cha workforce committee meeting · cha workforce committee meeting thursday, september 12, 2013...
TRANSCRIPT
*DENOTES ACTION ITEM
CHA WORKFORCE COMMITTEE MEETING
Thursday, September 12, 2013 10:00 a.m. - 2:30 p.m.
In Person
Hospital Council Board Room
1215 K Street, 7th Floor Sacramento, CA 95814
Call-In Information
Chorus Call: (800) 882-3610 Pass Code: 6506506#
AGENDA
ITEM TIME SUBJECT REPORTING PAGE
I. 10:00-10:05 WELCOME AND INTRODUCTIONS A. Welcome new members Mary Contreras and
Amy Anderson B. Workforce Committee Roster-Changes to
Christina Foncree
Anette Smith-Dohring
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II. 10:05-10:10 *MINUTES FROM PREVIOUS MEETING A. Approval of CHA Workforce Committee
Minutes from July 31, 2013
Anette Smith-Dohring
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III. 10:10-10:30 LANDSCAPE UPDATE A. Member Updates B. Staff Updates C. Union Discussion (Follow up item from May
16)
All
Gail Blanchard-Saiger
IV. 10:30-11:15 BUREAU OF LABOR AND STATISTICS (BLS) PRESENTATION A. Amar Mann of BLS will be presenting updated
information for California and describing how the BLS data is used.
Cathy Martin
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CHA Workforce Committee Meeting Thursday, September 12, 2013
*DENOTES ACTION ITEM
V. 11:15-11:45 *APPROVE STANDARD MATERIALS PRESENTATION A. Discuss and approve standard power point B. Other key messages
Cathy Martin
All
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VI. 11:45-12:15 2013-2015 WORKPLAN DISCUSSION Cathy Martin All
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VII. 12:15-12:45 LUNCH
All
VIII. 12:45-1:15 STRATEGIC WORKFORCE PLANNING (SWP) FORUM A. Teri Hollingsworth and Jim Finkelstein will be
presenting regarding a potential SWP forum in development
.
Teri Hollingsworth Jim Finkelstein
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IX. 1:15-1:45 *FINAL ALLIED HEALTH SURVEY RESULTS A. Review findings from Timothy Bates B. Determine key findings to highlight in
supplemental report
Cathy Martin 25
X. 1:45-2:15 LEGISLATIVE UPDATE A. Workforce Legislation B. Labor and Employment Legislation
Cathy Martin
Gail Blanchard-Saiger
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XI. 2:15-2:20 OTHER BUSINESS A. Next meeting: Wednesday, December 4, 2013
in Pasadena at Huntington Hospital B. *Approve Proposed 2014 In-Person Meeting
Dates
Anette Smith-Dohring
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XII. 2:20-2:30 CLOSING COMMENTS A. Final remarks and comments
Anette Smith-Dohring
XIII. 2:30 ADJOURN
Anette Smith-Dohring
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September 12, 2013 TO: CHA Workforce Committee FROM: Cathy Martin, Vice President, Workforce SUBJECT: Welcome and Introductions CHA Workforce Committee Roster I. ACTION
Review contact information and titles contained in the roster on the following pages. II. SUMMARY AND BACKGROUND
Attached please find the most recent CHA Workforce Committee Roster. Please review your contact information for accuracy. Forward all corrections to Christina Foncree at [email protected]. Welcome to new members Amy Anderson, Mary Contreras and Michelle Miranda.
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Updated: September 6, 2013
CHA Workforce Committee ROSTER
CHAIR ANETTE SMITH-DOHRING Workforce Development Manager Sutter Health Sacramento Sierra Region 2700 Gateway Oaks Drive, Suite 1100 Sacramento, CA 95833 Office: 916-924-7644 Fax: 916-924-7650 [email protected] VICE CHAIR LAURA LONG Director National Workforce Planning and Development/Strategic Workforce Initiatives Kaiser Permanente 1800 Harrison Street, 15th Floor Oakland, CA 94612 Office: 510-625-6655 [email protected] IMMEDIATE PAST CHAIR PATRICE RYAN Vice President Human Resources Cottage Health System P.O. Box 689 Santa Barbara, CA 93102 Office: 805-569-7843 Fax: 805-569-8217 [email protected]
MEMBERS GLENDA ADACHI Talent Planning & Performance Management Compensation Sutter Health 2700 Gateway Oaks Drive, Suite 2600 Sacramento, CA 95833 Office: 916-215-3429 [email protected] AMY ANDERSON, RN, BA, MBA Coordinator Workforce Development John Muir Health 2540 East Street Concord, CA 94520 Office: 925-674-2376 Fax: 925-674-2439 [email protected] JANICE BUEHLER Director Recruitment & Workforce Planning Cedars-Sinai Health System 8700 Beverly Blvd., SSB-110 Los Angeles, CA 90048 Office: 310-423-5521 Fax: 310-423-0375 [email protected] MARIA-JEAN CATERINICCHIO, MS, RN Director, Workforce Development-OC MemorialCare Health Services 24451 Health Center Drive Laguna Hills, CA 92653 Office: 949-452-7792 [email protected]
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CHA Workforce Committee Roster
Updated: September 6, 2013
Page 2
MARY CONTRERAS, RN Chief Nursing Officer Community Medical Centers 789 N. Medical Center Drive, East Clovis, CA 93611 Office: 559-324-4782 Fax: 559-324-3719 [email protected] RITA ESSAIAN Director, HR/Human Capital Huntington Hospital 100 West California Blvd. Pasadena, CA 91105-3097l Office: 626-397-5096 Fax: 626-397-2195 [email protected] RYAN FAULKNER Vice President Workforce Planning & Diversity St. Joseph Health System 500 S. Main Street, Suite 400 Orange, CA 92688 Office: 714-347-7648 [email protected] MARTHA GIGGLEMAN Senior Director Clinical Workforce Development Washington Hospital Healthcare System 2000 Mowry Avenue Fremont, CA 94538 Office: 510-745-6462 [email protected] MYRA GREGORIAN Vice President Human Resources Long Beach Memorial Miller Children’s Hospital Long Beach 2801 Atlantic Avenue Long Beach, CA 90807 Office: 562-933-1250 Fax: 562-933-1266 [email protected]
JENNIFER HERMANN Director, Human Resources UCSF Medical Center 3360 Geary Blvd., Suite 301 San Francisco, CA 94118-3324 Office: 415-353-4685 Fax: 415-353-4690 [email protected] TERRY JAQUA, MBA Director, Human Resources Shasta Regional Medical Center 1100 Butte Street Redding, CA 96001 Office: 510-244-5100 Fax: 510-244-5103 [email protected] SHAWN KANG Director, Human Resources Long Beach Memorial Miller Children’s Hospital 2801 Atlantic Avenue Long Beach, CA 90801 Office: 562-933-1294 [email protected] SARA LAUTENBACH Diversity & Talent Acquisition Director Sutter Health 2700 Gateway Oaks Drive, Suite 2600 Sacramento, CA 95833 Office: 916-215-3429 [email protected] STEPHANIE E. LEACH National Nursing Policy Consultant National Patient Care Services Kaiser Permanente 1800 Harrison Street, 17th Floor Oakland, CA 94612 Office: 510-625-5422 Fax: 510-625-2374 [email protected]
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CHA Workforce Committee Roster
Updated: September 6, 2013
Page 3
MICHELLE MIRANDA Senior Talent Acquisition Consultant Sutter Health Sacramento Sierra Region 2700 Gateway Oaks Drive, Suite 2500 Sacramento, CA 95833 Office: 916-614-1473 [email protected] JENNIFER MORROW, M.A., PHR Director – Human Resources San Joaquin Valley Rehabilitation 7173 N. Sharon Fresno, CA 93720 Office: 559-436-3649 Fax: 559-436-3688 [email protected] SCOTT MUMBERT Manager, Recruitment Cottage Health System P.O. Box 689 Santa Barbara, CA 93102 Office: 805-879-8787 Fax: 805-879-8737 [email protected] BRENT G. NIELSEN Interim Chief Human Resources Officer El Centro Regional Medical Center 1415 Ross Avenue El Centro, CA 92243 Office: 760-337-7990 ext. 25 [email protected] ANDREA PERRY (Alternate for Janice Buehler) Workforce Planning Specialist Cedars-Sinai Health System 8700 Beverly Blvd., PACT 700 Los Angeles, CA 90048 Office: 310-423-5533 Fax: 310-423-0370 [email protected]
MICHAEL PETERSON Director Workforce Development & Recruitment Strategies Sharp HealthCare 8695 Spectrum Center Blvd. San Diego, CA 92123 Office: 858-499-5285 [email protected] BOB REDLO Vice President Doctors Medical Center 2000 Vale Road San Pablo, CA 94806 Office: 510-970-5254 Fax: 510-970-5741 [email protected] YVONNE SPENCE Senior Director, Human Resources Dignity Health 251 South Lake Avenue, 7th Floor Pasadena, CA 91101 Office: 626-744-2317 Fax: 818-502-7629 [email protected] JOANNE WEBSTER Interim Human Resources Director Community Hospital of the Monterey Peninsula 23625 Holman Highway Monterey, CA 93940 Office: 831-622-2801 [email protected] RACHELLE WENGER, MPA Director, Public Policy & Community Advocacy Dignity Health 251 S. Lake Avenue, Suite 800 Pasadena, CA 91101 Office: 626-744-2209 Fax: 626-395-0499 [email protected]
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CHA Workforce Committee Roster
Updated: September 6, 2013
Page 4
DENNIS YEE, CHCR Recruitment Consultant Children's Hospital Central California 9300 Valley Children's Place Madera, CA 93636 Office: 559-353-7058 Fax: 559-353-7070 [email protected] REGIONAL ASSOCIATION REPRESENTATIVES: DIMITRIOS ALEXIOU VP Inland Office Hospital Association of Southern California 3993 Jurupa Avenue, Suite 105 Riverside, CA 92506 Office: 951-222-2284 Fax: 951-222-2075 [email protected] TERI HOLLINGSWORTH Vice President Human Resources Hospital Association of Southern California 515 S. Figueroa Street, Suite 1300 Los Angeles, CA 90071 Office: 213-538-0763 [email protected] REBECCA ROZEN Regional Vice President Hospital Council, East Bay Section 3840 Buskirk Avenue, Suite 205 Pleasant Hill, CA 94523 Office: 925-746-1550 Fax: 925-746-2401 [email protected] JUDITH YATES Senior Vice President/COO Hospital Association of San Diego & Imperial Counties 5575 Ruffin Road, Suite 225 San Diego, CA 92123 Office: 858-614-1557 Fax: 858-614-0201 [email protected]
CHA STAFF: GAIL BLANCHARD-SAIGER Vice President Labor & Employment California Hospital Association 1215 K Street, Suite 800 Sacramento, CA 95814 Office: 916-552-7620 Fax: 916-554-2220 [email protected] CATHY MARTIN Vice President, Workforce California Hospital Association 1215 K Street, Suite 800 Sacramento, CA 95814 Office: 916-552-7511 Fax: 916-554-2210 [email protected] CHRISTINA FONCREE Administrative Assistant California Hospital Association 1215 K Street, Suite 800 Sacramento, CA 95814 Office: 916-552-7656 Fax: 916-554-2226 [email protected]
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September 12, 2013 TO: CHA Workforce Committee FROM: Cathy Martin, Vice President, Workforce
SUBJECT: Draft July 31, 2013 Meeting Minutes
I. ACTION REQUESTED
Review and approve the minutes of the July 31, 2013 meeting via conference call.
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DENOTES ACTION ITEM
CALIFORNIA HOSPITAL ASSOCIATION WORKFORCE COMMITTEE DRAFT MEETING MINUTES July 30, 2013 – 10:00am-11:00am
Conference Call Call-in: 800-882-3610 Passcode: 6506506#
Members by Phone: Amy Anderson, Rita Essaian, Jennifer Hermann, Jan Hunter, Laura
Long, Scott Mumbert, David Schutt, Anette Smith-Dohring, Joanne Webster, Dennis Yee
CHA Staff: BJ Bartleson, Gail Blanchard-Saiger, Christina Foncree, Cathy Martin Regional Association Rebecca Rozen, Judith Yates Staff:
I. Call to Order/Introductions
Anette Smith-Dohring called the meeting to order at 10:05am. Introductions were made and Joanne Webster was welcomed back to the committee. The Committee roster was reviewed for accuracy and the members were asked to send any changes to Christina Foncree.
II. Minutes from the Previous Meeting The motion to approve the minutes from the previous meeting was moved, seconded and carried. Both Anette Smith-Dohring and Joanne Webster abstained since they were not present at the last meeting.
III. Review of May 16, 2013 Recommendations
A. Review recommendations for moving forward in 2013-2015 Cathy Martin reviewed the recommendations made by the committee during the May 16 meeting including the successes of the committee to date, the items still left to address, changes that have a refocus of attention, and emerging priorities.
B. Incorporate additional recommendations Cathy Martin asked if the committee members felt that the recommendations captured all of the priorities that should be addressed moving forward. No other priorities were identified at this time. If members do think of any emerging priorities to include moving forward,
please send them to Cathy Martin.
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CHA Workforce Committee July 31, 2013 MEETING DRAFT MINUTES
DENOTES ACTION ITEM
IV. Proposed New Structure for Our Work Cathy Martin reviewed the proposed new structure for workforce issue management and the establishment of the CHA Health Workforce Taskforce. The new taskforce will build upon the work already happening within CHA that is focused on allied health workforce and will use the existing workforce issue management infrastructure as a foundation for expanding the association’s focus on health workforce shortages and other workforce issues. Cathy asked that the members review and provide feedback on the proposal which will be presented to The California Endowment for grant consideration in the coming weeks. The potential grant has a tentative start date of September 1, 2013 and will run for three years.
V. Other Business
A. Next Meeting The next Workforce Committee meeting will be held on Thursday, September 12 from 10:00 am-2:30 pm at the Hospital Council in Sacramento.
B. August 15 Select Committee on Workforce and Vocational Education Hearing The Select Committee on Workforce and Vocational Education will be hosting an informational hearing on August 15, 2013. Anette Smith-Dohring will testify. If any members would like to participate, they can contact Cathy Martin for more information.
C. December 4, 2013 Workforce Committee Meeting The meeting place for the December 4th meeting is set to take place at Huntington Hospital in Southern California.
VI. Adjourn The meeting was adjourned at 10:36am.
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September 12, 2013 TO: CHA Workforce Committee FROM: Cathy Martin, Vice President, Workforce SUBJECT: Presentation by Amar Mann, U.S. Bureau of Labor Statistics I. ACTION None required II. SUMMARY AND BACKGROUND
The U.S. Bureau of Labor Statistics (BLS) is the principal fact-finding agency for the Federal Government in the broad field of labor economics and statistics. The BLS is an independent national statistical agency that collects, processes, analyzes, and disseminates essential statistical data to the American public, the U.S. Congress, other Federal agencies, State and local governments, business, and labor. The BLS also serves as a statistical resource to the Department of Labor. Amar Mann of BLS will present to the committee regarding the role of the BLS and uses of BLS data specific to hospitals.
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September 12, 2013 TO: CHA Workforce Committee FROM: Cathy Martin, Vice President, Workforce SUBJECT: Standardized Presentation of Key Facts I. ACTION Review and approve template presentation and messaging included. II. SUMMARY AND BACKGROUND
At the May 16 meeting of the CHA Workforce Committee, members suggested that a template be designed that could be used when requests for presentations come to any member of the committee. This would ensure consistency of key messages, as well as save time for members. Based on the most recent data collected during the fourth quarter of 2012, a standardized power point has been developed for this purpose. (See the following pages) Each member can add facility specific information as appropriate depending on the audience and purpose of the presentation. The template shown here uses the CHA design. It is anticipated that each presentation will be customized for the presenter. Christina Foncree has agreed to assist members with this customization, including the addition of any organization or facility specific data. As we gather additional data and further finalize key findings from the fourth quarter survey, this presentation will incorporate those elements as well.
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1
EXAMPLE
Your Name Here
Your Organization Name here
Date
Standard California Health Workforce
Presentation
September 2013
CHA Q4 2012 Allied Health Workforce Survey
• Fourth quarter of 2012
• 144 responses representing 174 hospitals
• 38,249 licensed beds
• Approximately 41% of total beds at GAC
hospitals in CA
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Q4 2012 Findings: Vacancy Rates by Position
Position Headcount Vacancies Vacancy Rate
Coder 1,028 58 5.3%
Ultrasound Technologist 1,096 56 4.9%
Clinical Laboratory Scientist 3,401 127 3.6%
Pharmacist 2,428 84 3.3%
Physical Therapist 2,706 93 3.3%
MRI Technologist 402 12 2.9%
CT Technologist 1,165 33 2.8%
Radiologic Technologist 2,177 50 2.2%
LCSW 797 18 2.2%
Respiratory Therapist 4,720 63 1.3%
CVIR Technologist 242 3 1.2%
All Employees (avg.) 233,458 7,621 3.2%
Higher than average vacancy rates:
• Coders
• Ultrasound Technologists
• Clinical Laboratory Scientist
• Pharmacist
• Physical Therapist
Vacancy rate is calculated as:
Total # of vacancies in the quarter / (Total # of vacancies + Total headcount)
Q4 2012 Survey Findings: Age of Health Care Workforce
• 40% of Clinical Lab Scientist workforce is
age 56 or older
• 30% of Coder workforce age 56 or older
• Similar age profile for most positions: 55%
- 60% age 45 or under
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Q4 2012 Findings: Top Workforce Concerns in the Next 5 Years
5%
58%
21%
8% Population Growth
Aging Health Workforce
Health Care Reform
Cultural Diversity
Q4 2012 Findings:
Concern/Impact of Environmental Issues
4% 11%
28% 57%
Health Care Reform 85% of respondents very concerned or concerned
about Health Care Reform and its impact on the demand for health workforce
Not Concerned
Slightly Concerned
Concerned
Very Concerned
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Hospital Industry: Contributions to Health Workforce Development
• RN Training Programs
• Hospital-based CLS Programs
• Faculty
• Scholarships to students
• Intern/externships
• INSERT YOUR ORGANIZATION’S
UNIQUE CONTRIBUTIONS HERE
Hospital Contributions Cont’d Graduate Medical Education (GME)
• California’s Academic Medical Centers
and teaching hospitals train 10,000 residents annually
• CMS only covers a portion of this cost • $1.1 billion gap • State contributes $0 to GME
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Protecting Public Post Secondary Education
Budget and Training for Health Professionals
• Public institutions produce 60-70% of imaging
professionals in the state. (IPEDS)
• Not including hospital based programs, public
institutions provide almost all Clinical Laboratory
Scientist education in the state.
• California’s Community Colleges provide the bulk of
accredited allied health professional education.
• Public post secondary institutions provide quality
candidates to the industry and serve the most diverse
student populations.
• Some private institutions do not offer appropriately
accredited education and training.
Summary: Health Care Workforce - A Long Term Perspective
• Evolving care models resulting from implementation of
the ACA will drive demand for health professionals,
these models may look different than they do now.
• Health professionals will be required to have a more
complex set of skills in the future.
• Education must be aligned with industry needs
because the health sector will play a critical role in job
creation.
• Opportunities for higher education must be preserved
and protected so that there is a workforce to meet the
demand for these jobs.
• An aging workforce is a significant long term factor.
Workers will be retiring, while at the same time
increasing demand for services.
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For more information:
Contact:
Cathy Martin Vice President, Workforce
California Hospital Association
www.calhospital.org
(916) 552-7511
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September 12, 2013 TO: CHA Workforce Committee FROM: Cathy Martin, Vice President, Workforce SUBJECT: CHA Workforce Committee Work Plan Revisited I. ACTION(S) REQUESTED
Approve drafted 2013-2015 Work Plan. II. SUMMARY AND BACKGROUND
At the May 16 meeting of the CHA Workforce Committee, members agreed that the health workforce landscape has changed significantly since the committee was established in 2008. Health care reform has introduced new issues and challenges which require new ways of approaching our work. Members agreed that it is now appropriate to adjust the focus of the committee from an allied health professionals-only approach, and to implement a broader vision that goes beyond allied health. There was consensus that it is time to turn our strategy into an interdisciplinary approach that includes working more closely with nursing, physicians, and potentially mental health stakeholders involved in workforce development and to support those leading efforts in those areas. A new work plan reflecting this vision has been drafted. During this segment, members and staff will review and approve the revised work plan for 2013-2015.
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CHA Workforce Committee 2013-2015 Work Plan
Purpose: The purpose of the CHA Workforce Committee is to lead a statewide, coordinated effort to develop, support and implement strategic solutions to address the shortage of allied health professionals and to support efforts related to the nursing workforce, as well as to collaborate with and support the Academic Medical Center Steering Committee as it works to create state-based solutions for graduate medical education funding in California.
Goals (What) Outcome (Why or ‘So that…’) Timeline
Strategic Goal 1 – Effective Advocacy: Increased policy maker and public awareness, knowledge and action on allied health workforce, nursing workforce and graduate medical education issues. Activities/Objectives:
• Support legislative proposals that address health workforce shortages. (formal positions on legislation, testify in committee)
• Meet with legislators and participate in informational hearings. • Support efforts that address the need for innovative (new or
novel) competency-based education and training models; including graduate medical education (Examples: shorter, more efficient training models, alternate training settings, etc.)
• Conduct informational briefing on statutory and regulatory barriers, articulation issues, and educational funding cuts.
Increased awareness among legislators about top priority health workforce issues as evidenced by: a.) 30 percent of state legislators increase their
awareness of the need to address critical allied health profession shortages and the importance of developing and implementing state-based solutions for funding graduate medical education. (n=36 legislators)
b.) The creation of a (1) statewide champion for Graduate Medical Education in the state legislature.
c.) Change in at least one regulatory, legislative, or licensing requirement that prevents innovation or evolution of the education and training of health professionals, including physicians.
2015
Strategic Goal 2 - Skills Alignment: Ensure health workforce strategies in California are aligned with hospital needs in light of health care reform and the transformation of health care delivery. Without employer input, the need for specific allied health professionals and issues related to skills gaps may be overlooked. Activities/Objectives:
• Define the skills that will be needed by the future healthcare workforce.
• Educate stakeholders on hospital challenges due to health care reform. (Example: Transforming for Tomorrow presentation to Statewide Health Workforce Initiative Advisory Council)
• Assist educational institutions in understanding what the health workforce of the future will require (skills, competencies).
• Ensure professionals are working at the top of their scope.
The development of a health care workforce that is sufficient in supply, highly skilled (including communication, service skills), culturally diverse, and prepared to deliver care in an interdisciplinary environment as evidenced by survey results indicating: a.) Increased level of employer satisfaction relative to
the applicant pool and new hire success in the workplace,
b.) For hard to fill positions: - Decreased vacancy rates - Increased retention rates - Decreased length of time to fill vacancies
2015
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Strategic Goal 3 –Greater Impact on Overall Health Workforce: Create deeper support for health workforce development efforts through the establishment of the Health Workforce Taskforce, an interdisciplinary intersection of health workforce experts, which will develop and implement the following: Activities/Objectives:
• State-based solutions for Graduate Medical Education funding and strategies for implementation.
• Recommendations for ensuring an adequate distribution of physicians and health professionals, as well as a diverse health workforce to serve the populations found in each local community.
• Strategies for addressing issues related to nursing (new grad issues, long-term demand due to aging workforce, changing role of nurses due to the Affordable Care Act).
• Recommendations for improving the effectiveness of interdisciplinary health professional teams.
• Advocacy efforts related to increasing health professions funding in general (funding for employers who train, funding for loan repayment in underserved areas, etc.).
The creation of an institutionalized intersection of health workforce related issues in the state designed to ensure that California has a sufficient supply of team-based, highly skilled, culturally diverse, technologically savvy health care professionals at all levels in order to meet the demand for health care services in the future, as evidenced by a 15 percent decrease in vacancy rates for high demand allied health professions (Clinical Lab Scientist, Ultrasound, and others TBD), as well as the development of state-based solutions for Graduate Medical Education.
2014-2015
Strategic Goal 4 – Data Collection: Enhance data collection efforts to improve timeliness and validity of data regarding health workforce shortages. Activities/Objectives/Indicators:
• Continue working with HASC/Allied for Health to further improve data collection efforts from hospitals regarding allied health.
• Collaborate with University of California, San Francisco, Center for the Health Professions on allied health workforce supply and demand data analysis and reporting.
• Collaborate with the California Community Colleges Chancellor’s Office, Centers of Excellence to enhance data collection from non-acute settings and to improve acute response rates.
Publication of two (2) reports detailing key findings regarding the supply and demand of specified health professionals in California.
Implementation of effective strategies that target the right occupations as evidenced by decreased vacancy rates and improved employer satisfaction with supply and applicant pool.
2014-2015
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September 12, 2013 TO: CHA Workforce Committee FROM: Cathy Martin, Vice President, Workforce SUBJECT: Potential Strategic Workforce Planning Forum
I. ACTION(S) REQUESTED
Provide feedback to Teri Hollingsworth and Jim Finkelstein on forum in development.
II. SUMMARY AND BACKGROUND
Teri Hollingsworth would like to feedback on a potential workforce planning forum for hospitals. Details can be found on the following pages.
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Fall 2013
Strategic Workforce Planning Facilitated FORUM
The phrase “strategic workforce
planning” piques both interest and
instills fear into many healthcare
organizations. Hospitals understand
the need to engage in the process, but
are often paralyzed by the complexity
of the process. The Institute for
Corporate Productivity (IC4P) found
that only 20% of companies think they
have effective strategic workforce
planning (SWP) initiatives. With an
increasing demand for forecasting and
aligning people practices with the
business plan, learning about and
engaging in the workforce planning is
more critical than ever.
In response to this critical need, HASC
is proud to offer a three-part forum
suited for HR, Staff Managers and
Leadership, Finance, and any other
business partners in your organization.
The goal is to work and learn together
while designing a realizable SWP action
plan for your organization. This
quintessential workforce planning
forum takes place over a series of 3
smaller sessions (2 webinars and 1 half
day in-person session) that will shift the
landscape of your organization and
develop the critical skills needed to
move forward in the SWP process. By
the end of the forum, you will have
completed several internal assessments
at your organization, learned best
practices in the industry, identified
hurdles to the SWP process,
understand future trends impacting
SWP, and have created an
implementable SWP for your
organization.
COURSE OBJECTIVES
• Understand strategic workforce planning metrics
• Create usable SWP spreadsheets for your organization
• Generate a SWP analysis of your organization’s business and people programs.
• Develop an action plan for a specific group and/or your organization using the information gathered in previous sessions.
• Create a dialogue guide for your discussions with senior leaders and HR as you embark on a new challenge going beyond HR as usual.
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Session 2: Performing a Qualitative Assessment
In the second 1.5-hour webinar, participants will explore global SWP trends and concepts
that impact their organizations. Training topics include: how to identify global, regional, and
local trends that may impact business operations, learning the template to facilitate a
conversation about issues impacting your organization with key leaders, staffing, and business
planning. Homework for this session includes conducting a qualitative assessment of business
and people strategy alignment in your organization.
Session 1: Quantifying Your SWP Metrics
In this 1.5-hour webinar participants learn about and explore quantifiable SWP charts and
tracking tools to assess your current workforce and forecast future needs. This process
ensures your staff can both meet present and future demands. We will explore how to use
these tools effectively and how to interpret the data you collect in your organization. We
then hand the torch to you, as your homework for Session 1 is to dig into your HR metrics to
assess your current workforce.
Session 3: Developing the Road Map
In this 4-hour in-person session, participants will explore best practices, trends, and issues facing hospitals engaging in the SWP
process. We will work to identify how to translate business goals into workforce strategy as you consider buying, borrowing and
building talent. Using the information and tools prepared during the first two sessions, a comprehensive action plan and value
proposition that builds your workforce philosophy and aligns it with business strategy.
Who Should Attend? This course is designed for any forward thinkers working in hospitals. Teams of “key players” (Nursing Leadership, HR, Finance, IT, etc.) attending together are strongly encouraged to maximize ROI on the course.
Cost: While similar 1-2 day seminars range from $1,800-2,800, we are offering this forum for $895.
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September 12, 2013 TO: CHA Workforce Committee FROM: Cathy Martin, Vice President, Workforce SUBJECT: Fourth Quarter Allied Health Survey
Final Data Analysis from UCSF
I. ACTION(S) REQUESTED
*Determine key findings for supplemental report.
II. SUMMARY AND BACKGROUND
The UCSF Center for the Health Professions has completed their analysis of the fourth quarter 2012 allied health workforce supplemental survey. The summary report is contained on the following pages. During this agenda item, members and staff will prioritize key findings for inclusion in a follow-up report to the 2011 Critical Roles: Report of Key Findings.
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1
Overview of survey data
Because of the differential response pattern in the survey data, this analysis treats the survey as having two distinct components:1
• A set of questions that ask respondents to report staffing data (headcount, new hires, separations, vacancies and per diem use, by position), which are a standard component to the HASC quarterly workforce survey
• A special set of questions implemented on behalf of the California Hospital Association (CHA) that ask respondents to report on key workforce issues, including the impact that vacancies have on patient care & hospital efficiencies, the impact that staffing shortages have on hospital services, the impact of environmental issues such as an aging population and implementing health reform, and the age profile of selected allied health workers.
In order to understand how well survey respondents represent hospital facilities in California, we constructed a database of general acute care (GAC) hospitals and associated facilities2 in California. This database was sourced from the current OSPHD licensed facility list (June, 2013) and AHA membership data (which were used to capture VA hospitals). Hospitals and associated facilities that provide psychiatric care exclusively were excluded. Using this database, we estimate there are 467 GAC hospitals and associated facilities in California with a total of 94,347 licensed beds.
Standard staffing component (HASC survey component)
Overall, the standard survey component (staffing data) returned 141 usable survey responses. Some respondents reported staffing data that covered multiple facilities, and so these 141 responses represent 171 total facilities and 32,820 total licensed beds. This is approximately 35% of all licensed beds at GAC hospitals and related facilities in California.
Special questions component (CHA survey component)
Assessing the facility response rate for the set of questions that formed the special component of the survey is more difficult. Hospitals did not respond consistently, meaning some questions were answered, others ignored. In addition, two large health systems (Dignity Health and Sutter Health) provided a single response for all facilities within their system (and Sutter Health only responded to two questions).3 It’s also worth pointing out that none of the 21 Kaiser Permanente hospitals that reported staffing data responded to the CHA survey component.
For Dignity Health and Sutter Health, a single response is meant to describe all hospitals in their respective systems (a total of 31 different Dignity Health hospitals and 31 different Sutter Health hospitals) and related facilities. For those survey questions where hospitals were asked to report perceptions (i.e. impact of staffing shortages on patient care, impact of healthcare reform, concern regarding environmental issues), it is unlikely
1 Out of the 205 hospitals and related facilities represented in the survey data, only 111 provided both staffing data and responded to at least one question in the CHA survey component. 2 These are skilled nursing facilities, rehabilitation, and behavioral health centers. 3 This was not the case for the staffing component of the survey. Dignity Health System members reported staffing data for individual hospitals and facilities, whereas Sutter Health System members simply didn’t report any staffing data.
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that the single response accurately captures differences in perceptions across the entire system. For this reason, Dignity Health and Sutter Health survey responses to these questions are each treated as a single response, rather than representing all hospitals and related facilities in the system.
120 hospitals responded to at least one question in the CHA survey component. These hospitals represent a total of 143 total facilities and 27,455 total licensed beds. This is approximately 29% of the total licensed beds at general acute care hospitals and related facilities in California.
Comparing survey respondents with GAC hospitals and CHA members
Table 1 (below) compares the distribution of hospitals that responded to the HASC survey component and those that responded to at least one question in the CHA survey component, with all GAC hospitals and related facilities in California, based on rural versus non-rural geographic location4 and then facility size (as measured by total number of licensed beds).
The rural versus non-rural geographic distribution of hospitals that responded to both the HASC and CHA survey components are very close to that of GAC hospitals across the state. A comparison of distributions based on facility size, however, shows some important differences. Small hospitals are underrepresented among survey respondents for both the HASC and CHA survey components. Hospitals with fewer than 100 beds represent just 16.4% of all HASC survey respondents, and 18.9% of CHA survey respondents, compared to 33.2% of all GAC hospitals in the state. This means both the HASC and CHA survey samples skew toward larger facilities. For both the HASC and CHA samples, it’s most pronounced among hospitals with 300 – 399 total beds. Hospitals of this size accounted for 20.5% of respondents to the HASC survey component, and 22.4% of respondents to the CHA survey component, but represent just 12.2% of GAC facilities across the state.
Table 1. Distribution of survey respondents versus GAC facilities in California by rural geography, and by facility size
HASC Survey Component
CHA Survey Component
GAC Facilities in CA
Description # % # % # % Rural geography 25 14.6% 24 16.8% 72 15.4% Non-rural geography 146 85.4% 119 83.2% 395 84.6% Less than 100 beds 28 16.4% 27 18.9% 155 33.2% 100 – 149 beds 27 15.8% 23 16.1% 84 18.0% 150 – 199 beds 28 16.4% 24 16.8% 51 10.9% 200 – 299 beds 31 18.1% 18 12.6% 70 15.0% 300 – 399 beds 35 20.5% 32 22.4% 57 12.2% 400 or more beds 22 12.9% 19 13.3% 50 10.7% Total 171 100% 143 100% 467 100%
4 The rural vs. non-rural status of a facility was determined using the Rural-Urban Commuting Area codes and the facility’s zip code. For more information see: http://depts.washington.edu/uwruca/
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Table 2 compares the distribution of hospitals that responded to the HASC survey component and those that responded to the CHA survey component with all California Hospital Association (CHA) members, based on regional hospital association membership.5 Hospital members of HASC are underrepresented among respondents to both survey components; to a greater extent in the HASC survey component. In the CHA survey component, most of this imbalance is skewed toward hospital members of HASDIC; in the HASC survey component, most of the imbalance is skewed toward hospital members of HCNCC.
Table 2. Distribution of survey respondents versus CHA facilities by regional hospital association
HASC Survey Component
CHA Survey Component
CHA Members
Description # % # % # % HASC 60 35.1% 55 38.5% 173 45.2% HASDIC 18 10.5% 18 12.6% 28 7.3% HCNCC 93 54.4% 70 48.9% 182 47.5% Total 171 100% 143 100% 383 100%
In Tables 1 and 2, the measure of survey participation in the CHA survey component is based on hospitals that answered at least one of the questions. But this measure obscures the variation in the response pattern in this section of the survey. For this reason, we provide a breakdown of the facility response total for each of the questions in the CHA survey component in Table 3, below:
Table 3. Number of responding hospitals and licensed beds, by CHA survey question
Description # of hospitals Total beds Answered at least one question 143 27,455 Answered questions regarding impact of vacancies 89 16,045 Answered questions about limited services due to shortages 99 17,765 Answered questions regarding concern over environmental issues 105 18,259 Provided data describing age profile 117 22,230
Current employment by position6
Table 4 compares the reported current7 headcount for regular employees8, by full-time versus part-time status for each position. These data demonstrate differences in the mix of full-time and part-time employees across positions. Notably, hospitals reported that approximately one-third of Ultrasound Techs, Respiratory Therapists, and Physical Therapists work as part-time employees. The column labeled “Total Hospitals” records the number of facilities that reported a non-zero total headcount for each position. It’s also of note that so few hospitals reported the use of CVIR Techs.
5 Hospital Association of Southern California (HASC), Hospital Association of San Diego and Imperial Counties (HASDIC), and Hospital Council of Northern and Central California (HCNCC). 6 The data used in this report refer to the period from October 1, 2012 to December 31, 2012. 7 Current employment refers to the number of employees as of the pay period closest to December 31, 2012 8 Regular employees include those reported as full-time or part-time, as distinct from per diem employees.
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Table 4. Current headcount of regular employees, by full-time vs. part-time status
Full-time
Part-time
Total Total
Position Headcount % of total Headcount % of total Headcount Hospitals Coder 922 91.1% 90 8.9% 1,012 157 CLS 2,454 72.2% 947 27.8% 3,401 168 CT Tech 877 75.3% 288 24.7% 1,165 127 CVIR Tech 205 84.7% 37 15.3% 242 40 MRI Tech 333 82.8% 69 17.2% 402 120 Pharmacist 1,913 78.0% 538 22.0% 2,451 158 Physical Therapist 1,807 66.8% 899 33.2% 2,706 150 Rad Tech 1,691 77.7% 486 22.3% 2,177 161 Respiratory Therapist 3,110 65.9% 1,610 34.1% 4,720 163 LCSW 577 72.4% 220 27.6% 797 128 Ultrasound Tech 696 63.5% 400 36.5% 1,096 157
Table 5 compares the share of regular full-time versus part-time employees by position, and by regional hospital association. Hospital members of HASC consistently reported a larger share of employees as working full-time, across the different positions. Hospital members of HCNCC consistently reported a larger share of employees as working part-time.
Table 5. Current full-time vs. part-time status of regular employees by regional hospital association
HASC
HASDIC
HCNCC
Position Full-time Part-time Full-time Part-time Full-time Part-time Coder 94.4% 5.6% 86.6% 13.4% 90.0% 10.0% CLS 81.7% 18.3% 70.0% 30.0% 65.5% 34.5% CT Tech 88.5% 11.5% 77.3% 22.7% 69.8% 30.2% CVIR Tech 97.0% 3.0% 87.0% 13.0% 80.3% 19.7% MRI Tech 90.8% 9.2% 83.6% 16.4% 77.7% 22.3% Pharmacist 82.0% 18.0% 80.3% 19.7% 73.7% 26.3% Physical Therapist 75.5% 24.5% 71.4% 28.6% 62.2% 37.8% Rad Tech 86.7% 13.3% 79.1% 20.9% 70.4% 29.6% Respiratory Therapist 84.5% 15.5% 71.8% 28.2% 46.4% 53.6% LCSW 81.6% 18.4% 66.8% 33.2% 68.7% 31.3% Ultrasound Tech 86.3% 13.7% 80.2% 19.8% 53.7% 46.3%
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Use of Per Diem employees
Table 6 shows the rate of per diem use by position9. Per diem employees as a share of current regular employees could also be expressed as a ratio. For example, the total number of per diem Rad Techs is equal to 34.9% of the total number of Rad Techs reported as regular employees; this is one Rad Tech per diem employee for every 3 Rad Techs reported as regular employees. The ratio of per diem Ultrasound Techs to regular employee Ultrasound Techs is also approximately 1:3. In general, these data demonstrate wide variation in the use of per diem employees across positions. The column labeled “Total Hospitals” records the number of facilities that reported a non-zero per diem headcount for each position.
Table 6. Per diem employees as a share of current regular employees
Per Diem Employees # of positions Share of
current employees Total
Hospitals Coder 69 6.8% 43 CLS 812 23.9% 143 CT Tech 176 15.1% 80 CVIR Tech 48 19.8% 20 MRI Tech 107 26.6% 63 Pharmacist 710 29.0% 140 Physical Therapist 793 29.3% 141 Rad Tech 759 34.9% 143 Respiratory Therapist 1,260 26.7% 152 LCSW 249 31.2% 78 Ultrasound Tech 366 33.4% 122
Table 7 shows the variation in per diem employee use across the different regional hospital associations. With the exception of pharmacists, hospital members of HASC and HASDIC consistently report much more frequent use of per diem employees by comparison with hospital members of HCNCC.
Table 7. Per diem employees as a share of current regular employees by regional hospital association
HASC HASDIC HCNCC
Per Diem Employees Share of
current employees Share of
current employees Share of
current employees
Coder 6.8% 8.8% 5.9% CLS 25.0% 34.2% 20.5% CT Tech 22.6% 27.3% 10.4% CVIR Tech 18.2% 27.3% 15.9% MRI Tech 35.4% 36.1% 18.5% Pharmacist 35.1% 20.0% 26.9% Physical Therapist 46.5% 27.8% 22.8% Rad Tech 37.6% 36.8% 32.0% Respiratory Therapist 29.4% 23.8% 25.1% LCSW 38.0% 38.9% 18.3% Ultrasound Tech 41.4% 32.4% 28.3%
9 The per diem share of current staff is calculated as follows: (number of per diem positions as of the pay period closest to December 31, 2012) / (number of regular staff positions as of the pay period closest to December 31, 2012)
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Employee separations
Table 8 describes regular employees who left their position in the fourth quarter of 2012 (whether through a layoff, voluntary leave, or involuntary leave).10 Calculating individual rates for full-time versus part-time separations is likely to result in a misleading picture, due to small headcounts for some of these positions. A small number of part-time separations could result in a very high separation rate for a position if the reported part-time headcount was also small. As an alternative, Table 7 includes the full-time versus part-time distribution of separations in order to provide some information about the mix differs across the different positions, without distorting the overall picture with misleadingly high separation rates.
Table 8 shows that there is some variation in the total separation rates for different positions. CVIR Techs had a reported separation rate of 3.6%, compared to a rate of just 1.4% for Respiratory Therapists. These data also show variation in the mix of full-time versus part-time separations across the different positions. Full-time separations always represent a majority of total separations, but range from a low of approximately 59% of total separations for both Respiratory Therapists and Physical Therapists, to a high of approximately 86% of Coders who left their position during the quarter.
Table 8. Separations as a share of current regular employees
Total Separation Rate
Share of Total Separations
Position Number Rate Full-time Part-time Coder 22 2.2% 86.4% 13.6% CLS 71 2.1% 63.4% 36.6% CT Tech 24 2.1% 62.5% 37.5% CVIR Tech 9 3.6% 77.8% 22.2% MRI Tech 10 2.5% 80.0% 20.0% Pharmacist 46 1.8% 73.9% 26.1% Physical Therapist 42 1.8% 59.5% 40.5% Rad Tech 34 1.6% 82.4% 17.6% Respiratory Therapist 68 1.4% 58.8% 41.2% LCSW 17 2.3% 82.4% 17.6% Ultrasound Tech 29 2.7% 69.0% 31.0%
New employees hired
Table 9 describes regular employees who were hired in the fourth quarter of 2012.11 As with separations, calculating individual rates for full-time versus part-time hires is likely to result in a misleading picture, due to small headcounts for some of these positions. As noted, a small number of part-time hires could result in a very high hiring rate for a position if the reported part-time headcount was also small. As an alternative, Table 9 includes the full-time versus part-time distribution of new hires in order to provide some information about the mix differs across the different positions, without distorting the overall picture.
10 The separation rate was calculated as follows: (number of positions at the start of the quarter beginning October 1, 2012) / (number of separations occurring during the quarter October 1, 2012 – December 31, 2012). 11 The hiring rate was calculated as follows: (number of positions at the start of the quarter beginning October 1, 2012) / (number of new employees hired during the quarter October 1, 2012 – December 31, 2012)
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Table 9 shows that there is some variation in the total hiring rates for different positions. The overall new hire rate for Ultrasound Techs was 3.5%, compared to just 0.6% for Respiratory Therapists. These data also show variation in the mix of full-time versus part-time hires across the different positions. Full-time separations did not represent a majority of total hires for every position. For MRI Techs, of the small number of reported new hires during the quarter approximately 45% were hired into full-time positions and 56% hired into part-time positions. Similarly, the full-time versus part-time distribution of new hires into Respiratory Therapy positions favored part-time employees (approximately 47% full-time versus 53% part-time). In contrast, nearly all of the new hires into Coder positions were full-time (96.3%).
Table 9. New hires as a share of current regular employees
Total Hire Rate
Share of Total Hires
Position Number Rate Full-time Part-time Coder 27 2.7% 96.3% 3.7% CLS 70 2.0% 70.0% 30.0% CT Tech 18 1.6% 50.0% 50.0% CVIR Tech 5 2.0% 100% 0% MRI Tech 9 2.3% 44.4% 55.6% Pharmacist 57 2.3% 78.9% 21.1% Physical Therapist 58 2.5% 65.5% 35.5% Rad Tech 29 1.3% 69.0% 31.0% Respiratory Therapist 30 0.6% 46.7% 53.3% LCSW 15 2.0% 73.3% 26.7% Ultrasound Tech 38 3.5% 55.3% 44.7%
Vacancy rates
Table 10 describes the total vacancy rate, as well as the distribution of total vacancies in terms of full-time versus part-time positions.12 As noted above regarding employee separations and hires, calculating separate rates for full-time and part-time vacancies could result in a misleading picture of vacancies. A small number of part-time vacancies would result in a very high vacancy rate for a position if the reported part-time headcount was also small. As an alternative, Table 10 includes the full-time versus part-time distribution of vacancies in order to provide some information about how the mix of vacancies differs across the different positions, without distorting the overall picture with misleadingly high vacancy rates.
Table 10 demonstrates that the total vacancy rate for both Coders and Ultrasound Techs is considerably higher by comparison with other positions. It also demonstrates that the mix of full-time and part-time vacancies is fairly consistent across the different positions. Reported full-time vacancies fall within a narrow range of approximately 75%-80% of total vacancies for most positions. Exceptions to this are reported vacancies for Coder positions (94.8% full-time) and reported vacancies for Respiratory Therapist positions (64.5% full-time).
12 The vacancy rate is calculated as follows: (number of vacancies reported as of the pay period closest to December 31, 2012) / ((headcount as of the pay period closest to December 31, 2012) + (number of vacancies reported as of the pay period closest to December 31, 2012))
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Table 10. Current total vacancy rates and distribution of vacancies by full-time versus part-time status
Total Vacancy Rate
Share of Total Vacancies
Position Number Rate Full-time Part-time Coder 58 5.4% 94.8% 5.2% CLS 127 3.6% 81.9% 18.1% CT Tech 33 2.8% 75.8% 24.2% CVIR Tech 2 0.8% 50.0% 50.0% MRI Tech 12 2.9% 66.7% 33.3% Pharmacist 83 3.3% 74.7% 25.3% Physical Therapist 92 3.3% 77.2% 22.8% Rad Tech 49 2.2% 79.6% 20.4% Respiratory Therapist 62 1.3% 64.5% 35.5% LCSW 16 2.0% 81.3% 18.8% Ultrasound Tech 56 4.9% 75.0% 25.0%
Table 11 displays total vacancy rates by position, by regional hospital association. The data show some variation in reported vacancy rates for positions across the different regional associations, both in terms of the comparative rates across positions and which positions had the highest reported rates.
Hospital members of HASC reported comparatively high vacancy rates for CLS, CT Tech, MRI Tech, Physical Therapist, and Ultrasound Tech positions; the highest vacancy rates were reported for Ultrasound Techs, MRI Techs and Coders. Among hospital members of HASDIC, reported vacancy rates were highest for Physical Therapists, Pharmacists, and CT Techs. For members of HCNCC, reported vacancy rates were highest for Coders and Ultrasound Techs, mirroring the statewide averages.
Table 11. Current vacancy rates by full-time versus part-time status, and by regional hospital association
HASC HASDIC HCNCC
Position Number Rate Number Rate Number Rate Coder 24 5.5% 6 3.0% 28 6.4% CLS 56 4.2% 12 2.8% 59 3.4% CT Tech 14 4.5% 4 3.5% 15 1.9% CVIR Tech 0 0.0% 1 1.3% 1 0.8% MRI Tech 8 5.8% 1 1.6% 3 1.4% Pharmacist 28 2.8% 15 3.6% 40 3.6% Physical Therapist 35 5.1% 17 4.1% 40 2.4% Rad Tech 22 2.8% 4 1.0% 23 2.2% Respiratory Therapist 29 1.5% 3 0.4% 30 1.4% LCSW 4 1.5% 5 2.0% 7 2.4% Ultrasound Tech 22 6.0% 8 3.0% 26 5.0%
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Difficult to fill positions
Overall, a total of only 17 hospitals reported any positions being difficult to fill. Table 12 below details the frequency with which specific positions were reported. The reasons given for why positions were difficult to fill were mainly generic: the lack of candidates with appropriate experience. However, several hospitals reported that they were having difficulty filling positions in areas related to pediatrics or neonatal care. This extended to several types of positions, including: LCSW (and related behavioral therapists), Audiologist, Ultrasound Tech, Pharmacist, Occupational Therapist, and Respiratory Therapist.
A few hospitals reported that finding candidates who were bilingual in Spanish and English was a challenge. Two hospitals also reported that there is very high demand for Ultrasound Techs in the Bay Area.
Table 12. Positions reported as being difficult to fill
Position # of facilities Physical Therapist 7 Clinical Laboratory Scientist 6 Ultrasound Tech 5 Occupational Therapist 3 LCSW 2 Pharmacist 2 Health Information Tech 2 Coder 1 Radiologic Tech 1 Respiratory Therapist 1 CVIR Tech 1 Medical Assistant 1 Audiologist 1 Occupational Therapy Assistant 1 Physical Therapy Assistant 1 Clinical Psychologist 1 Speech Therapist 1
Impact of Staff Vacancies on Patient Care and Hospital Efficiency
Hospitals were asked to rank the impact of staff vacancies (by position) on both patient care and hospital efficiency, on a scale of 1 to 7 where 1 is equal to “no impact”, 4 is equal to “somewhat negative impact”, and 7 is equal to “very negative impact”. Figure X shows the average ranking for each position (impact on patient care vs. impact on hospital efficiency). Overall, vacancies for Physical Therapists, Pharmacists, and Respiratory Therapists have the most negative impact on both patient care and hospital efficiency.
For most positions, there is little difference in how hospitals perceive the impact of staff vacancies on patient care compared to hospital efficiency. This is underscored by the fact that for most positions, the impact of staff vacancies on patient care and hospital efficiencies is strongly, positively correlated. The obvious exception to this is for Coders; hospitals reported the perception that vacancies for Coder positions have a more negative impact on hospital efficiency compared to patient care. We tested the difference in average
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ranking for Coders and found that it is statistically, significantly different. We also tested the difference in average ranking (impact on patient care vs. impact on hospital efficiencies) for CVIR Techs (vacancies reported to have greater negative impact on patient care) and for Clinical Laboratory Scientists (vacancies reported to have greater negative impact on hospital efficiency) and found the differences to be statistically, significantly different.13
Figure 1. Impact of vacancies on patient care vs. hospital efficiencies, average rank by position
Table 13 presents the same data seen in Figure X above (average score ranking the impact on staff vacancies on patient care versus hospital efficiency). We also tested to see if the difference in average score was statistically significant across positions (i.e. is the impact that a Coder vacancy has on patient care (or hospital efficiency) really different from the impact of an MRI vacancy or a Physical Therapist vacancy). We found that a difference in average score greater than or equal to .20 was statistically significant at the 1% level. For example, the impact of a Coder vacancy on patient care is significantly different compared to the impact of a vacancy in any other position, the impact of Rad Tech vacancy on patient care is significantly different compared to a Physical Therapist vacancy (a difference of .21), but there is no statistical difference in the impact on patient care of an MRI vacancy versus a CT Tech vacancy (a difference of .06).
13 The difference in average ranking (impact on patient care vs. hospital efficiencies) was significant at the 1% level for Coders (meaning there is a 99% chance the difference is not zero), and significant at the 5% level for CVIR Techs and Clinical Laboratory Scientists (meaning there is a 95% chance the difference is not zero).
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Table 13. Impact of vacancies on patient care vs. hospital efficiencies, average rank by position
Impact on Patient Care
Impact on Hospital Efficiency
Position Avg. rank # of hospitals Avg. rank # of hospitals Coder 2.98 90 3.73 85 LCSW 3.46 84 3.56 81 CVIR Tech 3.63 67 3.36 67 MRI Tech 3.90 80 3.96 82 CT Tech 3.96 85 4.00 84 CLS 4.03 87 4.23 88 Rad Tech 4.11 87 4.12 84 Ultrasound Tech 4.14 88 4.03 86 Respiratory Therapist 4.21 85 4.28 85 Pharmacist 4.24 87 4.29 84 Physical Therapist 4.32 85 4.26 87
Tables 14 and 15 display the distribution of hospital facilities by reported impact score, for the impact of vacancies on patient care (Table 14) and the impact of vacancies on hospital efficiency (Table 15) They show the total number of hospital facilities that reported each impact score, for each position.
Table 14. Impact of vacancies on patient care, distribution of hospital facilities by reported score
Vacancy Impact on Patient Care
Position 1 2 3 4 5 6 7 Total Coder 23 18 13 22 6 4 4 90 LCSW 15 15 6 26 13 4 5 84 CVIR Tech 21 2 4 16 7 12 5 67 MRI Tech 14 4 11 19 17 9 6 80 CT Tech 12 6 13 20 15 14 5 85 CLS 11 10 8 26 10 12 10 87 Rad Tech 10 6 12 23 12 20 4 87 Ultrasound Tech 14 3 11 19 17 18 6 88 Respiratory Therapist 9 8 9 17 19 18 5 85 Pharmacist 11 9 7 17 22 6 15 87 Physical Therapist 11 7 8 18 11 19 11 85
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Table 15. Impact of vacancies on hospital efficiency, distribution of hospital facilities by reported score
Vacancy Impact on Hospital Efficiency
Position 1 2 3 4 5 6 7 Total Coder 17 5 14 26 4 9 10 85 LCSW 11 6 22 21 12 8 1 81 CVIR Tech 24 1 6 16 5 13 2 67 MRI Tech 14 3 7 25 20 7 6 82 CT Tech 14 3 6 29 13 16 3 84 CLS 11 5 5 32 11 15 9 88 Rad Tech 11 4 7 27 14 19 2 84 Ultrasound Tech 15 3 5 31 8 21 3 86 Respiratory Therapist 10 2 8 21 26 14 4 85 Pharmacist 12 3 9 19 18 12 11 84 Physical Therapist 13 6 6 18 19 14 11 87
Services limited due to staffing shortages14
Hospitals were asked to report whether or not services had to be limited during the quarter due to staffing shortages. Table 16 presents their responses. The data show that staffing shortages, if they occurred, did not generally cause hospitals to limit services as a result.
Table 16. Hospital services limited due to staffing shortages, by position
Limited Services
Position Yes No Total Coder 4 91 95 Clinical Laboratory Scientist 3 94 97 Rad Tech 1 97 98 CT Tech 2 92 94 CVIR Tech 1 90 91 MRI Tech 3 90 93 Ultrasound Tech 2 93 95 Pharmacist 2 91 93 Physical Therapist 5 89 94 Respiratory Therapist 6 89 95
Hospitals that reported limiting services due to staffing shortages were given the chance to write-in a description of their response to the situation, listed here:
Coders – utilized contract staff; increased use of outsource coders by 30%; inpatient coding is backlogged.
Clinical Laboratory Scientists – had to send GC & Parasitology testing to outside laboratory.
Rad Techs – cannot suspend services, had to use overtime staff.
14 LCSW was left off the survey instrument so no data is included here.
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CT Techs – shut down services at one location.
MRI Techs – reduced number of procedures; shut down services at one location.
Ultrasound Techs – reduced the number of procedures; unable to suspend services, so added more shifts.
Pharmacists – increased turnaround time for med order, review and approval.
Respiratory Therapists – reduced outpatient testing; delayed treatments or had RNs deliver services; had to rearrange transport requests.
Impact of environmental issues
Hospitals were asked to rank their concern regarding specific environmental issues on a scale of 1 to 7 where a ranking of 1 represents “not concerned”, a ranking of 4 represents “somewhat concerned”, and a ranking of 7 represents “very concerned”. The environmental issues included the following:
• An aging healthcare workforce • Population growth in the region • An aging population in the region • Cultural diversity and linguistic capabilities • Impact of healthcare reform • Impact of budget cuts on health professions education
Table 17 shows the average score for each environmental issue, based on the ranking scale of 1 to 7. Clearly, hospitals are most concerned with the potential impact of healthcare reform as it relates to healthcare workforce supply, compared with other issues. This makes sense given the complexity of implementing reform, combined with expectations that it will affect most every facet of healthcare systems.
We tested to see if the differences in average score were statistically significant. We found that a difference in average score equal to or greater than .4 was significant at the 1% level.15 This means that there is no statistical difference in the average score for “cultural diversity/linguistic capabilities” versus “population growth”, but scores for both of these issues are statistically different from the scores of all other issues. Similarly, there is no difference in the scores for “budget cuts” versus “aging workforce”, but scores for both of these issues are statistically different from the scores of all other issues.
15 Significance at the 1% level means there is a 99% chance the difference is real (in other words, a 99% chance the difference is not zero).
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Table 17. Concern regarding environmental issues, by issue and average level of concern (rank)
Issue
Avg. rank
No. of hospitals Diversity/linguistic capabilities 3.01 105 Population growth 3.12 103 Aging population 3.66 103 Budget cuts 4.55 104 Aging workforce 4.61 104 Healthcare reform 5.09 105
Table 18 (below) presents the distribution of responding hospitals by level of concern for each of the environmental issues.
Cultural Diversity & Linguistic Capability – the model response is 1, the lowest possible level of concern regarding this issue. The distribution of responses skews toward the low end of the scale, with 57% of responses having a value of 3 or lower.
Population Growth – the modal response is 4, which describes having “some concern” regarding this issue as it relates to workforce supply. However, the overall distribution of responses skews toward the low end of the scale; 55% of all responses having a value of 3 or lower.
Aging Population – again, the modal response is 4, which describes having “some concern” regarding this issue as it relates to workforce supply. The overall distribution of responses is less skewed toward the lower end of the scale by comparison with concerns regarding cultural diversity/linguistic capabilities or population growth. Approximately 32% of responding hospitals regard the issue with more than “some concern”.
Impact of budget cuts on health professions education – the modal response is 4. However, the distribution of responses skews toward the end of the scale signaling greater levels of concern. Approximately 50% of responding hospitals regard the issue with more than “some concern”
Aging Workforce – again the modal response is 4, signaling at least some concern over the impact an aging workforce will have on workforce supply. The distribution of responses skews heavily toward the end of the scale signaling higher levels of concern, with more than 50% of responding hospitals regarding the issue with more than “some concern”.
Impact of health reform – this is the environmental issue hospitals are most concerned with, in terms of the impact on healthcare workforce supply. This makes sense given its complexities and how far-reaching its impact will be. The modal response is 7, the highest level of concern, and nearly 2 out 3 responding hospitals (64%) regard the issue with more than “some concern”.
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Table 18. Distribution of hospitals by environmental issue and level of concern
Level of Concern
Issue 1 2 3 4 5 6 7 Total Diversity/linguistic capabilities 29 14 16 23 17 4 1 104 Population growth 15 25 17 33 5 8 0 103 Aging population 14 15 16 25 17 12 4 103 Budget cuts 7 5 12 29 22 11 19 105 Aging workforce 7 5 4 35 26 11 17 105 Healthcare reform 5 4 11 17 20 14 33 104
Age Profile of Allied Health Workforce16
Table 19 shows the age profile for each position. For many of these positions, the age profile appears to be similar. The exceptions are Clinical Laboratory Scientists and Coders. The data indicate that approximately 40% of the CLS workforce is 56 yrs of age, or older; for medical coders, the share is 30%. Conversely, the data describing all other positions, excepting MRI Techs, indicate that approximately 55% - 60% of the workforce is age 45 or under.
Table 19. Distribution of workforce by position and age group
Distribution (%) by Age Group
Position
25-35 36-45 46-55 56-65 Over 65 Reported
headcount Respiratory Therapist 25.9 33.3 25.8 13.4 1.6 2,875 Physical Therapist 24.1 34.4 23.0 14.0 4.5 1,899 CVIR Tech 29.2 27.9 21.5 18.5 3.0 233 Pharmacist 23.4 32.2 26.7 14.4 3.3 3,358 CT Tech 18.3 36.2 29.2 14.7 1.6 627 Ultrasound Tech 23.7 30.6 32.1 12.3 1.2 1,080 Rad Tech 22.9 31.4 28.9 13.4 3.4 2,331 MRI Tech 10.8 31.5 42.0 14.1 1.6 305 Coder 9.0 24.0 36.4 24.4 6.2 915 CLS 10.1 18.0 31.0 30.5 10.4 2,941
Table 19 includes the reported headcount on which the age profile is based. Something to be aware of is that for a few of the positions, this headcount is considerably smaller than the total number of current employees reported as part of the regular survey component (the questions pertaining to staffing data).
Positions affected include:
Respiratory Therapists – a reported headcount of 2,875 used to create the age profile, compared to a current headcount of 4,720 reported in the staffing data section.
16 LCSW was left off the survey instrument so no data is included here.
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16
Physical Therapists – a reported headcount of 1,899 used to create the age profile, compared to a current headcount of 2,706 reported in the staffing data section.
CT Techs – a reported headcount of 627 used to create the age profile, compared to a current headcount of 1,165 reported in the staffing data section.
Other Data Concerns
Some of the staffing data reported by Kaiser Permanente is hard to explain. These data are included in all of the previous analysis, but the tables below demonstrate why they are puzzling. Table 20 describes data reported for Physical Therapists who are regular employees. There is a very large difference in headcount at the start of the quarter versus headcount at the end of the quarter for many of the Kaiser facilities, for both full-time and part-time Physical Therapists. These large changes cannot be explained by the data on new employee hires or separations during the quarter. Table 21 describes per diem Physical Therapists. If the per diem data showed big declines in the use of per diems, it might explain the big differences in starting and ending headcounts for full-time & part-time Physical Therapists, but the per diem data show a similar pattern.
Table 20. Full-time vs. part-time Physical Therapist staffing data reported by Kaiser facilities
Full-time PTs Part-time PTs
Facility Hdct start Hire Separate
Hdct end
Hdct start Hire Separate
Hdct end
KP Fresno 10 0 0 28 9 0 0 8 KP Hayward/Fremont 13 3 0 42 22 2 1 34 KP Oakland 17 0 0 50 23 0 1 18 KP Redwood City 4 0 0 18 15 3 1 8 KP Rehab Center Vallejo 25 2 1 28 10 0 0 16 KP Sacramento 61 0 2 85 11 0 0 58 KP San Francisco 15 0 0 37 21 2 1 14 KP San Jose 25 3 0 32 10 0 0 23 KP Santa Clara 24 2 1 57 21 1 1 26 KP Santa Rosa 15 0 0 34 31 0 1 43 KP South Sacramento 15 0 0 27 11 0 0 30 KP South San Francisco 9 0 0 23 9 0 0 12 KP Walnut Creek 13 0 0 34 25 4 0 42 KP Modesto 13 2 1 27 3 0 0 29 KP Antioch 9 1 0 11 7 3 2 24 KP Vacaville 11 1 1 13 4 0 0 14
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Table 21. Per diem Physical Therapist staffing data reported by Kaiser facilities
Per Diem PTs
Facility Hdct
start Hire Separate Hdct end
KP Fresno 3 0 0 5 KP Hayward/Fremont 2 1 0 6 KP Oakland 8 0 0 17 KP Redwood City 2 2 0 7 KP Rehab Center Vallejo 0 0 0 11 KP Sacramento 18 6 3 33 KP San Francisco 3 1 0 8 KP San Jose 7 0 2 8 KP Santa Clara 7 4 0 25 KP Santa Rosa 6 2 1 10 KP South Sacramento 5 1 0 5 KP South San Francisco 1 0 0 6 KP Walnut Creek 6 2 0 10 KP Modesto 3 0 0 11 KP Antioch 0 0 1 5 KP Vacaville 0 0 0 6
Table 22 describes the Respiratory Therapist staffing data reported by Kaiser Permanente facilities that responded to the survey. What is notable about these data is the reported mix of full-time versus part-time positions. By comparison with all other hospitals that reported staffing data, the extent to which KP hospitals utilize part-time Respiratory Therapists is unusual.
Table 22. Full-time vs. part-time Respiratory Therapist staffing data reported by Kaiser facilities
Full-time Respiratory Therapists Part-time Respiratory Therapists
Facility Hdct start Hire Separate
Hdct end
Hdct start Hire Separate
Hdct end
KP Fresno 3 0 0 3 20 0 0 20 KP Hayward/Fremont 2 0 0 2 54 0 2 54 KP Oakland 6 0 0 6 78 0 1 79 KP Redwood City 1 0 0 1 17 0 0 17 KP Rehab Center Vallejo 3 0 0 3 34 1 3 34 KP Sacramento 7 0 1 7 70 0 2 71 KP San Francisco 4 0 0 4 31 0 0 31 KP San Jose 6 0 0 6 28 0 1 28 KP Santa Clara 1 0 0 1 54 1 1 56 KP Santa Rosa 3 0 0 3 39 2 2 39 KP South Sacramento 5 0 0 5 24 0 3 23 KP South San Francisco 2 0 0 2 16 0 1 16 KP Walnut Creek 9 0 0 9 41 0 0 41 KP Modesto 2 0 0 2 45 0 0 45 KP Antioch 0 0 0 0 32 0 0 32 KP Vacaville 0 0 0 0 15 0 1 15
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A final concern regarding data has to do with the publication of the HASC 2012 Q4 Workforce Data Report. The results included in this publication differ from our findings in important ways. For the most part, this is because the HASC report did not edit any of the data collected from the hospitals that responded to the survey. For this reason, it would be misleading to compare any of the findings presented here, with the unedited data presented in the HASC Q4 Workforce Data Report.
Here are two examples of data editing that we performed which make comparisons with the HASC Q4 Workforce Data Report invalid. These are not the only two cases of data editing that we performed; they are examples of the two main types of edits we made throughout the data set.
Example 1 - All of the staffing data reported for Hanford Community Medical Center & Selma Community Hospital (members of Adventist Health) were identical. Meaning, each hospital reported an identical number of full-time, part-time, and per diem employees in each position, and an identical number of employee separations, new hires and vacancies for each position. This is highly improbable. We chose to use only one instance of the data and assumed that it represents both hospitals. The HASC Q4 Workforce Data Report uses both data records; in essence, it is double counting these data.
Example 2 - Long Beach Memorial Medical Center reported 45 full-time Coders at start of quarter, 0 new hires and 0 separations during the quarter, and 15 full-time Coders at end of quarter. This is almost certainly a data-entry error. We recoded the ending headcount as 45 full-time Coders (rather than recode the starting headcount at 15 full-time Coders), based on the pattern for all of the staffing data reported by Long Beach Memorial, and how this compared with other hospitals of its size.
Finally, it would be misleading to compare any of the analysis of the questions in the CHA survey section (the impact of vacancies on patient care and hospital efficiencies, environmental issues, and age distribution etc.) presented here, with what is published in the HASC 2012 Q4 Workforce Data Report. For one, the HASC report treats the system-wide responses from Dignity Health and Sutter Health as individual responses. As a result, their data findings are skewed toward whatever was reported by these two health systems. For example, if Dignity & Sutter reported that the impact of a vacancy was “extremely negative”, the HASC report gives that response the weight of all the individual facility within these systems. As discussed above in the overview of these survey data, it is highly unlikely that one system administrator’s perception of the impact of staffing vacancies accurately describes every facility throughout the system.
In addition, the summary of these data derived from the CHA questions and published in the HASC report is suspect, given the raw survey data file we received from HASC. The summary of the data derived from questions related to the impact of staff vacancies, in particular, looks highly problematic. These are the data that needed to be recollected because the initial survey instrument contained poorly constructed versions of the questions. In essence, the original data were contaminated. We have tried to reconstruct the findings published in the HASC report that summarize these data, using the old, contaminated data, and the revised, usable data that we had to recollect, and in neither case were we able to do so. It could be that they’ve used some mix of contaminated and usable survey data. We have no good explanation for how the report arrives at the results it published.
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September 12, 2013 TO: CHA Workforce Committee FROM: Cathy Martin, Vice President, Workforce
Gail Blanchard-Saiger, Vice President, Labor and Employment SUBJECT: Workforce & Labor and Employment Legislative Update I. ACTION
Provide input to Gail regarding sharing of labor and employment legislative updates. II. SUMMARY AND BACKGROUND
Cathy and Gail will update the committee regarding legislative proposals related to health workforce and labor and employment. The health workforce index of bills can be found on the following pages. Please note that the status of bills may change by the date of this meeting. The labor and employment index will be provided as a hand out at the meeting. Gail would like feedback from the committee for how best to report on labor and employment legislation in future committee meetings.
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Revised: September 6, 2013
Legislative Update: Workforce Bills – 2013
AB 1176 Bocanegra
Graduate Medical Education: The bill would establish the Graduate Medical Education Fund in the State Treasury to consist of annual assessments, on insurers or health care services plans that provide prescribed health care coverage, of $5 per covered life. The bill would require that moneys in the fund be used, upon appropriation by the Legislature, to fund grants to graduate medical residency training programs. The bill would require the Office of Statewide Health Planning and Development, in consultation with the California Healthcare Workforce Policy Commission, to develop criteria for distribution of available funds. POSITION: F,X
05/01/13 • Two-year bill
AB 1215 Hagman
Clinical Laboratories: This bill would expand the definition of “laboratory director” for purposes of a clinical laboratory test or examination classified as waived to include a duly licensed clinical laboratory scientist. POSITION: F, X
09/06/2013 • Signed by the Gov
SCA 5 Hernandez
Public Postsecondary Education: Student Recruitment Proposes an amendment to the Constitution to provide that institutions of higher education may implement student recruitment and selection programs permissible under the equal protection clause of the 14th Amendment of the United States Constitution. POSITION: S
08/22/13 • Senate
Appropriations
SB 20 Hernandez
Steve Thompson Loan Repayment Program: This bill, beginning on the date that the Major Risk Medical Insurance Program becomes inoperative, would instead require all the funds in the Managed Care Administrative Fines and Penalties Fund to be transferred each year to the Medically Underserved Account for Physicians in the Health Professions Education Fund for purposes of the Steven M. Thompson Physician Corps Loan Repayment Program. POSITION: S
8/22/13 • Assembly
Appropriations Suspense File
SB 21 Roth
UC Riverside Medical School: Funding Appropriates funds from the General Fund to the Regents of the University of California for allocation to the School of Medicine at the University of California, Riverside. POSITION: F
08/28/13 • Enrolled to the
Governor
SB 118 Lieu
Sector Strategies: This bill would provide that the CWIB is responsible for assisting the Governor in the alignment of the education and workforce investment systems to the needs of the 21st century workforce and the promotion and development of a well-educated and highly skilled 21st century economy and workforce. This bill would require the board to assist the Governor in targeting resources to specified industry clusters that provide economic security and leverage state and federal funds to ensure that resources are invested in activities that meet the needs of specified industry sectors and advance the education and employment of students and workers so they can meet the specified needs of the state, its regional economies, and leading industry sectors. POSITION: S
09/06/2013 • Enrolled to the Gov
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Revised: September 6, 2013
SB 271 Hernandez
Associate Degree Nursing. Existing law establishes, until January 1, 2014, the statewide Associate Degree Nursing (A.D.N.) Scholarship Pilot Program in the Office of Statewide Health Planning and Development to provide scholarships to students, in accordance with prescribed requirements, in counties determined to have the most need. Existing law provides that the program be funded from the Registered Nurse Education Fund, administered by the Health Professions Education Foundation within the office. This bill would extend the operation of this program indefinitely and would make related changes. POSITION: S
09/06/2013 • Enrolled to the Gov
SB 440 Padilla
This bill would express findings and declarations of the Legislature relating to timely progression from lower division coursework to degree completion. The bill would require community colleges to create an associate degree for transfer in every major and area of emphasis offered by that college for any approved transfer model curriculum, as prescribed. The bill would require California State University campuses to accept transfer model curriculum-aligned associate degrees for transfer every major and concentration offered by that California State, as specified. This bill would provide that the guarantee of admission for those community college students described above includes admission to a program or major and concentration that is either similar to the student’s community college transfer model curriculum-aligned associate degree for transfer or may be completed with 60 semester units of study beyond that degree for transfer, the determinations to be made by the campus to which the student is admitted. The bill would require the California State University to develop an admissions redirection process for students admitted pursuant to the Student Transfer Achievement Reform Act who apply for admission to the California State University, but are not accepted into the campuses specifically applied to. The bill would require the California Community Colleges and the California State University, in consultation with specified parties, to develop a student-centered communication and marketing strategy in order to increase the visibility of the associate degree for transfer pathway for all students in California.
POSITION: S
09/06/2013 • Assembly third
reading
SB 491 Hernandez
Nurse Practitioners: This bill would remove the requirement that acts performed by a nurse practitioner that are consistent with the Nurse Practice Act be performed pursuant to a standardized procedure or in consultation with a physician and surgeon. The bill would also authorize a nurse practitioner to perform specified additional acts, including, among others, examining patients and establishing a medical diagnosis and prescribing drugs and devices. The bill would require that, on and after July 1, 2016, an applicant for initial qualification or certification as a nurse practitioner hold a national certification as a nurse practitioner from a national certifying body recognized by the board. POSITION: Support if Amended
8/22/13 • Assembly
Appropriations Suspense File
SB 492 Hernandez
Optometric Practice: This bill would add the provision of habilitative optometric services to the definition of the practice of optometry. The bill would expand the practice parameters of optometrists who are certified to use therapeutic pharmaceutical agents by removing certain limitations on their practice and adding certain responsibilities, including, but not limited to, the ability to immunize and treat certain diseases, and deleting the specified drugs the optometrist would be authorized to use, and authorizing the optometrist to use all therapeutic pharmaceutical agents approved by the United States Food and Drug Administration, as provided. The bill would also delete limitations on what kinds of diagnostic tests an optometrist could order and instead would authorize an optometrist to order appropriate laboratory and diagnostic imaging tests. POSITION: S
08/22/13 • Two-year bill
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Revised: September 6, 2013
SB 493 Hernandez
Pharmacy Practice: This bill, instead, would authorize a pharmacist to administer drugs and biological products that have been ordered by a prescriber. The bill would expand other functions pharmacists are authorized to perform, including, among other things, to furnish self-administered hormonal contraceptives, prescription smoking cessation drugs, and prescription medications not requiring a diagnosis that are recommended for international travelers, as specified. Additionally, the bill would authorize pharmacists to order and interpret tests for the purpose of monitoring and managing the efficacy and toxicity of drug therapies, and to independently initiate and administer routine vaccinations, as specified. This bill also would establish board recognition for an advanced practice pharmacist, as defined, would specify the criteria for that recognition, and would specify additional functions that may be performed by an advanced practice pharmacist, including, among other things, performing patient assessments, and certain other functions, as specified. POSITION: S
09/06/2013 • Assembly third
reading
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CHA Workforce Committee
2013 In-Person Meetings
_____________________________________________________________________________________ Following are the remaining in-person meeting dates for 2013. Conference Calls
will be schedule on an as-needed basis.
THURSDAY, SEPTEMBER 12, 2013
10:00 AM- 2:30 PM HOSPITAL COUNCIL
1215 K Street, Suite 730 Sacramento, CA 95814
WEDNESDAY, DECEMBER 4, 2013 10:00 AM- 2:30 PM HUNTINGTON HOSPITAL
100 W. California Blvd., Pasadena, CA 91105
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CHA Workforce Committee
2014 In-Person Meetings
PROPOSED DATES
_____________________________________________________________________________________
THURSDAY, FEBRUARY 13, 2014
Sacramento, CA
THURSDAY, MAY 15, 2014 Southern California
THURSDAY, SEPTEMBER 11, 2014 Sacramento, CA
THURSDAY, DECEMBER 4, 2014 Southern California
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