patient is available and arranged properly in the patient's chart,and translates the names of diseases and surgical procedures into coding symbols for retrievaland payment purposes. Technicians also file and microfilm records, compile statistics anddata, type medical reports, and, with experience, may supervise other personnel. A HealthInformation Technician has a two-year associate degree.


2

8

10

0

2

4

6

8

10

12

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s Main Campuses

Branch Campuses

No Campus Nearby

Total Number of Positions & Annual Turnover Rates by Campus Category

15

2

12

5

02

0

5

10

15

20

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


17

HEALTH INFORMATION ADMINISTRATOR

Summary:Health Information Administrators ranked relatively low on survey variables, most likely becauseso few are employed in the industry. Nevertheless, there appears to be a relatively highturnover, with an estimated 32% of reported positions turning over annually.



Totalvacancies


12 monthprojection





10 Stay thesame

4 Somewhatdifficult

5 Relocation


positions2

positions7

positions20

positions

4 Don't know

N=17 N=16 N=13 N=17 N=17 N=15




The Health Information Administrator is responsible for seeing that a patient’s medical recordsare complete, kept confidential, and safeguarded from individuals not involved with themedical care of the patient. In large hospitals, Health Information Administrators areresponsible for the overall functions of a Medical Records Department, including themanagement and supervision of other personnel, utilization review, and analysis of the qualityof patient care. Confidentiality and legal aspects are also among their responsibilities,including handling subpoenas and depositions. In small hospitals, Health InformationAdministrators may be one of a few employees in the medical records department and mayperform technical as well as professional duties. A Health Information Administrator has a four-year baccalaureate degree.


9

7

1

0

2

4

6

8

10

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s Main Campuses

Branch Campuses

No Campus Nearby

Total Number of Positions & Annual Turnover by Campus Category14

47

31

0

5

10

15

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


18

MEDICAL TRANSCRIPTIONIST

Summary:Medical Transcriptionists are one of the 18 occupations in urban Alaska that ranked highly on 4variables:1) highest turnover; 2) most difficult to recruit; 3) most difficult to recruit because oftraining; and 4) the largest number of organizations expecting an increase in hiring in the next 3-5 years.



Totalvacancies


12 monthprojection





28 Stay thesame

12 Somewhatdifficult

2 Relocation


positions13

positions17.5

positions147

positions

4 Don't know

N=56 N=39 N=34 N=38 N=39 N=46




Medical Transcriptionists spend the majority of their time typing transcripts for medical records.The transcripts are usually typed from a dictaphone, so familiarity with medical terminology,and accurate spelling of medical terms is vital. They must also handle confidential medicalinformation with discretion. Though not required, many Medical Transcriptionists take medicalterminology courses.


36

18

20

10

20

30

40

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s Main Campuses

Branch Campuses

No Campus Nearby


116

12 6

50

3 00

50

100

150

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


19

RECORDS CLERK

Summary:Records Clerks are one of the 18 occupations that ranked highly on 4 variables:1) highestturnover; 2) most difficult to recruit; 3) most difficult to recruit because of training; and 4) thelargest number of organizations expecting an increase in hiring in the next 3-5 years.



Totalvacancies


12 monthprojection





51 Stay thesame


2 Relocation


positions17

positions66.75

positions305

positions

11 Don't know

N=87 N=80 N=78 N=87 N=84 N=77




A Records Clerk works under the direction of a Health Information Manager and understandsthe medical records filing system. Minimum employment requirements are generally a highschool education or equivalent with computer experience required.


8

48

31

0

10

20

30

40

50

60

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s Main Campuses

Branch Campuses

No Campus Nearby

Total Number of Positions & AnnualTurnover by Campus Category

197

36

98

30116

0

50

100

150

200

250

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


20

CODER

Summary:Coders were rated "somewhat" to "very difficult" to recruit by 71% of the respondentorganizations. Training was the most frequently cited reason for having difficulty recruiting. Inaddition, over 40% of the responding organizations projected an increase in coding staff in thenext 3-5 years.



Totalvacancies


12 monthprojection





19 Stay thesame


4 Relocation


positions22

positions9

positions108

positions

5 Don't know

N=41 N=40 N=32 N=40 N=41 N=38




Coders work under generalized supervision and are responsible for assigning ICD-9 andCPT/HCPCS codes to all medical records in the hospital or clinic. Coders understand andabide by the correct coding guidelines as determined by the American Medical Association.Coders have a high school education plus formalized training in medical coding. They mayhave a CCS-P (certified coding specialist-physician offices), CPC (Certified ProfessionalCoder), or a CCS (Certified Coding Specialist).


5

20

16

0

5

10

15

20

25

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s Main Campuses

Branch Campuses

No Campus Nearby


60

5 2

42

8 20

20

40

60

80

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


21

BILLER

Summary:Billers are one of the 18 occupations that ranked highly on 4 variables:1) highest turnover; 2)most difficult to recruit; 3) most difficult to recruit because of training; and 4) the largest numberof organizations expecting an increase in hiring in the next 3-5 years.



Totalvacancies


12 monthprojection





41 Stay thesame


3 Relocation


positions15

positions39.25

positions243

positions

8 Don't know

N=75 N=71 N=66 N=74 N=74 N=66




Billers work under generalized supervision and are responsible for understanding and knowinghow to use the hospital or clinic's information system relating to billing/accounts receivable. ABiller knows and understands UB92 and 1500 correct billing guidelines as mandated by ThirdParty Payers and Federal and State policies. A Biller prepares and sends primary bills for allpatients or clients. He/she accurately tracks files and attachments to registration forms forpayments on accounts. Minimum employment requirements are generally a high schooleducation or equivalent with computer experience required.


6

48

21

0

10

20

30

40

50

60

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s Main Campuses

Branch Campuses

No Campus Nearby


143

26 12

85

13 10

50

100

150

200

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


22

COMBINED CODER/BILLER

Summary:Combined Coder/Billers are one of the 18 occupations that ranked highly on 4 variables:1)highest turnover; 2) most difficult to recruit; 3) most difficult to recruit because of training; and 4)the largest number of organizations expecting an increase in hiring in the next 3-5 years.This occupation was listed on the survey because many small organizations must cross trainstaff to conduct the office’s coding and billing.



Totalvacancies


12 monthprojection





56 Stay thesame


9 Relocation


positions4

positions36.45

positions166

positions

15 Don't know

N=97 N=94 N=90 N=96 N=95 N=90




Combined Coders/Billers work under generalized supervision and are responsible forunderstanding and knowing how to use the hospital or clinic's information system relating tobilling/accounts receivable. A Combined Coder/Biller knows and understands UB92 and 1500correct billing guidelines as mandated by Third Party Payers and Federal and State policies.He/she prepares and sends primary bills for all patients or clients. A Combined Coder/Billeralso understands ICD-9 and CPT/HCPCS codes relating to billing and the impact onreimbursement. He/she codes as necessary. Minimum employment requirements aregenerally a high school education or equivalent with computer experience required.


6

62

29

0

10

20

30

40

50

60

70

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s Main Campuses

Branch Campuses

No Campus Nearby

Total Number of Positions & AnnualTurnover by Campus Category108

27

5

41

9 40

20

40

60

80

100

120

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


23

2. Behavioral Health

Occupations include: Human Service Worker (entry-level, 2-year degree, and 4-year degree),Psychiatric Nurse Assistant, Marriage and Family Therapist (Licensed and Unlicensed),Licensed Professional Counselor, Mental Health Counselor, Psychological Associate, ClinicalPsychologist, Social Worker (4-year degree (BSW) and 6-year degree (MSW)) Licensed ClinicalSocial Worker, Substance Abuse Technician, Substance Abuse Counselor 1, Substance AbuseCounselor 2, Substance Abuse Clinical Supervisor, School Counselor, and School Psychologist.

Several occupations in the behavioral health field topped our lists for high turnover, difficulty inrecruiting, and projected increase in future hiring. These occupations include Human ServiceWorkers, Substance Abuse Workers, Mental Health Counselors, Licensed ProfessionalCounselors, and Social Workers. Behavioral health workers can be found in a wide variety ofurban and rural settings in Alaska including: community mental health centers, long-term carefacilities, Native health corporations, hospitals, clinics, and school districts. Many behavioralhealth organizations have difficulty recruiting personnel because applicants lack experience andqualifications and/or because jobs often lack benefits, competitive wages, and desirability.

Lack of funding for behavioral health care organizations was the most significant trendmentioned. Many organizations reported being unable to expand and meet demands becauseof limited funding. In rural Alaska, this can be particularly problematic with travel and trainingcosts. Other trends reported in the behavioral health care field include: increased need for homehealth care, changes in the insurance and billing regulations, and an expansion of treatmentplans to include families and the community.

Many respondents emphasized the need for flexible coursework in behavioral health to includedistance learning, internships, and practicums. Many specific areas of study suggested include:substance abuse, mental health therapy, gerontological studies, developmental disabilities,cultural competencies, domestic violence, and special needs children. Cross training wasmentioned as a common practice in behavioral health organizations. Clinical staff, especiallymental health counselors, are often cross trained in addiction, domestic violence, pregnancy,and parenting issues. Most respondents wanted to see further cross training take place in theirorganization.

Sorting out the wide variety of behavioral health occupations and their associated job titles wasa complicated task (see Methodology, p. 4). Respondents at times struggled with where to “fit”their employees on our survey. In many cases, entry level workers that did not have a particulareducational background were placed in the Human Services category. It should also be notedthat School Counselors and School Psychologists were listed separately. These occupationsare both certified by the State of Alaska Department of Education and Early Development, butnot necessarily licensed by Alaska’s Division of Occupational Licensing, as are PsychologicalAssociates, Psychologists, and Licensed Professional Counselors.

It should be noted behavioral health organizations in the yellow pages were sampled. As aresult, numbers on the following occupation pages are conservative.

For a more detailed qualitative analysis of behavioral health occupations, see Appendix F.


24

HUMAN SERVICE WORKER/ENTRY-LEVEL

Summary:Human Service Workers at the certified or entry-level are one of the 18 occupations that rankedhighly on 4 variables:1) highest turnover; 2) most difficult to recruit; 3) most difficult to recruitbecause of training; and 4) the largest number of organizations expecting an increase in hiringin the next 3-5 years. Human Service Workers have the third highest turnover per year of allallied health occupations surveyed.



Totalvacancies


12 monthprojection





13 Stay thesame


2 Relocation


positions84

positions119.25

positions461

positions

2 Don't know

N=27 N=26 N=21 N=25 N=25 N=24




Human Service Workers are knowledgeable in human behavior and relationships. They haveskills and experience in assessment and counseling, interviewing, and working in a humanservice agency such as mental health, alcohol and substance abuse, or social serviceprograms. In rural Alaska, employment opportunities include regional health corporations andfederal, state, and local governmental agencies. The entry-level Human Service Worker mayhave a certificate, such as in Rural Human Services.


1

11

15

0

5

10

15

20

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s Main Campuses

Branch Campuses

No Campus Nearby


202

40

286

69

1027

0

100

200

300

400

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


25

HUMAN SERVICE WORKER/2-YEAR DEGREE

Summary:Human Service Workers with a two-year degree are one of the 20 occupations in rural Alaskathat ranked highly on 4 variables:1) highest turnover; 2) most difficult to recruit; 3) most difficultto recruit because of training; and 4) the largest number of organizations expecting an increasein hiring in the next 3-5 years.



Totalvacancies


12 monthprojection





13 Stay thesame


3 Relocation


positions28

positions59.75

positions202

positions

3 Don't know

N=25 N=23 N=17 N=22 N=24 N=23




Human Service Workers are knowledgeable in human behavior and relationships. They haveskills and experience in assessment and counseling, interviewing, and working in a humanservice agency such as mental health, alcohol and substance abuse, or social serviceprograms. In rural Alaska, employment opportunities include regional health corporations andfederal, state, and local governmental agencies. The Human Service Worker may be aparaprofessional with a two-year associate degree in Human Services.


14

9

2

0

5

10

15

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s Main Campuses

Branch Campuses

No Campus Nearby


170

5233

7 170

50

100

150

200

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


26

HUMAN SERVICE WORKER/4-YEAR DEGREE

Summary:Human Service Workers with a four-year degree are one of the 18 occupations that rankedhighly on 4 variables:1) highest turnover; 2) most difficult to recruit; 3) most difficult to recruitbecause of training; and 4) the largest number of organizations expecting an increase in hiringin the next 3-5 years.



Totalvacancies


12 monthprojection





21 Stay thesame


6 Relocation


positions51

positions71.5

positions356

positions

4 Don't know

N=39 N=35 N=32 N=34 N=37 N=33




Human Service Workers are knowledgeable in human behavior and relationships. They haveskills and experience in assessment and counseling, interviewing, and working in a humanservice agency such as mental health, alcohol and substance abuse, or social serviceprograms. In rural Alaska, employment opportunities include regional health corporations andfederal, state, and local governmental agencies. The Human Service Worker can have a four-year bachelor’s degree in Human Services.


23

14

2

0

5

10

15

20

25

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s Main Campuses

Branch Campuses

No Campus Nearby


302

58104

13 150

100

200

300

400

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


27

PSYCHIATRIC NURSE ASSISTANT

Summary:Psychiatric Nurse Assistants are primarily employed in urban areas, and are concentrated in 7respondent organizations. They have a relatively high number of employees turning over eachyear: 42 of 210 positions (20%). All responding organizations reported Psychiatric NurseAssistants as "somewhat" to "very difficult" to recruit.



Totalvacancies


12 monthprojection





5 Stay thesame

4 Somewhatdifficult

2 Relocation


positions1

position42

positions215

positions

1 Don't know

N=7 N=7 N=6 N=7 N=7 N=6




Psychiatric Nurse Assistants help in the care and treatment of psychiatric or developmentallydisabled patients and work under immediate supervision. Examples of responsibilities include:1) learning to recognize potential hazards and creating an orderly, safe, and therapeuticenvironment for patients; 2) assisting patients with daily routine activities, such as oralhygiene, preparing for meals, toileting, or preparing for bed; 3) assisting patients inoccupational, recreational and industrial therapy, and school programs; 4) escorting patients tolocations within the institution; 5) restraining combative or self-abusive patients; and 6) givingroutine diagnostic and treatment skills such as blood pressure, temperature, and respiratorycount, and administering minor medical treatments. No specific education is required as anentry level Psychiatric Nurse Assistant.


0

5

2

0

1

2

3

4

5

6

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s Main Campuses

Branch Campuses

No Campus Nearby


207

41

3 10

50

100

150

200

250

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


28

MARRIAGE AND FAMILY THERAPIST/LICENSED

Summary:Licensed Marriage and Family Therapists were rated as "somewhat" to "very difficult" to recruitby 76% of the responding organizations. Training was the most frequently cited reason fordifficulty in recruitment.



Totalvacancies


12 monthprojection





13 Stay thesame

7 Somewhatdifficult

8 Relocation


positions2

positions4

positions34

positions

2 Don't know

N=25 N=24 N=21 N=23 N=22 N=21




Licensed Marriage and Family Therapists are mental health professionals trained inpsychotherapy and family systems. They are licensed to diagnose and treat mental andemotional disorders within the context of marriage, couples, and family systems. LicensedMarriage and Family Therapists take a holistic perspective to health care; they are concernedwith the overall, long-term well-being of individuals and their families. This position typicallyfunctions in an outpatient, Community Mental Health Center, or in a Family Services Agency.A Licensed Marriage and Family Therapist has either a master’s or doctoral degree and atleast two years of clinical experience.


17

5 3

0

5

10

15

20

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s Main Campuses

Branch Campuses

No Campus Nearby


3

7

1 03

0

5

10

15

20

25

30

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


29

MARRIAGE AND FAMILY THERAPIST/UNLICENSED

Summary:Unlicensed Marriage and Family Therapists ranked relatively low on survey variables, mostlikely because so few are employed in the industry. Seventy-five percent (75%) of theresponding organizations rated Unlicensed Marriage and Family Therapists "somewhat" to "verydifficult" to recruit.



Totalvacancies


12 monthprojection





5 Stay thesame

3 Somewhatdifficult

2 Relocation


positions0

positions2

positions14

positions

2 Don't know

N=8 N=8 N=6 N=8 N=8 N=8




Marriage and Family Therapists are mental health professionals trained in psychotherapy andfamily systems. They diagnose and treat mental and emotional disorders within the context ofmarriage, couples, and family systems. Marriage and Family Therapists take a holisticperspective to health care; they are concerned with the overall, long-term well-being ofindividuals and their families. This position typically functions in an outpatient communitymental health center, or in a family services agency.


0

4 4

0

1

2

3

4

5

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s Main Campuses

Branch Campuses

No Campus Nearby


0

5

2

0

2

4

6

8

10

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


30

LICENSED PROFESSIONAL COUNSELOR

Summary:Licensed Professional Counselors are one of the 18 occupations that ranked highly on 4variables:1) highest turnover; 2) most difficult to recruit; 3) most difficult to recruit because oftraining; and 4) the largest number of organizations expecting an increase in hiring in the next 3-5 years.



Totalvacancies


12 monthprojection





17 Stay thesame


15 Relocation


positions10

positions21.20

positions79

positions

7 Don't know

N=38 N=32 N=28 N=34 N=34 N=35




Licensed Professional Counselors diagnose and treat mental, emotional, and behavioraldisorders, and work in a variety of clinical settings. They provide individual, group, family, andcouples counseling for adults and children who have problems ranging from chronic mentalillness to adjustments to life problems, such as grief/loss issues, relationship and familyproblems, workplace difficulties, and other problems within the context of human relationships.Licensed Professional Counselors utilize a range of clinical interventions to assist clients intheir efforts to address their problems, develop plans for change, and support personal growthand recovery. They may develop treatment and continuing care plans, and provideprofessional case management services as part of the service delivery process. LicensedProfessional Counselors possess a master’s degree in Counseling and at least two years ofsupervised counseling experience.


5

22

11

0

5

10

15

20

25

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s Main Campuses

Branch Campuses

No Campus Nearby


63

12

23

816

0

20

40

60

80

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


31

MENTAL HEALTH COUNSELOR

Summary:Mental Health Counselors are one of the 18 occupations that ranked highly on 4 variables:1)highest turnover; 2) most difficult to recruit; 3) most difficult to recruit because of training; and 4)the largest number of organizations expecting an increase in hiring in the next 3-5 years. Overhalf of the respondent organizations ranked Mental Health Counselors "very difficult" to recruit.



Totalvacancies


12 monthprojection





20 Stay thesame


16 Relocation

1 1 Decr Elimin 8 Not difficult 18 Training149

positions13

positions34.5

positions158

positions

9 Don't know

N=49 N=46 N=40 N=45 N=46 N=41




Mental Health Counselors use their knowledge and skills to assist individuals in their recoveryby assessing and treating behavioral problems, psychological problems, and social problems.Assessment is based on conversations with the client, specialized tests, and/or understandingof the person’s family and other social relationships. Mental Health Counselors use a variety ofindividual, group, family, or other therapeutic modalities to assist clients in their efforts tounderstand the causes of their mental health problems, and to develop and carry out a plan ofbehavioral, lifestyle, and/or other environmental and psychosocial change and growthessential to self-understanding and recovery. Mental health counselors may be responsible fordeveloping aftercare, providing referral planning, and/or providing a range of professional levelcase management services. Mental Health Counselors typically have a master’s degree inSocial Work, Psychology, Counseling, or a related field.


30

15

4

0

5

10

15

20

25

30

35

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s

Main Campuses

Branch Campuses

No Campus Nearby

Total Number of Positions & AnnualTurnover by Campus Location

103

30

55

3 140

20

40

60

80

100

120

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


32

PSYCHOLOGICAL ASSOCIATE

Summary:Psychological Associates were rated "somewhat" to "very difficult" to recruit by 72% of therespondent organizations. Training was the most frequently cited reason for difficulty inrecruitment.



Totalvacancies


12 monthprojection





21 Stay thesame

9 Somewhatdifficult

3 Relocation


positions3

positions2.7

positions35

positions

2 Don't know

N=27 N=22 N=22 N=26 N=26 N=25




Psychologists work directly with clients using diagnostic tests and a range of therapeuticinterventions to help clients deal with their problems. In addition to individual, family, group, orother therapeutic treatment, psychologists may teach, conduct research, or serve asconsultants to a wide range of organizations. Psychologists work alone or with otherspecialists in hospitals, correctional institutions, mental health clinics, private practice, schools,businesses, government agencies, and research laboratories. A Psychological Associate islicensed at the master’s level.


20

3 4

0

5

10

15

20

25

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s

Main Campuses

Branch Campuses

No Campus Nearby


29

230 1

5

0

10

20

30

40

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


33

CLINICAL PSYCHOLOGIST

Summary:Seventy-eight percent (78%) of the respondent organizations rated Clinical Psychologists as"somewhat" to "very difficult" to recruit.



Totalvacancies


12 monthprojection





27 Stay thesame


11 Relocation


positions7

positions2

positions68

positions

7 Don't know

N=44 N=41 N=36 N=40 N=41 N=41




Psychologists work directly with clients using diagnostic tests and a range of therapeuticinterventions to help them deal with their problems. In addition to individual, family, group, orother therapeutic treatment, psychologists may teach, conduct research, or serve asconsultants to a wide range of organizations. Psychologists work alone or with otherspecialists in hospitals, correctional institutions, mental health clinics, private practice, schools,businesses, government agencies, and research laboratories. A Clinical Psychologist islicensed at the doctoral level.


30

13

10

5

10

15

20

25

30

35

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s

Main Campuses

Branch Campuses

No Campus Nearby

Total Number of Positions & AnnualTurnoverby Campus Category57

1

17

1 010

10

20

30

40

50

60

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


34

SOCIAL WORKER/4-YEAR DEGREE (BSW)

Summary:Social Workers with 4-year degrees are one of the 18 occupations that ranked highly on 4variables:1) highest turnover; 2) most difficult to recruit; 3) most difficult to recruit because oftraining; and 4) the largest number of organizations expecting an increase in hiring in the next 3-5 years.



Totalvacancies


12 monthprojection





20 Stay thesame


5 Relocation


positions17

positions32.60

positions190

positions

7 Don't know

N=39 N=39 N=33 N=33 N=36 N=33




Social Workers promote, restore, maintain, and enhance the functioning of individuals,families, groups, organizations, and communities by helping them accomplish tasks, preventand alleviate distress, and use resources available to assist them in enhancing the quality oftheir lives. Social Workers plan, formulate, and implement policies, services, resources, andprograms needed to meet basic human needs, to achieve and sustain quality of life, toadvocate for the empowerment of groups at risk of harm or oppression, and to promote socialand economic justice. Some of the arenas in which professional social workers are employedinclude: child welfare, services to families, addictions, domestic violence, geriatrics, mentalhealth, health care, the justice system, developmental disabilities, and schools. An entry-levelprofessional will have a bachelor’s degree in Social Work.


21

15

3

0

5

10

15

20

25

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s

Main Campuses

Branch Campuses

No Campus Nearby


164

2734

4 150

50

100

150

200

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


35

SOCIAL WORKER/6-YEAR DEGREE (MSW)

Summary:Social Workers with 6-year degrees are one of the 20 occupations in rural Alaska that rankedhighly on 4 variables:1) highest turnover; 2) most difficult to recruit; 3) most difficult to recruitbecause of training; and 4) the largest number of organizations expecting an increase in hiringin the next 3-5 years.



Totalvacancies


12 monthprojection





28 Stay thesame


11 Relocation


positions11

positions12.70

positions102

positions

4 Don't know

N=49 N=44 N=38 N=43 N=45 N=41




Social Workers promote, restore, maintain, and enhance the functioning of individuals,families, groups, organizations, and communities by helping them accomplish tasks, preventand alleviate distress, and use resources available to assist them in enhancing the quality oftheir lives. Social Workers plan, formulate, and implement policies, services, resources, andprograms needed to meet basic human needs, to achieve and sustain quality of life, toadvocate for the empowerment of groups at risk of harm or oppression, and to promote socialand economic justice. Some of the arenas in which professional social workers are employedinclude: child welfare, services to families, addictions, domestic violence, geriatrics, mentalhealth, health care, the justice system, developmental disabilities, and schools. An advancedlevel professional will have a master’s degree in Social Work. Advanced level professionalSocial Workers are typically employed as clinicians, administrators, policy makers, teachers,or researchers, or engage in other leadership roles.


28

20

10

5

10

15

20

25

30

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s

Main Campuses

Branch Campuses

No Campus Nearby


62

7

46

601

0

20

40

60

80

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


36

LICENSED CLINICAL SOCIAL WORKER

Summary:Licensed Clinical Social Workers are one of the 20 occupations in rural Alaska that rankedhighly on 4 variables:1) highest turnover; 2) most difficult to recruit; 3) most difficult to recruitbecause of training; and 4) the largest number of organizations expecting an increase in hiringin the next 3-5 years.



Totalvacancies


12 monthprojection





29 Stay thesame


21 Relocation


positions10

positions18.50

positions101

positions

7 Don't know

N=54 N=49 N=48 N=50 N=49 N=47




Social workers promote, restore, maintain, and enhance the functioning of individuals, families,groups, organizations, and communities by helping them accomplish tasks, prevent andalleviate distress, and use resources available to assist them in enhancing the quality of theirlives. Social Workers plan, formulate, and implement policies, services, resources, andprograms needed to meet basic human needs, to achieve and sustain quality of life, toadvocate for the empowerment of groups at risk of harm or oppression, and to promote socialand economic justice. Some of the arenas in which professional social workers are employedinclude: child welfare, services to families, addictions, domestic violence, geriatrics, mentalhealth, health care, the justice system, developmental disabilities, and schools. A LicensedClinical Social Worker must have a master’s or doctoral degree in Social Work to seeklicensing. These advanced level professionals are typically employed as clinicians,administrators, policy makers, teachers, or researchers, or engage in other leadership roles.


32

14

8

0

5

10

15

20

25

30

35

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s

Main Campuses

Branch Campuses

No Campus Nearby


67

5

28

9 513

0

20

40

60

80

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


37

SUBSTANCE ABUSE TECHNICIAN

Summary:Substance Abuse Technicians are one of the 20 occupations in rural Alaska that ranked highlyon 4 variables:1) highest turnover; 2) most difficult to recruit; 3) most difficult to recruit becauseof training; and 4) the largest number of organizations expecting an increase in hiring in the next3-5 years.



Totalvacancies


12 monthprojection





12 Stay thesame

7 Somewhatdifficult

6 Relocation


positions28

positions33

positions198

positions

6 Don't know

N=28 N=28 N=24 N=27 N=27 N=26




Substance Abuse Technician certification is primarily held by individuals entering the field ofsubstance abuse treatment. These individuals typically assist in various aspects of treatmentunder the supervision of a Substance Abuse Counselor 1 or Counselor 2. This certificationlevel requires a combination of training and experience. Substance Abuse Technicians mustdemonstrate competencies, including effective communication skills, knowledge of addictivesubstances, sociological-cultural issues, record keeping, intake interviewing, and basictreatment issues.


4

10

14

0

5

10

15

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s

Main Campuses

Branch Campuses

No Campus Nearby


74

12

93

714

27

0

20

40

60

80

100

Positions TurnoverCampus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


38

SUBSTANCE ABUSE COUNSELOR 1

Summary:Substance Abuse Counselor 1s are one of the 18 occupations that ranked highly on 4variables:1) highest turnover; 2) most difficult to recruit; 3) most difficult to recruit because oftraining; and 4) the largest number of organizations expecting an increase in hiring in the next 3-5 years.



Totalvacancies


12 monthprojection





20 Stay thesame


10 Relocation


positions9

positions22

positions103

positions

6 Don't know

N=35 N=31 N=27 N=32 N=34 N=33



OCCUPATIONAL DESCRIPTIONSubstance Abuse Counselors are trained in the area of substance abuse and chemicaldependency. They are skilled in assessing, intervening, and providing treatment for substanceabuse and addiction issues. Substance Abuse Counselors commonly use group and individualcounseling and family involvement when treating addiction. The Substance Abuse Counselorcan provide referrals for other services, such as mental health issues, when needed. In ruralAlaska, many certified alcohol and substance abuse counselors work for regional healthcorporations in larger communities. They work closely with professional mental healthcounselors, physicians, health educators, and many other health professionals. SubstanceAbuse Counselor certification in the state of Alaska recognizes two levels of competency. ACounselor Level 1 must have 2 years of fulltime work experience with increasingly specializedexperience in chemical dependency treatment to be certified. A Bachelor of Arts or Science (orhigher degree) may be considered as a substitute for one of the two years of required workexperience.


1513

7

0

5

10

15

20

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s

Main Campuses

Branch Campuses

No Campus Nearby


60

8

48

113

14

0

20

40

60

80

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


39

SUBSTANCE ABUSE COUNSELOR 2

Summary:Substance Abuse Counselor 2s are one of the 18 occupations that ranked highly on 4variables:1) highest turnover; 2) most difficult to recruit; 3) most difficult to recruit because oftraining; and 4) the largest number of organizations expecting an increase in hiring in the next 3-5 years.



Totalvacancies


12 monthprojection





18 Stay thesame


10 Relocation


positions13

positions22.5

positions142

positions

8 Don't know

N=40 N=38 N=28 N=36 N=37 N=37




Substance Abuse Counselors are trained in the area of substance abuse and chemicaldependency. They are skilled in assessing, intervening, and providing treatment for substanceabuse and addiction issues. Substance Abuse Counselors commonly use group and individualcounseling and family involvement when treating addiction. The Substance Abuse Counselorcan provide referrals for other services, such as mental health issues, when needed. In ruralAlaska, many certified alcohol and substance abuse counselors work for regional healthcorporations in larger communities. They work closely with professional mental healthcounselors, physicians, health educators, and many other health professionals. SubstanceAbuse Counselor certification in the state of Alaska recognizes two levels of competency. ACounselor Level 2 must have three year’s work experience as a Substance Abuse Counselor1 to be certified. A Bachelor of Arts or Science (or higher degree) may be considered as asubstitute for one of the three years of required work experience.


6

22

12

0

5

10

15

20

25

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s

Main Campuses

Branch Campuses

No Campus Nearby


95

13

39

7 314

0

20

40

60

80

100

120

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


40

SUBSTANCE ABUSE CLINICAL SUPERVISOR

Summary:Substance Abuse Clinical Supervisors have a relatively high turnover, with 14 of the 48 (29%)positions turning over each year. Eight-eight percent (88%) of the respondent organizationsrated Substance Abuse Clinical Supervisors as "somewhat" to "very difficult" to recruit.



Totalvacancies


12 monthprojection





15 Stay thesame

5 Somewhatdifficult

6 Relocation


positions4

positions14

positions49

positions

4 Don't know

N=27 N=24 N=18 N=25 N=24 N=24




Substance Abuse Clinical Supervisors are typically substance abuse counselors withadvanced counseling skills and experience; they are also experienced in personnelmanagement. Clinical Supervisors may provide direct counseling to individuals or groups,supervise other counselors in their patient management, and/or conduct case file reviews andprovide quality assurance reviews. Supervisors are often involved in maintaining an agency’saccreditation. Clinical Supervisors may become involved with program development andmanagement. Substance Abuse Clinical Supervisors typically have a master’s degree orequivalent experience.


16

8

3

0

5

10

15

20

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s Main Campuses

Branch Campuses

No Campus Nearby


34

911

50

3

0

10

20

30

40

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


41

SCHOOL COUNSELOR

Summary:School Counselors were rated "somewhat" to "very difficult" to recruit by 82% of the respondentorganizations. Training was the most frequently cited reason for difficulty in recruitment.

Note: the Anchorage School District, which reported 76 currently employed school counselors,did not provide a 12 month projection, hence the total 12 month projection number in the tablebelow is underrepresented



Totalvacancies


12 monthprojection





17 Stay thesame


6 Relocation

1 Decrease 4 Not difficult 12 Training222 *

positions3

positions13.3

positions144

positions

0 Don't know

N=27 N=23 N=21 N=23 N=23 N=22


*An additional 13 school counselors were reported by 10 school districts, but were not included in our surveysample as their role was more focused in career guidance.



School Counselors work with students, teachers, parents, and administrators to help ensurethat students' educational, vocational, and emotional needs are being met. School Counselorsprovide crisis intervention services and individual and group counseling to help all studentsdevelop their educational, social, career, and personal strengths, and to become responsibleand productive citizens. School Counselors must have a bachelor’s or higher degree toreceive an Alaska Type C certificate with an endorsement in School Counseling.


9

4

14

0

5

10

15

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s

Main Campuses

Branch Campuses

No Campus Nearby


4

52

2 7

36

0

50

100

150

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


42

SCHOOL PSYCHOLOGIST

Summary:School Psychologists were rated "somewhat" to "very difficult" to recruit by 89% of therespondent organizations. Training was the most frequently cited reason for difficulty inrecruitment.



Totalvacancies


12 monthprojection





22 Stay thesame

9 Somewhatdifficult

8 Relocation


positions5

positions9.8

positions103

positions

1 Don't know

N=28 N=27 N=21 N=27 N=27 N=27




School Psychologists collaborate with teachers, parents, and school personnel about learning,social, and behavior problems. School Psychologists use a wide variety of techniques toevaluate academic skills, learning aptitudes, social skills, self-help skills, personality, andemotional development. School Psychologists determine eligibility for special serviceprograms and work directly with students or families to help solve conflicts and problemsrelated to learning and adjustment. They provide counseling, social skills training, behaviormanagement, and other interventions to help families deal with difficult crises such asseparation or loss. A School Psychologist must have a master’s or higher degree inPsychology to receive an Alaska Type C certificate with an endorsement in SchoolPsychology.


5

15

8

0

5

10

15

20

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s

Main Campuses

Branch Campuses

No Campus Nearby


5

38

41

8

0

10

20

30

40

50

60

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


43

3. Ancillary Services

Occupations include: Biomedical Equipment Technician, ECG/Treadmill/Holter Technician,Cardiovascular Technician, Cardiac Sonographer, Registered Dietitian, Dietetic Technician,Radiologic Technologist, Diagnostic Medical Sonographer, Nuclear Medicine Technologist,Imaging-MRI, Imaging-CAT, Mammographer, Phlebotomist, Clinical Lab Assistant, Clinical LabTechnician (2-year degree and 4-year degree), Patient Advocate/Interpreter, Pharmacist,Pharmacy Technician, Surgical Technician, and Physician Assistant.

Pharmacists, Pharmacy Technicians, and Radiologic Technologists topped the list in terms ofthe most difficult ancillary services to recruit and the positions most needed in the future.

The most significant reported trend in the pharmacy field is the current nationwide shortage ofpharmacists. Most respondents don’t foresee this shortage improving any time soon, especiallywith our aging “baby boomer” population. As a result, respondents predict that both the numberof pharmacy technician positions will increase in the future and their roles within the pharmacysetting will be expanded. Another identified trend in the pharmacy field is an increase in moredirect patient care. Many respondents expressed a desire for a pharmacy technician program inAlaska, as well as continuing education courses for updating licenses.

Respondents from large hospitals, Native health corporations, and small clinics expressed theneed for both an in-state radiology program and continuing education courses. Manyrespondents, especially in small offices, reported the use of cross training between RadiologicTechnologists, nurses, lab technicians, and medical assistants. In addition, a number of smalloffices reported that full-time Radiologic Technologists are often not needed and as a result mayhave other duties, such as drawing blood. It should be noted that a sample of medical clinicswas surveyed and single physician offices were not included in this sample (see Methodology,p. 4). As a result, the number of Radiologic Technologists reported is most likelyunderrepresented.

In addition to the above occupations, other areas of occupational needs within ancillary servicesreported include: lab personnel, medical technology, ultrasound technology, andmammography. Many respondents expressed the desire for courses in these areas to beavailable through distance delivery. Several respondents also expressed a desire for theUniversity of Alaska to offer a physician assistant program.


44

BIOMEDICAL EQUIPMENT TECHNICIAN

Summary:Biomedical Equipment Technicians ranked relatively low on most survey variables, most likelybecause so few are employed in the industry (hospitals and Native health corporations).Nevertheless, nearly half of responding organizations projected hiring more technicians in thenext 3-5 years.



Totalvacancies


12 monthprojection



Reasons fordifficulty


6 Stay thesame

5 Somewhatdifficult

2 Relocation


positions2

positions4

positions46

positions

1 Don't know

N=14 N=13 N=10 N=13 N=13 N=13




Biomedical Equipment Technicians maintain, repair, adapt, and sometimes even construct toorder the medical electronic equipment used daily in hospitals. Knowledge of electronic,mechanical, hydraulic, and pneumatic equipment is necessary. Biomedical EquipmentTechnicians may assist other hospital personnel in conducting experiments and trainingpractitioners, nurses, and researchers in the operation of the machines. Supervision ofequipment schedules is also sometimes involved. It is necessary not only for the BiomedicalEquipment Technician to have the working knowledge of a particular machine, but to alsounderstand the theory of operation, the physiological principles involved, and the practical,safe, and clinical applications of biomedical equipment. The Association for the Advancementof Medical Instrumentation maintains the certification process for Biomedical EquipmentTechnicians.


0

7 7

0

2

4

6

8

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s Main Campuses

Branch Campuses

No Campus Nearby


32

3

14

10

10

20

30

40

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


45

ECG/TREADMILL/HOLTER TECHNICIAN

Summary:ECG/Treadmill/Holter Technicians ranked relatively low on survey variables, most likelybecause so few are employed in the industry (hospitals and two clinics). Nevertheless, over onethird of the positions reportedly turn over each year.



Totalvacancies


12 monthprojection





5 Stay thesame

5 Somewhatdifficult

3 Relocation


positions1

position6

positions17

positions

1 Don't know

N=7 N=7 N=6 N=7 N=7 N=7




ECG Technicians attach electrodes to the patient's chest, arms, and legs; then manipulateswitches on an electrocardiograph machine to obtain a reading. This test is done to rule outheart attacks and disease before most kinds of surgery are performed, as well as during theroutine physical examinations of people who have passed a certain age. Treadmills are ECGtests used in conjunction with a treadmill to look at the effect of exercise on an ECG. Thesetreadmills may or may not be used in conjunction with medications and/or radioactive material.For Holter monitors, ECG technicians place electrodes on the patient’s chest and connectthese to a continuous ECG recording device. After 24 hours or longer electrodes are removedand the recordings downloaded by computer into reports. The minimum requirement to be anECG/Treadmill/Holter Technician is a high school diploma. A one-year certificate programexists, though most ECG Technicians are still trained on-the-job by an ECG supervisor or acardiologist.


0

4

3

0

1

2

3

4

5

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s

Main Campuses

Branch Campuses

No Campus Nearby


12

5

1

5

0

5

10

15

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


46

CARDIOVASCULAR TECHNICIAN

Summary:Cardiovascular Technicians ranked relatively low on survey variables, most likely because sofew are employed in the industry (urban hospitals). They were rated "very difficult" to recruit byall 3 respondent organizations.



Totalvacancies


12 monthprojection





1 Stay thesame

0 Somewhatdifficult

3 Relocation


positions2

positions0

positions10

positions

1 Don't know

N=3 N=3 N=2 N=3 N=3 N=3




Cardiovascular Technicians and Technologists assist physicians in diagnosing and treatingcardiac (heart) and peripheral vascular (blood vessel) ailments. Those technologists whospecialize in cardiac catheterization procedures, also known as invasive technology, are calledCardiology Technologists. They assist a physician who winds a small tube, or catheter,through a patient's blood vessel from a spot on the patient's leg into the heart to determine if ablockage exists and for other diagnostic purposes. Technologists have completed a two-yeartraining program and are board certified.


3

0 00

0.5

1

1.5

2

2.5

3

3.5

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s

Main Campuses

Branch Campuses

No Campus Nearby


10

00

2

4

6

8

10

12

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


47

CARDIAC SONOGRAPHER

Summary:Cardiac Sonographers ranked relatively low on survey variables, most likely because so few areemployed in the industry (hospitals and one specialty clinic, mostly in urban areas). They wererated "very difficult" to recruit by all 4 respondent organizations.



Totalvacancies


12 monthprojection





2 Stay thesame

0 Somewhatdifficult

3 Relocation


positions3

positions2

positions21

positions

0 Don't know

N=5 N=5 N=4 N=5 N=5 N=4




Cardiac Sonographers may do cardiac, peripheral vascular echoes, or ultrasounds. Ultrasoundequipment transmits sound waves through the part of the body being examined, and thencollects the echoes to form an image on a screen. Individuals who focus on blood flows andcirculation problems are known as vascular technologists, while those who use ultrasound onthe heart are referred to as echocardiographers. Most Cardiac Sonographers complete a oneto two-year accredited training program, though some are occasionally trained on-the-job.


0

4

1

0

1

2

3

4

5

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s

Main Campuses

Branch Campuses

No Campus Nearby


210

0

5

10

15

20


Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


48

REGISTERED DIETITIAN

Summary:Registered Dietitians were rated "somewhat" to "very difficult" to recruit by 67% of therespondent organizations.



Totalvacancies


12 monthprojection





19 Stay thesame


6 Relocation


positions6

positions8.2

positions53

positions

1 Don't know

N=27 N=26 N=22 N=26 N=24 N=21




Many Registered Dietitians are employed in hospitals. The organization of the Department ofDietetics is under the direction of an experienced Dietitian. Dietitians, who are specialists infood administration, therapeutic nutrition, and education, assist the director in fulfilling theobjectives of the department. Administrative Dietitians are responsible for all aspects of foodservice in hospitals for patients and personnel. The principles of nutrition and management areapplied in menu planning, and in the purchase, preparation, and service of food. Otherresponsibilities involve establishing standards for quality food service, conducting in-serviceeducation, supervising personnel, and controlling costs. Therapeutic (or Clinical) Dietitiansprovide nutritional care to patients. Many teaching Dietitians coordinate dietetic educationprograms within medical centers, or serve on university faculties. Students earn abaccalaureate or master's degree in dietetics, food and nutrition, or foodservice systemsmanagement from a college or university with an ADA accredited Coordinated Program.


0

17

10

0

5

10

15

20

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s Main Campuses

Branch Campuses

No Campus Nearby


6

20

20

10

20

30

40

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


49

DIETETIC TECHNICIAN

Summary:Dietetic Technicians ranked relatively low on survey variables, most likely because so few areemployed in the industry.



Totalvacancies


12 monthprojection





4 Stay thesame

2 Somewhatdifficult

1 Relocation


positions2

positions1

position8

positions

0 Don't know

N=6 N=6 N=5 N=6 N=5 N=4




Dietetic Technicians work under the guidance of a Registered Dietitian in food servicemanagement and/or dietary counseling. They perform a variety of tasks including preparingquality food, developing standardized recipes, managing cafeterias, and training personnel.Dietetic Technicians in food service management may also be responsible for budget control,employee and production scheduling, sanitation and safety, and security standards andcontrol. Technicians who specialize in nutrition care are assigned to work under thesupervision of a clinical or community dietitian. Typical duties include reporting diet histories,calculating routine modified diets, teaching patients proper nutritional behavior, and visitingpatients to evaluate their food programs. Dietetic Technicians have an associate degree froman accredited community college. An examination is given by the Commission on DieteticRegistration for individuals who want to become a Registered Dietetic Technician.


3 3

00

0.5

1

1.5

2

2.5

3

3.5

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s

Main Campuses

Branch Campuses

No Campus Nearby


5

1

4

00

1

2

3

4

5

6

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


50

RADIOLOGIC TECHNOLOGIST

Summary:Radiologic Technologists are one of the 18 occupations that ranked highly on 4 variables:1)highest turnover; 2) most difficult to recruit; 3) most difficult to recruit because of training; and 4)the largest number of organizations expecting an increase in hiring in the next 3-5 years.



Totalvacancies


12 monthprojection





11 Stay thesame

7 Somewhatdifficult

12 Relocation


positions20

positions33

positions180

positions

2 Don't know

N=28 N=28 N=22 N=26 N=25 N=26




The Radiologic Technologist assists the radiologist in the use of x-ray and fluoroscopicequipment for the diagnosis and treatment of disease or injury. X-rays work on photographicfilm to create images that enable the study of internal organs and bones. Fluoroscopes involveingestion of radioactive liquid and the use of diagnostic x-rays to allow deep internalobservation of organs. Work activities include evaluation of the patient's condition to ensurethe most accurate x-ray films for diagnosis, explanation of procedures to the patient, andassisting the radiologist in invasive procedures. Effective use of equipment, including propervoltage, current, and exposure time, are essential components of this job. Colleges anduniversities with approved clinical affiliation provide associate and bachelor degrees inRadiology. Some hospitals provide certification programs.


3

1213

0

2

4

6

8

10

12

14

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s

Main Campuses

Branch Campuses

No Campus Nearby


121

20

52

1215

0

50

100

150

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


51

DIAGNOSTIC MEDICAL SONOGRAPHER

Summary:Diagnostic Medical Sonographers were rated "somewhat" or "very difficult" to recruit by 100% ofthe respondent organizations. Sixty-three percent (63%) of the responding organizationsprojected an increase in sonographers in the next 3-5 years.



Totalvacancies


12 monthprojection





6 Stay thesame

1 Somewhatdifficult

8 Relocation


positions9

positions6.5

positions49

positions

0 Don't know

N=19 N=19 N=14 N=17 N=16 N=15



OCCUPATIONAL DESCRIPTIONDiagnostic Medical Sonographers use complex equipment to direct high frequency soundwaves into specific areas of the patient's body to produce images that show the shape andposition of internal organs, fluid accumulations, masses, or fetuses. The "echo" informationwhich results from the "bounceback" of sound from areas being scanned is viewed on ascreen and may be recorded on film. Sonographers must be able to recognize subtledifferences between healthy and diseased tissues, and to judge if the images are satisfactoryfor diagnostic purposes. Certification to become a Registered Diagnostic Medical Sonographeris through the American Registry of Diagnostic Medical Sonographers. To qualify,Sonographers must complete a one to two-year accredited training program. Many programsrequire a degree in another health-related field (such as Radiology, Nursing, or MedicalTechnology) prior to acceptance.


98

2

0

2

4

6

8

10

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s

Main Campuses

Branch Campuses

No Campus Nearby

Total Number of Positions & AnnualTurnoverby Campus Category

35

4 2

17

2 10

10

20

30

40

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


52

NUCLEAR MEDICINE TECHNOLOGIST

Summary:Nuclear Medicine Technologists ranked relatively low on survey variables, most likely becauseso few are employed in the industry (hospitals and 2 specialty clinics). They were rated "verydifficult" to recruit by 88% of the respondent organizations.



Totalvacancies


12 monthprojection





4 Stay thesame

0 Somewhatdifficult

5 Relocation


positions4

positions2.5

positions18

positions

0 Don't know

N=8 N=8 N=7 N=8 N=8 N=8




Nuclear Medicine Technologists work under the supervision of a physician in the diagnosisand treatment of a wide range of medical conditions. Duties frequently involve direct contactwith patients in performing scans (Nuclear Imaging Studies), but also include laboratoryprocedure preparation, recording images, computer processing, decision making, andadministration of radiopharmaceuticals. More specific duties of technologists include:calculating, preparing, and administering radioactive drugs; positioning and operatingequipment for detecting the drugs; and preparing films and graphs for physician interpretation.Certificate programs are one year in length and include clinical experience as well asclassroom instruction. Applicants must be certified or certified-eligible in radiography,registered in nursing or medical technology, or have a bachelor's degree in a science or healthfield. Graduates of the one-year program may apply for the American Registry of RadiologicTechnologist or the Nuclear Medicine Technology Certification Board of Examination.


6

2

00

1

2

3

4

5

6

7

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s

Main Campuses

Branch Campuses

No Campus Nearby


33

00

5

10

15

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


53

IMAGING- MRI

Summary:Magnetic Resonance Technologists ranked relatively low on survey variables, most likelybecause so few are employed in the industry (hospitals and one specialty clinic). They wererated "very difficult" to recruit by 88% of the respondent organizations. Eight-nine percent (89%)of the responding organizations projected hiring more MRI staff in the next 3-5 years.



Totalvacancies


12 monthprojection





1 Stay thesame

0 Somewhatdifficult

2 Relocation


positions3

positions5.5

positions18

positions

0 Don't know

N=9 N=8 N=6 N=8 N=9 N=8




Magnetic Resonance Technologists use radio waves, magnetic fields, and a computer toproduce images of body tissues. They also may inject the patient with a material that assists invisualizing the images produced. Candidates for certification must pass the certificationexamination in radiography, nuclear medicine, or radiation therapy technology at least oneyear prior to taking the magnetic resonance technology examination.


6

3

00

1

2

3

4

5

6

7

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s

Main Campuses

Branch Campuses

No Campus Nearby


25

63

00

5

10

15

20

25

30

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


54

IMAGING - CAT

Summary:Imaging-CAT technologists ranked relatively low on survey variables, most likely because sofew are employed in the industry (hospitals, Native health corporations, and one specialtyclinic). Eighty-nine percent (89%) of the respondent organizations rated Imaging-CATtechnologists "somewhat" to "very difficult" to recruit.



Totalvacancies


12 monthprojection





7 Stay thesame

4 Somewhatdifficult

4 Relocation


positions2

positions.5

position18

positions

0 Don't know

N=11 N=10 N=7 N=10 N=11 N=9




Imaging technologists use radiation and a computer to produce cross-sectional images of thebody. These individuals also may inject the patient with a material that assists in visualizingthe images produced. Candidates for certification must pass the certification examination inradiography or radiation therapy technology at least one year prior to taking the computedtomography technology examination.


6

5

00

1

2

3

4

5

6

7

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s

Main Campuses

Branch Campuses

No Campus Nearby


1 0

6

0

5

10

15

20

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


55

MAMMOGRAPHER

Summary:Mammographers were rated "somewhat" to "very difficult" to recruit by 94% of the respondentorganizations. Training was the most frequently cited reason for difficulty in recruitment. Eight ofthe responding organizations projected hiring more mammographers in the next 3-5 years.



Totalvacancies


12 monthprojection





11 Stay thesame

7 Somewhatdifficult

7 Relocation


positions6

positions4.5

positions43

positions

0 Don't know

N=21 N=19 N=15 N=17 N=19 N=18




Mammographers use radiation to produce images for screening or diagnostic procedures fordetecting breast disease. Mammographers also provide breast health education. Candidatesfor certification must pass the certification examination in radiography at least one year prior totaking the mammography examination.


1

10 10

0

2

4

6

8

10

12

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s Main Campuses

Branch Campuses

No Campus Nearby


29

3

25

2 010

10

20

30

40

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


56

PHLEBOTOMIST

Summary:Phlebotomists have a relatively high turnover rate, with over one quarter of the positionsreportedly turning over each year. Training was the most frequently cited reason for difficulty inrecruitment.



Totalvacancies


12 monthprojection





13 Stay thesame

6 Somewhatdifficult

0 Relocation


positions6

positions21

positions80

positions

1 Don't know

N=20 N=20 N=16 N=20 N=20 N=18




Phlebotomists are trained to collect blood samples and work under the supervision of theClinical Laboratory Scientist. Training is typically on-the-job and is available when there is anemployment need in a particular facility. Certified Nurse Assistants and Medical Assistants areoften selected for this type of on-the-job training.


1

9 10

0

2

4

6

8

10

12

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s Main Campuses

Branch Campuses

No Campus Nearby


59

1221

901

010203040506070

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


57

CLINICAL LAB ASSISTANT

Summary:Clinical Lab Assistants have a relatively high turnover rate, with 33% of the positions turningover each year. In addition, 42% of the responding organizations projected hiring more labassistants in the next 3-5 years.



Totalvacancies


12 monthprojection





6 Stay thesame

1 Somewhatdifficult

0 Relocation


positions2

positions12

positions35

positions

0 Don't know

N=12 N=12 N=8 N=12 N=12 N=12




Clinical Lab Assistants perform routine, basic procedures in the medical laboratory under thedirection of a qualified physician and/or clinical laboratory scientist/medical technologist. Theseprocedures involve the use of common laboratory instruments in processes wherediscrimination is clear, errors are few and easily corrected, and results of the procedures canbe confirmed with a reference test or source within the working area. The period of clinicaleducation is usually 12 months, with graduates receiving a certificate. Prerequisites are a highschool diploma or equivalent.


56

1

0

1

2

3

4

5

6

7

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s

Main Campuses

Branch Campuses

No Campus Nearby


106

1 120

5

10

15

20

25

30

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


58

CLINICAL LAB TECHNICIAN/2-YEAR DEGREE (MLT)

Summary:Clinical Lab Technicians with a two-year degree were rated "somewhat" to "very difficult" torecruit by 69% of the respondent organizations. Training was the most frequently cited reasonfor difficulty in recruitment.



Totalvacancies


12 monthprojection





9 Stay thesame

8 Somewhatdifficult

2 Relocation


positions5

positions6

positions77

positions

1 Don't know

N=15 N=14 N=10 N=14 N=15 N=13




Clinical Lab Technicians with two-year degrees, also known as Medical LaboratoryTechnicians (MLT), perform procedures that require less technical or theoretical knowledgethan those performed by the Clinical Lab Technician with a four-year degree, also known as aMedical Technologist (MT). MLT responsibilities include routine laboratory procedures and useof such equipment as microscopes, computers, chemicals, and specialized equipment andinstruments. Clinical Lab Technicians make independent decisions relating to the completionof their duties, but are supervised by a MT. The MLT must complete an associate degree orcertificate program in laboratory sciences with an emphasis in chemistry and biology. This isan academic-based program that integrates both academic courses and clinical laboratoryexperience. Upon completion of their education, a technician is eligible to apply for certificationthrough one of several certifying agencies, such as the American Society of ClinicalPathologists or the National Certification Agency.


1

6

8

0

2

4

6

8

10

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s Main Campuses

Branch Campuses

No Campus Nearby


51

4

28

2 020

10

20

30

40

50

60

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


59

CLINICAL LAB TECHNICIAN/4-YEAR DEGREE (MT)

Summary:Clinical Lab Technicians with a four-year degree were rated "somewhat" to "very difficult" torecruit by 86% of the respondent organizations. Training was the most frequently cited reasonfor difficulty in recruitment.



Totalvacancies


12 monthprojection





14 Stay thesame

8 Somewhatdifficult

10 Relocation


positions11

positions14.5

positions168

positions

1 Don't know

N=23 N=23 N=18 N=22 N=23 N=22




Clinical Lab Technicians with four-year degrees, also known as Medical Technologists (MT),perform laboratory tests that play a vital role in the maintenance of health and the detection,diagnosis, and treatment of diseases. They are knowledgeable in all areas of routineprocedures as well as in those specialized tests that require more complex techniques. MTsexamine blood tissue and other body fluids to assist the physician in the proper diagnosis andtreatment of the patient. Tests include analysis for chemical make-up, coagulation studies,culturing to ascertain the presence of pathogenic organisms, transfusion testing, andhematologic and immunologic studies. Medical Technologists earn a Clinical LaboratoryScience or a related field from an accredited four-year college or university. Clinicalcoursework in a hospital laboratory is also required.


3

911

0

2

4

6

8

10

12

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s Main Campuses

Branch Campuses

No Campus Nearby


97

4

59

7 411

0

20

40

60

80

100

120

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


60

PATIENT ADVOCATE/INTERPRETER

Summary:Patient Advocate/Interpreters ranked relatively low on survey variables, most likely because sofew are employed in the industry.



Totalvacancies


12 monthprojection





5 Stay thesame

2 Somewhatdifficult

0 Relocation


positions1

position3

positions34

positions

0 Don't know

N=9 N=9 N=6 N=8 N=8 N=6




Patient Advocates act as a liaison between the staff and the patient by answering generalquestions, locating appropriate clinics or programs, and resolving patient concerns. Theyassist patients in learning more about their health, and may also play the role of an AlaskaNative Language Interpreter. Patient Advocates are trained in medical terminology and mustbe bilingual to be an interpreter.


6

3

00

1

2

3

4

5

6

7

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s

Main Campuses

Branch Campuses

No Campus Nearby

Total Number of Positions & AnnualTurnoverby Campus Category36

35

00

10

20

30

40

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


61

PHARMACIST

Summary:Pharmacists are one of the 18 occupations that ranked highly on 4 variables:1) highest turnover;2) most difficult to recruit; 3) most difficult to recruit because of training; and 4) the largestnumber of organizations expecting an increase in hiring in the next 3-5 years.



Totalvacancies


12 monthprojection





28 Stay thesame


23 Relocation


positions38

positions33.6

positions331

positions

7 Don't know

N=57 N=57 N=50 N=56 N=53 N=52




Pharmacists are primary dispensers of medicines and health supplies. They also serve thecommunity as a prime source of information on health topics. Pharmacists must understandthe following: drug composition, chemical and physical properties of drugs, the manufacturingand use of drugs, and the activity of drugs in the normal body and the person who is ill. Theymust also be familiar with tests for purity and strength. A license to practice pharmacy isrequired in all states. To obtain a license, one must graduate from an accredited college orpharmacy, pass a state exam, and serve an internship under a Licensed Pharmacist. Moststates require continuing education for license renewal. At least five years of study beyondhigh school is required to graduate from programs accredited by the American Council onPharmaceutical Education. Five years are needed for a Bachelor of Science degree inpharmacy, and a Doctor of Pharmacy usually requires six years of education.

*Numbers adjusted to accommodate three organizationsthat reported statewide results

Number of Organizations* Employing this Occupation by Campus Category

3

36

21

0

10

20

30

40

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s Main Campuses

Branch Campuses

No Campus Nearby


250

19

126

1325

0

50

100

150

200

250

300

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


62

PHARMACY TECHNICIAN

Summary:Pharmacy Technicians are one of the 18 occupations that ranked highly on 4 variables:1)highest turnover; 2) most difficult to recruit; 3) most difficult to recruit because of training; and 4)the largest number of organizations expecting an increase in hiring in the next 3-5 years.



Totalvacancies


12 monthprojection





22 Stay thesame


4 Relocation


positions28

positions78.5

positions532

positions

3 Don't know

N=48 N=48 N=45 N=47 N=45 N=45




Pharmacy Technicians work as support personnel under the immediate supervision ofpharmacists. Duties include pre-packing tablets and capsules, assisting the pharmacist infilling pharmacy requisitions, maintaining records and files, and typing labels. The PharmacyTechnician may be in charge of ordering, receiving, and keeping current inventory of allmedication as it is used. This person is also in charge of seeing that sufficient medication is onhand to meet projected needs in the hospital. Two methods of training include short-termcertification programs and on-the-job training. Individuals who have previous pharmaceuticalcoursework, for instance a pharmacy student, are the most likely candidates for on-the-jobtraining. Community colleges, vocational technical schools, hospitals, and retail pharmaciesare the primary sources for training.

*Numbers adjusted to accommodate three organizationsthat reported statewide results


30

19

2

0

5

10

15

20

25

30

35

Campus Category

Nu

mb

er o

f O

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izat

ion

s

Main Campuses

Branch Campuses

No Campus Nearby


341

54

180

25 040

100

200

300

400

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


63

SURGICAL TECHNICIAN

Summary:Surgical Technicians ranked low on survey variables, most likely because they are concentratedin only 9 respondent organizations (hospitals). Surgical Technicians were rated "somewhat" to"very difficult" to recruit by 63% of the respondent organizations.



Totalvacancies


12 monthprojection





7 Stay thesame

3 Somewhatdifficult

2 Relocation


positions6

positions4

positions70

positions

0 Don't know

N=9 N=9 N=7 N=8 N=9 N=8



OCCUPATIONAL DESCRIPTIONSurgical Technicians provide technical support to surgeons, registered nurses, andanesthesiologists in an operating room setting. The Surgical Technician arranges supplies andinstruments, keeps an accurate count of the latter at all times, helps surgical team membersscrub and dress for surgery, passes instruments and other sterile supplies to the surgeonduring the operation, helps apply dressings, and helps prepare and preserve specimens takenfor testing. The Surgical Technician may also operate sterilizers, lights, suction machines, anddiagnostic equipment, and may become specialized in certain areas of surgery. After theoperation, the Surgical Technician may transfer the patient and help restock the operatingroom and maintain its aseptic conditions. Educational programs generally last nine to twelvemonths and include classroom instruction and clinical education. Some community collegeprograms award associate degrees. Certification by examination is available from the LiaisonCouncil on Certification of the Association of Surgical Technologists.


4

5

00

1

2

3

4

5

6

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s Main Campuses

Branch Campuses

No Campus Nearby


77

1

12

30

20

40

60

80

100

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


64

PHYSICIAN ASSISTANT

Summary:Physician Assistants were rated "somewhat" to "very difficult" to recruit by 76% of therespondent organizations. Eight organizations projected an increase in Physician Assistantstaffing over the next 3-5 years.



Totalvacancies


12 monthprojection





18 Stay thesame


13 Relocation


positions21

positions15.5

positions114

positions

6 Don't know

N=34 N=33 N=28 N=32 N=32 N=29




Physician assistants (PAs) are licensed to practice medicine with the supervision of a licensedM.D. In urban areas, PAs work in close association with a supervising M.D. However, in ruralareas, they often work independently in a clinic, with their supervising physician stationedmany miles away. PAs can be found in all medical and surgical specialties. They are trained toperform physical examinations, compile patient medical histories, and order and interpretdiagnostic testing, including echocardiograms, laboratory tests, and x-rays. PAs often performtherapeutic procedures (including suturing and cast application), develop and monitor patienttreatment plans based on medical diagnosis, and counsel patients about preventive care andrisk management. In Alaska, PAs can prescribe medications and controlled substances. A PAmust complete at least two years of coursework in the sciences. Some programs require abachelor's degree prior to admission. In addition, a PA must complete a 24-month PA programthat includes coursework and clinical experiences.


14 13

7

0

5

10

15

20

Campus Category

Nu

mb

er o

f O

rgan

izat

ion

s

Main CampusesBranch CampusesNo Campus Nearby


53

3

42

94

22

0

10

20

30

40

50

60

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

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ns



65

4. Long-term Care

Occupations include: Certified Nursing Assistant, Medial Foster Care Provider, Personal CareAttendant

Certified Nursing Assistants and Personal Care Attendants topped the lists for high turnover. Itis not clear from the data collected whether this high turnover is due to employees movingbetween health organizations or whether employees are actually leaving the health care field forother higher paying positions. It should be noted that Certified Nursing Assistants also had thelargest number of current employees and projected staff in the next 12 months of alloccupations counted on the surveys. Many respondents expressed the need for a wider rangeof courses and training for Certified Nursing Assistants.

Note: Although Certified Nursing Assistants were listed under the Long-term Care section, werealize they are occupied in a wider variety of settings.


66

CERTIFIED NURSING ASSISTANT

Summary:Certified Nursing Assistants have the highest turnover of all the allied health professionssurveyed. They are one of the 18 occupations that ranked highly on 4 variables:1) highestturnover; 2) most difficult to recruit; 3) most difficult to recruit because of training; and 4) thelargest number of organizations expecting an increase in hiring in the next 3-5 years.



Totalvacancies


12 monthprojection





10 Stay thesame


5 Relocation


positions97

positions299

positions1013

positions

6 Don't know

N=37 N=36 N=32 N=33 N=35 N=32




Certified Nursing Assistants (CNAs) care for ill, injured, disabled, or infirm individuals confinedto hospitals, nursing or residential care facilities, and mental health settings. CNAs work underthe supervision of nursing and medical staff. Typical duties include personal patient care, suchas bathing, feeding, and dressing, as well as the following support functions: transportingpatients, making beds, and answering patient calls. Clinical duties include taking vital signs,performing massages, helping patients become ambulatory, and observing signs of medicalchange. Nursing Assistant training is offered in many different settings. High schools,vocational schools, community colleges, and geriatric facilities all offer CNA training. Trainingis usually six to eight weeks long, at which time students take an exam to become certified andeligible for work in a particular state.


4

16 17

0

5

10

15

20

Campus Category

Nu

mb

er o

f O

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ion

s Main Campuses

Branch Campuses

No Campus Nearby


928

247204

42 11510

200

400

600

800

1000

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

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ns

Main Campuses

Branch Campuses

No Campus Nearby


67

MEDICAL FOSTER CARE PROVIDER

Summary:Medical Foster Care Providers ranked relatively low on survey variables, most likely becauseonly 1 respondent organization reported employing staff in this occupation. Note the highturnover (nearly 50%) of this occupation within this organization.



Totalvacancies


12 monthprojection





0 Stay thesame

0 Somewhatdifficult

0 Relocation


positions3

positions13

positions29

positions

0 Don't know

N=1 N=1 N=1 N=1 N=1 N=1




Medical Foster Care Providers specialize in the care of infants and/or children who experiencemultiple medical conditions. The foster home must be first licensed as a foster home by DFYS.This is usually through an agency providing services to the developmentally disabled, which isa licensing placement agency for DFYS. Anchorage examples include: ASSETS, the ARC,Catholic Social Services, and Hope Community Resources. The foster parents must initiallyhave CPR and First Aid training and then receive training specific to the care of the individualchild through a registered nurse. The children are considered medically fragile and require theuse of specialized equipment such as apnea monitors, gastrostomy feeding tubes, oxygentherapies, and multiple medications to maintain medical stability. Medical Foster Care requires24-hour monitoring, frequent coordination with medical professionals, and the ability to calmlyand efficiently respond to medical crises.


1

0 00

0.2

0.4

0.6

0.8

1

1.2

Campus Category

Nu

mb

er o

f O

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ion

s Main Campuses

Branch Campuses

No Campus Nearby


29

13

05

101520253035

Positions Turnover

Campus Category

Nu

mb

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f P

osi

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ns

Main Campuses

Branch CampusesNo Campus Nearby


68

PERSONAL CARE ATTENDANT

Summary:Personal Care Attendants have the second highest turnover of all allied health professionssurveyed. They are one of the 20 occupations in rural Alaska that ranked highly on 4variables:1) highest turnover; 2) most difficult to recruit; 3) most difficult to recruit because oftraining; and 4) the largest number of organizations expecting an increase in hiring in the next 3-5 years.



Totalvacancies


12 monthprojection





5 Stay thesame

8 Somewhatdifficult

1 Relocation


positions36

positions145

positions373

positions

5 Don't know

N=25 N=24 N=21 N=23 N=25 N=23




Personal Care Attendants (PCAs) are trained paraprofessionals who, under the clinicalsupervision of a nurse, perform tasks related to the activities of daily living for ill, injured,disabled, or infirm individuals in their own homes or in assisted living homes. Typical dutiesinclude personal client care, such as bathing, feeding, and dressing, as well as supportfunctions that include transporting clients, light housekeeping, meal preparation, and othertasks that require semi-skilled care. Personal Care Attendants are not certified or licensed bythe State of Alaska. The State has an approved PCA curriculum that includes 75 hours ofclassroom instruction. This training is offered by various agencies around the state.


10

14

10

5

10

15

20

Campus Category

Nu

mb

er o

f O

rgan

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ion

s Main Campuses

Branch Campuses

No Campus Nearby


194

71

169

75

010

50

100

150

200

250

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


69

5. Rehabilitation

Occupations include: Audiologist, Occupational Therapist, Occupational TherapyTechnician/Assistant, Orthotist/Prosthetist, Physical Therapist, Physical Therapist Assistant,Respiratory Technician, Respiratory Therapist, Speech Pathologist, and Therapeutic RecreationSpecialist.

Several occupations in the rehabilitation field topped the lists in terms of difficulty to recruit. Inparticular, many school districts and health care organizations report having to recruit physicaltherapists, occupational therapists, and speech pathologists from outside of Alaska. Respiratorytherapists are also reportedly difficult to recruit by most health care organizations. In the case ofspeech pathology, shortages are nationwide.

Recent changes in Medicare reimbursement policies have resulted in fewer physical therapistsbeing hired. It is becoming more advantageous financially for organizations to have fewertherapists seeing more patients. In fact, there is currently a national moratorium on thedevelopment of new physical therapy programs. Nevertheless, many respondents said theyexpect to see an increase in the need for physical therapists as the “baby boomer” populationages.

Many school districts employ physical therapists, occupational therapists, and speechpathologists, though mostly on a part-time basis. In some cases these services are contractedout through the Southeast Regional Resource Center and a single therapist may service severaldistricts. On average most therapists will visit a site three or four times a year. Besides thescarcity of qualified personnel, school districts report that the extensive travel requirements,along with the variety of accommodations, play a role in recruitment difficulty. In addition, lack offunding for services and lack of competitive wages make recruiting difficult. Most school districtemployers report having to recruit outside of Alaska and expressed a strong desire for in-stateprograms that would enable them to “home-grow” their own.

Respondents from school districts and health care organizations expressed the need for in-statetherapy programs, along with continuing education courses to help maintain a therapist’slicense.


70

AUDIOLOGIST

Summary:Audiologists ranked relatively low on survey variables, primarily because so few are employedin the industry (hospitals, Native health corporations, one school district, and three privatepractices).



Totalvacancies


12 monthprojection





8 Stay thesame

4 Somewhatdifficult

4 Relocation


positions1

position3

positions18

positions

2 Don't know

N=13 N=12 N=9 N=11 N=11 N=12




Audiologists help both children and adults overcome hearing problems. Because speech andhearing are so interrelated, Speech Therapists and Audiologists work closely with each otherand other professionals. They also work as consultants to educational, medical, and otherprofessional groups. Audiologists concentrate on individuals with hearing problems; theyassess the type and degree of hearing impairment, then plan, direct, and conduct auralrehabilitation and training programs. The American Speech-Language and HearingAssociation certification requires master’s level training and one year’s experience, as well assuccessful completion of a national exam.


0

76

0

2

4

6

8

Campus Category

Nu

mb

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s Main Campuses

Branch Campuses

No Campus Nearby


16

3

7

00

5

10

15

20

Positions Turnover

Campus Category

Nu

mb

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Main Campuses

Branch Campuses

No Campus Nearby


71

OCCUPATIONAL THERAPIST

Summary:Occupational Therapists are one of the 18 occupations that ranked highly on 4 variables:1)highest turnover; 2) most difficult to recruit; 3) most difficult to recruit because of training; and 4)the largest number of organizations expecting an increase in hiring in the next 3-5 years.



Totalvacancies


12 monthprojection





33 Stay thesame


22 Relocation


positions5

positions21.25

positions139

positions

12 Don't know

N=61 N=59 N=53 N=59 N=59 N=58




Occupational Therapists help individuals with mentally, physically, developmentally, oremotionally disabling conditions to develop, recover, or maintain daily living and work skills.They not only help patients improve basic motor functions and reasoning abilities, but alsohelp them compensate for permanent loss of function. Their goal is to help patients haveindependent, productive, and satisfying lifestyles. Occupational Therapists use activities of allkinds to assist the patient in caring for daily needs (i.e. dressing, bathing, cooking), as well asexercises aimed at regaining physical strength and dexterity. For those with permanentfunctional disabilities, therapists provide adaptive equipment (such as wheelchairs, splints, andprosthetic devices) and training in their use. A bachelor or master’s degree program, whichincludes 6-9 months of clinical training, in Occupational Therapy is required to practice. Tobecome licensed, applicants must have a degree or certificate from an accredited educationalprogram and pass a national certification examination. Alaska requires a license to practiceoccupational therapy.


2926

6

0

5

10

15

20

25

30

35

Campus Category

Nu

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s

Main Campuses

Branch Campuses

No Campus Nearby


13

42

7 270

20

40

60

80

100

120

Positions Turnover

Campus Category

Nu

mb

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ns

Main Campuses

Branch Campuses

No Campus Nearby


72

OCCUPATIONAL THERAPY TECHNICIAN/ASSISTANT

Summary:Occupational Therapy Technicians/Assistants ranked relatively low on survey variables, mostlikely because so few are employed in the industry. Training was the most frequently citedreason for difficulty in recruitment.



Totalvacancies


12 monthprojection





7 Stay thesame

4 Somewhatdifficult

2 Relocation


positions1

position.25

position13

positions

1 Don't know

N=11 N=11 N=10 N=11 N=11 N=11



OCCUPATIONAL DESCRIPTIONOccupational Therapy Technicians/Assistants work closely with Occupational Therapists toprovide restorative, supportive, and preventive services to persons with physical injury orillness, psychosocial dysfunction, or developmental or learning disabilities in order to achievethe highest level of independent functioning in daily living skills. After evaluation by aregistered Occupational Therapist, the Occupational Therapy Assistant engages the client inpurposeful activity to achieve goals. Treatment areas addressed may include developing self-care and daily living skills (i.e. feeding, dressing, and hygiene), increasing physical mobilityand fine motor skills, and assisting the patient in learning to use prosthetic devices or adaptiveequipment. To become an Occupational Therapy Assistant, one must graduate from anaccredited or approved occupational therapy educational program and complete a nationalcertification examination. One may choose a two-year associate degree or one-year certificateprogram.


7

3

1

0

2

4

6

8

Campus Category

Nu

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s Main Campuses

Branch Campuses

No Campus Nearby


9

0

3

0 01

0

2

4

6

8

10

12

Positions Turnover

Campus Category

Nu

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osi

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ns

Main Campuses

Branch Campuses

No Campus Nearby


73

ORTHOTIST/PROSTHETIST

Summary:Orthotists and Prosthetists ranked relatively low on survey variables, most likely because so feware employed in the industry, all within urban areas (two hospitals and one private practice).



Totalvacancies


12 monthprojection





2 Stay thesame

0 Somewhatdifficult

0 Relocation


positions0

positions0

positions5

positions

0 Don't know

N=3 N=3 N=2 N=3 N=3 N=2




Orthotics and prosthetics are applied physical disciplines that address neuromuscular andstructural skeletal problems in the human body with a treatment process that includesevaluation and transfer of forces using orthoses and prostheses to achieve optimum function,prevent further disability, and provide cosmesis. The Orthotist and Prosthetist work directlywith the physician and representatives of other allied health professions in the rehabilitation ofthe physically challenged. The Orthotist designs and fits devices, known as orthoses, toprovide care to patients who have disabling conditions of the limbs and spine. The Prosthetistdesigns and fits devices, known as prostheses, for patients who have partial or total absenceof limb. Orthotic and/or prosthetic education occurs in two forms: baccalaureate degree andcertificate programs. Degree programs are based on a standard four-year curriculum, andcertificate courses range from 6 months to 1 year for one discipline, to 18 months to 2 yearsfor both disciplines.


3

0 00

0.5

1

1.5

2

2.5

3

3.5

Campus Category

Nu

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s

Main Campuses

Branch Campuses

No Campus Nearby


4

00

1

2

3

4

5

Positions Turnover

Campus Category

Nu

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Main Campuses

Branch Campuses

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74

PHYSICAL THERAPIST

Summary:Physical Therapists are one of the 18 occupations that ranked highly on 4 variables:1) highestturnover; 2) most difficult to recruit; 3) most difficult to recruit because of training; and 4) thelargest number of organizations expecting an increase in hiring in the next 3-5 years.(Note: Providence Hospital, which reported 44 currently employed Physical Therapists, did notreport a 12 month projection, hence the total 12 month projection number in the table below isunderrepresented.)



Totalvacancies


12 monthprojection





35 Stay thesame


28 Relocation


positions9

positions34.25

positions218

positions

10 Don't know

N=74 N=73 N=67 N=70 N=72 N=70



OCCUPATIONAL DESCRIPTIONPhysical Therapists work with patients to restore function, prevent disability, and relieve painafter disease or injury. All treatment is directed toward normal movement and independence.Physical Therapists review records and conduct assessments of joint motion, muscle strength,posture, gait, sensory perception, reflexes, muscle tone, endurance, and cardiac status.Treatment programs are designed to emphasize the patient's re-entry into his/her homeenvironment. As a member of the health team, the Physical Therapist has the ability to workwith doctors, occupational therapists, speech therapists, nurses, and others who contribute toa patient's progress. In all cases, the Physical Therapist teaches the patient about his/herdisability and how best to deal with limitation. A strong emphasis on patient education andresponsibility is essential for maximum success. Those who have already graduated fromcollege with a four-year degree and want to study physical therapy may take an intensivecourse leading to a certificate (at least four semesters) or a master’s degree.


35

28

11

0

10

20

30

40

Campus Category

Nu

mb

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s

Main Campuses



22

71

12 0110

50

100

150

200

Positions Turnover

Campus Category

Nu

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Main Campuses

Branch Campuses

No Campus Nearby


75

PHYSICAL THERAPIST ASSISTANT

Summary:One third of respondent organizations that employ Physical Therapist Assistants project a hiringincrease in the next 3-5 years.



Totalvacancies


12 monthprojection





14 Stay thesame


8 Relocation

1 Eliminated 14 Not difficult 8 Training57

positions4

positions6.75

positions55

positions

6 Don't know

N=33 N=32 N=27 N=31 N=32 N=29




Physical Therapy Assistants are skilled technicians who have completed an educationalprogram approved by the American Physical Therapy Association. A Physical TherapyAssistant's function is to help the Physical Therapist in patient-related activities. Assistantsperform treatment procedures in accordance with the planned programs, assist the PhysicalTherapist in carrying out more complex procedures, and observe and report patient behaviorto their supervisor. Becoming a Physical Therapy Assistant requires the completion of a two-year college level course leading to an associate degree. The program must be held in anaccredited college and approved by the American Physical Therapy Association.


1

1715

0

5

10

15

20

Campus Category

Nu

mb

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s Main Campuses

Branch Campuses

No Campus Nearby


43

6

18

100

10

20

30

40

50

Positions Turnover

Campus Category

Nu

mb

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ns

Main Campuses

Branch Campuses

No Campus Nearby


76

RESPIRATORY TECHNICIAN

Summary:Respiratory Technicians ranked relatively low on survey variables, most likely because so feware employed in the industry. Training was the most frequently cited reason for difficulty inrecruitment.



Totalvacancies


12 monthprojection





5 Stay thesame

4 Somewhatdifficult

1 Relocation


positions2

positions3

positions20

positions

0 Don't know

N=7 N=7 N=7 N=7 N=7 N=7




Respiratory Technicians treat individuals with heart and lung abnormalities. Employed invarious types of health care settings, Respiratory Technicians administer tests and treatmentsto patients who range in age from the newborn to the elderly. Other work settings includeintensive care units and the emergency room. Activities might involve resuscitation, monitoringsophisticated equipment, or treating postoperative or critically ill patients. RespiratoryTechnicians work under the supervision of a Registered Respiratory Therapist or physician.Although their duties are essentially the same as those of the therapist, technicians generallymake fewer decisions and have less responsibility in performing treatments. One year ofhospital and/or college coursework is required to become a Respiratory Therapy Technician.Graduates are eligible for certification through the National Board for Respiratory Therapy. ATechnician may advance to a Therapist with additional education.


0

3

4

0

1

2

3

4

5

Campus Category

Nu

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Main Campuses

Branch Campuses

No Campus Nearby


13

21

9

0

5

10

15

Positions Turnover

Campus Category

Nu

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Main Campuses

Branch Campuses

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77

RESPIRATORY THERAPIST

Summary:Respiratory Therapists were rated "somewhat" to "very difficult" to recruit by 83% of therespondent organizations.

(Note: Providence Hospital, which reported 65 currently employed Respiratory Therapists, didnot report a 12 month projection, hence the total 12 month projection number in the table belowis underrepresented.)



Totalvacancies


12 monthprojection





8 Stay thesame

7 Somewhatdifficult

5 Relocation


positions5

positions20.50

positions85

positions

1 Don't know

N=13 N=13 N=10 N=12 N=13 N=12




Respiratory Therapists treat individuals with heart and lung abnormalities. Employed in varioustypes of health care settings, Respiratory Therapists administer tests and treatments topatients who range in age from the newborn to the elderly. Other areas of work includeintensive care units and the emergency room. Activities might involve resuscitation, monitoringsophisticated equipment, or treating postoperative or critically ill patients. Credentials forRegistered Respiratory Therapists are gained through the National Board for Respiratory Careand require completion of an accredited two or four-year program.


0

8

5

0

2

4

6

8

10

Campus Category

Nu

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s

Main Campuses

Branch Campuses

No Campus Nearby


125

1925

20

20406080

100120140

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


78

SPEECH PATHOLOGIST

Summary:Speech Pathologists are one of the 18 occupations that ranked highly on 4 variables:1) highestturnover; 2) most difficult to recruit; 3) most difficult to recruit because of training; and 4) thelargest number of organizations expecting an increase in hiring in the next 3-5 years.



Totalvacancies


12 monthprojection





41 Stay thesame

5 Somewhatdifficult

22 Relocation


positions15

positions27.25

positions220

positions

4 Don't know

N=58 N=57 N=50 N=56 N=57 N=55




Speech Pathologists help children and adults overcome speech problems. Because speechand hearing are so interrelated, Speech Pathologists and Audiologists work closely with eachother and other professionals. They also work as consultants to educational, medical, andother professional groups. Speech Pathologists primarily specialize in helping people withproblems of speech, language, and voice disorders. They diagnose and evaluate theindividual's speech and language ability, then plan, direct, and conduct a treatment program torestore or develop the patient's communication skills. Speech Pathologists may advance toadministrative or supervisory positions such as clinic director or coordinator of clinical services.The American Speech-Language and Hearing Association certification requires master’s leveltraining, successful completion of a national exam, and one year experience.


22

27

9

0

5

10

15

20

25

30

Campus Category

Nu

mb

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f O

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ion

s

Main Campuses



145

17

81

10 0100

50

100

150

200

Positions Turnover

Campus Category

Nu

mb

er o

f P

osi

tio

ns

Main Campuses

Branch Campuses

No Campus Nearby


79

THERAPEUTIC RECREATION SPECIALIST

Summary:Therapeutic Recreation Specialists are primarily employed in urban areas within hospitals andlong-term care facilities. They have a relatively high annual turnover (36%). In addition, 29% ofresponding organizations expected an increase in future hiring. Training was the mostfrequently cited reason for difficulty in recruitment.



Totalvacancies


12 monthprojection





8 Stay thesame

3 Somewhatdifficult

2 Relocation


positions1

position13.1

positions31

positions

3 Don't know

N=17 N=15 N=15 N=14 N=17 N=14




Therapeutic Recreation Specialists plan and provide treatment programs, leisure education,and recreational opportunities for individuals with physical mental, development, andemotional disabilities. Therapeutic Recreation Specialists use a variety of activities, includingsports, exercise, dramatics, social activities, arts and crafts, music, and games to helpminimize their patients’ symptoms and improve their physical, mental, and emotionalfunctioning. Most Therapeutic Recreation Specialists work in the hospital specialties ofpsychiatry, rehabilitation, or pediatrics, or in a variety of institutional and community settings,with individuals who have physical, mental, social, and emotional limitations. They may alsowork in clinical and community settings and public or private agencies, such as acute carehospitals, rehabilitation centers, psychiatric hospitals, half-way houses, community livingarrangements, and long-term care facilities. Therapeutic Recreation Specialists have at least abachelor’s degree in their field.


12

4

1

0

2

4

6

8

10

12

14

Campus Category

Nu

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Main Campuses

Branch Campuses

No Campus Nearby


12

14

0 005

101520253035

Positions Turnover

Campus Category

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80

6. Miscellaneous Occupations

Occupations include: Community Health Aide, Community Health Representative, DentalAssistant, Dental Hygienist, Environmental Health Technician, Health Educator, Home HealthAide, Medical Assistant, Licensed Optician, Apprentice Optician, and Optometric Technician.

Dental Assistants are in high demand. In addition, Community Health Aides are needed in ruralAlaska and Medical Assistants are needed in the urban communities.

Many dental offices reported having difficulty finding qualified dental assistants and expressedthe desire for dental assisting programs in Anchorage and other parts of the state, especially inFairbanks. In particular, respondents suggested coursework, which emphasized hands-onexperiences and teamwork skills. Cross training is a common practice in dental offices,especially between front desk staff and dental assistants.

A shortage of Certified Medical Assistants is reported within the urban areas of Alaska. Severalrespondents expressed a need for more medical assisting programs. Some also suggestedcombining a Medical Assisting program with a certified nursing assistant program, so that healthcare organizations would have a broader use of their employees. In addition, manyorganizations reported that cross training between medical assistants and front desk staff wasfrequently used, particularly in smaller offices.

The need for Community Health Aides is high in rural Alaska, where a majority of the employeeswork. Many respondents expressed a desire to see a wider range of coursework and continuingeducation training for Community Health Aides.

Respondents reported a shortage of licensed opticians within Alaska. This is attributed to thelack of an opticianary program in the state. With the current aging population of licensedopticians, who are able to sponsor apprenticeships, this shortage is likely to become more of aproblem in the future. Additional general trends in the optical field include an increase intechnology and movement toward bigger and more expansive offices. Several respondentsexpressed a desire for an in-state optician program that would include the opportunity fordistance delivery.

It should be noted that a sample of private medical and dental clinics were surveyed (seeMethodology, p. 4), so numbers for dental assistants, dental hygienists, and medical assistantsare conservative.


81

COMMUNITY HEALTH AIDE

Summary:Community Health Aides are one of the 20 occupations in rural Alaska that ranked highly on 4variables:1) highest turnover; 2) most difficult to recruit; 3) most difficult to recruit because oftraining; and 4) the largest number of organizations expecting an increase in hiring in the next 3-5 years.



Totalvacancies


12 monthprojection





11 Stay thesame

9 Somewhatdifficult

7 Relocation


positions62

positions56.5

positions503

positions

5 Don't know

N=23 N=20 N=20 N=21 N=23 N=22




The Community Health Aide (CHA) is unique to Alaska, and is one of the most importanthealth care providers in rural Alaska. CHAs work under the supervision of a referral physicianwho is employed by the Indian Health Service or one of the tribally managed hospitals orclinics. Because CHAs live and work in remote areas, they communicate regularly with theirreferral physicians by telephone or radio. Community Health Aides use the Alaska CommunityHealth Aide/Practitioner Manual to guide them through obtaining a medical history, performinga physical examination, making an assessment, and planning care. CHAs also coordinate theappointments of other visiting health care professionals, including public health nurses,dentists, and doctors who regularly visit the village to provide care. Community Health Aidesgenerally work in the village where they live, and are employed by their tribal council orregional health corporation. Basic training consists of fifteen weeks divided into four sessionsthat include classroom time and clinical practice.


4

13

6

0

5

10

15

Campus Category

Nu

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89

21

380

33 341

0

100

200

300

400

Positions Turnover

Campus Category

Nu

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Main Campuses

Branch Campuses

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82

COMMUNITY HEALTH REPRESENTATIVE

Summary:Community Health Representatives have a relatively high turnover, with 22% of the positionsreportedly turning over annually.



Totalvacancies


12 monthprojection





12 Stay thesame

8 Somewhatdifficult

4 Relocation


positions7

positions19.5

positions76

positions

6 Don't know

N=22 N=20 N=19 N=21 N=21 N=22




A Community Health Representative (CHR) serves as a liaison between the health caresystem and the community. Community Health Representatives are paraprofessionals whoserve as health educators in many Alaskan communities. In the past, many focused on suchtopics as diabetes education. The background education and training can vary between CHRs.Many are Personal Care Attendants or Certified Nursing Assistants, and in Alaska a largenumber of the Community Health Representatives have an even higher education level, withmany certified as LPNs or RNs. All need to have knowledge of village lifestyles and sensitivityto cultural issues.


5

12

5

0

2

4

6

8

10

12

14

Campus Category

Nu

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s

Main Campuses

Branch Campuses

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17

3

14

58

14

30

10203040506070

Positions Turnover

Campus Category

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83

DENTAL ASSISTANT

Summary:Dental Assistants are one of the 18 occupations that ranked highly on 4 variables:1) highestturnover; 2) most difficult to recruit; 3) most difficult to recruit because of training; and 4) thelargest number of organizations expecting an increase in hiring in the next 3-5 years.



Totalvacancies


12 monthprojection





28 Stay thesame


5 Relocation

1 Eliminated 20 Not difficult 16 Training232

positions10

positions30.50

positions210

positions

13 Don't know

N=57 N=56 N=51 N=54 N=55 N=53




Dental Assistants greet patients, prepare them for examinations and treatment, and assistDentists. Other duties include preparing solutions, mixing materials, keeping accurate patienttreatment records, processing x-rays, and sterilizing instruments. The dental assistant mayalso be responsible for clerical work that keeps the office running smoothly. Cleaning,polishing, and making uncomplicated repairs on removable partials or complete dentures areother tasks that may be delegated to the Dental Assistant. Most obtain their skills on-the-job,yet an increasing number are being educated in formal programs. The program may be from 9months to 2 years in length and lead to a certificate or associate degree. No licensing isrequired. Certification is optional, and not usually a requirement for employment, although itmay occasionally result in higher wages.


39

14

4

0

10

20

30

40

50

Campus Category

Nu

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158

22

74

8 1100

50

100

150

200

Positions Turnover

Campus Category

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84

DENTAL HYGIENIST

Summary:Twenty percent (20%) of respondent organizations project an increase in staffing of DentalHygienists over the next 3-5 years. Training was the most frequently cited reason for difficulty inrecruitment.



Totalvacancies


12 monthprojection





29 Stay thesame


8 Relocation


positions4

positions13.75

positions119

positions

6 Don't know

N=49 N=48 N=44 N=46 N=48 N=45



OCCUPATIONAL DESCRIPTIONDental Hygienists provide direct care to the patient with diverse duties, including oralprophylaxis (cleaning); exposing, processing, and mounting radiographs; collecting andevaluating medical history information; performing health and neck screening examinations;and applying agents for the prevention of decay. Other functions include assessing thecondition of the periodontium (gums) and providing periodontal therapy including root planingand curettage, applying desensitizing and antimicrobial agents, and administering localinfiltration anesthesia and nitrous oxide/oxygen analgesia. Dental Hygienists also act as dentalhealth educators and are responsible for teaching patients to prevent dental disease and forproviding nutritional counseling. Education for the Dental Hygiene can be obtained in a two-year certificate course or associate degree program, or may be completed as a four yearbachelor's degree program. All states require a license to practice dental hygiene. This isobtained by successfully completing a clinical and written exam, the National Board DentalHygiene Examination, or a comparable state exam.


36

12

10

10

20

30

40

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Nu

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10

36

400

20

40

60

80

100


Nu

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85

ENVIRONMENTAL HEALTH TECHNICIAN

Summary:Environmental Health Technicians have a relatively high turnover, with 33% of positions turningover annually. (Note: Providence Hospital, which reported 80 Environmental Health Technicianpositions, and Tanana Chiefs Conference, which reported 20 positions, did not report 12 monthprojections. Hence, the total 12 month projection number in the table below isunderrepresented.)



Totalvacancies


12 monthprojection





6 Stay thesame

2 Somewhatdifficult

1 Relocation


positions6

positions44

positions30

positions

2 Don't know

N=12 N=10 N=8 N=8 N=10 N=10



OCCUPATIONAL DESCRIPTIONEnvironmental Health Technicians plan, develop, and implement systems to improve thequality of air, water, food, and other environmental factors that affect human health. They alsopromote public awareness of environmental health hazards, and enforce environmental healthlaws. Professional goals are to prevent environmental diseases and protect people fromnatural and human-made environmental hazards. Examples of public health areas in whichEnvironmental Health Technicians may be involved include air and water pollution, commu-nicable disease control, food sanitation, hazardous materials management, vector and pestcontrol, water supply, and liquid and solid waste disposal. Environmental Health Technicianswork in consultation with other health professionals such as public health nurses, epidemiolo-gists, and sanitary engineers. A four-year bachelor's degree in environmental or public healthis required to become an Environmental Health Technician. Many Environmental HealthTechnicians complete a one or two-year master’s degree in public or environmental health.


0

5

7

0

2

4

6

8

Campus Category

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3326 11

0

20

40

60

80

100

120

Positions Turnover

Campus Category

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86

HEALTH EDUCATOR

Summary:Health Educators ranked relatively low on survey variables, most likely because so few areemployed in the industry. They were rated "somewhat" to "very difficult" to recruit by 71% of therespondent organizations.



Totalvacancies


12 monthprojection





13 Stay thesame

8 Somewhatdifficult

4 Relocation


positions5

positions4

positions35

positions

2 Don't know

N=19 N=18 N=14 N=17 N=18 N=14




Health educators use educational processes to promote health and influence human well-being in a variety of school, community, workplace, and medical care settings. The NationalCommission for Health Education Credentialing, Inc. adopted seven responsibility areas that aHealth Educator should possess: 1) assessing individual and community needs for healtheducation; 2) planning effective health education programs; 3) implementing health educationprograms; 4) evaluating the effectiveness of health education programs; 5) coordinatingprovision of health education services; 6) acting as a resource person in health education; 7)communicating health and health education needs, concerns, and resources; and 8) havingadditional competencies, depending on the health educator’s responsibility area. The minimumeducational requirement is usually a four-year baccalaureate degree, with a minimum of 25semester hours for a health education emphasis. Some Health Educators complete a one ortwo-year master’s degree program in Health Education.


1

10

8

0

2

4

6

8

10

12

Campus Category

Nu

mb

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s



25

4

17

0 010

5

10

15

20

25

30

Positions Turnover

Campus Category

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Main Campuses

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87

HOME HEALTH AIDE

Summary:Home Health Aides are primarily employed in rural Alaska. They have a relatively high turnover,with 29% of the positions reportedly turning over annually.



Totalvacancies


12 monthprojection





7 Stay thesame

2 Somewhatdifficult

1 Relocation


positions13

positions21.5

positions63

positions

1 Don't know

N=12 N=11 N=9 N=9 N=12 N=8




As members of a home health team, Home Health Aides provide personal and homemakingservices to ill, elderly, or disabled persons and to children of families unable to perform basictasks for themselves. Their assistance enables the people they serve to remain in their ownhomes. The responsibilities of Home Health Aides include assisting with bathing, helpingpatients with walking and prescribed exercise, and helping individuals with braces or artificiallimbs. Aides check pulse and respiration rates, change surgical dressings, and assist patientswith medications. They plan and prepare meals and special diets for the family and patient anddo food shopping. Home Health Aides observe the patient's progress, report findings to theirsupervisors, and help the professional health team determine if services should be changed.Their supervisors are usually registered nurses but in some cases they are physical, speech,or occupational therapists, or social workers.


4

5

3

0

1

2

3

4

5

6

Campus Category

Nu

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s



19

4

46

14

410

0

10

20

30

40

50

Positions Turnover

Campus Category

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88

MEDICAL ASSISTANT

Summary:Medical Assistants are one of the 20 occupations in urban Alaska that ranked highly on 4variables:1) highest turnover; 2) most difficult to recruit; 3) most difficult to recruit because oftraining; and 4) the largest number of organizations expecting an increase in hiring in the next 3-5 years.



Totalvacancies


12 monthprojection





12 Stay thesame


4 Relocation


positions19

positions32.5

positions157

positions

5 Don't know

N=32 N=31 N=25 N=31 N=31 N=29




Medical Assistants perform a wide variety of duties in the medical office. These duties includemeasuring vital signs (pulse, temperature, and blood pressure), hematology, pharmacology,urinalysis, patient scheduling, insurance billing, and assisting in minor surgery. MedicalAssistants are also responsible for recording information and procedures in the patient’s chart.They must be familiar with expected vital signs recordings and observations, and reportnormal and abnormal findings to the practitioner. In clinics, Medical Assistants are primarilyresponsible for seeing that patients are readied for the practitioner’s examination. They alsoassist patients and practitioners during examinations. Other duties include monitoring andstocking supplies, scheduling clinics, educating patients, and phoning in refills. MedicalAssistants are employed in medical clinics or offices. Medical Assistant certification from anaccredited school is highly recommended, but not required.


25

5 2

0

5

10

15

20

25

30

Campus Category

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167

2710 3 370

50

100

150

200

Positions Turnover

Campus Category

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89

LICENSED OPTICIAN

Summary:Licensed Opticians were rated "somewhat" to "very difficult" to recruit by 82% of the respondentorganizations. Training was the most frequently cited reason for difficulty in recruitment.



Totalvacancies


12 monthprojection





8 Stay thesame

8 Somewhatdifficult

3 Relocation


positions6

positions9

positions63

positions

6 Don't know

N=24 N=23 N=22 N=23 N=23 N=22




Licensed Opticians make and fit eye glasses and lenses prescribed by ophthalmologists oroptometric physicians. They measure facial contours and assist in frame and lens selection.Although optical laboratories usually produce the actual lens, some opticians grind lensesaccording to the prescription and patient’s measurements. Opticians adjust eye glasses to thecustomer. They can also dispense contact lenses from the prescription provided by anophthalmologist or optometric physician if properly certified to do so, but must be under thesupervision of a doctor while working with contact lenses. In rural Alaska, most opticians workin regional hospital eye clinics. Opticians can receive training through college and technicalschool-based programs, or through an apprenticeship. School-based programs last from oneto two years. Regardless of the method of training, some states require a dispensing opticianto have a license. Licensing requirements usually include completion of an approvededucational or apprenticeship program and a written and practical examination.

*Numbers adjusted to accommodate one organizationthat reported statewide results


0

20

5

0

5

10

15

20

25

Campus Category

Nu

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58

9121

010203040506070

Positions Turnover

Campus Category

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90

APPRENTICE OPTICIAN

Summary:Fifty percent (50%) of the respondent organizations rated Apprentice Opticians "not difficult" torecruit.



Totalvacancies


12 monthprojection





10 Stay thesame

4 Somewhatdifficult

2 Relocation


positions3

positions16.5

positions68

positions

3 Don't know

N=20 N=19 N=17 N=20 N=16 N=14




An Apprentice Optician is an unlicensed optician who must work under the license of anOptometrist or a Licensed Optician. Opticians make and fit eye glasses and lenses prescribedby ophthalmologists or optometric physicians. They measure facial contours and assist inframe and lens selection. Although optical laboratories usually produce the actual lens, someopticians grind lenses according to the prescription and patient’s measurements. Opticiansadjust eye glasses to the customer. They can also dispense contact lenses from theprescription provided by an ophthalmologist or optometric physician if properly certified to doso, but must be under the supervision of a doctor while working with contact lenses. In ruralAlaska, most opticians work in regional hospital eye clinics. Opticians can receive trainingthrough college and technical school-based programs, or through an apprenticeship.

*Numbers adjusted to accommodate one organizationthat reported statewide results


0

19

2

0

5

10

15

20

25

Campus Category

Nu

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Main Campuses

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52

1315

40

10

20

30

40

50

60

Positions Turnover

Campus Category

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Main Campuses

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91

OPTOMETRIC TECHNICIAN

Summary:Optometric Technicians have a relatively high turnover, with 24% of the positions reportedlyturning over annually. Training was the most frequently cited reason for difficulty in recruitment.



Totalvacancies


12 monthprojection





9 Stay thesame

5 Somewhatdifficult

2 Relocation


positions2

positions9.25

positions29

positions

3 Don't know

N=18 N=17 N=11 N=15 N=16 N=15




The Optometric Technician’s primary responsibility is to help the Optometric Physician in eyeand vision care. Activities include measuring the curvature of the cornea, color testing, stereo-testing, taking acuitys, retinal and corneal photography, measuring the pressure of the eye,determining the power of old and new eye glass prescriptions, helping clients select frames,and measuring facial contours. The Optometric Technician educates the patient on the testsbeing done and on choices in eye glasses. Other duties may include dispensing contactlenses, determining the power and dimensions of old and new contact lenses, and explainingthe care and handling of lenses. Laboratory work and general management of a vision clinic isoccasionally necessary. Optometric Technicians are employed by optometric physicians invision clinics. In rural Alaska, these clinics are located in regional hospitals. A two-yearassociate degree from a community college is required to become an Optometric Technician.There are no licensing requirements in Alaska.


0

13

5

0

4

8

12

16

Campus Category

Nu

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s Main Campuses

Branch Campuses

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25

6

13

3

0

5

10

15

20

25

30

Positions Turnover

Campus Category

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92

7. Emergency Medical Services

Occupations include: EMT I, EMT II, EMT III, Paramedic, and EMS Instructor.

It was difficult to collect accurate numbers of EMS staff with the allied health survey. This isbecause many EMTs are volunteers and thus not counted as staff by many survey respondents.To develop a better understanding of the EMS field and training needs, ACRH staff conductedstructured key informant interviews with three experts:

• Matt Anderson, EMS Unit Manager, State EMS Program• Dan Johnson, Regional EMS Program Director, Interior Region EMS Council• Ronni Sullivan, Executive Director, Southern Region EMS Council

The following information was derived from those interviews:

Statewide Numbers as of January 2001(includes volunteers and paid staff)

EMT 1 1,674EMT 2 564EMT 3 533Paramedic about 300EMS Dispatcher about 25 (only includes those who are certified)EMS Instructor about 200

Distribution of EMS Workers

Alaska’s urban communities (Anchorage, Fairbanks, and Juneau) enjoy a high proportion ofparamedics. Employees are paid relatively well and have good benefits. Further, EMS training islocated in urban areas and, as a result, recruitment and retention are not a problem for thesecommunities.

Communities with populations of about 3,000 to 10,000 have a mix of paid and volunteerstaff. Some do not have any paramedic level workers. Recruitment and retention can be aproblem.

Communities with populations under 3,000 have primarily volunteer EMS staff. Whenvolunteers leave the community or “burn-out,” there often isn’t anyone to replace them.

Regarding paramedic training: with the exception of Anchorage, Fairbanks, and Soldotna, it isnot possible to conduct paramedic internships in rural communities within Alaska due to low-density populations. 480 hours of field internship time is required for paramedic licensure, alongwith specific procedures that need to be demonstrated. As a result, students often must gooutside of Alaska for their internships.

Lack of funding for training was a consistent theme, not only in the key informant interviews, butwith the survey respondents as well. Respondents particularly emphasized the lack of funding inrural communities where EMS training is most needed. Other trends noted by surveyrespondents include an increase in the level of skills for EMS workers, an increase in the role ofparamedics in the community, and an increase in the use of technology. Providing EMS coursesto rural residents is a top priority to respondents.


93

EMERGENCY MEDICAL TECHNICIAN I (EMT I)

Summary:See page 92 for EMT statewide numbers and comments.



Totalvacancies


12 monthprojection





8 Stay thesame

2 Somewhatdifficult

0 Relocation


positions30

positions12

positions169

positions

1 Don't know

N=12 N=10 N=9 N=10 N=11 N=11




An Emergency Medical Technician (EMT) provides emergency medical care until the patientarrives at a clinic or hospital. At each progressive level of certification or licensure, the rolesand responsibilities of the caregiver increase. All EMTs are taught to assess the emergencyscene, control bleeding, apply splints, assist with childbirth, administer oxygen, and performCPR and other basic life support skills. An EMT-I may assist a patient with the administrationof prescribed nitroglycerin, handheld bronchodilator inhaler, or epinephrine autoinjector foranaphylaxis. In rural Alaska, most EMTs work for volunteer or paid fire departments orambulance services. All Community Health Aides are trained as Emergency MedicalTechnicians. A unique aspect of rural emergency medical care is the need to take care ofpatients for longer periods of time because of the long distances between communities. AnEMT-I is certified through the Department of Health and Social Services.


4 4 4

0

1

2

3

4

5

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99

1226

0 0

22

0

20

40

60

80

100

120

Positions Turnover

Campus Category

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94

EMERGENCY MEDICAL TECHNICIAN II (EMT II)




Totalvacancies


12 monthprojection





7 Stay thesame

1 Somewhatdifficult

0 Relocation


positions0

positions2

positions24

positions

2 Don't know

N=12 N=10 N=9 N=7 N=10 N=9




An Emergency Medical Technician (EMT) provides emergency medical care until the patientarrives at a clinic or hospital. At each progressive level of certification or licensure, the rolesand responsibilities of the caregiver increase. All EMTs are taught to assess the emergencyscene, control bleeding, apply splints, assist with childbirth, administer oxygen, and performCPR and other basic life support skills. In addition to described EMT-I skills, an EMT-II mayalso, under direct or indirect supervision of a physician, perform the following: use approvedairway management techniques; start peripheral IVs; and use D5W, crystalloid volumereplacement solutions, sodium bicarbonate, 50% glucose, and naloxone hydrochloride(Narcan). In rural Alaska, most EMTs work for volunteer or paid fire departments or ambulanceservices. An EMT-II is certified through the Department of Health and Social Services.


4

5

3

0

1

2

3

4

5

6

Campus Category

Nu

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18

2

20

0 0

8

0

5

10

15

20

25

Positions Turnover

Campus Category

Nu

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95

EMERGENCY MEDICAL TECHNICIAN III (EMT III)




Totalvacancies


12 monthprojection





5 Stay thesame

0 Somewhatdifficult

0 Relocation


positions0

positions2

positions51

positions

2 Don't know

N=10 N=9 N=9 N=7 N=8 N=8




An Emergency Medical Technician (EMT) provides emergency medical care until the patientarrives at a clinic or hospital. At each progressive level of certification or licensure, the rolesand responsibilities of the caregiver increase. All EMTs are taught to assess the emergencyscene, control bleeding, apply splints, assist with childbirth, administer oxygen, and performCPR and other basic life support skills. In addition to described EMT-I and EMT-II skills, EMT-III personnel may apply electrodes and monitor cardiac activity; defibrillate life-threateningarrhythmias; and use lidocaine, morphine, atropine, and epinephrine 1:1,000 and 1:10,000. Inrural Alaska, most EMTs work for volunteer or paid fire departments or ambulance services.An EMT-III is certified through the Department of Health and Social Services.


5

3

2

0

1

2

3

4

5

6

Campus Category

Nu

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2

15

0 0

10

0

10

20

30

40

50

60

Positions Turnover

Campus Category

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96

PARAMEDIC

Summary:Paramedics were rated "somewhat" to "very difficult" to recruit by 91% of the respondentorganizations. Training was the most frequently cited reason for difficulty in recruitment.

Note: See page 92 for EMS statewide numbers and comments.



Totalvacancies


12 monthprojection





6 Stay thesame

4 Somewhatdifficult

2 Relocation


positions9

positions12

positions113

positions

2 Don't know

N=12 N=12 N=11 N=11 N=11 N=11




Mobile Intensive Care Paramedics are called "pre-hospital providers" since they usuallyprovide emergency medical care to individuals until they arrive at the clinic or hospital. Inaddition to the described EMT skills, paramedics have the most training and expansive scopeof authorized activities. They administer a wide variety of emergency medications and performa wider variety of invasive procedures, such as needle chest decompression. A unique aspectof rural emergency medical care is the need to take care of patients for longer periods of timebecause of the long distances between communities. Mobile Intensive Care Paramedics arelicensed by the Department of Community and Economic Development.


4

7

1

0

2

4

6

8

Campus Category

Nu

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12

47

0 030

20

40

60

80

Positions Turnover

Campus Category

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97

EMS INSTRUCTOR

Summary:See page 92 for EMS statewide numbers and comments.



Totalvacancies


12 monthprojection





9 Stay thesame

2 Somewhatdifficult

1 Relocation


positions0

positions0

positions27

positions

3 Don't know

N=14 N=13 N=11 N=11 N=13 N=12




There are five levels of EMS Instructors certified through the Department of Health and SocialServices. Depending upon their certification, an EMS Instructor can teach Emergency TraumaTraining (ETT), EMT 1, EMT 2, or EMT 3 courses. The highest level of EMS Instructor is aMobile Intensive Course Coordinator.


67

1

0

2

4

6

8

Campus Category

Nu

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Branch Campuses

No Campus Nearby


12

0

29

0 0205

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C. Summary of Qualitative Comments

In addition to the quantitative data, the allied health workforce assessment includes a qualitativecomponent. Respondents were asked to comment on recruiting difficulties, current or futuretraining needs, and cross training that was used or would be beneficial in their organizations.They were also asked to describe developing trends in their field in terms of the workforce andto offer any thoughts or comments that would help the University of Alaska in planning healthrelated coursework and programs. (For specific questions asked, please refer to the surveyinstrument in Appendix A).

Due to the diversity of organizations that participated, analysis of these questions wasconducted in categories. For example, responses from dental clinics, medical clinics, andpharmacies are likely to focus on the 3-4 occupations they employ. In contrast, large clinics orhospitals are likely to provide more thematic responses. Categories include: 1) dental clinics, 2)medical clinics, 3) pharmacies, 4) vision clinics, 5) school districts, 6) rehabilitation offices, 7)emergency medical services, 8) behavioral health organizations, and 9) large health careorganizations, including hospitals and Native health corporations. (For a complete summary ofcomments see Appendix F.)

1. Dental Clinics (N= 41)

General trends identified include: 1) clients with less dental insurance coverage; 2) fewer dentaloffices taking care of insurance billing; 3) a lack of experienced applicants; and 4) an increase inclient knowledge of dental care.

Most dental offices are providing training to their staff, but could use additional training in areassuch as x-ray.

Cross training is a common practice in dental offices, particularly between the front desk staffand dental assistants, and occasionally dental hygienists.

Respondents expressed the need for the University of Alaska to provide more dental assistingprograms in other parts of the state, especially in Fairbanks. In particular, respondents reportedthe need for coursework to emphasize hands-on experiences and teamwork skills. Courses thatfocus on clerical work in dental offices, such as billing, insurance coverage, and medicalterminology are also needed.

2. Medical Clinics (N= 32)

The most frequently mentioned trend in medical clinics is the shortage of qualified personnel,especially certified medical assistants and nurses. Other noteworthy trends include: the use ofelectronic (rather than paper) medical records, increased regulations and complications incoding, and the influence of insurance companies, which are limiting service coverage andadvocating the use of preferred providers.

Survey respondents were highly concerned about enhancing clerical training. Coding was themost frequently mentioned area of clerical training needed in medical offices. Other frequentlylisted training needs include legal issues, insurance billing, medical terminology, and customerservice.


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Cross training occurs frequently in medical clinics, particularly among clerical or front desk staffmembers. Many are cross trained to deal with medical records, billing, and coding. Crosstraining also occurs between nurses, x-ray technicians, and medical assistants.

Respondents would like to see the University of Alaska offer specific medical programs andtraining. In particular, they requested a physician assistant program, a medical assistingprogram, an x-ray program, and a more accessible nursing program that graduates morenurses. Respondents also requested courses in cardiology and phlebotomy. 3. Pharmacies (N= 27)

The most significant trend noted is the shortage of pharmacists in Alaska and across the nation.A resulting trend is a foreseeable increase in the number of pharmacy technician positions andan expansion of the pharmacy technician’s role. Respondents also noted that the pharmacist’srole is moving towards more direct patient care.

Many respondents commented that they would like to see both a pharmacy and pharmacytechnician program within Alaska. A desire for continuing education courses to update licenseswas also expressed.

4. Vision Clinics (N= 29)

An increase in technology and a shortage of licensed opticians were the most frequentlymentioned trends among vision clinics. Other trends include: movement toward bigger and moreexpansive offices, fewer optometric technicians with licenses, and more patients being referredby general practitioners to eye doctors.

Respondents want a two-year university optician program in Alaska, as well as a licensingprogram for optometric technicians. Several respondents suggested correspondence coursesfor opticians.

5. School Districts (N= 38)

There is currently a shortage of qualified allied health personnel in the schools, especiallyspecialists such as speech pathologists and school psychologists. Undesirable travelrequirements, lack of funding, and lack of competitive wages were probable reasons for thisshortage.

Respondents identified a trend toward increased medical needs of students, yet a number ofschools in the state reportedly do not have school nurses.

School staff members are in need of additional training to help them work with FAS/FAE andautistic children.

There is a substantial need for in-state programs in speech pathology, occupational therapy,and physical therapy. Respondents want local programs in these areas so they can recruitindividuals from within Alaska. They also encouraged the University of Alaska to create a schoolcounseling/psychology program, and to more actively urge high school students into careers inthe health care fields.


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6. Rehabilitation Offices (N= 27)

Trends in the physical rehabilitation field include: 1) a decreased number of physical therapistsbeing hired due to changes in Medicare policies; and 2) an emphasis on improved workingconditions and ergonomics.

Cross training is a common practice among staff members in rehabilitation offices, particularlybetween clinical and clerical staff.

Respondents want to have a physical therapy program and speech pathology program withinAlaska. They also want more continuing education courses to help them maintain their licenses.

7. Emergency Medical Services (N= 11)

Lack of funding in EMS organizations is a significant trend that negatively impacts trainingneeds, especially in rural communities. Other significant trends include: 1) an increase in theparamedic’s level of skill and role in the community and 2) the increased use of technology.

Recruitment and retention in the EMS system is particularly difficult in rural communities.

Providing EMT1, EMT 2, EMT 3, paramedic, and dispatching courses to rural residents is of toppriority to respondents – either in the form of a local program or through distance education.

8. Behavioral Health (N= 105)

Lack of funding is the most significant trend reported in the behavioral health care field. Othermajor trends include: increased need for home health care, changes in insurance and billingregulations, and expansion of treatment plans to include families and the community.

Behavioral health organizations have difficulty recruiting personnel because applicants lackexperience and qualifications, and because jobs often lack benefits, competitive wages, anddesirability.

Cross training is a common practice in behavioral health organizations. Clinical staff, particularlymental health counselors, are often cross trained in addiction, domestic violence, pregnancy,and parenting issues. Administrative and clerical staff may be cross trained to do billing anddata processing. Respondents want to see further cross training take place in most areas oftheir organization.

Respondents emphasized the need for flexible coursework in the behavioral health care field,including distance learning options, continuing education, internships, and practicums.Programs listed as a priority include: doctoral programs, MSW programs, speech therapy, andpersonal care attendant programs. The following specific areas of needed study were alsoidentified: substance abuse, mental health therapy, gerontological studies, developmentaldisabilities, cultural competency, domestic violence, special needs children, and computers.

9. Large Health Care Organizations (N= 59)

Trends in large health care organizations included a scarcity of qualified personnel, especiallyqualified nurses, pharmacists, counselors, social workers, radiologists, and respiratorytherapists. Reasons given for recruitment difficulties include: location of employment (rural


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setting), noncompetitive wages and benefit packages, increased demands and stress in healthcare jobs, and difficulty finding adequate housing. Other trends include: 1) lack of funding, 2)expansion of the number and type of health care services, 3) increased use of telemedicine andcomputerized technology, 4) an aging health care staff, and 5) the increased need forcollaboration between large health care organizations.

Respondents identified a strong need for training in administration, management, and clericaltasks in the health care fields. Most notably, they want computer training and courses in billing,coding, medical terminology, and grant writing.

Most staff members in large health care organizations are cross trained in some capacity.Among clerical and administrative staff, cross training frequently occurs between billing clerks,accountants, medical records staff, and coders. In the clinical setting, the following werementioned as being cross trained in a wide variety of ways: counselors, nurses, lab technicians,certified nursing assistants (CNA), community health aides (CHA), and respiratory therapists.Respondents reported that they could use further cross training in their organization, particularlyamong clerical staff in the area of billing and coding.

Respondents want more programs offered through the University of Alaska in health care fields.In particular, they requested a wider range of coursework and continuing education training fornurses, CNAs, and CHAs. They also requested training programs for radiologists, medicalassistants, dentists, counselors, pharmacists, physician assistants, dietitians, andpolysomanographic technologists, as well as additional training in geriatrics, behavioral health,respiratory care, and phlebotomy.

There is a strong need for university-level programs and courses for rural communities.Respondents want more distance delivery courses and continuing education for professionals.These courses should be more culturally relevant, especially for Alaska Natives.


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IV. DISCUSSION AND RECOMMENDATIONS

In this section, quantitative and qualitative findings converge to become the Project Team’srecommendations. On February 22, 2001, these recommendations were presented to theUniversity of Alaska's Planning & Budgeting Advisory Committee (PBAC) on Health where theywere transformed into proposed implementation strategies for Fiscal Year 2002 funding. ThePBAC’s recommendations follow each of the Project Team’s findings and recommendations.

A. Billing and Coding

1. Findings and Recommendations

a. Findings

Staff working as coders, billers, and combined coder/billers are in very high demand. Theseoccupations ranked highly on four variables: 1) highest turnover; 2) most difficult to recruit;3) most difficult to recruit because of training; and 4) the largest number of organizationsexpecting an increase in hiring in the next 3-5 years. They are employed in urban and rurallocations, and in large and small organizations. Qualitative data support the quantitativefindings; there is an overwhelming need for more people to be trained in these occupations.In addition, organizations reported that administrators and practitioners would also benefitfrom a better understanding of the reimbursement process as it would encourage a moreefficient and “reimbursable” approach to work.

b. Project Team Recommendations

There is high demand for staff trained to code and bill for reimbursement. Further, manyrespondents expressed a need for more allied health personnel to be cross trained incoding/billing or to understand how and which activities are reimbursed.

• Advertise coding/billing classes that are currently available• Enhance and expand distance delivered coding classes (possibly with web-based

instruction or other modalities)• Offer multiple levels of training, to reflect the range of ways this knowledge may be

used by allied health workers

2. PBAC Proposed Implementation Strategy

See Other Allied Health Professions (p. 107)

B. Dental Assisting Program


a. Findings

Dental Assistants ranked highly on four variables: 1) highest turnover; 2) most difficult torecruit; 3) most difficult to recruit because of training; and 4) the largest number oforganizations expecting an increase in hiring in the next 3-5 years. Survey respondentsreported 232 positions spanning 57 organizations. Respondents often reported recruiting


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part-time dental assistants out of the dental hygiene program, or hiring students in the dentalassisting program before program completion.


Expand the current program to reach more students, including those outside of the greaterAnchorage area.



C. Pharmacy Technician Program


a. Findings

Pharmacy Technicians ranked highly on four variables: 1) highest turnover; 2) most difficultto recruit; 3) most difficult to recruit because of training; and 4) the largest number oforganizations expecting an increase in hiring in the next 3-5 years. Survey respondentsreported 497 pharmacy technician positions spanning 48 organizations statewide. Giventhe developing scarcity of pharmacists nationwide, more pharmacy technicians – with moreskills – will be needed to cover the growing gap.


Expand the current program to reach more students, including those outside of the greaterAnchorage area.


Expand the pharmacy technician training at UAF using the instructional models developedat UAA. Sixty thousand dollars in FY02 general fund coupled with $20,000 in tuition wouldcover the estimated $80,000 in program expenses.

D. Radiologic Technology Program


a. Findings

Radiologic Technologists ranked highly on four variables: 1) highest turnover; 2) mostdifficult to recruit; 3) most difficult to recruit because of training; and 4) the largest number oforganizations expecting an increase in hiring in the next 3-5 years. Survey respondentsreported 158 radiologic technologist positions spanning 28 organizations statewide. Phonesurveyors learned that demand will grow further when the state institutes licensingrequirements.


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Expand the currently planned radiology program to reach more students, including thoseoutside of the greater Anchorage area.


Continue the current efforts to develop radiological health training including the FY03proposal to increase faculty appointments from 9 to 12 months. Additional assessments ofthe program should be conducted for possible inclusion in FY04 initiatives.

E. Rehabilitation


a. Findings

Physical therapy, occupational therapy, and speech pathology are all high demandoccupations. All three ranked highly on four variables: 1) highest turnover; 2) most difficult torecruit; 3) most difficult to recruit because of training; and 4) the largest number oforganizations expecting an increase in hiring in the next 3-5 years. Other rehabilitationprofessionals and paraprofessionals ranked lower, possibly because of the low volume ofthem employed in Alaska. There is still relatively high need for all of them, and they aredifficult to recruit. Survey respondents reported that lack of funding for services and lack ofcompetitive wages (especially in the school districts) make recruiting difficult. Respondentsfrom both school districts and health care organizations expressed the need for in-statetherapy programs, along with continuing education courses to help maintain a therapist’slicense.


It is not likely that the University of Alaska will be able to start programs in any of theseareas in the immediate future.

• Hire an advisor who specializes in rehabilitation occupations. This person would beresponsible for counseling students on prerequisites for speech pathology, physicaltherapy, occupational therapy, and therapeutic recreation specialist programs.

• Working with the Commission on Post-secondary Education, develop formal (à laWWAMI) and informal relationships with rehabilitation programs in other universities(especially in the WICHE and WUE areas) to facilitate University of Alaska studentmatriculation.

• Support Professional Student Exchange Program (PSEP)


The committee recommends that a full-time equivalent faculty member be hired togetherwith travel and incidental costs for a cost not to exceed $120,000.


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F. Behavioral Health Programs


a. Findings

A range of behavioral health occupations consistently floated to the top of every prioritizationlist. These occupations include human service workers, substance abuse workers, mentalhealth counselors, licensed professional counselors, and social workers. They workthroughout Alaska in a variety of organizations. Responding organizations reported difficultyin recruitment because positions lack benefits, competitive wages, or desirability. Theyreported that applicants often lack experience or appropriate qualifications. For personnelserving Alaska Natives, familiarity with substance abuse/multigenerational grieving isimportant. And rural respondents reported that high turnover can often be attributed to staffhaving limited skills for life in “bush” Alaska.


Due to problems in how occupations were organized, and the number of job titles, they arelumped together for these recommendations. The University of Alaska offers a wide range ofbehavioral health training, including but not limited to, human services, psychology, andsocial work. Specialties, or additional coursework, are offered in substance abuse anddevelopmental disabilities. Students can study for an Associate level degree, or continuethrough a Bachelor’s or Master’s degree. Distance delivery is available for some programs.It should be noted that the recommendations do not come directly from the quantitative orqualitative data; rather, the team reviewed the data and took a larger view of the recruitmentand retention problem.

• Coordinate the behavioral health programs offered campus-wide, especially toencourage cross training among sub-specialties

• Repackage curricula to include substance abuse training and mental illness• Repackage curricula to raise awareness of Alaska-specific issues (living in “bush”

Alaska, multigenerational grieving, etc.)• Offer continuing education courses, including some delivered over distance• Offer a distance delivery course orienting current and future providers of human

services to the Alaska specific issues mentioned above, as well as to Alaska’s publicbehavioral health services and systems and to appropriate Alaska statutes regardingservice delivery


The committee recommends an extension of the existing Allied Health Services contractwith the Alaska Center for Rural Health to provide an initial $10,000 for the study ofbehavioral health efforts. This money has been taken from the FY01 pool and therefore willnot affect the FY02 Allied Health set-aside.

Additional activities to be included are as follows:

• Behavioral Health Personnel Analysis - $50,000• Associated Travel - $10,000• Curriculum Development in Cross-Cultural and Intergenerational Mental Health Issues -

$5,000


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• Curriculum Development in Substance Abuse - $5,000

G. Emergency Medical Services


a. Findings

It was difficult to collect accurate numbers on EMT staff because many EMTs are volunteersand thus not counted as staff by responding organizations. Thus, ACRH staff conductedstructured key informant interviews with three leaders in the EMS field. There are over 3,000EMS workers in Alaska – both paid and volunteer. Urban communities provide trainingopportunities and paid employment opportunities. Thus, they enjoy staff with a higher levelof training and relatively low turnover compared to rural and remote regions of the state.Limited funding for rural training, and limited rural training in general, contributes to thescarcity of trained personnel in rural Alaska – and the desperate need for skilled EMTs. TheUniversity of Alaska provides limited EMT courses outside of Anchorage, Fairbanks, andJuneau. In addition, Native corporations no longer provide consistent funding for training,and costs have increased. There are instructor fees, housing, and transportation costs toconsider in the provision of training.


• Provide rural EMT courses in more communities.• Provide college credits for EMT courses, as it may improve matriculation.• Broaden EMT training to include leadership and management – as many people are

promoted into these positions without any management knowledge or experience.



H. Entry-Level Occupations


a. Findings

Certified Nursing Assistants and Medical Transcriptionists are in very high demand. CNAshave the highest turnover of all allied health professions and ranked highly on four variables:1) highest turnover; 2) most difficult to recruit; 3) most difficult to recruit because of training;and 4) the largest number of organizations expecting an increase in hiring in the next 3-5years. Medical Transcriptionists ranked highly on the same variables for urban Alaska.Psychiatric Nurse Assistants did not rank as highly, but are also needed. Turnover in theCNA field is partially attributed to poor pay and difficult working conditions – and moretraining will not resolve these issues. Medical transcription pays relatively well; anecdotalcomments from survey respondents suggests this work is done outside of Alaska due to thelack of trained people available within Alaska.


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Partnering with high schools or secondary programs to offer courses and training in theseentry-level allied health occupations may give the University an opportunity and avenue toencourage high school students to pursue health related careers.

• Offer university courses and credits for these entry-level occupations. These wouldbecome career “bridges,” as the credits would facilitate studying more advanced healthcareers, but would not apply directly to the programs.


See Other Allied Health Professions (below)

I. Other Allied Health Professions

The committee found common themes in the study’s discussion of the need for coordination ofother Allied Health professions including coding and billing specialists, dental assisting, entrylevel health occupations and some emergency medical services training. The committeediscussed the need for distance delivery of many of these programs and the need for qualifiedpersonnel at each MAU to assist students in:

• Service coordination• Instruction• Distance education• Preceptorship site development and management• Student placement

These Allied Health coordinators would assure that students enrolled in various Allied HealthDistance Education courses of study would receive the support required for successfulcompletion. High school student recruitment – especially minority students – into health careerswould be another critical element in this initiative. It was estimated that the cost would notexceed $200,000.

The committee recommends that the chair contact individuals who could put together a moredetailed proposal for the expenditure of the FY02 Allied Health resources in line with theserecommendations.

alaska’s allied health workforce: a statewide assessment · the estimated $80,000 in program...

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