Mental Health and the Healthcare Workforce Crisis

By: Van Ton-Quinlivan

During May, the nation observes Mental Health Awareness Month, dedicated to raising awareness, challenging stigmas, and advocating for mental well-being.

According to Mental Health America, one in five adults in the country suffers from mental illness. While behavioral health challenges affect individuals from all backgrounds and occupations, healthcare workers face heightened levels of stress, making them particularly susceptible to conditions such as anxiety, depression, and post-traumatic stress disorder.

Recently released government data indicates an alarming increase over the past three years of healthcare workers who have left or resigned their roles due to burnout and other mental health conditions, exacerbating the existing strain on healthcare providers. A study conducted by the National Forum of State Nursing Workforce Centers revealed that 100,000 nurses left the profession during the pandemic, and it is projected that up to an additional 800,000 nurses plan to retire by 2027 due to factors such as stress, burnout, or opting for early retirement.

The demand for healthcare professionals extends beyond the need for nurses. The shortage of allied health workers is at unprecedented levels, with one recent survey concluding that more than 85% of hospitals and health systems are experiencing a critical shortage of allied health staff. Currently, the allied healthcare sector accounts for approximately 60 percent of all healthcare positions in the United States, with the need for additional allied health workers only expected to grow by 20% through 2026.

A Perfect Storm

The exodus of experienced healthcare workers seeking respite from emotional strain, on top of normal attrition is creating a significant workforce gap, leaving healthcare employers facing staffing and retention challenges as remaining workers are burdened with increased workloads to compensate for the shortfall.  

Why not bring in new graduates, you may ask?  Shortages in the capacity to supervise new grads hinder a seemingly solid solution for curing this cycle. It’s an ongoing conundrum, as outsized cost pressures loom large for healthcare employers, yet many continue to hire travelers, often at two to three times the cost. In fact, reducing cost was a central theme as C-suite executives gathered at The Healthcare Management Academy in Nashville, where I recently spoke on the topic of workforce best practices. There is no fast, easy solution to today’s complex circumstances.

Care for the Caregiver

Futuro Health has brought thousands of diverse adults into education journeys along their way to allied healthcare careers, reflecting 90 percent diversity and with an average age of 29.  Changing careers and returning to education can be a rewarding adventure for adults looking to reinvent themselves or pursue new jobs. However, it can also be a highly stressful and a mentally challenging experience.

One of the most significant sources of stress is the financial burden of returning to school. Adult students may need to juggle the high costs of tuition while also managing their living expenses. Additionally, many struggle to balance a job, family, or caregiving responsibilities while resuming their education, which can be extremely demanding on their time and energy. For any older adult, simply returning to school can be intimidating itself, particularly with coursework now online or hybrid.

Our staff at Futuro Health spends countless hours supporting our adult Scholars, and our unique model provides a solution to their challenges, including offering tuition-free training opportunities and pathways into careers in allied health, while our online approach to learning allows them the convenience of completing training remotely, often at their own pace, and with guidance from a dedicated team of Futuro Health Success Coaches to assist them all along their educational journey and prepare them for new careers. This includes our Human Touch Healthcare training, which provides the essential interpersonal skills to work in healthcare, encompassing such competencies as Empathy & Compassion,  Effective Communication, Emotional Intelligence, Teamwork & Collaboration, and Ethics & Integrity.

Futuro Health is taking steps to assure we are mindful of the mental well-being of our team members and the Scholars they serve. As just one such example, John Cordova, RN and Futuro Health’s Director of Workforce Development & Externship, advocates for self-care and shared this useful link to Take Action for Mental Health (among other resources) within our organization to remind each of us to: 

  • Check in about mental health.
  • Learn More about mental health needs and what you can do.
  • Get Support for yourself or someone you care about.

By nurturing a lifelong resilience mindset and fostering a supportive network, we can all strive to create an environment that prioritizes mental well-being. Mental Health Awareness Month presents an opportunity to shine a light on the mental well-being of healthcare workers during May – and throughout the year – as we actively work towards building a more sustainable future for these compassionate individuals who dedicate their lives to caring for others.

Futuro Health CEO Van Ton-Quinlivan is a nationally recognized expert in workforce development. Her distinguished career spans the private, public, and nonprofit sectors. She is a White House Champion of Change and California Steward Leader, and formerly served as Executive Vice Chancellor of the California Community Colleges.

The Unique Role of an “Education Whisperer” in Workforce Development

By: Van Ton-Quinlivan

In the U.S., over 80% of healthcare facilities have reported a shortage of allied healthcare workers. This persistent workforce deficit necessitates collaboration between employers and higher education to find a solution. Yet, interpreting the languages between these two worlds can be a challenge. That’s where the need for an “education whisperer” comes in. Our team at Futuro Health fills this crucial role.

Crafting a “win-win” matters a lot in workforce development. Ask incoming California Community Colleges Chancellor Dr. Sonya Christian

Dr. Christian, in her prior role overseeing a district of three rural California community colleges, she sought to increase participation of diverse communities in healthcare careers. Like the rest of America, her colleges were losing enrollment. According to the National Center for Education Statistics, higher education nationwide suffered from 7.6% less students enrolling in 4-year colleges and 16.2% fewer students in community colleges compared to pre-pandemic levels. Enrollment is the lifeblood of colleges.  Creating costly new programs when there is enrollment uncertainty brings only risk.

Because Dr. Christian and I worked together during my time as Executive Vice Chancellor of California Community Colleges, we talked about engaging Futuro Health’s expertise to de-risk enrollment uncertainty for a community college in her district, Cerro Coso College, to launch a new hybrid Medical Assistant Program for rural communities. Futuro Health took on the role of education whisperer by encouraging Cerro Coso College to adopt best practices, such as decoupling from the academic calendar, to accommodate more adult learners.  Together, our organizations worked through new data exchange and enrollment protocols to enable us to support working adults in their educational journey more seamlessly. The first cohort launched and was quickly filled. In turn, Futuro Health stepped in to engage with employers who provided qualified applicants for the hybrid Medical Assistant Program. 

Futuro Health Scholar Support Team Leaders Sam Collazo and Jin Kim joined John Cordova, Futuro Health’s Director of Workforce Development & Clinical Partnerships, during a recent visit with Lucy Erdene AUMT General Manager. AUMT is the latest education provider to partner with Futuro Health, providing phlebotomy and other training programs.

Just imagine asking an employer to do all the above, or educators to tackle these challenges alone.  It’s a lot. And yet, Futuro Health has whispered and cultivated an entire ecosystem of education partners, all of whom provide quality, adult-friendly career education programs.  In concert, we invite our network of employers to lean-in and fund scholarships, provide externships and hire our program graduates. Each year, thousands of new enrollees find their way into healthcare credentials and new careers thanks to this unique ecosystem built and monitored by Futuro Health.

Perhaps “win-win” should really be stated “win-win-win” because the third stakeholder – the learner – must also benefit from the collaboration, not just employers and educators.

Futuro Health works with educators and employers to resolve their disconnects.  Every year since our inception, thousands of Futuro Health Scholars, 90% ethnically- and 52% linguistically diverse, pursue education journeys and move into important roles in care.

Consider Alicia’s story. From an early age she knew she wanted to join the medical field. Alicia started pre-med classes at UC Davis but soon learned she was pregnant. Even though she was unable to finish her studies, the financial debt she acquired in the process lived on. To provide for her children and family, Alicia worked jobs that paid the bills, but they did not fuel her passion. Alicia then started Futuro Health’s debt-free Medical Assistant program and got a second chance to do what she enjoys the most, helping people. After completing the program, she secured her dream job with Kaiser Permanente, earning a steady paycheck, with job security that pays her peace of mind. Futuro Health provided Alicia with the tuition-free scholarship, coaching support, and simplified education journey to pursue the education she needed to move into healthcare.

Alicia’s journey demonstrates the transformative power when educators and employers work in lockstep, and how Futuro Health serving as an education whisperer can bring together the necessary resources for individuals to achieve their career goals.

Futuro Health is built for scale and welcomes employers, educators, and learners to contact us via www.futurohealth.org.

Futuro Health CEO Van Ton-Quinlivan is a nationally recognized expert in workforce development. Her distinguished career spans the private, public, and nonprofit sectors. She is a White House Champion of Change and California Steward Leader, and formerly served as Executive Vice Chancellor of the California Community Colleges.

A Podcaster’s (Grateful) Perspective: What would ChatGPT Say?

A Podcaster’s (Grateful) Perspective
A Podcaster’s (Grateful) Perspective

Recently, we celebrated the release of the 50th episode of my podcast WorkforceRx with Futuro Health. As I reflect on this milestone, I am filled with appreciation for all the incredible guests and listeners who have been a part of this journey.  My guests include a wide range of inspiring individuals with diverse backgrounds, including education, healthcare and business thought leaders, entrepreneurs, clinicians and many others.  They readily shared their knowledge and experience as we probed innovations that ready us for the future of work, future of care and future of learning. 

In preparing for this blog, I looked back at our first 50 podcast episodes and was struck by the number of issues we covered that have since gained national prominence – including workforce shortages, the adoption of skills-based hiring, burgeoning mental health issues, and strategies for inclusive economies.  However, no topic has gained more attention recently than advances made in Artificial Intelligence (AI) and its impact in the workplace and classroom.   

Today, chatbots like ChatGPT have thrust AI into the center of major debate and controversy, generating buzz and fear in equal measure for its ability to generate conversational text to produce anything from simple answers to elaborate essays, scripts, lyrics, and much more.  If ChatGPT can generate a 1,000-word essay in under two minutes and solve a complicated math formula in one, it begs the question: What are humans for? Especially as technology becomes significantly refined in the future. 

I had the privilege of interviewing one of the nation’s leading AI experts on my podcast, Dr. Tom Mitchell, AI Scientist and founder of the very first Machine Learning academic departments in the nation at Carnegie Mellon University. He addressed concerns that AI in the workplace will replace humans and make many current work functions obsolete. Experts like Dr. Mitchell contend that AI will create additional career opportunities through more collaborative relationships between workers and technology.  “Humans paired with technology” was his phrase. 

Since ChatGPT’s launch in November, those in academia have raised concerns it could facilitate cheating, and the response by educators has been swift and varied. Last week, New York City’s education department blocked ChatGPT on all school devices and networks, citing negative impacts on student learning, and concerns regarding the safety and accuracy of content.  While in other states, educators are embracing the technology’s ability to improve student writing, helping them generate ideas and reimagine the writing process.  

I gave ChatGPT my own test drive, asking it to produce responses to some rudimentary “how to” questions commonly asked in my field of workforce development – like What is workforce development?    and How Do you create a public-private partnership? I was generally impressed with the resulting write ups generated by ChatGPT.  Then, I wondered if it could generate podcast scripts (which would make podcast producers, including mine, quite unhappy), and could I feed it all 50 podcast transcripts to render a book that synthesizes themes, which could make developmental editors skittish. 

My findings using ChatGPT confirmed for me what many of the AI experts featured on my podcast also concluded: 

  • The importance of emotional intelligence in the workspace cannot be overemphasized. Intelligence is one distinguishing factor that will assure that humans forever remain relevant in the workplace.  
  • Digital skills and digital access are so fundamental to maneuvering the future that those without both will not be positioned well in the economy. 
  • The rapid breakthroughs in technology will challenge how we train, adapt and adopt at a more rapid pace.  All education and training modalities will need to continuously reinvent themselves, from higher education institutions to smart devices. 

It wasn’t long ago that advances like cloud technology, data collection and video-based communications sparked its own wave of concerns about technology replacing humans in the workplace.  Today, we can hardly imagine a work environment without these technologies. We not only adapted, but these advances in technology have ushered in entirely new career sectors and job opportunities.   

Perhaps this is a good time to remember a quote from one of the founding fathers of technology, Steve Jobs, Co-founder of Apple, who said “It’s not a faith in technology. It’s faith in people.”  

I look forward to continuing to host our WorkforceRx podcast and sharing my (very human) conversations with all of you for many more episodes to come.   

Futuro Health CEO Van Ton-Quinlivan is a nationally recognized expert in workforce development. Her distinguished career spans the private, public, and nonprofit sectors. She is a White House Champion of Change and California Steward Leader, and formerly served as Executive Vice Chancellor of the California Community Colleges.

Speaking Out – The Healthcare Workforce Crisis

Through our Futuro Health Speakers Bureau , I am frequently invited by employer groups, national organizations, and education- and workforce-based organizations from across the country to speak.  At these conferences, symposiums, forums, and other events, I highlight best practices from my book Workforce Rx: Agile and Inclusive Strategies for Employers, Educators and Workers in Unsettled Times to inspire action. (Note: Proceeds go to benefit Futuro Health’s nonprofit mission).  Although states have their differences, what they have in common is a shared pain around their shortage of healthcare workers. While the need for physicians and nurses has been widely publicized, the shortage of allied health workers too often goes overlooked.

According to new data, the allied health worker shortage has put employers in a highly precarious situation, with 85% of healthcare facilities facing unprecedented needs for allied health professionals. In California alone, the deficit of allied health workers is expected to increase to 500,000 by 2024. The demand for these essential workers, including medical assistants, pharmacy technicians, health IT specialists, EMTs, phlebotomists, peer support specialists, community health workers and more, has reached critical levels, adding to an already strained healthcare delivery system in the U.S.

My book drew from my years of experience in the private, public, and now nonprofit sector refining best practices in workforce development. Doing speeches to Wyoming, DC, NY, Connecticut, Colorado and California audiences helped me understand which workforce challenge, which stories, which solutions best resonates.  Let me share with you what themes states have in common.

Aleki’s Story, A Fishing Tale

Recently I keynoted the Connecticut Workforce Summit, hosted by the state’s largest business organization, CBIA, and by Social Venture Partners. Like other states, Connecticut is facing significant worker shortages in many sectors, from manufacturing to healthcare.  Mark Argosh, chair of Connecticut Governor Workforce Council (and WorkforceRx podcast guest speaker), estimates 109,000 job vacancies, which is more than the number of those unemployed in the state.

One-third of high school graduates in Connecticut do not go on to any form of higher education. Connecticut fortunately does prepare youths while they are still in high school for careers by collaborating with the state’s school systems to develop career pathways.  Post high school, many are stuck in low-wage jobs and are prime candidates for upskilling.  Others may have the necessary requisites but encounter problems navigating the search and hiring process.  That population needs a different solution and employing industry sector strategies has enabled the state to do deeper work.  On the sidelines, a large number of disconnected youths – estimated at 40,000 – are neither working nor attending school and need to be reengaged in order to supply the needed workforce.

Speaking to the Connecticut audience of mostly 500 business leaders and employers, I shared the story of Aleki from my book chapter entitled: Leveling the Slope of Unconscious Bias. During an earlier time in my career working in the energy sector, I launched and led the Pacific Gas and Electric PowerPathway(tm) workforce development program, where I met Aleki, an inspiring 19-year-old who was seemingly a good fit for an open position in our organization.  Following the standard drug screen, background check and completion of a 3-month pre-hire training, we were perplexed as to why Aleki had fallen off the short list of candidates.

Upon making inquiries, we learned that Aleki didn’t pass his background check due to, of all things, an unpaid fishing fine he received at the age of 15 for catching a fish that was too small by local regulations. Aleki was unaware that his unpaid fine escalated up through the court system, leading to him being charged with a nonviolent felony. Fortunately, our community partner helped Aleki get his record expunged, and he got the job.

Aleki’s story serves as an example of why workforce development is a team sport between employers, education providers, and the workforce- or community-organizations, with each stakeholder doing what they do best, to enable the Alekis to enter the talent pipeline. The collaborative efforts in Connecticut – including career pathways, sector strategies, and a collaborative approach to workforce development – combine to put Connecticut in the right direction.  Connecticut received in 2022 the largest federal Good Jobs Challenge grant award (nearly $25M) for its momentum.

The Robot Zombie Apocalypse and other Misperceptions

There have been many misperceptions related to workforce development, artificial intelligence (AI) and robotic process automation. For years I’ve been hearing about the coming of the robot zombie apocalypse, the speculative fear that AI and automation will replace humans in the future of work.

This past summer I was honored to speak on a panel about Automation and the U.S. Workforce, hosted by The National Academies, a private, nonprofit institution that provides expert advice on some of the most pressing challenges facing the nation and world, shaping sound policies, informing public opinion, and advancing the pursuit of science, engineering, and medicine.  Carnegie Mellon University Dr. Tom Mitchell of the National Academies invited me to address its leadership body tasked with refreshing a report to Congress on the impact of AI.

I reflected on the views of leading experts from both private and public sectors, including Jamie Merisotis, CEO of The Lumina Foundation, and author of his own book: Human Work in the Age of Machines. Experts like Jamie agree that one of the things that differentiate humans from machines in the workplace is that for us as humans, work matters. AI lacks the softer skills to work in jobs that require critical thinking and creative approaches. Like Dr. Mitchell who espouses that AI will augment the workers (hear him speak on my podcast interview of him here), Jamie believes AI and automation do not pose a threat to the workforce as much as it will open opportunities for a more collaborative relationship between employers and technology.

To prevent the worker from being left behind with advances in technology, however, regular skills upgrades will be required.  What states have in common is the challenge to bring down structural silos that hinder employers and education from working together more symbiotically. The chapter in my book entitled Making the Fire Hose and the Garden Hose Work Together advances the premise that education and employment can no longer operate independent of each other’s respective priorities. Employers need to form consortia to aggregate jobs across divisions, suppliers, adjacent industries, and competitors – and better match the economics of higher education to engage in creating up-to-date curriculum needed especially by working learners to keep pace with the workplace changes.

Uniting for Solutions

Perhaps one of the most impactful examples of collaboration I observed while on speaking across state lines comes from my participation earlier this year in the kickoff meeting of the National Governors Association’s (NGA) Healthcare Workforce Collaborative. The NGA is a bipartisan organization comprised of the nation’s governors, with a mission to share best practices and speak with a collective voice on issues of concern impacting all 50 states.

This kickoff NGA meeting marked the introduction of a six-month multi-state program collaboration aimed at addressing the healthcare workforce shortages in 14 states. By learning directly from other states and national experts, the participating states understood innovative policies, programs, and practices to create a positive environment for an enduring healthcare workforce.

In my keynote, I offered up solutions drawn from in my book to address what keeps healthcare CEOs and COOs up at night, touching on such issues as retention, cost, and reskilling challenges, as well as the desire to add diversity in new hires.

The lack of healthcare workers has become so prevalent across the country that more than 20 governors this year directly addressed the situation in their state of the state speeches, proposing a range of policy fixes and funding initiatives, including California Gov. Gavin Newsom, who recently announced a new plan to invest $4.7 billion to overhaul California’s mental health system by adding 40,000 new skilled workers in mental health fields.

This level of cooperation and rallying among states to find common ground solutions to the healthcare workforce shortage underscores my earlier point that the shortage has indeed become a national crisis, impacting those in every state.

During any crisis, it is human instinct to want to play defense. Instead, applying best practices in workforce development – as outlined in WorkforceRx – puts in place proactive tactics that equip an organization with the right skills at the right time. I am encouraged by the openness of the many groups I speak who are recognizing that this is the right time to reconceptualize staffing shortages as an opportunity among industry, education, government and regional organizations and providers to work together on a solution.  Workforce development, after all, is a team, not individual, sport.

Futuro Health CEO Van Ton-Quinlivan is a nationally recognized expert in workforce development.  Her distinguished career spans the private, public, and nonprofit sectors.  She is a White House Champion of Change and California Steward Leader, and formerly served as Executive Vice Chancellor of the California Community Colleges.

What We Can Learn from Education Disruptor All-Star Sal Khan and His Innovations

I have the privilege of meeting many leading experts and innovators in the education and healthcare sectors in my role as CEO of Futuro Health (see some featured in my WorkforceRx podcast). Recently, I bumped into education icon, Sal Khan, in Silicon Valley. Sal is an education innovator all-star not only in my eyes but of many around the world. And, his latest creation, SchoolHouse.World.org, will infuse innovation into the college admissions process.

Sal does his global work on the second floor of a Google building in Mountain View, California. My youngest son enrolled in Sal’s experimental Khan Lab School, an in-person K-12 school located on the first floor of the same building, after the pandemic wreaked havoc with his schooling, as it did for many. Now a senior, my son is going through the college admissions process, which unfortunately in the U.S. is an all-too-stressful rite of passage.

Sal and two college admission directors hosted a discussion with students and parents. That was where I met him in-person. I had seen Sal speak over a decade earlier when he delivered a provocative keynote to a skeptical audience of national higher education leaders. I was inspired then by his notion that learning can be based on mastery rather than time-in-seat. Almost everything in higher education is anchored in the construct of time – a.k.a., the credit hour.

What Makes Sal Khan an Education Disruptor All-Star?

Mastery-based learning will no doubt become a best practice in the future landscape of workforce development as workers struggle to pace with the rate of technology ingestion. All of us will need more strategies to accelerate our attainment and demonstration of new skills.

Can we speed through what we have already mastered and spend more time on what we haven’t yet? Sal’s Khan Academy has shown what can be done. The learning tools developed in Khan Academy are used by 135+ million people from over 190 countries who pursue knowledge through mastery-based learning. Learners, upon demonstrating competency on a concept, can move ahead quicker.

The converse would also be true for learners who need more time.  Student progress no longer is measured by the 50 minutes spent in the classroom and is decoupled from when the bell rings or calendar year ends.

Working the Problem Can Lead to Unintentional Innovations in Education

Back to Sal.  With Khan Academy and Khan Lab School in full deployment, he is once again at work solving the dilemmas of education in novel ways.  Sal now wants to provide free tutoring to the world in a new venture called SchoolHouse.World.  His team had a dilemma to solve, “How do we know a person is qualified to be a tutor?” In working the problem, his team designed a process whereby applicants recorded themselves on video teaching a topic (e.g., in calculus), then submitting the recording for peer rating.  Qualified submissions would earn a SchoolHouse.World certification.

Coincidentally, the pandemic came about whereupon colleges suspended their collection of standardized scores.  Seeing the value of SchoolHouse.World.org certifications as a good indicator of what students knew, faculty at MIT, Georgia Tech, and the University of Chicago began accepting them in lieu of ACT and SAT scores – and, as such, introduced innovation into the archaic college admissions process.

Like the invention of the Post-Its by 3M, Sal’s innovation was accidental for he was focused on the K-12 space.  Few people know that Post-It Notes were amazingly close to complete failure. In 1968, Dr. Spencer Silver, a chemist at 3M Company, invented a unique, low-tack adhesive that would stick to things but also could be repositioned multiple times. He was trying to invent a super-strong adhesive, but he came up with a super-weak one instead. 3M shelved the discovery for five years, until an opportunity arose for its use bookmarking and highlighting textbook pages without damaging them. Fast forward 50 years, and Post-It Notes can be found in offices and meeting rooms worldwide.

Embracing the Needed Innovation to Higher Education Practices

The story behind the invention of Post-It Notes is a favorite example of how experimentation often leads to unplanned discoveries. Sal’s college admissions innovation came about when he sought a solution for something else.

Since launching in 2020, Futuro Health benefitted from having a whiteboard in which to approach developing the allied health workforce.  We have uncovered novel ways to organize community organizations and unions to efficiently scout diverse adults and being them onto education paths.  At a moment in time when higher education enrollment nose-dived across the nation, especially in 2-year institutions, Futuro Health has met and exceeded our goals for how many students we serve each year.  We are infusing some of those learnings into our collaboration with our public institution partners, including California community college, California State University and University of California brethren, who join us in a federal grant to grow the state’s public health IT workforce called California Consortium for Public Health IT (CCPHIT).

As I look back on my recent encounter with Sal Khan, I am reminded that innovations come about in so many ways.

Futuro Health CEO Van Ton-Quinlivan is a nationally recognized expert in workforce development.  Her distinguished career spans the private, public and nonprofit sectors.  She is a White House Champion of Change and California Steward Leader, and formerly served as Executive Vice Chancellor of the California Community Colleges.

Filling the Mental Health Worker Pipeline Amid a Growing Crisis

By Van Ton-Quinlivan, CEO Futuro Health

You don’t have to look further than the daily news headlines to be reminded that we are facing an unprecedented mental health crisis in our nation. The unfortunate aftermath of COVID-19 has resulted in a subsequent pandemic impacting the mental and behavioral health of those in communities across the country, and the numbers are alarming.

According to new data from the National Alliance on Mental Illness (NAMI), one in five adults in America experience a mental illness and nearly one in 25 adults live with a serious mental illness. And, perhaps even more startling, one-half of all chronic mental illness begins by the age of 14. In some instances, this equates to a 25 percent increase in those being diagnosed with behavioral health disorders when compared to pre-pandemic levels.

There have been numerous studies on the pandemic’s impact on the state of mental health in America, many citing isolation, disruptions to schools and businesses, and limitations placed on in-person health care services as contributing factors to the current mental health crisis. While the pandemic was undoubtedly a tipping point in the escalation of mental health diagnoses, behavioral health experts have been warning of looming disruptions for mental health providers for years prior to the repercussions of COVID-19, including job burnout, availability of training, lack of opportunity for minorities, an aging workforce and retirement drain.

These factors become compounded when considering that mental health services have historically been difficult to access in rural communities, where healthcare choices are more limited than they are for residents of cities and suburbia. And for those hoping to find a Black or Spanish-speaking therapist, their options are even less, resulting in significant disparities in care for those who need it most, all of which has only been exacerbated by the aftermath effects of the pandemic.

A Skilled Workforce: Building Blocks to a Solution

It’s difficult to solve the big issues when there are missing pieces to construct the solution.  A key piece is always the workforce necessary to do the work.  A skilled workforce is one of those building blocks that enables and, when not available, certainly hinders progress.

The lack of mental health workers isn’t confined to rural America. In California this week, the San Diego Workforce Partnership issued its own call to action by highlighting the importance of adding more skilled workers as a solution to the mental and behavioral health issues within its own densely populated county lines.

The Workforce’s new report: Addressing San Diego’s Behavioral Health Worker Shortage, emphasizes the need to fill the mental health worker pipeline by educating, training, attracting, employing, and retaining 18,500 additional professionals between 2022 and 2027 to meet the anticipated behavioral health and addiction treatment needs for residents of San Diego County. According to the report, the worker shortage in San Diego County spans a range of titles, some trained through certificates that can be attained under one year, while others require advanced degrees.

Barriers to Mental Health for Racial and Ethnic Minority Groups

Research has shown that racial and ethnic minorities have significantly less access to mental health services than others, and thus are less likely to receive proper care and treatment. Many of these same studies show that one of the best ways to improve health outcomes in underserved communities and among minority populations is to ensure that the medical professionals not only serve their communities but are representative of their communities they serve.

At Futuro Health, we place critical importance in helping students get a tuition-free education in healthcare roles that are in-demand and impactful, filling the gaps caused by differences in income, education, race, ethnicity, and location. Since our launch in 2020, Futuro Health has successfully brought over 8,000 adults back into higher education, with 80% diversity, to train at our partner colleges.

We make education journeys into allied health careers possible by growing the talent that employers need and creating a path to opportunity that workers want.

0
Average Age
0%
Ethnically Diverse
0%
Bilingual
0%
Female

Investing in Growing the Mental Health Workforce

It is encouraging to see new funding initiatives and legislative actions that many states have taken in response to the need for growing their behavioral health workforce. In California, Gov. Gavin Newsom recently announced a new plan to invest $4.7 billion to overhaul California’s mental health system for children, laying out strategies to improve access to mental health and substance abuse services, including adding 40,000 new skilled workers in mental health fields. This investment comes at a critical time for parents of adolescents experiencing mental health concerns. Since the pandemic the wait time to see a professional has increased to nearly four months according to data from the Association for Behavioral Healthcare.

“Mental and behavioral health is one of the greatest challenges of our time. California is doubling down with the most significant overhaul of our mental health system in state history.”

The Governor’s announcement adds to California’s mental health assistance coffers, which includes more than $260 million already earmarked in the state’s 2022-23 budget  for initiatives and programs to address the state’s behavioral health crisis. As the Council Vice-Chair of the Health Workforce Education and Training Council – the state’s entity responsible for helping coordinate California’s health workforce education – I foresee these funds creating new and innovative approaches to increase the capacity and diversity of the behavioral health workforce in California over the next one to three years.

The allocation of additional mental health funding comes on the heels of the passage of Senate Bill 803 (SB 803), positioning California on the list of other states that allow certification of Peer Support Specialists, to fill the needed gap in the behavioral healthcare workforce, and improve access, recovery, and outcomes for patients. Peer Support Specialists have lived experience with the process of recovery from mental health or substance use challenges and provide peer support for others experiencing similar issues.

As mental healthcare providers in California prepare for this new benefit, data from other states where Peer Support Specialists have existed for years has proven that professionalizing these roles has bolstered the ranks of mental health workers by providing new pipelines into behavioral health careers for many more individuals seeking jobs in the mental health field. Futuro Health is proud to have been selected as a  state approved Medi-Cal Peer Support Specialist Training Program provider, and will begin student enrollment in the program beginning in the fall of 2022.

This is a pivotal time for mental health care providers, educators, workers, and residents of communities everywhere, both large and small. Like other crisis situations, it is vitally important that we approach the mental health workforce shortage crisis in a comprehensive, strategic manner – creating a systems solution, understanding the causes and factors that contributed to the shortage, while keeping focused on actions needed now to recruit and train behavioral workers and get more individuals into the education and training pipeline to fill the vacancies that currently exist.

Futuro Health CEO Van Ton-Quinlivan is a nationally recognized expert in workforce development. Her distinguished career spans the private, public and nonprofit sectors. She is a White House Champion of Change and California Steward Leader, and formerly served as Executive Vice Chancellor of the California Community Colleges.

Solving Workforce Shortages is Not an Individual Sport: What Healthcare Needs to Do Differently

by Van Ton-Quinlivan, CEO of Futuro Health and Jeff Weiss, Founder and Managing Director of Center for Corporate Innovation (CCI) 

We all know how deep and severe the demand for nurses and allied health workers grew over the course of the pandemic. We still live it. From the skyrocketing cost of traveling nurses to retaining those who are burnt out and frustrated, from sourcing diverse hires for better health outcomes to reskilling current employees for technology changes, to addressing how telework impacts culture and employment tenure, these challenges facing the healthcare workforce keep CEOs up at night. Many of you share in their struggle and seek to find solutions.  

How do we fill vital allied health roles in a reliable and inclusive way? Allied health roles comprise an estimated 60% of the care workforce. They run the gamut of occupations including medical assistants, phlebotomists, vocational/practical nurses, sterile processing techs, surgical techs, health IT and data analysts, peer support specialists, community health workers, and so on.   

According to pre-pandemic numbers, the United States will need an additional 2.3 million allied healthcare workers by 2025, and California alone will need 500,000 of them by 2024. Numbers this large mean the challenge is structural, and no one organization can realistically take on the challenge alone.  

One proven solution is through industry collaboration: working together to source, support, and train a diverse talent pool so they have the right skills at the right time. It’s often tempting for healthcare employers to try and build their own workforce solution. Forming a consortia can feel like an anathema for healthcare systems that normally compete. However, reaching out to partners and forging a path of collaboration can make a stronger workforce pool and one infused with more diverse talent. 

Employer consortia is a best practice in workforce development.

Grouping employers into a consortia is a workforce best practice. Bringing together peers, suppliers, adjacent industries, and even competitors in order to bring forth solutions at a level of scale to mirror the size of the issue can have outstanding results. Once employers form into a consortia within a region, education and public sector resources can more efficiently liaison and braid to meet the labor market needs.

This playbook comes road tested. The nation’s electric, gas, and nuclear sectors (for short, we’ll call it the energy sector) went through a similar metamorphosis in the early 2000s when it foresaw 25-50% of workers on the verge of retirement. Like the aging of seasoned nurses in healthcare, energy employers foresaw the exodus and ushered in a whole set of strategies based on collaboration. State-by-state, employers within the industry coalesced to form consortia to take on workforce challenges they had in common.  

These consortia infused vibrancy into outdated curriculum, retrained faculty at participating colleges in the latest skill sets, added seat capacity to previously atrophied programs, and stood alongside certificate and degree offerings to signal their intent to hire students. They exchanged tools and practices for their regionalized and localized needs.

Healthcare can rally in a similar way. Solving workforce shortages is better done as a team, not as an individual sport. Additionally, the Governor’s proposed 2023 California state budget offers $1.7B in new healthcare workforce incentive funds that can be more readily tapped when employers collaborate. 

No one size fits all when it comes to the intervention.

No one size fits all when it comes to the intervention.

Top of mind for all healthcare executives are nurses. Paying 2-3 times more for traveling nurses is financially unsustainable and bad for employee morale. To determine the fix, remember to evaluate where the workforce pipeline is broken.  

Are colleges graduating enough nurses? According to a University of California, San Francisco presentation of data hosted by the California Department of Labor, the anticipated shortage of RNs in the state will dissipate as new graduates enter the labor market over the next five years. Total enrollments were down from 2018-2019 to 2020-2021, but projected enrollments for 2022-2023 trend higher than the two previous academic years. However, attrition remains high for both new and seasoned RNs, and not all new graduates are getting hired – and those that do are not staying on the job.  Base in point, the same UCSF presentation noted that between 2018 and 2020 nearly 1,000 new, younger RN graduates did not persist.  

While employers prefer to hire seasoned workers, there’s not enough of them, and they’re commanding high wages as traveling nurses.  To grow and retain the talent pool, new graduates need to get hired, and industry should invest in a first-year nursing retention and preceptor program to prepare them to persist. Common Spirit just announced an innovative nurse residency program for their 45,000-person nursing workforce across 21 states.   

Meanwhile, specific nursing specialties in California are in limited supply. More nurses are required in the emergency department, operating room, and psychiatric settings. Rather than starting from scratch, the prescription here is to develop more advanced skills in the existing workforce through upskilling existing RNs and BSNs to these specialty areas.  

Employers need to go a step further and adopt best practices in tuition support programs – shifting from tuition reimbursement to disbursement in order to help workers address cashflow. If you want to know how employers are changing their thinking about educating workers in the wake of COVID, Jaime Fall is in a great position to tell you. As director of the Aspen Institute’s workforce development initiative Upskill America, Jaime is constantly in touch with some of the 5,000 businesses in the program’s network. He shared ideas and best practices with me on a recent episode of the WorkforceRx podcast.  

Another significant challenge at hand are “bottlenecks” in the workforce pipeline, wherein more students are trying to fulfill their required clinical hours—which are as high as 1,850 hours, depending on the program—than there are clinical hours available. Last year, California Competes, in partnership with Futuro Health, conducted a study to measure the extent of the allied healthcare worker shortage, forecast the increased demand of clinical placements, and identify policy solutions to address the bottleneck caused by the lack of availability of and access to clinical training hours.  We offered three categories of solutions to address the bottleneck issue: 

  1. Changes in collective stakeholder efforts: Strengthening regional consortia composed of educational institutions, employers, and community organizations who are committed to addressing the bottleneck problem.

  2. Changes in education programs: Increasing the use of various simulation modalities, implementing credit for prior learning and competency-based education, and incorporating the use of telehealth are all ways to help students achieve minimum competencies.

  3. Changes in employers: Incentivizing clinical training sites to increase clinical training opportunities, identifying currently untapped physical facilities, and expanding the use of Federally Qualified Health Centers can help with not having enough clinical placements for students. 

Download the study for a more complete examination of each category. 

You don’t have to do this work alone. Futuro Health is here to help.

Kaiser Permanente invested to create Futuro Health (as a nonprofit) to bring forth innovative solutions for the whole healthcare industry. In just two years since launch, over 5,000 diverse adults have gone on to pursue healthcare credentials thanks to the education and support ecosystem developed by Futuro Health. Futuro Health’s design of the student journey and generous scholarship opportunities create a diverse talent pool employers can draw from. Eighty percent of our adult students are ethnically diverse, 51% are bilingual (an essential skill in any healthcare setting), 73% are female, and the average age of our participants is 30.  With the right employer and consortia of healthcare partners, we can bring our best practices to share. 

About Van Ton-Quinlivan:  Ton-Quinlivan is CEO of Futuro Health and the Vice Chair of  the California Healthcare Workforce Education and Training Council, established to coordinate the State’s healthcare workforce needs. She served previously as Executive Vice Chancellor of the California Community Colleges and was named a White House Champion of Change. 

About Jeff Weiss: Jeff Weiss founded CCI, Inc. in 1986.  He is also an Adjunct Assistant Professor of Medicine at UCLA, where he co-leads the Leadership Program for UCLA/Rand National Clinician Scholars Program (Formerly Robert Wood Johnson Clinical Scholars) and is a Trustee and was a Founding Director of Thrive Scholars, which provides mentoring and scholarships to gifted minorities nationally.  Jeff is also on the Board of AltaMed Foundation and RAND Health. 

About the Center for Corporation Innovation: CCI runs exclusive ongoing forums where CEOs and senior executives from Global 1000 firms and large healthcare systems can explore strategies and growth.  CCI is partnered with major global consulting firms.   

About Futuro Health:
Futuro Health’s nonprofit mission is to improve the health and wealth of communities by growing the largest network of allied health workers in the nation. We make education journeys into allied health careers possible by growing the talent that employers need and creating a path to opportunity that workers want.

Intrigued by what you read? For more best practices in workforce development read Ton-Quinlivan’s best-selling book WorkforceRx: Agile and Inclusive Strategies for Employers, Educators and Workers in Unsettled Times (proceeds benefit Futuro Health’s nonprofit mission). You can also stay up to date by learning from experts on WorkforceRx, wherever you listen to podcasts.

Invest in a Culture of Learning

The old way of managing a workplace was relentless, and the message was clear: Work comes above all else.

That approach has been slowly changing over the years, and was drastically rewritten during the COVID-19 pandemic. As companies were forced to allow employees to work from home and to take personal time when they and their families were impacted by sickness, it became clear that there was no turning back to the era of unrealistic demands.

Continue reading