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Related Guides on this Topic

You may also want to see these guides on related topics: Health Education Financial Aid, J-1 Visa Waiver

Introduction

Health care is one of the largest industries in the country, employing a vast number of workers. Still, many communities experience health care workforce shortage problems, with the most severe being in rural health professional shortage areas and medically needy and underserved population groups.

Rural health care workforce shortages carry a negative impact on health care quality, through reduced health care access as well as through increased stress on providers. Shortages not only contribute to higher costs by raising compensation levels to reflect increased demand but also by increasing the use of overtime pay and expensive temporary personnel.

Frequently Asked Questions

Tools

AHA Issues: Health Care Workforce
Database
Comprised of a Commission on Workforce, which focuses on developments and resources to deal with the present health care workforce shortage.
Sponsoring organization: American Hospital Association

Career Voyages
Web site
A collaboration between the U.S. Department of Labor and the U.S. Department of Education designed to provide information on high growth, in-demand occupations along with the skills and education needed to attain those jobs.
Sponsoring organization: U.S. Department of Labor

Community HealthCorps
Web site
Promotes health care for America's underserved. Works to increase access to health care, provide health education, support use of health care services, and recruit and develop volunteers to support community health centers.
Sponsoring organization: National Association of Community Health Centers

Electronic Residency Application Service (ERAS)
Database
Transmits residency applications, letters of recommendation, Dean's Letters/MSPE, transcripts, and other supporting credentials from applicants and medical schools to Fellowship, Osteopathic Internship and Residency programs using the Internet.
Sponsoring organization: Association of American Medical Colleges

FindAResident
Database
Helps in locating residency and fellowship positions; puts residents in direct contact with the programs looking to fill these positions; supplements the Electronic Residency Application Service (ERAS); and is an effective resource when changing specialty, location or residency program.
Sponsoring organization: Association of American Medical Colleges

FREIDA Online
Database
Stands for Fellowship and Residency Electronic Interactive Database. Contains over 7800 medical education programs accredited by the Accreditation Council for Graduate Medical Education, as well as over 200 combined specialty programs. Allows searching for specialty and subspecialty programs, training institutions, medical schools, aggregate training statistics by specialty, and career plans of recent graduates.
Sponsoring organization: American Medical Association

Guidelines for Medically Underserved Area and Population Designation
Web site
Guidelines for use in applying the established Criteria for Designation of Medically Underserved Areas (MUAs) and Populations (MUPs). Describes three methods for designation.
Sponsoring organization: Bureau of Health Professions

Health Care Shortage Designations
Web site
Contains information about health care shortage designations such as Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas and Populations (MUAs/MUPs).
Sponsoring organization: Bureau of Health Professions

Medically Underserved Area/Medically Underserved Population (MUA/MUP) Database
Database
Allows searching by state, county, or ID number. Includes designation status and date.
Sponsoring organization: Health Resources and Services Administration

Midwest Center for Health Workforce Studies
Web site
Conducts research on the health workforce to improve health workforce policy and planning at the state, Midwest regional and national level, which leads to increased access to care for underserved populations.
Sponsoring organization: Health Resources and Services Administration

National Center for Health Workforce Analysis
Database
Provides detailed state-by-state data on supply, demand, distribution, education and use of health personnel. Collects, analyzes and disseminates health workforce information and facilitates national, state and local workforce planning efforts. Monitors trends to assure that all segments of society have access to quality health care professionals providing appropriate health care services in all geographic areas.
Sponsoring organization: Health Resources and Services Administration

National Clearinghouse on the Direct Line Workforce
Web site
Consists of a national on-line library for people in search of solutions to the direct-care staffing crisis in long-term care. Includes government and research reports, news, issue briefs, fact sheets, and other information on topics such as recruitment, career advancement supervision, workplace culture, and caregiving practices.
Sponsoring organization: Paraprofessional Healthcare Institute

NHSC Job Opportunities
Database
Listing of health professional job opportunities available serving underserved populations. Job listings are not exclusive to NHSC Scholars and those interested in the NHSC Loan Repayment Program.
Sponsoring organization: National Health Service Corps

Partners in Information Access for the Public Health Workforce
Web site
Information and resources to help the public health workforce find and use information effectively. Includes funding sources, data and statistics, career resources and more. Provided by a collaboration of U.S. government agencies, public health organizations and health sciences libraries.

Rural Health Career Center
Database
Jobs are searchable by location, job title or industry segment. Resumes and jobs may be posted, are self-contained, and are instantly displayed.
Sponsoring organization: National Rural Health Association

Rural Health Research: Workforce
Web site
Provides summaries of current and completed rural health research projects and related publications addressing the topic of health care workforce, produced by the Office of Rural Health Policy's funded rural health research centers.
Sponsoring organization: Rural Health Research Gateway

Rural Hospital Education Gateway
Web site
A one-stop shop for rural hospitals to access distance and web-based educational resources on topics including community engagement, hospital finance, management and leadership, performance improvement, workforce and quality.
Sponsoring organization: Rural Health Resource Center

State Health Workforce Profiles
Web site
Detailed state-by-state data on supply, demand, distribution, education and use of health personnel.
Sponsoring organization: National Center for Health Workforce Analysis

WWAMI Center for Health Workforce Studies Regional Information Center
Web site
Provides access to health workforce information for Washington, Wyoming, Alaska, Montana, Idaho. Content is available by state and by profession.
Sponsoring organization: WWAMI Center for Health Workforce Studies

Funding

2008 Cherokee Inspired Comfort Award
The award provides nurses, healthcare workers, their colleagues, and the public a national opportunity to recognize exceptional service, sacrifice and innovation resulting in encouraging and inspirational accounts that we share with the nation.

Robert Wood Johnson Foundation New Careers in Nursing
A scholarship program to help alleviate the nursing shortage and increase the diversity of nursing professionals.

Robert Wood Johnson Foundation Unsolicited Grants
Grants to address health care workforce, innovative health care solutions, and health care to vulnerable populations.

Inactive Funding

Inactive Funding Opportunities - Lists additional funding programs for this topic that are not currently accepting applications. Programs that are inactive may be offered again in the future.

Maps & Map Collections

Health Professional Shortage Areas (HPSA) - Primary Medical Care, Clinician Priority Scores
Geographic coverage: United States
Printable map that shows the clinician priority scores of dental HPSAs nationwide. These scores are used by the National Health Service Corps in determining priorities for assignment of clinicians. Scores range from 1 to 25, with higher scores having greater priority. Data source: Health Resources and Services Administration, Bureau of Health Professions, January 2008.
Sponsoring organization: Rural Assistance Center
Date: 2008

Health Professional Shortage Areas (HPSA) - Primary Medical Care, Designated Populations
Geographic coverage: United States
Printable map that shows the location and type of population that is underserved for population group primary medical care HPSAs nationwide. Data source: Health Resources and Services Administration, Bureau of Health Professions, January 2008.
Sponsoring organization: Rural Assistance Center
Date: 2008

Health Professional Shortage Areas (HPSA) - Primary Medical Care, Designated Type
Geographic coverage: United States
Printable map that shows the designated types of mental health HPSAs, Population Group, Single County, and Geographical Area, nationwide. Data source: Health Resources and Services Administration, Bureau of Health Professions, January 2008.
Sponsoring organization: Rural Assistance Center
Date: 2008

Medically Underserved Areas (MUAs) and Medically Underserved Populations (MUPs), Designated Type
Geographic coverage: United States
Printable map that shows the designated type of MUAs and MUPs nationwide. Data source: Health Resources and Services Administration, Bureau of Health Professions, January 2008.
Sponsoring organization: Rural Assistance Center
Date: 2008

Regulations, Forms & Other Useful Documents

2005 Physician Supply and Distribution in Rural Areas of the United States (full report)
Author(s): Meredith A. Fordyce, Frederick M. Chen, Mark P. Doescher, L. Gary Hart
Sponsoring organization: WWAMI Rural Health Research Center
Describes the 2005 supply and distribution of physicians with particular emphasis on generalists in rural areas.
Date: 11 / 2007

2007 State Physician Workforce Data Book
Sponsoring organization: Association of American Medical Colleges
Examines the active physician supply in each state, current medical school enrollment, physicians in graduate medical education programs, and in-state retention rates. Includes data charts and tables for all 50 states, in addition to national averages.
Date: 11 / 2007

Action Plan for Behavioral Health Workforce Development
Author(s): Annapolis Coalition on the Behavioral Health Workforce
Sponsoring organization: Substance Abuse and Mental Health Services Administration
Describes a broad, national workforce development plan for the behavioral health workforce. Covers workforce issues relevant to persons with mental health conditions, substance abuse or substance use disorders, and co-occurring mental and addictive conditions. Includes a chapter focused on rural behavioral health workforce issues.
Date: 2007

Allied Health Job Vacancy Tracking Report
Author(s): Erin Fraher, Phillip Summers, Katie Gaul, Stephen Rutledge
Sponsoring organization: North Carolina Rural Health Research and Policy Analysis Center (Cecil G. Sheps Center)
Quantifies workforce demand for selected allied health professions in North Carolina, tracks job vacancy advertisements in print and online sources, summarizes vacancy advertisements by profession, region, and employer type, and describes the types of sign-on bonuses offered by employers.
Date: 04 / 2007

An Aging U.S. Population and the Health Care Workforce: Factors Affecting the Need for Geriatric Care Workers
Sponsoring organization: U.S. Department of Health and Human Services
Identifies and critiques major long-term care projection models related to the demand for care of the elderly in three major settings: nursing homes, residential care, and home care.
Date: 02 / 2006

Are Advanced Practice Psychiatric Nurses a Solution to Rural Mental Health Workforce Shortages?
Author(s): David Hartley, Valerie Hart, Nancy Hanrahan, Stephenie Loux
Sponsoring organization: Maine Rural Health Research Center
Discusses the role advanced practice psychiatric nurses (APPNs) could play in providing mental health services to rural areas. Includes information on prescription authority and collaboration requirements for each state, as well as state distribution of APPNs.
Date: 04 / 2004

Around the Country: Special Series: Technical Assistance Centers: National Rural Recruitment and Retention Network (3RNet)
Author(s): Hope Hanson
Sponsoring organization: Rural Assistance Center
Fourth in a series of articles on rural health technical assistance resources around the country funded by the federal Office of Rural Health Policy (ORHP). Highlights the National Rural Recruitment and Retention Network (3RNet).
Journal citation: Rural Monitor
Date: 08 / 2006

Changes in the Rural Registered Nurse Workforce from 1980 to 2004 (Final Report)
Author(s): Susan M. Skillman, Lorella Palazzo, L. Gary Hart, Patricia Butterfield
Sponsoring organization: WWAMI Rural Health Research Center
Describes changes in rural and urban Registered Nurse demographics, education, and employment characteristics over time.
Date: 10 / 2007

Community Colleges: Critical Training
Author(s): Thomas D. Rowley
Sponsoring organization: Rural Assistance Center
Discusses the role community colleges play in health care workforce training across the nation.
Journal citation: Rural Monitor Volume 11 Issue 3
Date: 01 / 2005

Community Health Aide Program: Overview 2007
Provides a detailed overview of Community Health Aide Program (CHAP) including the history, current practice, training, field supervision, and quality assurance of this unique program that facilitates health care services in Alaska's remote villages.
Date: 03 / 2007

Contribution of Nurse Practitioners and Physician Assistants to Generalist Care in Washington State
Author(s): Eric H. Larson, Lorella Palazzo, Bobbi Berkowitz, Michael J. Pirani, L. Gary Hart
Sponsoring organization: WWAMI Rural Health Research Center
Describes the contribution to generalist care made by nurse practitioners (NPs) and physician assistants (PAs) in Washington State. Includes data on NP and PA contributions in rural areas.
Journal citation: Health Services Research Volume 38 Issue 4 Pages: 1033-1050
Date: 08 / 2003

Critical Care Workforce: A Study of the Supply and Demand for Critical Care Physicians
Sponsoring organization: U.S. Department of Health and Human Services
Examines the adequacy of the critical care workforce. Working with the American College of Chest Physicians, HRSA and its consultants updated the physician workforce models to include critical care physicians.
Date: 2006

Effects of the Workforce Investment Act of 1998 on Health Workforce Development in the States
Sponsoring organization: Health Resources and Services Administration
Describes how WIA resources have been used by state and local workforce investment boards to develop the health care workforce. Describes characteristics of WIA that can be used to support health workforce development.
Date: 11 / 2004

Female Physician Recruitment Secrets for Rural Communities
Sponsoring organization: University of Colorado Health Sciences Center
Lists the top 10 things a woman physician should know about rural medical practice as well as tips for rural communities in recruiting and retaining female physicians.
Date: 2005

Financing Dental Education: Public Policy Interests, Issues and Strategic Considerations
Sponsoring organization: U.S. Department of Health and Human Services
Informs State and Federal officials about key issues concerning the structure and financing of dental education and, in particular, to highlight salient public policy considerations. The report's primary focus is on predoctoral dental education (i.e., programs that award D.D.S. or D.M.D. degrees to graduates of U.S. dental schools).
Date: 2006

Health Care Challenges Abundant in the Alaskan Frontier
Author(s): Candi Helseth
Sponsoring organization: Rural Assistance Center
Discusses health care workforce shortages in Alaska’s Wrangell and Petersburg frontier communities. Highlights Alaska’s Community Health Aide Program (CHAP), which serves the state’s Native population, using more than 550 Community Health Aides/Practitioners, employed by 27 tribal health organizations, who practice in more than 180 rural villages in the state’s most remote areas known as the bush.
Journal citation: Rural Monitor
Date: 08 / 2007

Health Professions Programs: Over 1,000,000 Trained and Counting FY 2008 Brochure
Sponsoring organization: Health Professions and Nursing Education Coalition
Discusses Titles VII and VIII of the Public Health Service Act which are health professions programs that support the training and education of health care providers with the aim of enhancing the supply, diversity, and distribution of the workforce, filling the gaps in the health professions' supply.
Date: 2007

Health Workforce Recruitment and Retention in Critical Access Hospitals
Sponsoring organization: Rural Hospital Flexibility Program Tracking Project Consortium, 1999-2003
Describes Critical Access Hospitals (CAHs) workforce and successful recruitment and retention strategies used in CAHs.
Journal citation: Findings from the Field Volume 3 Issue 5
Date: 11 / 2003

Imported Care: Recruiting Foreign Nurses to U.S. Health Care Facilities
Author(s): Barbara Brush
Examines past and current foreign nurse use as a response to nurse shortages and its implications for domestic and global nurse workforce policies.
Journal citation: Health Affairs Volume 23 Issue 3 Pages: 78-87
Date: 2004

In Our Hands: How Hospital Leaders Can Build A Thriving Workforce
Sponsoring organization: American Hospital Association
Presents the recommendations and conclusions of the AHA Commission on Workforce for Hospitals and Health Systems.
Date: 04 / 2002

International Medical Graduate Physicians in the U.S.: Changes Since 1981
Author(s): L. Gary Hart, Susan M. Skillman, Amy Hagopian, Meredith A. Fordyce, Matthew J. Thompson, Thomas R. Konrad
Sponsoring organization: WWAMI Center for Health Workforce Studies
Results of a study which describes changes over time in IMGs' country of education, demographics, type of practice, specialty, and propensity to practice in needy locations since 1981.
Date: 03 / 2005

International Medical Graduates and the Primary Care Workforce for Rural Underserved Areas
Author(s): Kenneth S. Fink
An analysis of primary care IMGs compared to U.S. medical graduates working in rural underserved areas.
Journal citation: Health Affairs Volume 22 Issue 2 Pages: 255-262
Date: 04 / 2003

Measuring the Years: State Aging Trends & Indicators
Author(s): Laura Summer
Sponsoring organization: National Governors Association Center for Best Practices
Identifies current trends and future directions confronting state policy makers. Provides a wealth of information on topics ranging from demographic shifts, health care concerns, and long term care workforce shortages.
Date: 11 / 2004

Medical School Programs to Increase the Rural Physician Supply: A Systematic Review and Projected Impact of Widespread Replication
Author(s): Howard K. Rabinowitz, James J. Diamond, Fred W. Markham
Sponsoring organization: Association of American Medical Colleges
Study which examined rural physician training efforts. Six medical school programs designed to increase the ranks of rural physicians could be nationally replicated to more than double the number of graduates who choose to practice in rural areas across the next decade.
Journal citation: Academic Medicine Volume 83 Issue 3 Pages: 235-243
Date: 03 / 2008

Medicare Physician Payment: Impacts of Changes on Rural Physicians
Author(s): Keith J. Mueller, A. Clinton MacKinney, Timothy D. McBride
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
Overview of the effects of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 on physician payment rates in rural areas. Discusses the impact of creating a floor of 1.00 in the geographic practice cost index (GPCI) for work expense and the effects of the Medicare incentive payment (MIP) for providing services in shortage areas and of the bonus for practicing in a physician scarcity area.
Date: 09 / 2006

Nursing Workforce: HHS Needs Methodology to Identify Facilities with a Critical Shortage of Nurses
Sponsoring organization: Government Accountability Office
GAO reports on changes in the RN shortage since 2000. Also discusses the impact of the Nursing Education Loan Repayment Program (NELRP) and Nursing Scholarship Program (NSP) on the shortage of nurses.
Date: 04 / 2007

On-Line Atlas of International Medical Graduates
Sponsoring organization: WWAMI Center for Health Workforce Studies
Displays trends in the geographic distribution of IMGs over the past 20 years through a series of maps.
Date: 2006

Partnering to Address Health Care Workforce
Sponsoring organization: Rural Assistance Center
Describes a program in rural Wisconsin, Minnesota and Iowa that combines an effort to lower unemployment and to address the area's health workforce shortage.
Journal citation: Rural Monitor Volume 10 Issue 1
Date: 2003

Pathways to Rural Practice: A Chartbook of Family Medicine Residency Training Locations and Characteristics
Author(s): L. Gary Hart, Denise M. Lishner, Eric H. Larson, Frederick M. Chen, C. Holly A. Andrilla, Thomas E. Norris, Ronald Schneeweiss, Tim M. Henderson, Roger A. Rosenblatt
Sponsoring organization: WWAMI Rural Health Research Center
Discusses characteristics and geographic locations of family medicine residency programs' rural locations, types of rural family medicine training by location, and rural mission of family medicine residencies.
Date: 08 / 2005

Physician Shortage and Distribution
Sponsoring organization: American Hospital Association
Brief overview of the physician shortage issues faced by rural hospitals. Includes information on current public policy, and resources for hospitals.

Physician Supply and Demand: Projections to 2020
Sponsoring organization: U.S. Department of Health and Human Services
Presents projections of physician supply and requirements for 18 physician specialties using the Physician Supply Model and the Physician Requirements Model. Describes data, assumptions and methods used to project the future supply of and requirements for physician services.
Date: 10 / 2006

Physician Workforce: Supply Increased in Metropolitan and Nonmetropolitan Areas but Geographic Disparities Persisted
Sponsoring organization: Government Accountability Office
Describes the change in supply of physicians from 1991 to 2001. Includes data nationally and by state on physicians in nonmetropolitan areas and on the number of specialists versus generalists. Includes list of Health Resources and Services Administration programs that address the supply and distribution of health professionals, with 1991 and 2001 expenditures for each program.
Date: 10 / 2003

Primary Care Professionals: Recent Supply Trends, Projections, and Valuation of Services
Sponsoring organization: Government Accountability Office
Focuses on recent supply trends for primary care professionals, including information on training and demographic characteristics; projections of future supply for primary care professionals; and the influence of the health care system's financing mechanisms on the valuation of primary care services.
Date: 02 / 2008

Public Health Worker Shortages: Trends Alert
Author(s): Melissa Taylor Bell
Sponsoring organization: Council of State Governments
Discusses results of a survey done with human resource directors in state public health offices regarding public health workforce issues.
Date: 11 / 2004

Quality Through Collaboration: The Future of Rural Health Care (Full Report)
Sponsoring organization: Institute of Medicine
Examines the quality of health care in rural America. Includes recommendations to improve health care quality and safety in rural communities. Addresses workforce, information technology, finance and other factors that impact rural health care quality.
Date: 11 / 2004

Rationale for Diversity in the Health Professions: A Review of the Evidence
Sponsoring organization: Bureau of Health Professions
Examined publicly available studies addressing a diverse health professions workforce.
Date: 10 / 2006

Reaching Out to Rural Regions: New MD Program Aims to Address Shortages
Author(s): Dian Land
Sponsoring organization: Wisconsin Office of Rural Health
Highlights the University of Wisconsin School of Medicine and Public Health WARM Program, which is a new medical degree created and aimed at addressing the serious shortage of physicians in rural areas of Wisconsin. WARM stands for The Wisconsin Academy for Rural Medicine.
Date: 11 / 2006

Recruiting Local People to Fill Health Care Needs
Author(s): Candi Helseth
Sponsoring organization: Rural Assistance Center
Discusses how frontier and rural health care providers looking for innovative ways to solve increasing workforce shortages, are recruiting and training local people to be health care professionals in their communities. Highlights programs in Nevada, Maryland, and Alaska.
Journal citation: Rural Monitor
Date: 08 / 2007

Recruiting Physicians for Rural Settings
Author(s): Brian McCartie
Sponsoring organization: Catholic Health Association of the United States
Discusses effective strategies rural communities can use to recruit and retain physicians.
Journal citation: Health Progress
Date: 04 / 2004

Recruitment Process of Foreign Nurses gets a Boost from INS
Author(s): Scott Shepard
Discusses how the Immigration and Naturalization Service gave the recruiting industry a boost at the end of the year by issuing for the first time clear guidelines for using a H1-B visa for a nurse.
Journal citation: Memphis Business Journal
Date: 02 / 2003

Registered Nurse Population: Findings from the March 2004 National Sample of Registered Nurses
Sponsoring organization: Health Resources and Services Administration
Summarizes results of a study on collected data on the actively licensed registered nurse population as of March 2004.
Date: 03 / 2006

Rescuing the Health Workforce: Options for State Action
Sponsoring organization: National Governors Association Center for Best Practices
Discusses projected health workforce shortages nationwide, causes of the shortage in health care workers, and strategies used in several states to address the problem.
Date: 01 / 2004

Retaining Rural Nurses: Midwestern Summit on Retaining and Making Best use of the Older More Experienced Rural Registered Nurse
Sponsoring organization: Minnesota Office of Rural Health and Primary Care
Highlights of a one-day session, consisting of 25 nurse-leaders from Iowa, Minnesota, North Dakota and South Dakota who engaged in a series of roundtable discussions on the future of older nurses in rural communities.
Date: 08 / 2007

Retention of Family Physicians
Author(s): Robert C. Bowman
Helpful for all of those currently challenged with funding and other areas regarding family medicine and rural health. Document has text and links to other resources. Has a Midwest focus, but it can be revised to meet specific states.

Rural Health Facts: North Dakota Health Professions: Nursing
Sponsoring organization: University of North Dakota Center for Rural Health
Facts on the supply and demand for nurses in North Dakota. Includes data for RNs and LPNs.
Date: 2004

Rural Kaleidoscope: A Guide on Promising Practices to Diversify California's Rural Healthcare Workforce
Author(s): Lisel Blash, Eva Schiorring
Sponsoring organization: California State Rural Health Association
Focuses on helping those who recruit new health care professionals, retain existing staff, develop workforce partnerships, and work with community organizations.
Date: 12 / 2005

Rural Populations and Health Care Providers: A Map Book
Author(s): Randy Randolph, Katherine Gaul, Rebecca Slifkin
Sponsoring organization: North Carolina Rural Health Research and Policy Analysis Center (Cecil G. Sheps Center)
Uses 2000 Census data to reassess and provide a visual picture of where rural people live, how the racial and ethnic nature of rural populations is changing, and whether the distribution of health care providers matches the population distribution.
Date: 09 / 2002

Rural Spotlight: An Interview with Robert C. Bowman, M.D.
Sponsoring organization: Rural Assistance Center
An interview with one of the country’s leading researchers in rural medical education who discusses ways to recruit and retain rural physicians.
Journal citation: Rural Monitor
Date: 11 / 2007

Rural Workers Would Benefit More Than Urban Workers from an Increase in the Federal Minimum Wage
Author(s): William O'Hare
Sponsoring organization: Carsey Institute
Looks at how an increase in the minimum wage would impact rural workers relative to urban workers by examining workers who are likely to benefit directly from an increase in the minimum wage because they currently earn less than $7.25 an hour. This group is called "low-wage workers." Looks at 74 million hourly workers who represent about 60 percent of all workers.
Date: 2007

Shortages of Medical Personnel at Community Health Centers
Author(s): Roger A. Rosenblatt, C. Holly A. Andrilla, Thomas Curtin, L. Gary Hart
Discusses staffing shortages at Community Health Centers (CHCs) in rural and urban locations and how these workforce shortages may impact efforts to expand the CHC program.
Journal citation: JAMA: The Journal of the American Medical Association Volume 295 Issue 9 Pages: 1042-1049
Date: 03 / 2006

State of the Health Workforce in Rural America: Profiles and Comparisons
Author(s): Eric H. Larson, Karin E. Johnson, Thomas E. Norris, Denis M. Lishner, Roger A. Rosenblatt, L. Gary Hart
Sponsoring organization: WWAMI Rural Health Research Center
Overview of rural health care workforce issues. National and state-by-state data on the health care workforce, with rural-urban comparisons and interstate comparisons. Also includes data on rural health care facilities.
Date: 08 / 2003

State Public Health Employee Worker Shortage Report: A Civil Service Recruitment and Retention Crisis
Sponsoring organization: Association of State and Territorial Health Officials
Results of a survey of 37 state public health agencies on public health employee workforce shortages.
Date: 2005

Training Programs for Certified Nursing Assistants
Author(s): Esther Hernández-Medina, Susan Eaton, Donna Hurd, Alan White
Sponsoring organization: AARP
Reports on CNA education and training by exploring how many additional hours of initial training and clinical training are needed to equip CNAs to provide good quality care to residents. It also examines pre-training screening, remedial education, training in English as a Second Language, and shadowing; CNA testing; and reimbursement of CNAs for their training and testing expenses.
Date: 03 / 2006

Trends in the Supply of Dentists in North Carolina, 1996-2005
Author(s): Erin Fraher, Katie Gaul, Jennifer King, Hazel Hadley, Claire de la Varre, Thomas Ricketts
Sponsoring organization: North Carolina Rural Health Research and Policy Analysis Center (Cecil G. Sheps Center)
Highlights workforce supply, distribution, professional shortage areas, demographics, and practice characteristics and training.
Date: 02 / 2007

United States Licensure for International Dentists
Sponsoring organization: American Dental Association
Provides information to dentists, who were educated outside the United States and Canada and wish to obtain a dental license in the U.S.
Date: 01 / 2006

Unlocking the Potential of Nursing: A Guide for Grantmakers
Author(s): Edward O'Neil, Elizabeth Mertz, Jenny Vance
Sponsoring organization: Robert Wood Johnson Foundation
Guide to help grantmakers working at the local level to address the nursing shortage. Includes an overview of the current nursing shortage, promising programs to address the shortage, and suggestions and resources for local foundations.
Date: 2006

War Has Big Impact in Rural Areas
Author(s): Candi Helseth
Sponsoring organization: Rural Assistance Center
Describes the challenges rural health care facilities experience when their health care providers are deployed to Iraq and Afghanistan.
Journal citation: Rural Monitor
Date: 2007

What is Behind HRSA's Projected Supply, Demand, and Shortage of Registered Nurses?
Sponsoring organization: U.S. Department of Health and Human Services
Provides a brief overview of two models: Nursing Supply Model (NSM) and the Nursing Demand Model (NDM). Describes the data, methods, and assumptions used to project RN supply and demand; presents findings from the models; and discusses the limitations of these and other models and methods to forecast demand for health workers.
Date: 2006

Who is Caring for the Underserved? A Comparison of Primary Care Physicians and Nonphysician Clinicians in California and Washington
Author(s): Kevin Grumbach, L. Gary Hart, Elizabeth Mertz, Janet Coffman, Lorella Palazzo
Sponsoring organization: WWAMI Rural Health Research Center
Compares the geographic distribution and patient populations of physician and nonphysician primary care clinicians. Includes the proportion of clinicians within each discipline practicing in rural areas, Health Professional Shortage Areas (HPSAs), and areas with vulnerable populations.
Journal citation: Annals of Family Medicine Volume 1 Issue 2 Pages: 97-104
Date: 07 / 2003

Will Rural Family Medicine Residency Training Survive?
Author(s): Rosenblatt, Roger; Hagopian Amy; Andrilla Holly; Hart Gary
Sponsoring organization: Society of Teachers of Family Medicine
Examines the recent performance of rural residencies in the National Resident Matching Program as an indicator of their viability.
Journal citation: Family Medicine Journal Volume 38 Issue 10 Pages: 705-711
Date: 11 / 2006

Workers Who Care: A Graphical Profile of the Frontline Health and Health Care Workforce
Sponsoring organization: Robert Wood Johnson Foundation
Chartbook providing information about frontline health care occupations, covering 32 occupational groups of health and health care workers with high levels of direct care/service, median annual wages under $40,000 and required educational training of a bachelor's degree or below. Data is available at the national level and by state.
Date: 2006

Workforce Development in Rural Local Public Health Agencies
Sponsoring organization: National Association of County and City Health Officials
Focuses on the public health workforce recruitment and retention challenges as well as strategies for training and retraining new and existing staff in rural local public health practice areas.
Date: 07 / 2005

Workforce Development Networks in Rural Areas of the United States
Author(s): Gary Paul Green
Sponsoring organization: Southern Rural Development Center
Examines how workforce development networks are organized, why employers and community colleges participate in them, and the factors influencing their success.
Date: 09 / 2003

Organizations

Bureau of Clinician Recruitment and Service (BCRS)
Federal government
Coordinates the recruitment and retention of caring health professionals in the healthcare system and supports communities' efforts to build more integrated and sustainable systems of care. Part of the Health Resources and Services Administration (HRSA), U.S. Department of Health & Human Services.

Center for the Health Professions
National organization
Works to help health care professionals, schools, organizations and policymakers respond to the challenges of educating and managing the health care workforce. Part of the University of California, San Francisco.

Council on Graduate Medical Education (COGME)
Federal government
Provides an ongoing assessment of physician workforce trends, training issues and financing policies, and recommends appropriate federal and private sector efforts on these issues.

Health Professions and Nursing Education Coalition (HPNEC)
National organization
Comprised of an alliance of over 50 national organizations representing schools, programs, health professionals and students dedicated to ensuring the health care workforce is trained to meet the needs of our diverse population.

Hire Heroes Program
National organization
Designed to help military veterans who were wounded find careers within the healthcare industry after serving in Afghanistan, Iraq and other locations around the world.

National Area Health Education Center Organization (NAO)
National organization
Supports and advances the AHEC network in improving the health of individuals and communities by transforming health care through education.

National Association of State Workforce Agencies (NASWA)
National organization
National organization of state administrators of unemployment insurance, employment and training services, and labor market information programs in the 50 states, the District of Columbia, Puerto Rico, and the Virgin Islands.

National Association of Workforce Boards (NAWB)
National organization
Represents the interests of the nation's Workforce Investment Boards that provide workforce development leadership in their communities. Governs and oversees the federal resources that support the operations of the national network of One-Stop Career Centers and federal training investments.

National Health Service Corps (NHSC)
Federal government
Works to improve the health of the underserved by recruiting and retaining the health professionals to deliver health care in underserved communities. Provides technical assistance to federally designated Health Professional Shortage Areas (HPSAs) on projects that enhance the NHSC's site development mission. Part of the Bureau of Health Professionals, Health Resources and Services Administration.

National Rural Recruitment & Retention Network (3Rnet)
National organization
Helps health care professionals, including dentists and dental hygienists find practice opportunities in rural areas throughout the country. Includes individual state information as well as a list of state contacts.

National Workforce Association (NWA)
National organization
Dedicated to strengthening the nation's workforce development system. Provides expertise and input to federal, state and local elected officials to enable them to make sound policy decisions about the workforce system.

Rural Health Resource Center (RHRC)
National organization
Provides technical support for the State Offices of Rural Health and their flex coordinators for the Rural Hospital Flexibility Program, focuses on rural practice opportunities for healthcare providers in Minnesota and the surrounding region, does performance improvement with hospitals across the country, and develops the Rural Health Resource Directory of rural consultants and speakers found throughout the United States.

WWAMI Center for Health Workforce Studies
Academic/Research
Conducts relevant health workforce research and policy analysis in collaboration with federal and state agencies as well as develops and refines analytical methods for measuring state health workforce supply and requirements.

Terms & Acronyms

Health Professional Shortage Area (HPSA) Geographic regions that have shortages of professionals working in primary medical care, dental or mental health care. HPSAs may be urban or rural areas, population groups or medical or other public facilities. Geographically, HPSAs can be cities or towns, counties or groups of counties. HPSA designations are reviewed and revised annually by the Secretary of Health and Human Services based on criteria set forth in the Public Health Service Act.

Health Professional Shortage Area - Mental Health (HPSA - Mental Health) HPSA designation for a shortage of mental healthcare professionals that requires three criteria are met. First, the area must be a rational area for delivery of mental healthcare services. Second, the ratio of population to existing providers must meet at least one of several criteria detailed in the Health Professional Shortage Area Mental Health Designation Criteria listed on the Bureau of Health Professions website. Also, the area under consideration must have mental health professionals in continuous (nearby/adjoining) areas that are over utilized, excessively distant or inaccessible.

Health Professional Shortage Area - Primary Care (HPSA - Primary Care) HPSA designation for a shortage of primary care health professionals that meets three requirements. First, the area must be a rational area for delivery of primary medical care services. Second, the ratio of population to existing providers must meet or exceed 3,500 people to every single provider or meet or exceed a ratio of 3,000 to 1 and have an unusually high level of need. Lastly, the area under consideration must have primary medical care professionals in continuous (nearby/adjoining) areas that are over utilized, excessively distant or inaccessible.

Health Professional Shortage Area - Dental Care (HPSA - Dental Care) The federal designation for a shortage of dental care health professionals that meets the following three criteria. First, the area must be a rational area for delivery of dental care services. Second, the ratio of population to existing providers must meet or exceed 5,000 people to every single provider or meet or exceed a ratio of 4,000 to 1 and have an unusually high level of need for dental services. Lastly, the area under consideration must have dental care professionals in continuous (nearby/adjoining) areas that are over utilized, excessively distant or inaccessible.

J-1 Visa Waiver Eliminates the two year residency requirement, allowing the physician to remain and practice in the United States.

Medically Underserved Area (MUA) Medically Underserved Areas (MUAs) are federal designations derived from the Index of Medical Underservice (IMU). This index ranges from 0 to 100 and is based on four criteria: 1) ratio of primary medical care physicians per 1,000 people, 2) infant mortality rate, 3) percent of the population with incomes below the poverty level and 4) the percent of the population age 65 or older. An IMU of 62.0 or less qualifies an area to be designated a MUA. Geographic areas designated as MUAs can be a whole county or a group of contiguous (adjoining) counties, minor civil divisions (MCD), census county divisions (CCD) or census tracts.

Medically Underserved Population (MUP) A federal designation that is derived by using the Index of Medical Underservice (IMU). This index ranges from 0 to 100 and is based on four criteria: 1) ratio of primary medical care physicians per 1,000 people, 2) infant mortality rate, 3) percent of the population with incomes below the poverty level and 4) the percent of the population age 65 or older.

Recruitment Process of adding new individuals to a population by growth or immigration.

Retention To keep in one's service or employment

Workforce Workers employed in a specific project or activity.

Success Stories

RAC Success Stories: Workforce

Nelson County Rural Health Outreach
This Rural Health Outreach Program launched a school nursing program that placed registered nurses in each of the six Nelson County public schools as well as creating a supplementary health education program provided by a registered nurse who traveled to each site.

Tri-State Rural Health Partnership
This seven organization partnership made it possible to provide a wide range of health services including training to middle school students and teachers to recognize and respond to heart attack situations, access to health services and information, including walk-in services, general health education, parent education and health screenings for a variety of conditions such as elevated blood pressure and cholesterol, and an osteoporosis prevention program, and wellness programs for older women.

Rural Health Careers in Wisconsin

This free, interactive website focuses on rural Wisconsin. Offers resume posting, as well as searching for clinical and non-clinical positions.

Article Searches & Bibliographies

RAC Documents Search: Health Care and Workforce

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Page last updated 5/2/2008
Topic last reviewed 5/1/2008

News
May 2, 2008 -- OHSU President Bemoans Lack of Rural Doctors

Apr 30, 2008 -- Medicare Program; Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2009 Rates; Proposed Changes to Disclosure of Physician Ownership in Hospitals and Physician; Self-Referral Rules; Comment Request

Apr 30, 2008 -- Study Projects Shortage of Generalist Physicians for Adults

Apr 29, 2008 -- May 7 is "Legacy Free" Day – An Opportunity to Check Your NPI Readiness!

Apr 25, 2008 -- More Emergency Rooms Open Away from Hospitals

Apr 23, 2008 -- Conferees Withdraw Self-referral Proposal from Farm Bill

Apr 23, 2008 -- Only 1 in 3 Doctors Use E-mail with Patients

Apr 23, 2008 -- Robert Wood Johnson Foundation Partners with AACN to Launch New Careers in Nursing Scholarship Program

Apr 22, 2008 -- Congress Seeks to Ease Doctor Shortage

Apr 21, 2008 -- Congress Should Ban Physician Self-referral, Hospital Groups Say

Apr 18, 2008 -- NIH Study Reveals Factors That Influence Premature Infant Survival, Disability

Apr 18, 2008 -- Congress Aims to Ease Doctor Shortage

Apr 18, 2008 -- Quality Reporting Initiative Will Help Improve Health Care for Beneficiaries and Provide Incentives for Eligible Professional

Apr 15, 2008 -- Dr. Fay Raines from the University of Alabama in Huntsville Assumes Presidency of the American Association of Colleges of Nursing

Apr 15, 2008 -- AHRQ Web Resource Features 100 Examples of Health Care Innovations and Tools

Apr 15, 2008 -- IOM: Health Care Workforce Unprepared for Aging Baby Boomers

Apr 15, 2008 -- OIG Refines Self-Disclosure Protocol

Apr 11, 2008 -- Money Magazine Ranks Physician Assistant One of Best Careers to Have in a Recession

Apr 10, 2008 -- Reports Recommend Increased Funding, Flexibility for GME

Apr 10, 2008 -- Notice: "Low Income Levels" Used for Various Health Professions and Nursing Programs Included in Titles III, VII, and VIII of the Public Health Service Act

Apr 8, 2008 -- Use of E-prescriptions is Growing

Apr 4, 2008 -- Medicare Pushing Health-care Providers to Use Electronic-Records, Some to be Paid

Apr 3, 2008 -- Report: Self-referral to Hospitals Weakens Health Care Safety Net

Apr 3, 2008 -- E-Prescribing Tools to Help Prevent Adverse Drug Interactions

Apr 2, 2008 -- Consumers, Health Care Purchasers, Physicians, and Health Insurers Announce Agreement on Principles to Guide Physician Performance Reporting

Apr 2, 2008 -- AMA Physicians Make a House Call on Congress

Apr 1, 2008 -- Locum Tenens Practice Option May Extend Careers in Medicine, Help Physicians Avoid Burn-Out

Apr 1, 2008 -- Targeted Med School Programs Could Alleviate Rural Physician Shortage

Mar 28, 2008 -- Nurse Practitioners Fill Key Role

Mar 27, 2008 -- Council Calls on White House to Convene Conference on Physician and Nurse Supply

Mar 26, 2008 -- Network Will Email Patient Safety Alerts to Physicians

Mar 24, 2008 -- Study: Nurses Key to Care Improvement Efforts

Mar 24, 2008 -- Family Medicine Surges in 2008 Match Results

Mar 20, 2008 -- Demands on Nurses Grow as Hospital Quality Improvement Activities Increase

Mar 20, 2008 -- Physicians Survey Offers Fair Assessment of Rural Medicine

Mar 19, 2008 -- Federal Trade Commission to Host Workshop on Health Care Clinical Integration

Mar 19, 2008 -- New Poll Shows Public Worried About Medicare Cuts Impact on Seniors, Boomers -- Wants Congress to Act

Events
Jun 25, 2008
Rural Health Innovations - WebEXpert Call
Rural Health Resource Center
"Retention in Times of Exponential Change"
Rural Health Innovations
2:00pm - 3:30pm CST
Contact:
  Summer Fosdick
  218.727.9390 ext. 23
  sfosdick@ruralcenter.org


Jul 14 - 17, 2008
NRHA Quality and Clinical Conference
National Rural Health Association
Sheraton San Diego Hotel & Marina
San Diego, CA
Contact:
  Meaghan McCamman
  703.519.7910
  mccamman@nrharural.org


Oct 14 - 16, 2008
2008 3RNet Annual Conference
National Rural Recruitment & Retention Network
Embassy Suites Downtown
Omaha, NE
Contact:
  Nikki Kennedy
  800.787.2512
  info@3rnet.org


Sep 23 - 25, 2009
2009 3RNet Annual Conference
National Rural Recruitment & Retention Network
Albuquerque Hyatt
Albuquerque, NM
Contact:
  Nikki Kennedy
  800.787.2512
  info@3rnet.org


About this Page
Credits

Thanks goes to Karen Welle, University of Minnesota Office of Rural Health & Primary Care

Developed by:
Mary Reinertson-Sand
mary@raconline.org



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