Legislature(2023 - 2024)BELTZ 105 (TSBldg)
03/01/2023 01:30 PM Senate LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| Presentation(s): Workforce Challenges in Alaska | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 70 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE LABOR AND COMMERCE STANDING COMMITTEE
March 1, 2023
1:33 p.m.
MEMBERS PRESENT
Senator Jesse Bjorkman, Chair
Senator Click Bishop, Vice Chair
Senator Elvi Gray-Jackson
Senator Kelly Merrick
Senator Forrest Dunbar
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
PRESENTATION(S): WORKFORCE CHALLENGES IN ALASKA
- HEARD
SENATE BILL NO. 70
"An Act relating to coverage for additional insureds under owner
and contractor controlled insurance programs; and providing for
an effective date."
- REMOVED FROM AGENDA
PREVIOUS COMMITTEE ACTION
No previous action to record
WITNESS REGISTER
GLORIA BURNETT, Director
Alaska Center for Rural Health and Health Workforce
University of Alaska - Anchorage (UAA)
Anchorage, Alaska
POSITION STATEMENT: Presented a slideshow titled "Healthcare
Workforce Development - A Spectrum of Solutions."
ACTION NARRATIVE
1:33:39 PM
CHAIR JESSE BJORKMAN called the Senate Labor and Commerce
Standing Committee meeting to order at 1:33 p.m. Present at the
call to order were Senators Merrick, Dunbar, Bishop, and Chair
Bjorkman. Senator Gray-Jackson joined the meeting shortly
thereafter.
^PRESENTATION(S): WORKFORCE CHALLENGES IN ALASKA
PRESENTATION(S): WORKFORCE CHALLENGES IN ALASKA
1:34:32 PM
CHAIR BJORKMAN announced a presentation by Gloria Burnett from
the University of Alaska-Anchorage Center for Rural Health and
Health Workforce. He invited Ms. Burnett to put herself on the
record.
1:34:50 PM
GLORIA BURNETT, Director, Alaska Center for Rural Health and
Health Workforce, University of Alaska - Anchorage (UAA),
Anchorage, Alaska, presented a slideshow titled "Healthcare
Workforce Development - A Spectrum of Solutions." She expressed
her intention to discuss Alaska Area Health Education Centers
(AHEC) and how the AHEC model applies to workforce development
across industries statewide.
MS. BURNETT reviewed slide 2, "Healthcare Workforce Shortages."
She said healthcare challenges are comprehensive across medical,
behavioral health, and administrative positions. She said hiring
faculty to teach clinically specialized professions in the
academic and apprenticeship setting is also a challenge.
Shortages exist across the board and are exacerbated in rural
communities.
1:37:02 PM
MS. BURNETT reviewed slide 3, highlighting the effects of
healthcare shortages on constituents and patients:
Impact of Workforce Shortages
• Difficulty accessing healthcare
• Long wait lists for appointments
• Increased cost of care
• Decrease in quality of care
• Closure of facilities
• Reliance on itinerant staffing
• Impaired relationships of providers and patients
• Increased reliance on emergency care
• Health inequity
1:38:17 PM
At ease.
1:39:06 PM
CHAIR BJORKMAN reconvened the meeting.
1:39:20 PM
MS. BURNETT reviewed slide 4, stating this presentation focuses
on a full spectrum of solutions and addresses the problem
simultaneously from multiple angles. There is not just one
solution. Workforce shortages are vast. Even if the state grew
its own health professionals and tripled the number of health
graduates in Alaska, it would not meet the demand. A spectrum of
solutions must be implemented simultaneously to put a dent in
the shortage. She listed three solution categories on slide 4:
A Spectrum of Solutions
PIPELINE PROGRAMMING
Health career exploration for youth in rural and
underserved communities
MS. BURNETT said this long-term strategy grows its own
workforce. It introduces students who grew up and are invested
in their community to healthcare pathways. This strategy does
not happen overnight and requires constant attention to help
students see their future in healthcare professions.
COMMUNITY BASED LEARNING
Health professions student exposure to practice in
rural/underserved communities
MS. BURNETT said this is more of a middle-term strategy. She
said there is a disproportionate distribution level of
healthcare providers statewide. Research shows that most
students in health profession training programs receive their
instruction in an urban center. They do their training,
clinicals, and practicums in an urban center. Students stay in
those urban settings because they are familiar with that
environment and have built relationships with preceptors,
faculty members, etc. Students need increased exposure to rural
and underserved communities in their study program for this
middle-term strategy to be effective. Students who receive this
exposure understand what it means to practice in hard-to-fill
locations and whether it interests them.
CONTINUING EDUCATION & LOAN REPAYMENT
Training, education, loan repayment and direct
incentives to current providers
MS. BURNETTE said these are short-term strategies that can be
done now. She said one retention issue is burnout. Providers
need to get the support they need, especially in rural
communities where they might be the only healthcare provider.
Continuing education is essential to build a retention network
that connects rural providers with their peers, especially in
isolated communities. Direct-incentive and loan repayment is a
short-term strategy. It attracts more out-of-state talent
aligned with what she calls "the grit" of being Alaskan.
Specifically, what it takes to be accepted in Alaska communities
and what it takes to thrive in Alaska communities. She said the
state needs to seek out those individuals and encourage them to
come to Alaska.
1:42:04 PM
SENATOR GRAY-JACKSON joined the meeting.
1:43:04 PM
MS. BURNETT advanced to slide 5, "A Little About Me." She gave
an overview of her history to illustrate how exposure to a rural
community can grow an Alaskan. She was born in the Bronx, New
York. Her dad immigrated to the USA from Italy, and her mom is a
straight-up New Yorker. She was a city girl and would drive to
New York City on the weekends with friends. She said she is the
last person anyone would think would end up in a place like
Utqiagvik. She moved to Alaska from New York. She lived in
Utqiagvik for six years and is passionate about rural health
from that experience. She said her story illustrates that just
about anybody can make a rural community their home by
cultivating relationships and having experiences that connect
them to what makes Alaska special. She said this is true across
the board, not just Utqiagvik. Every part of Alaska has
something that makes it unique. She said the state has a better
shot at retaining people from the Lower 48 long-term if
individuals understand this is how to discover what makes Alaska
special and are prepared to invest in the experience.
1:44:44 PM
MS. BURNETT advanced to slide 6, titled "What the Heck is an
AHEC Anyway?" AHEC is the acronym for Area Health Education
Centers.
1:45:06 PM
MS. BURNETT provided a brief history of AHECs on slide 7:
The History - Area Health Education Centers
• 1970 Carnegie Commission Report: Higher Education
and the Nation's Health
• 1971 Congress enacts the Comprehensive Health
Manpower Training Act (funding AHECs)
• 1972 US Department of Health, Education & Welfare
awards first ever AHEC contracts in 11 states (1st
Generation AHECs)
• 1978-Present: AHEC Network continues to grow
• Recommended development of AHECs to address
workforce shortages and maldistribution of providers
in rural/underserved communities
• Recommended federal funding for communities without
academic health centers
• Goals to enhance supply, distribution & quality of
healthcare in these communities
• Leverage federal, state & local resources
• Engage community connections to industry and
academia
• Increase diversity in the healthcare workforce
• Improve retention of healthcare professionals in
rural communities
1:46:00 PM
MS. BURNETT reviewed slide 8, stating AHEC is a great example of
what workforce development looks like for high-need areas. She
said the AHEC program reaches out to youth in rural communities
and shows them what healthcare looks like in their home
communities, not only what it looks like in an urban center. In
rural settings, the program includes education on community
health aides, care at sub-regional clinics, how clinics link to
hubs, and how life-med and air transportation works. She said
AHEC flips the narrative and asks rural students to describe the
health challenges they see in their communities and have them
think about ways to engage with community health practice and
programming. She said students often need and are interested in
improving healthcare in their home community. When they start
thinking of themselves as part of the solution, the project
results are two-fold. The students become healthier themselves
and begin to think of themselves from the perspective of
supporting and helping their communities in the future. So, the
program tackles healthcare issues in addition to workforce
development issues. She said there are a lot of ways AHEC enters
a community. These programs are offered throughout the state by
request of health programs and facilities and by request of
school districts. The main goal is to expose students in a fun,
hands-on way. In addition to youth entering the healthcare
field, adults are re-entering the area, returning to work, or
switching careers. Slide 8 reads:
Pipeline Programming
Career Exploration Camps and Activities
Pre-Apprenticeship Training
Career Preparedness
1:48:43 PM
MS. BURNETT advanced to slide 9, stating the AHEC scholars'
program offers community-based learning. She said it is open to
students of all health professions regardless of their
university, so long as the school is in Alaska. The most
important qualification is a passion for rural and underserved
populations. The program prepares students for rural and
underserved practice. She reviewed slide 9:
Community Based Learning
AHEC Scholars
• Open to all health professions students
• Two year program (some 1 year exceptions)
• 40 hours/year of extracurricular didactic training
• 40 hours/year of community experiential learning
Community Experiential Learning
• Opportunities for rural/underserved rotations or
clinical experiences
Rural Immersion Institute of the North
• Opportunities for students from the Lower 48 to
explore Alaska
1:50:38 PM
CHAIR BJORKMAN sought confirmation that training is offered at
regional centers.
MS. BURNETT replied correct.
CHAIR BJORKMAN asked which communities have a regional center.
MS. BURNETT answered there are six regional centers statewide.
Each regional center has a host organization. She explained that
two regional offices located in Anchorage serve outlying
communities. She listed the six regional centers:
- Two organizations are physically based in Anchorage but serve
outlying communities:
The Alaska Primary Care Association hosts the South Central
Regional Office, which serves the Mat-Su Borough, the Kenai
Peninsula Borough, Kodiak, Cordova, and Valdez, and
The Aleutian Pribilof Island Association hosts the Southwest
Regional Office, which serves Bristol Bay and Dillingham
through the Aleutian Chain and Eastern Aleutian tribes.
- The Yukon-Kuskokwim Health Corporation (YKHC) in Bethel hosts
the Yukon-Kuskokwim Regional Office.
1:51:44 PM
- The Tanana Chiefs Conference in Fairbanks hosts the Interior
Regional Office.
- The Norton Sound Health Corporation in Nome hosts the
Northwest Regional Office. It serves Nome, Utqiagvik,
Kotzebue, and all the surrounding villages.
- The SouthEast Alaska Regional Health Consortium in Juneau
hosts the Southeast Regional Office.
MS. BURNETT said Alaska follows the national model, which
requires an academic center to host a program office. The
academic center can be either a school of nursing or medicine.
She said 75 percent of AHEC federal funds go to the regional
centers and support their operating budgets. Federal funds
require a one-to-one match. She said 75 percent of matches
consist of piecemeal, in-kind support from regional centers.
1:53:02 PM
MS. BURNETT reviewed slide 10, stating these are short-term
solutions to obtain providers now. She said in addition to the
Nursing Licensure Compact and system-level policy changes, here
are some ideas that attract workers to Alaska:
CE [Continuing Education] & Loan Repayment
• Training webinars, conferences & events for health
professionals
• Continuing Education Credit for licensure
• SHARP [Supporting Health Care Access Through Loan
Repayment] Loan Repayment Program
MS. BURNETT elaborated on the SHARP Loan Repayment Program.
There is a federal funding source for primary care providers and
a private funding source available to individual organizations.
She said she serves on the SHARP Advisory Council and noticed
there are applications from people who do not yet have a job in
Alaska even though there is no system to support these
interested individuals. She said AHEC has been honing in on how
to connect these individuals with vacant positions. The SHARP
Program is starting to branch off and do some targeted marketing
campaigns in the Lower 48 to attract more talent to Alaska.
MS. BURNETT said AHEC offers continuing education. The focus is
on making system-level changes within organizations to improve
retention. Much of the work surrounds compassion, burnout,
fatigue, and resiliency.
1:54:52 PM
MS. BURNETT advanced to slide 11, expressing her belief that the
AHEC model is a valuable and replicable workforce development
solution that she could see working in various industries. She
said one key reason for this belief is the program's focus on a
connection to community. Training programs are often built in
academic centers and need more of a trickle-down effect to meet
the needs of individual communities. AHEC does a great job of
this through the regional center model, and it tackles all
levels of the solution spectrum, leading to healthcare workforce
development. She suggested investing in existing solutions
rather than reinventing the wheel. Slide 11 reads:
Investment in Existing Solutions:"
AHEC is integral to alleviating Alaska's Healthcare
Workforce Crisis!
The AHEC model can be utilized for any industry.
1:56:13 PM
SENATOR GRAY-JACKSON thanked the presenter.
1:56:52 PM
SENATOR BISHOP expressed curiosity about what precipitated her
move from the Bronx to Alaska. He asked how to expound on the
AHEC model and leverage unique experiences to recruit more
workers.
MS. BURNETT replied that it is all about exposure. She said she
had never felt a sense of a community like the one she
experienced in Utqiagvik. She relies on that feeling and wants
to replicate it; she emphasized this is Alaska's selling point.
Students tell her rural communities are different, including
those who have lived in Alaska their whole lives. Bush Alaskans
have to rely on each other. It is an important message and
aspect of rural living. She said a person needs exposure to this
to understand and feel it. Academia can talk and read about it
in books, but people only know once they experience it. That's
the special sauce that will latch onto job seekers and inspire
them to live in Alaska.
1:58:30 PM
SENATOR BISHOP asked what influenced her decision to move to
Utqiagvik.
MS. BURNETT replied her friend worked in a hotel in Barrow every
year and would share stories about his experiences. She said on
a whim, she moved to Utqiagvik after graduating with a master's
degree. She booked a one-way ticket and got a job offer at
Ilisagvik College summer camp. When she decided to leave, the
dean pleaded with her to stay. She expressed a love for
everything Alaska.
SENATOR BISHOP asked if the dean's name was Ms. Pearl Brower.
MS. BURNETT answered yes, it was. She said Ms. Brower was one of
her closest mentors, colleagues, and friends.
1:59:53 PM
CHAIR BJORKMAN asked what she needs from the legislature to
improve the reach and effectiveness of Alaska Area Health
Education Centers throughout the state.
MS. BURNETT answered she struggles with becoming operational.
She served on the National AHEC Organization Board and is its
past president. She is invested in the work AHEC does nationwide
and in the state. The biggest struggle is insufficient staffing
to meet demand. She said the organization is all hands on deck.
Four of her six regional centers are one-person shops; they do a
remarkable job given the fact they are flying solo. There is no
sustainable way to expand AHEC's staffing model. It has been
tough. Colleagues advised that AHEC must be written in statutory
language; it is the best way to proceed. Alaska statutory
language needs to support the presence of AHEC regardless of
federal funding and sustain it as a mechanism for workforce
development. States that have done this include Arizona,
Georgia, and South Carolina, which get state funds and
appropriations utilized as a match. The Alaska team piecemealed
an in-kind match, but it does not provide sufficient staffing
capacity. She expressed her belief that other strategies could
develop if this problem were resolved. The Northwest Regional
Office is located in Nome and serves Kotzebue and Utqiagvik. She
said logistics are near impossible without extra staff in those
outlying communities. Building statutory language to uphold this
program to allow it access to federal resources is the most
critical area the legislature could help.
2:03:06 PM
SENATOR BISHOP asked if she had ever presented before the Alaska
Workforce Investment Board (AWIB).
MS. BURNETT replied that members of the AHEC Steering Committee
serve on AWIB. She said AHEC is strategic about ensuring
steering committee members are represented on AWIB, but AHEC has
yet to be invited to speak specifically about its program.
SENATOR BISHOP asked when she last visited Juneau.
MS. BURNETT replied that she started traveling to Juneau last
year. She had her second trip to Juneau a couple of weeks ago.
Colleagues advised her to make regular trips to Juneau, to be
present and talk so everyone learns and is informed about the
program.
2:04:23 PM
CHAIR BJORKMAN expressed appreciation for the presentation and
made comments about the AHEC model and workforce development.
2:06:07 PM
There being no further business to come before the committee,
Chair Bjorkman adjourned the Senate Labor and Commerce Standing
Committee meeting at 2:06 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| 03.01.23 AHEC Presentation to SL&C.pdf |
SL&C 3/1/2023 1:30:00 PM |
AHEC Presentation to SL&C |
| 03.01.23 2023-AHEC One-Pager-Final (1).pdf |
SL&C 3/1/2023 1:30:00 PM |
AHEC SUPPORTING DOCUMENT FOR PRESENTATION TO SL&C |
| 03.01.23 2022 AHEC Annual Report_FINAL.pdf |
SL&C 3/1/2023 1:30:00 PM |
AHEC SUPPORTING DOCUMENT FOR PRESENTATION TO SL&C |
| 03.01.23 Alaska AHEC 2021 to 2022 one-pager (2).pdf |
SL&C 3/1/2023 1:30:00 PM |
AHEC SUPPORTING DOCUMENT FOR PRESENTATION TO SL&C |
| 03.01.23 Position Paper_Alaska AHEC.pdf |
SL&C 3/1/2023 1:30:00 PM |
AHEC SUPPORTING DOCUMENT FOR PRESENTATION TO SL&C |