The care crisis, with its health care worker shortage and rising rates of worker burnout, is having a ripple effect throughout the state. A Minnesota Department of Health survey and report, Minnesota’s Health Care Workforce: Pandemic-Provoked Workforce Exits, Burnout, and Shortages, highlights the effect of the COVID-19 pandemic on most of the licensed health care workforce in Minnesota.
The report is a first-time effort, drawing on a survey given at the time of license renewal for “front-line” providers including physician assistants, respiratory therapists, pharmacists, nurses, physicians, mental health providers and others.
Coupled with the shortage of personal care and direct support staff statewide, the MDH report is cause of alarm in Greater Minnesota.
Nearly one in five rural health care providers say they plan to leave their profession within the next five years, according to the survey. The largest projected losses are among physicians. One out of every three rural physicians report planning to leave their profession within the next five years.
“We are going to need several approaches and solutions aimed at both recruiting the future workforce and retaining the current one,” said Minnesota Commissioner of Health Jan Malcolm. “We in government and health care must do more to prioritize retention, work with educational institutions to expand clinical training opportunities, and focus more broadly on the care team, including nurses, physicians, physician assistants, respiratory therapists and others.”
In almost every profession, more providers than in prior years reported that they planned to leave their profession within the next five years, and a much higher share of these exits is due to burnout.
The report indicates that vacancies have increased in nearly all health professions since their pre-pandemic levels, in some cases dramatically. The largest increases are in mental health and substance abuse counseling occupations, where one in four jobs is currently vacant and open for hire.
While burnout among nurses has been widely recognized, other providers are also struggling. Burnout or job dissatisfaction accounted for 26 percent of all physician assistant workforce exits, and 22 percent of respiratory therapy exits.
Potential solutions outlined in the report include retaining the incumbent workforce through programs such as loan forgiveness for health care providers, career exploration initiatives for new and dislocated workers, and programs aimed at increasing the diversity of the workforce. Employers can also focus on overcoming the hiring challenge by making health care jobs safe, flexible, well-paid and family-friendly.
State officials say there is need to establish a pipeline of health care professionals in high-need fields to serve Greater Minnesota. Current proposal at the capitol are meant to bolster and revitalize the health care workforce include launching rural clinical training tracks to create a pipeline of primary care physicians and psychiatrists trained in greater Minnesota; funding to expand rural rotations and clinical training opportunities for pre-licensure nurse practitioners, physician assistants, behavioral health students and dental graduates; and financial supports to mental health providers to pay for the supervised training they are required to complete before becoming licensed to practice.
Gov. Tim Walz’s administration has called for building on recent programs like free certified nursing training and the Minnesota Future Together Grant, both of which provide tuition-free pathways for students in high-need career areas.
The governor also wishes to provide $1 billion payments to frontline workers who have sacrificed during the pandemic to keep Minnesotans safe, healthy, fed and cared for. This would provide $1,500 payments to an estimated 667,000 workers, including health care workers.
Another Walz proposal is to allocate more than $250 million to address the workforce shortage, including an incentive program that would provide retention and bonus payments for workers who join and stay in the caring professions, including those who provide care for people with disabilities, older adults, people with behavioral health needs and people experiencing homelessness.
Staff numbers down, abuse reports up
Facilities around the state that house and provide employment and other services for people with disabilities continue to report severe staffing shortages. Prospective clients continue to find themselves on waiting lists, or force to move into care center or in with family due to lack of staffing.
Long-term care leaders said care facilities are struggling to fill about 23,000 open positions, or about 20 percent of their workforce. The staff shortage means that care facilities are turning people away.
A survey from Care Providers of Minnesota and Leading Age Minnesota, groups that represent long-term care facilities in the state, say nearly 70 percent of nursing homes are restricting admissions in some way because of a lack of staffing ability.
Another difficult issue state lawmakers are discussing is a rise in sexual abuse complaints within long-term care facilities is cause for concern, a Senate committee was told earlier this spring. Cheryl Hennen, the state’s ombudsman for long-term care, told a Senate committee earlier this spring that between 2020 and 2021 the number of such abuse reports rose from nine to 19.
Physical abuse complaints dropped slightly during that same period, which abuses including neglect and financial exploitation rose slightly.
“But it is important to note that these statistics may underestimate the actual abuse statistics because we were not able to be in person,” Hennen said to the committee.
The state ombudsman’s office suspended in-person visits to facilities in 2020, Such visits are being conducted again in-person.
Hennen also told the committee that labor shortages in long-term care can lead to abuse and neglect, using the example of a nursing home resident with an amputated leg. When that resident needs to use the restroom, he has sometimes been left waiting for help for as long as three hours.