The California Health Workforce Alliance
(CHWA)
Sponsored by
The California Endowment
Increasing Workforce Demand:
  Health reform
  Population growth
  Aging population
  Chronic disease growth
  Increasing diversity
  Linguistic needs
  Medical and tech advances
  Biomedical industry growth
  Healthcare occupational
growth
  Prison growth
  Economic Importance
Insufficient Workforce Supply:
  Workforce shortages
  Aging health workforce
  Training capacity constraints
  Poor K-12 preparation
  Lack of diversity & leaky
pipeline
  Reduced in-migration
  Geographic mal-distribution
  Increased “talent wars”
  Lack of public awareness
  Rising training program costs
  Misaligned employer needs
and educational products
From: The Connecting the Dots Initiative, January 2009
Why Health Workforce Development Now?
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Duane Dauner, President CHA
“In migration is gone, out migration up”
“California infrastructure and training capacity must increase”
“Long-term strategy needed, short term euphoria will not last, it
will be like falling off a cliff as aging and retirements progress”
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Victoria Bradshaw, Governor’s Chief of Staff
“Healthcare is vital to CA’s economy and health needs”
“Healthcare is our only growing sector”
“Demand for Health Workforce will increase 22%, less skilled 26%”
“Make changes now, to come out of this stronger than went in”
Critical CA Health Workforce Needs
•  Nursing
•  Allied HealthImaging, Pharmacy,
Lab
•  Public Health
•  Home Health, longterm care
•  Primary care and
other specialties
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Community Health
Oral Health
Mental Health
Senior leaders and
middle managers in
all sectors
•  Life Sciences
•  Health IT
Source: California Department of Finance
Connecting the Dots:
Summary Findings:
Many innovative efforts across the state, but
•  Small scale
•  Dependent on Sr. Leader & busy passionate champions
•  Siloed and fragmented within & across institutions
•  Lack adequate/sustainable funding & infrastructure
•  Collaboration difficult without capacity and stability
•  No well defined strategy or critical path
•  No overall ownership, home or accountability
Connect the Dots At and Among Multiple Levels
• Federal
• State
• Regional/Community
• Institutional
• Profession
• Individual
A Need to “Connect the Dots” Among Major California
Initiatives
CA Health Workforce Alliance
California Labor Agency
CA Health Workforce Development Council
•  CA Workforce Invest. Board
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Health Reform Workforce Grant
•  Regional Boards
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Policy recommendations
•  Nursing Initiative
The CA Wellness Foundation
The California Endowment
•  Raising awareness
Office of Statewide Health
•  Workforce diversity
•  Program support
Planning and Development
CA Dept of Education
•  Convening
•  Clearinghouse
•  Mini-grants
Regional Funders Collaboratives
•  Song Brown
•  Support of sector initiatives
Ca Inst. for Nursing in Health Care
•  Workforce Master Plan
•  Increase Capacity & Diversity
University of California
•  UCOP and Campus Diversity Initiatives
•  PRIME
•  Post Bac Programs
Connect Ed
•  Lansing Report
•  K-12 Multiple pathways programs
CSU Chancellors Office
AHEC’s
• Improving Health Professions Pathways
California Health Professions Consortium
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Advocacy, Convener, Clearinghouse
California Institute for Mental Health
Campaign for College Opportunity
Community College Initiatives
•  Nursing, Welcome Back, RHORC’s
Assembly Select Committee
California Primary Care Association
•  Workforce Initiative
CHA Workforce
•  Allied Health
Latino Coalition For a Healthy
California
Greenlining Institute
•  Reports, advocacy
HOSA
California Edge Campaign
•  Regional sector initiatives
California Workforce Association
•  Regional Health Planning Initiative
Coordinated Health Workforce Pathway
Target Groups:
•  Incumbent Workers
•  High School and Community College Students
•  Career Changers
•  Displaced Workers
•  Undergraduates
•  Immigrant Health Professionals
•  Residents
K-12
Education
Career
Awareness
Academic
Preparation
Assessment
& Entry
Support
Financial &
Logistic
Feasibility
Pre-Training
Coordination and Support
Infrastructure
Health
Professions
Training
Program
Access
Training
Program
Retention
Internships
Health Professions Education
Hiring &
Orientation
Culturally
Retention & Competent
Advancement Enabling
Conditions
Workforce
Quality, Culturally
Competent, Health
Workforce
Jeff Oxendine Copyright ©a
Managing Complex Change
Vision
Skills
Incentives
Resources
Action
Plan
Change
Skills
Incentives
Resources
Action
Plan
Confusion
Incentives
Resources
Action
Plan
Anxiety
Resources
Action
Plan
Gradual
Change
Action
Plan
Frustration
Vision
Vision
Skills
Vision
Skills
Incentives
Vision
Skills
Incentives
Resources
False
Starts
From American Productivity & Quality Center
The California Health Workforce
Alliance (CHWA)
A public-private partnership dedicated to the
implementation of coordinated, systematic
strategies to meet California’s emerging
health workforce needs.
Alliance Partners:
•  Health Employers
•  Public and Private Higher
Education
•  Health Professions
Education Institutions
•  Foundations
•  Associations
•  Government Agencies
•  Policy Makers
•  Business
•  Advocates
•  Workforce Development
Organizations
•  K-12 Education
•  Organized Labor
•  Regional and State-wide
workforce coalitions
•  Workforce Investment
Boards
•  Economic Development
•  Consumers
CHWA Steering Committee
•  Dr. Jack Stobo- Sr. VP Health Affairs, UC Office of the President
•  Dr. Charles Alexander- Vice Provost, UCLA
•  Bob Redlo- Director of National Workforce Planning and
Development, Kaiser Permanente
•  Deanna Kennard- VP Catholic Healthcare West
•  Cindy Beck- Ca Dept of Education
•  Dr. Gary Hlady- HRSA Region IX Director’s Office
•  Anne Drumm- OSHPD Director’s Office
•  Carla Cherry- K-12 Kern Resource Center
•  Carmela Castellano-Garcia- CEO, Ca Primary Care Assoc.
•  Chad Silva- Latino Coalition for Healthy California
CHWA Steering Committee
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Diane Lahola, Sutter Health HR
Noel Barakat, Los Angeles County Public Health Dept.
Deloras Jones, California Institute for Nursing in Healthcare
Shelia Thomas, CSU Chancellor’s Office
Juan Carlos Belliard, Loma Linda University School of Public
Health
•  Alisi Tulua, Orange County Asian Pacific Islander Community
Alliance (OCAPICA)
•  Michelle Siquieros- Exec. Dir, Campaign for College Opportunity
•  Steve Barrow, California Rural Healthcare Association
1. Act on immediate programmatic or policy priorities to advance
current health workforce needs
2. Serve as single point of convergence for emerging workforce
and diversity issues. Respond to changing dynamics
3. Develop and implement a master plan and infrastructure
–  provide process, infrastructure, accountability
–  promote shared investment and coordinated action
–  inform and collaborate with legislature
–  align with regional, profession, sector initiatives
–  lead systems and practice change
4. Develop and promulgate innovative, proactive practice and
training model solutions
5.  Expand and harmonize CA and regional workforce and
economic development initiatives.
6.  Mobilize, leverage and optimally utilize public and private
funds, partnerships to meet priority health workforce needs
7.  Connect workforce and education initiatives to align strategies,
foster innovation, increase efficiency and reduce duplication
8.  Align employer workforce needs with training program
capacity and candidate preparation.
9.  Dedicated workforce expertise, evidence, capacity and
network
Alliance Roles and Functions
Network and Knowledge
•  Development and Management
•  Evidence and practices Inform and Educate
•  Synthesize
•  Map
•  Informed Voice
•  Disseminate
•  Shared Learning
•  Clearinghouse
Technical Assistance
•  State-wide
•  Regional
•  Organizational
Planning and Action
Neutral Broker
•  Connect
• Convene
• Coordinate
• Mobilize
• Forum
•  Long Term and Immediate
• Dedicated Infrastructure
•  Partner
Innovate and Lead
• Catalyze
• Demonstrate
• Develop leaders
Current CHWA Priority Areas of Focus
1.  K-12 student health career readiness & motivation
3.  Align academic production & employer needs.
Innovation in delivery systems, practice & training
3. Partnership & technical assistance with regional,
profession and state-wide workforce initiatives
4. Coordination of the CA HIT Workforce Strategic Plan
5. Short & long-term workforce planning & development
Current CHWA Initiatives
1.  Quarterly Convenings
2.  CA Health IT Workforce Strategy Coordination
3.  Technical assistance to CSU, CPCA, CHPC, Inland Empire,
CWA/WIB projects. Advisory to CHA and others
4.  Workgroups in priority areas- Data, Delivery Systems Change
5.  OSHPD and Labor Agency collaboration and projects
6.  State-wide and regional program inventories and maps
13.  Assembly Select Health Workforce Committee Support
14.  Master Plan or Road Map process development
15.  Website and networking tool development
16.  Mobilize support for priority member initiatives
CA HIT Workforce Strategy
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HIT Workforce Workgroup- summer 09
9k additional CA HIT workers needed to achieve meaningful use goals
Developed Workforce Strategic Plan with CHHS:
•  Training Program development and on-line resources
•  Workforce projections and tracking by career path/jobs
•  Curriculum development
•  Hands-on training
•  Recruitment and retention using the CTD framework
•  Regional development with RHORC’s, WIBs, local CC
•  Partner with REC’s to train the on-the-job workforce
•  Develop informatics leaders
•  Develop guideing coalition and infrastructure
Funding from TCE to assist with implementation
CHWA HIT Strategy Implementation
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Work group
HIT Survey
Pilot Internship Program
ONC Demonstration Project proposal
Career paths, competencies and training programs
CalHIPSO training assessment
Community College Collaboration
CHWA Pilot HIT Internship Program
•  Goals:
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Provide hands-on EHR implementation training
Contribute to HIT workforce & implementation
Opportunity for Californians
Learn what works and how to scale
Partner with Health Career Connection to run
3 and 6 month paid internships, all settings
Minimum pay of $1500/mo, $3k Program Fee
College graduate, clinical or admin exp, HIT or IT exp
Sourced, pre-screened, supervised candidates
Hired or job placement at end
Pilot Internship Program
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350 applicants
15 Fellows placed, others hired
Health centers and hospitals
Primarily urban and northern CA
Recent graduates, HIT Certificates, 10 yr HIT exp
Diverse cohort
Webinars on priority topics
Primary roles: readiness, testing, project mgmt,
workflow redesign, data and reporting
Pilot HIT Internship: Lessons Learned
•  Employer needs not well defined, evolving
•  Often expecting intern to play central role
•  Challenging to match candidate skills and availability
with location of opportunity
•  Candidates have wide range of experiences, training
and expectations
•  Long recruitment and placement lead time
•  Important to make hosting easy, turn key
•  Webinars important
•  Infrastructure and hiring mechanisms critical
•  Need partners to help succeed and scale
HIT Internship Program: Next Steps
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Infrastructure in place
Process to begin in Dec or Jan for next cycle
New partnership with HIMSS So Cal
Collaboration with Community Colleges
Collaboration with REC’s, LEC’s
Expand opportunities
eHealth Workforce Workgroup
Employer Survey
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Conducted May 2010
Online via Survey Monkey
54 unique responses
California health organizations
Contact: Kathy Kim (kathy@kimconsultants.com)
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Respondent Demographics (N=54)
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Respondent Demographics
Number
of
organiza2ons
by
geographic
se9ng
Number
of
organiza2ons
by
size
of
employee
base
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Percent of respondents who have this
position in their organization
The list below shows several Health IT related positions. What job title, if any, do you use to refer to each of these types of
positions in your organization?
120.0%
100.0%
80.0%
60.0%
40.0%
20.0%
Trainer
Clinical expert
Interface specialist
Technical analyst
Project manager
Practice workflow
specialist
Implementation support
specialist
0.0%
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Job Titles
What do you call these positions in your organizations?
•  Implementation support specialist
•  Practice workflow specialist
•  Project manager
•  Technical analyst
•  Interface specialist
•  Clinical expert
•  Trainer
See Attached Spreadsheet
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Employee Hiring
Does your organization plan to hire any Health IT
workers from June 2010 to June 2011?
Do you have funding for these positions you plan to hire from June
2010-June 2011?
60.0%
50.0%
50.0%
45.0%
40.0%
40.0%
35.0%
30.0%
30.0%
25.0%
20.0%
20.0%
15.0%
10.0%
10.0%
5.0%
0.0%
Yes
No
Don't Know
0.0%
Yes
No
Partial
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Top 10 Ranked Knowledge and Skills*
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Introduction to Information and Computer Science
Health Management Information Systems
Working with Health IT Systems
Installation and Maintenance of Health IT Systems
Fundamentals of Health Workflow Process Analysis and Redesign
Configuring EHRs
Quality Improvement
Professionalism/Customer Service in the Health Environment
Working in Teams
Planning, Management and Leadership for Health IT
*Out of 25 subject areas
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Workforce Needs
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Workforce Survey Next Steps
•  Write up and publish results
•  Identify funding to do more large scale and obtain
better response rate
•  Link to ONC and CA career paths and competencies
Career Path and Competencies
Development
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Start with ONC Paths
Vet with Workgroup and others
Collaborate with Dr. Hersch in Oregon
Project need based on paths
Create on-line resources for prospective candidates
Use for training program development
Use by employers to develop workforce
CalHIPSO Training Assessment
1. Environmental Scan and Gap Analysis
–  Summarize existing EHR training content in use by the
LECs, REC’s and key CalHIPSO partners
–  Outline content that is appropriate and available for
CalHIPSO to use as part of its eHealth Training Strategy as
well as to identify the gaps in content that need to be
developed by CalHIPSO & others
2. Identify key partnerships and resources to leverage
for effective eHealth Training Strategy
3. Recommend “value added” eHealth Training Strategy
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Western Region Health IT Program
•  Community College Consortia to Educate Health Information
Technology Professional - $5.4 million, 14 colleges in four states
•  Objective: By 2012 the Western Health IT Regional Consortium
will have produced 4,200 highly trained HIT Implementation
Workers
•  Health IT Roles:
–  Practice Workflow/Information Management Redesign
Specialist
–  Clinician/Practitioner Consultant
–  Implementation Support Specialist
–  Implementation Manager
–  Technical Software Support Role
–  Trainer
•  http://wrhealthit.org/
GIS Map of colleges
Region B
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Pop. = 47.5 Million
Nat % = 15%
MC’s = 14
Next Steps: Phase 2
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Workgroup expansion
Strengthen infrastructure and coordination
Link to new delivery models work
Rural workforce collaboration
Dr. Hersch collaboration re Career Paths
Internship Program expansion and refinement
CA Workforce Development Council
New projections
Community College collaboration
CalHIPSO project
Other?
For Further Information
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CHWA Website: http://Calhealthworkforce.org
Next CHWA Meeting 12/13, TCE Oakland
For further information:
Jeff Oxendine, MPH, MBA
oxendine@berkeley.edu (510) 642-2414
•  Katherine Kim, MPH/MBA: HIT Employer Survey
and CalHIPSO Training Assessment,
kathykimsfsu@gmail.com
•  Jenna Krishenman, MPH: HCC HIT Internship
Manager, jkirschen@gmail.com