ALASKA STATE LEGISLATURE  SENATE LABOR AND COMMERCE STANDING COMMITTEE  February 15, 2007 1:31 p.m. MEMBERS PRESENT Senator Johnny Ellis, Chair Senator Gary Stevens, Vice Chair Senator Bettye Davis MEMBERS ABSENT  Senator Lyman Hoffman Senator Con Bunde COMMITTEE CALENDAR  Overview: Health Care Industry Workforce Development PREVIOUS COMMITTEE ACTION  No previous action to consider WITNESS REGISTER DELISA CULPEPPER Mental Health Trust Authority POSITION STATEMENT: Commented on health care workforce development. KAREN PERDUE, Associate Vice President Health Programs University of Alaska POSITION STATEMENT: Commented on health care workforce development. ROD BEATTIE Alaska Workforce Investment Board President, Alaska State Hospital and Nursing Home Association (ASHNHA) Juneau AK POSITION STATEMENT: Commented on health care workforce development. BILL HOGAN, Deputy Commissioner Department of Health & Social Services Juneau, AK 99801-0601 POSITION STATEMENT: Commented on health care workforce development. ACTION NARRATIVE CHAIR JOHNNY ELLIS called the Senate Labor and Commerce Standing Committee meeting to order at 1:31:47 PM. Present at the call to order were Senators Davis and Ellis. The Chair announced that Senator Stevens would be here soon. ^Workforce Development: Health Care Industry 1:32:51 PM LISA CULPEPPER, Mental Health Trust, said at 35 percent the health care workforce is one of the fastest growing job sectors in Alaska and it will continue to be for the next 10 years. 1:35:51 PM The Trust is working with the Department of Labor and Workforce Development (DOLWD) to develop strategies for making health care workforce development a priority in this administration - not for just doctors and nurses, but across the whole spectrum of health care. Another tool they are working on with the DOLWD is the student loan repayment program, not just for state student loans, but for people from other states who have trained as professionals and who might want to come to Alaska to work and get loan repayment. She said Alaska is competing with other states because almost every other state has this program in place already. 1:38:37 PM SENATOR STEVENS joined the committee. KAREN PERDUE, Associate Vice President, Health Programs, University of Alaska, said in the last year it had prioritized health care development and she was going to highlight some of the partnerships that Ms. Culpepper mentioned. She said the University has prioritized the health care workforce development over the last five years - because these are great jobs, there's a shortage in virtually every profession and a lot of money is spent importing workers who could be Alaskans. Enrollment in the health care programs has grown 66 percent in the last five years with an increase of 55 percent in the graduation rate. About 4,400 students are currently working through the university system across Alaska in health care programs. She said that the explosion in distance learning has dramatically helped them in doing this. Nursing, radiology, medical laboratories, social work, psychology, human services and public health are robust programs and are reaching out to rural Alaska and to people who also work. While some people think distance learning is inferior, but in some of the professions where the students must pass a licensing exam, such as nursing and social work, the performance of distance and on- campus students can be measured and no difference can be found and, "In fact, in some cases the distance students perform better." 1:41:16 PM MS. PERDUE said that behavioral health is an area where the Trust has had huge partnerships with the University. Pages 16-17 of "Pathway to Alaska Health Care Careers" covered those. Together they invested money in expansions in social work, psychology, professional development and a program targeting bringing the kids home. The behavioral health area graduates about 360 students per year and the Trust has asked them to ramp that number up, which they are talking about right now. The nursing program has had great partnerships with the hospitals - doubling its graduates. They have gone from 1 nursing program to 11 and are graduating around 220 nurses a year. The industry has donated about $4 million to the University to do that work. MS. PERDUE said the state also needs more doctors and the WWAMI program is being doubled. She concluded by saying their budget reflects increases to strengthen all these areas. The Trust and Hospital Association partnerships have allowed the University to organize these programs in an efficient way to meet the state's need. 1:44:13 PM CHAIR ELLIS commented that the double WWAMI buttons his office made are very popular and that nursing programs are of particular interest to him especially in dealing with poverty and getting people off of public assistance. He asked if the folks trained in Alaska are staying in the state or leaving. MR. PERDUE replied that a lot of students stay in Alaska and one of the reasons is that the program is not in Anchorage only. Today more students are off the Anchorage campus than are on; they are in communities like Kodiak, Bethel and Sitka. The local hospitals and physicians recruit these students very heavily from the time they enter their course work. Anchorage students get offers from out of state that include high bonuses, but the numbers show that 95 percent of them stay in Alaska. 1:46:11 PM ROD BEATTIE, President of the Alaska State Hospital and Nursing Home Association (ASHNHA), thanked the committee for passing recent legislation expanding the WWAMI program. He said he is currently a member of the Alaska Workforce Investment Board, but he has been critical of it because it does not place significant importance on development of the work force for health care occupations and careers. These jobs pay very well, and there is a great need for them around the state. These jobs are environmentally friendly. He said the Alaska Health Education Consortium (AHEC) is attached to the University's School of Nursing. Alaska is the only state that doesn't have it attached to the School of Medicine. This is specifically geared towards waking high school students up to health careers and working with the health care community to develop those kinds of jobs. "But if they don't have a place to go to get the education they need and we don't find a way to make that available to them, we'll lose them to other places." He thought the DOLWD should carve out some money to dedicate toward health careers. He said funding is a competitive process and they end up losing out to all the other things that the state is trying to accomplish. He said the University can't do it by itself. He represents 37 health care facilities around the state, but there is only so much they can do. MR. BEATTIE said his rural members are really struggling in terms of trying to fill some critical positions. For example, he wanted to see certification occur on rad/techs so that people are safely exposed to having X-rays taken or ultra-sounds performed. However, he said, the more certification and requirements placed on those, the fewer candidates there are and the more likely people will have to travel even more in the state to get services because they can't get them locally in smaller locations. 1:50:55 PM CHAIR ELLIS mentioned talking with Click Bishop, Commissioner of the DOLWD, about dedicated funding for training within the DOLWD toward the health care fields. MR. BEATTIE replied that he would be interested in the answer, because he had asked that same question and didn't get an answer. Minimal money, if any, was going into that area. CHAIR ELLIS asked if the residency programs could be expanded like the one at Providence Hospital. MR. BEATTIE agreed that would be a good way to keep physicians here once they complete residency. He thought other hospitals have that capability. The accreditation has to be addressed for people going through residency, however, so they can see it as being a creditable program. He said the whole graduate medical education piece has been altered by the federal government in the last few years, so it is trickier to get into. 1:54:09 PM BILL HOGAN, Deputy Commissioner, Department of Health and Social Services (DHSS), said workforce development is a priority of his department that cuts across all of its divisions, not only for the state, but for all the grantees. Through a very strong collaboration with the University and the Mental Health Trust Authority significant progress was made with the curriculum within the University as well as expanding entry level human service options and bachelors and masters degrees of social work options. He is happy to say that there is now a PhD program in psychology that is jointly governed from both UAA and UAF. Clearly the expectation they set with development of this program is that those individuals practice in community settings when they come out of the program. That is a significant step forward for Alaska. MR. HOGAN said they need a number of behavioral health paraprofessionals and professionals at all levels in all sorts of settings to not only bring kids back to Alaska from out-of- state into residential psychiatric treatment centers, but to keep them from going out. Before the meeting started, Mr. Hogan said he glanced through the Alaska Commission on Aging draft state aging plan and came to the page on workforce development. Aging folks will grow dramatically over the next 20-25 years. "We need a workforce that can keep seniors in their homes in their own communities and if not, we need a workforce to work in long-term care facilities." MR. HOGAN said he is enthused about the direction the state is taking and strongly supported the bill that increased WWAMI slots and the Governor's new Health Care Strategies Council that will focus on what a health care system should like in Alaska. Workforce development is a key piece. 1:57:57 PM CHAIR ELLIS asked if it has been hard to recruit and retain certain professional positions. MR. HOGAN replied yes. Last year the nurses were provided a two- range increase. That made a big difference in the department's being able to recruit and retain public health nurses as well as nurses in the Pioneer Homes, the Alaska Psychiatric Institute and in juvenile justice facilities. His frustration is that filling professional behavioral health positions is still a problem. CHAIR ELLIS thanked everyone for their comments and adjourned the meeting at 1:59:43 PM.