Assembly Budget Subcommittees Convene Joint Informational Hearing on Healthcare Workforce

On Monday, Assembly Budget Subcommittees No. 1 on Health and Human Services and No. 2 on Education Finance convened a joint informational hearing entitled, “Meeting the Demand for Health: Final Report of the California Future Health Workforce Commission.” Recall, the California Future Health Workforce Commission released its final report in February, which assessed the current state of California’s healthcare workforce and identified strategies to increase capacity, education, and training.

Monday’s hearing featured presentations by and discussions with key medical professionals and stakeholders involved in the commission report and delivery of health services. Sandra Hernández, President and CEO, of the California Health Care Foundation began the hearing by providing an overview of the landscape of California’s current health care system and health workforce, pointing to California’s uninsured rate, access issues, and severe workforce shortages and provider mismatches. As California’s population is projected to grow older and become more diverse over the next several decades, its workforce shortage is also expected to worsen. These issues, according to Dr. Hernández and the commission, comprise a “looming crisis,” posing a significant threat to the health and medical care of all Californians.

The first panel featured presentations on the 10 priority recommendations by the California Future Health Workforce Commission, which largely focus on recruitment and expansion of workforce development and training opportunities. The 10 priority recommendations carry a price tag of approximately $3 billion over a 10-year period; this amount is less than one percent of what Californians are projected to spend across the entire health care system in 2019 alone. Key examples of the top 10 priorities identified by the California Future Health Workforce Commission include:

• Expanding and scaling pipeline programs to recruit and prepare students from underrepresented and low-income backgrounds for health careers
• Supporting scholarships for qualified students who pursue priority health professions and serve in underserved communities
• Expanding the number of primary care physician and psychiatry residency positions
• Establishing and scaling a universal home care worker family of jobs with career ladders and associated training
• Scaling the engagement of community health workers, promotores, and peer providers through certification, training, and reimbursement

Assembly Member Jim Wood, who played an active role in the commission’s report, shared his perspective on his district’s healthcare workforce shortages, as well as the increasingly aging workforce in his district. Other committee members queried panelists on how the commission’s priority recommendations should be scaled up and phased in throughout the state, as well as how the recommendations should be financed.

The second panel included presentations by representatives from the University of California, California State University, and California Community Colleges on how to meet the educational and training demands in order to implement the recommendations identified by the commission. Educational officials discussed efforts currently underway, as well as planned initiatives to augment healthcare workforce training programs, develop a team-based medical approach, and increase allied and associated health care professional availability in California. Of note, Alison Wynn, Interim Assistant Vice Chancellor and Interim State University Dean of the California State University, and other panelists indicated the need to partner with schools of public health and local health departments to broaden the health care focus and address social determinants of health, health inequities, and health disparities. Panelists discussed various educational and training pipeline initiatives in place increase workforce placement and development in healthcare professions.

Last, the Legislative Analyst’s Office (LAO) discussed key programs currently in place related to healthcare workforce development, as well as proposals included in Governor Gavin Newsom’s January budget. New investments to strengthen workforce proposed by the Newsom Administration are focused on physician placement programs, mental health workforce, and state agency workforce shortages, and specifically include an ongoing $33 million General Fund to continue support of the current Office of Statewide Health Planning and Development (OSHPD) healthcare workforce development initiatives and a proposed one-time $50 million General Fund to increase training opportunities for mental health workforce programs. Committee members asked LAO representatives for input on how workforce development funding should be prioritized and directed to different vocations and areas of the state.

During public comment, CHEAC Executive Director Michelle Gibbons acknowledged the importance of increasing healthcare workforce capacity but called attention to the need to address public health workforce challenges, particularly as it relates to public health nurses, epidemiologists, disease investigators, and public health laboratory staff. Highlighting the challenges experienced in recruiting and retaining specialized public health professionals, Michelle Gibbons urged consideration of the role of the public health workforce in promoting prevention and upstream interventions in the broader health and medical arenas.

The informational hearing agenda is available here, and background materials are available here.