Virginia Health Workforce Development Authority Initial Report: Healthcare Workforce Study 2022

Summary

Initial report to the Governor and General Assembly from the Virginia Health Workforce Development Authority (VHWDA), titled Healthcare Workforce Study 2022 and issued under Appropriation Act Item H.2. (Special Session I, 2022). The executive summary states that the Appropriations Act directs VHWDA to establish a workgroup to study primary care workforce issues and potential solutions, including the feasibility of loan forgiveness programs. It states that VHWDA has enlisted Deloitte Consulting, LLP to conduct the study. The timeline lists the initial assessment as due January 29, 2023, the resources and regulation report as due June 30, 2023, and the comprehensive final report as due September 22, 2023.

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2022 Report to the Governor and General Assembly




 Virginia Health Workforce Development Authority


     Initial Report Healthcare Workforce Study
2022 REPORT TO THE GOVERNOR AND GENERAL ASSEMBLY                                  Initial Report- 2



Mandate

Enabling Authority: Appropriation Act - Item 292 H.2. (Special Session I, 2022)

Initial report on the on the findings of the work group convened to study primary care workforce
issues and potential solutions, including but not limited to the feasibility of loan forgiveness
programs.


Contact Information
Harrison Hayes
Executive Director, Virginia Health Workforce Development Authority
7818 E. Parham Road, Richmond, VA 23294
Office: (804) 562-4928 Cell: (804) 393-6349
hhayes@vhwda.org
2022 REPORT TO THE GOVERNOR AND GENERAL ASSEMBLY                                  Initial Report- 3



Executive Summary

The Appropriations Act, (Chapter 2, Item 292, H1-2) directs the Virginia Health Workforce

Development Authority (VHWDA) to establish a workgroup to conduct a study on addressing

primary care workforce issues and potential solutions, including but not limited to the feasibility

of loan forgiveness programs. VHWDA has enlisted Deloitte Consulting, LLP to conduct the

study as outlined in the Appropriations Act. This preliminary report includes an outline of the

study and timeline for completion.
2022 REPORT TO THE GOVERNOR AND GENERAL ASSEMBLY                                   Initial Report- 4



Introduction

       The Virginia Healthcare Workforce Development Authority (“Authority” or “VHWDA”)

is conducting a study on addressing primary care, behavioral and nursing healthcare workforce

issues and potential solutions, including but not limited to the feasibility of loan forgiveness

programs. Deloitte Consulting, LLP (“Deloitte”) was selected to lead this healthcare workforce

study which will require support from a designated workgroups to assist in reviewing current and

projected healthcare workforce shortages, as well as clinical and preceptor shortages, and offer

recommendations to address these issues. These include but are not limited to alternative

educational approaches to preparing and retaining healthcare practitioners.




Background


       The Authority selected Deloitte given it has supported Virginia’s healthcare workforce

through numerous projects integrated across government, educational, and non-profit entities.

Deloitte will support and collaborate with the Authority bringing talent, market-leading

capabilities, and passion for the Commonwealth to achieve optimal value for Virginia. Using a

data driven approach to identify strategies and opportunities to increase the pipeline of the future

healthcare workforce and its instructors. Representatives for the study’s workgroups and

interviews have been identified and come from the healthcare ecosystem around the

Commonwealth. These include public and private providers, industry groups and associations, and

state and local officials. State officials include Secretary of Health and Human Resources; John

Little and Secretary of Labor; George “Bryan” Slater.
2022 REPORT TO THE GOVERNOR AND GENERAL ASSEMBLY                                     Initial Report- 5



       Data Collection. Working with the Commonwealth and currently existing data sources, a

data gap analysis will be conducted to examine what data Virginia has related to the healthcare

workforce and what data is needed to develop metrics and an accountability structure. This

information will guide our assessment of current data and additional data needs with potential

examples of reports from other states.


       Stakeholder Interviews and Focus Groups. An interview guide will confirm consistency

across the discussions, addressing issues including ways to increase career awareness, support

recruitment, incent retention and instructor recruitment, and support evidence-based practices. A

review of previous solutions attempted, impact of access issues on patients and their families, and

impacts on marginalized communities will be explored. Lastly, a review process to confirm diverse

representation and inclusive standards of operations in data collection, with insights and leading

practices guided by our Diversity, Equity, and Inclusion practitioners will be undertaken. These

insights will contribute to data collection of Commonwealth data analytics trends to identify

current and projected primary care, behavioral health and nursing healthcare workforce shortages,

and clinical and preceptor shortages. In tandem with other analysis and research, devise

recommendations for the Initial Report which will address these issues, including advising on

alternative educational approaches to prepare and retain nurses and nurse educators. The

interviews and focus groups will also enable an analysis of the current ability to coordinate regional

and statewide efforts, including evaluating the status of existing technology platforms, preclinical

and clinical programs, and needed advancements in these programs, which will inform our

recommendations of governance structure to oversee healthcare workforce development
2022 REPORT TO THE GOVERNOR AND GENERAL ASSEMBLY                                   Initial Report- 6



       Facilities Assessment. An analysis will be conducted of facility plans to review, realign,

and integrate current existing facility plans and infrastructure at the beginning of the study with

recommendations for how to best meet future predicted program demands. The physical

assessment will include such spaces as the higher education lab and classroom space, clinical

availability, and alternative learning environments.


       Additional Research and State Comparisons. A thorough research on national trends

and challenges in workforce development for healthcare and national leading practices on

workforce development will be conducted. The study will draw upon prior experience creating a

pipeline for the future workforce, as well as our familiarity with work by leaders in this field who

are identifying potential solutions and frameworks for enhancing the state of behavioral healthcare

services. Using searchable data and outreach interviews, we will complete a landscape study of at

least five other states with comparable economies and population, including governance structure

of healthcare workforce; budget review of federal and state allocations, private funding of

healthcare workforce; regulatory environment, which includes scope of practice, provisional

licensure, and sub- baccalaureate pathways; data gathering and reports; and examples of effective

programs. Related, a resource map will be created which summarizes the current state and federal

allocations, private support and any additional revenue streams that support healthcare workforce

in primary care, behavioral health, and nursing.


   Survey Administration. The scope, design, and administration of surveys are informed by the

availability and quality of existing data sets, and selected sampling parameters. Deloitte’s survey

tools follow survey design leading practices as defined by the academic community and we have
2022 REPORT TO THE GOVERNOR AND GENERAL ASSEMBLY                                      Initial Report- 7



existing frameworks, templates, and subject matter specialists who design and build surveys that

are culturally competent to various communities.


    Phase 1, the Initial Report, will conclude on January 29, 2023 and will be comprehensively

assess the current state, strengths, gaps, and obstacles for the Commonwealth’s healthcare

workforce, including key deliverables:


    •   Synthesis of current and projected healthcare workforce shortages, strengths, and obstacles

        to addressing the Commonwealth’s issues;

    •   Physical assessment of existing infrastructure to report on current and future facility needs

        to meet future program demand;

    •   Analysis of current regional and statewide coordination capabilities, and recommendations

        of a governance structure to oversee healthcare workforce development;

    •   Comparative landscape study of similar states’ healthcare workforce ecosystem;

    •   A resource map that summarizes funding streams that support the healthcare workforce;

        and

    •   Data gap analysis that assesses Virginia’s current healthcare workforce data.


    Phase 2, continue a data approach to examine current resource streams from Commonwealth,

federal and private entities as well as investigate regulations as barriers to enter into the healthcare

workforce for a Resources and Regulation Report, including building a resource roadmap, gap

analysis on additional funding needed to meet the current and anticipated demand for healthcare

workforce in primary care, behavioral health, identification of leading programs and practices in

healthcare workforce training, a cost model with base costs and price per student, and a three-year

budget to improve the healthcare workforce in the state, recommendations on loan forgiveness
2022 REPORT TO THE GOVERNOR AND GENERAL ASSEMBLY                                  Initial Report- 8



programs for healthcare positions, examination of licensure requirements for healthcare positions,

recommendations on reciprocity between states for licensed positions, and a review of alternative

pathways to licensure for immigrants, veterans, military spouses and other specialized populations,

focusing on primary care, behavioral health, and nursing.


       Efforts will then culminate in the Phase 3 comprehensive final report with any updates to

the previous two reports and a strategic implementation plan that includes goals and objectives

with measurable outcomes, detailed roles and responsibilities matrix, expansion readiness plan,

implementation timeline, communication tools, and proposed executive, legislative, agency or

budgetary action.




Timeline for Study


   •   Phase 1, Initial Assessment due January 29, 2023

   •   Phase 2, Resources and Regulation Report due June 30, 2023

   •   Phase 3, Comprehensive Final Report due September 22, 2023


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