Editorial: Increasing Support for Health Careers

Hawaii faces a severe shortage of healthcare workers — a “wake-up call” that will take solutions from all sectors, from incentives from private healthcare companies to proactive state policies and funding, to better educational pipelines.

Since the start of the pandemic, there has been a 76% increase in unfilled healthcare job openings, from 2,200 in 2019 to 3,873 this year, reports the Healthcare Association of Hawaii (HAH ). Nearly 1,000 licensed specialist nurses are needed; more than 700 positions for qualified nursing assistants and nursing assistants are open.

With a current vacancy rate of 17%, up from 10% in 2019, this is a pressing issue.

Health Care Providers Need to Conduct a Cost-Benefit Analysis of Their Hiring Models: Do Hawaii’s Salary and Benefits Offerings Give the State’s Young People a Reason to Plan a Career in the Field and in the islands?

In Hawaii, affordable housing is the top concern for future healthcare workers, and workers have lobbied for compensation that reflects the high cost of living. It’s up to Hawaii’s health care providers, as well as insurers who moderate their revenue, to take heed.

Preventative healthcare offerings such as gym memberships and wellness classes can also be a tool to prevent more Hawaii residents from developing serious illness. Effective offers should be expanded, as should access to mental health services.

Those who share concerns about health care costs, including employers, can help reduce medical needs by promoting public welfare, pursuing preventive measures against chronic diseases such as obesity, diabetes and kidney disease, and advocating for a healthy environment.

However, it is also an inescapable fact that Hawaii’s population is aging and elderly patients are increasingly likely to require extensive health care services, overburdening hospitals and increasing shortages of medical personnel.

To meet this need, state and county governments must play a role. The best strategy here is to nurture Hawaii’s educational pathways to these careers.

The Healthcare Workforce Initiative, a group of volunteer leaders from various sectors, is doing just that by supporting partnerships with community colleges and even high schools to bring students into entry-level certification programs.

Another promising pilot program allows certified nurse aides to continue working while taking on-the-job courses to become registered nurse practitioners, advancing their careers. This type of personalized advancement incentive for local healthcare workers is encouraging, as is the expansion of nursing residency and “transition to specialty” programs for registered nurses.

There is also a need to ramp up training programs outside of Oahu, especially on Lanai and Maui, which have the highest percentage of job openings. This year, $1.75 million in public funds went to the University of Hawaii to hire additional nursing instructors; it is a step in the right direction.

Federal aid can also help. UH last week announced a $1 million federal grant to support a new UH Center for Rural Health Research and Policy. Staff members here analyze data and research sources of federal funds, including enhanced Medicare payments, to help meet Hawaii’s unique needs.

Traveling healthcare workers have filled the void, and HAH is calling for an extension of state emergency rules allowing out-of-state nurses to temporarily practice in Hawaii. This should be granted, but it must be understood that the use of temporary and mobile nurses is not a permanent solution. This will require real and sustained investment in growing and retaining the medical staff here, as well as preventative incentives to help Hawaiians stay healthy.