Texas Public Health Association, 16apr09
ALLIED HEALTH:
PROFESSIONAL SHORTAGE
Eldon L. Nelson, Ph.D.
Professor and Dean, School of Health Sciences
The University of Texas at Brownsville
and Texas Southmost College
Shortage: Allied Health Workforce




AH makes up 60% of healthcare workforce
15 of the 30 fastest growing occupations are Allied
Health
A need for 5.3 million AH workers through
departures and new positions (2010)
1.6 to 2.5 million vacant positions (2020)
HRSA, Bureau of Labor Statistics
HRSA – Report to Congress, 2002
The Allied Health Program plays a crucial role providing a rapid transition of students with a
baccalaureate degree into the health-related sciences. Allied health professions encompass about 30
percent of the total health care workforce and projections are that by 2010, 5.3 million new allied
health workers will be needed. Already there are shortages in critical allied health fields.
HRSA Report to Congress 2002, Allied Health Shortage
12 Nov 2006
“Laboratory sciences are just critical to our delivery of
healthcare in an acute-care hospital, but they are out
of sight, out of mind.”
Roger E. Seaver, CEO, Henry Mayo Newhall Memorial Hospital,
Valencia, CA (Los Angeles Times, July 27, 2008)

nationally, 77% of academic health center CEO’s declared AH shortages to be a
problem
Who are Allied Health Professionals ?


More than 100 separate disciplines/occupations
AMA 2008-09 Health Careers Directory

77 Health Professional groups; 8000 training programs

Physicians, nurses, radiologic technologists…. Many others
Definition: Allied Health Professionals



HRSA – Health Resources and Services
Administration
U.S. Code 42USC Sec. 295p
Association of Colleges of Allied Health
Who are Allied Health Professionals ?

HRSA* (2000) - Allied Health Professionals:
2,672,000
 made up of:

Dental hygienists/assts/lab techs
 Dieticians/dietetic technicians
 EMT / Paramedic
 Health Information Admin / Tech
 Occupational Therapists
 Orthotics and Prosthetics
 Physical Therapists


*Health Resources and Services Administration
HRSA – Allied Health (cont.)
 Radiologic
service workers
 Respiratory Therapy workers
 Speech Pathologist /audiologists
 Other:








Dietetic assistants
Genetic assistants
Operating room technicians
Ophthalmic / optometric medical assistants
Medical transcriptionists
Vocational rehab counselors
Other rehabilitation workers
Other social and mental health workers
US Code Definition (42 USC Sec. 295p):
Allied Health Professionals

… a health professional (other than a registered nurse or
physician assistant)


who has received a certificate, an associate's degree, a
bachelor's degree, a master's degree, a doctoral degree, or
post-baccalaureate training, in a science relating to health
care;
who shares in the responsibility for the delivery of
health care services or related services, including (i) services relating to the identification, evaluation,
and prevention of disease and disorders;
(ii) dietary and nutrition services;
(iii) health promotion services;
(iv) rehabilitation services; or
(v) health systems management services…
42USC Sec. 295p (continued)

… and, who have NOT received a degree of:













doctor of medicine
doctor of osteopathy
doctor of dentistry
doctor of veterinary medicine
doctor of optometry
doctor of podiatric medicine
bachelor or doctorate of science in pharmacy
graduate degree in public health
doctor of chiropractic
graduate degree in health administration
doctoral degree in clinical psychology
degree in social work
degree in counseling
Allied Health Professionals
“… are involved with the delivery of health or related services
pertaining to identification, evaluation and prevention of
diseases and disorders; dietary and nutrition services;
rehabilitation and health systems management, among others.
Allied health professionals, to name a few, include dental
hygienists, diagnostic medical sonographers, dietitians, medical
technologists, occupational therapists, physical therapists,
radiographers, respiratory therapist and speech language
pathologists.”
The Association of Schools of Allied Health Professions
Summary Definition:
Allied Health Professionals

“Allied Health” … typically excludes :
Physicians AND most doctorate level health professionals
 Nurses and Physician Assistants
 Public Health, Counseling and Social Workers
 Healthcare Administration


All Others having credentials in the Healthcare
professions:
Allied Health Professionals
Among the Most Recognized
Allied Health Disciplines
Occupation
1970
1990
2000
Total Allied Health
750,000
1,831,000
2,672,000
(256)
Dental Hygienists
40.000
81,000
112,000
(180)
Dieticians
17,000
57,000
90,000
(429)
EMT - Paramedic
36,000
93,000
125,000
(247)
Health Information Admin /Tech
52,000
87,000
101,000
(100)
Clinical Laboratory
135,000
297,000
337,000
(150)
Occupational Therapists
6,000
42,000
72,000
(1100)
Physical therapists
30,000
92,000
130,000
(333)
Radiologic workers
87,000
157,000
220,000
(153)
Speech Pathologists/audiologists
19,000
65,000
121,000
(537)
HRSA, Bureau of Health Professions, National Center for Health Workforce Analysis
(% change)
Allied Health Professions:
Projections 2006-2016
Employment Number*
Occupation
Graduate Degree level
Occupational therapists
Physical Therapists
Speech-Lang Pathologists
2006
2016
Total job openings
Growth & net
replacement 2006-16*
99
173
110
122
220
121
37
68
33
Baccalaureate Degree
Dieticians / Nutritionists
Med & Clinical Lab Tech
57
319
62
362
19
92
Associate Degree
Dental Hygienists
Med. Records / HIT
Radiologic techs
Respiratory Therapists
167
170
196
102
217
200
226
126
82
76
56
38
* thousands,
Data from S.N. Collier, 2007 Health Workforce Articles, BLS projections to 2016
Causes for the Shortage?
- Demand exceeds Production


Growing population
Lag of educational AH programs to meet need




Limited enrollment (small) programs
Lack of AH faculty
Lack of students (many AH programs are not known)
Limitation of Clinical Sites





restricted student / faculty ratio
Attrition rates are high
Retirement of aging AH professionals
AH Programs advancing entry-level to higher degree
Some occupations have limiting salary attraction
(e.g., EMS, MLT)
Texas: Shortage of Allied Health Professionals
Texas:
Shortage of Allied Health Professionals

764,000 health care workers
 8.2%

of total workforce
Population grew 26%, 1988-2000
 Health


worker employment, 51%
Population expected to increase 23%, 2000-2020
The Hispanic patient population will increase
 Texas
projected to have a majority Hispanic pop. 2030
 Need for bilingual health care providers
Texas: Job Openings VS. Number of Graduates
2004-2014
Profession
# Annual
Openings (1)
# Graduates*
Minus 10% (2)
#/Percent Unfilled
Positions (1)
Clin Lab Scientist
610
246
364 / 60%
Dental Hygienist
465
322
143 / 31%
EMT/Paramedic
560
276
284 / 51%
Occupational Therapy
340
131
209 / 39%
Physical Therapy
480
155
325 / 68%
Physician Assist
270
230
40 / 15%
Respiratory Care
460
363
97 / 21%
Speech /Lang Pathology
445
171
274 / 62%
[Modified from M. Harrington, Dean, College of Health Professions UTHSCSA]
1. Texas Workforce Commission, Data Link, Future Job Growth by Occupation 2004-2014.
http://www.tracer2.com/cgi/dataanalysis/AreaSelection.asp?tableName=Occprj
2. AMA. Health Professions Career and Education Directory 2007-08. Chicago, IL
Allied Health Education Programs: Texas

In 2008:

379 AH Programs in Texas (2008)





264 programs in community/technical colleges
115 programs in universities
127 programs are CAAHEP accredited programs
representing 20 of the AH disciplines
Expected AH 8,000 Graduates
Job Openings – 12,000*
* Estimated based on the average shortage (52%) of the most recognized AH professions
Allied Health Data:
Border Region of South Texas
Allied Health Workforce Projections
- South Texas
2007 2012
Jobs Jobs
Med. & Clinical Lab. Tech
619
Radiology Technology
710
Openings
New Replace Total
(%)
91
46
137
(22)
1068 1273 205
72
277
(26)
Physical Therapy
1348 1686 338
73
411
(30)
Dental Hygiene
456
560
104
43
147
(32)
Respiratory Therapy
679
810
131
64
195
(29)
Speech Path/Audio
937
1110 173
81
254
(27)
Occupational Therapists
486
597
111
30
141
(29)
Surgical Technology
473
583
110
72
182
(38)
Source: Texas Workforce Commission and Comptroller report, Texas in focus: South Texas, Aug 2008
Allied Health Programs: Border Institutions
Faculty, Enrollment, and Graduation
Allied Health
Programs
Cert./
Assoc.
Bachelor
Master
Master/
PhD
Number of
Programs
29
8
7
2
Faculty FT/PT
Current
73/39
18/11
43/7
Needed FT/PT
40/30
5/1
10
3
AY 2007
974
2294
123
15
AY 2008
1010
2456
131
16
4%
7%
7%
7%
2007
386
116
92
pending
2008
415
131
85
pending
8%
13%
-8%
Enrollment Data
Change
Graduate Data
Change
•Laredo CC, South Texas College, Texas State Technical College - Harlingen,
UT-Brownsville /TSC, UT-El Paso, UT-Pan American
Programs along the Border *
- 22 Allied Health Disciplines
Dental Assistant
Dental Hygiene
Cancer Information Management
1
Clinical Laboratory Science
1
Dental Assistant
1
Dental Hygiene
1
Diagnostic Medical Sonography
1
Dietetics
1
Emergency Medical Services
4
Health / Medical Administration
1
Health Promotion
1
Medical Assistant
3
Medical Laboratory Technology
3
Occupational Therapy
1
Occupational Therapist Asst.
2
Pharmacy Technology
1
Phlebotomy
1
Physical Therapy
1
Physical Therapist Assisting
2
Polysomnography
1
Radiology Technology
3
Respiratory Care/Therapy
2
Speech – Language Pathology
2
Surgical Technology
1
* Laredo CC, STC, TSTC, UTB/TSC, UTEP, UTPA
High Demand Allied Health Professions in
LRGV*








Laboratory Technologists /Medical Laboratory Technicians
OR/Surgical Technologists
Pharmacists / Pharmacy Technicians
Phlebotomists
Radiologic Technologists (AART certified)
Respiratory Technologists (Registered or Certified)
Physical Therapy / PTA
Occupational Therapy / OTA
*employment practices vary among hospitals; regular employment, use of PRN
Mitigation of AH Shortage
Federal Legislation

Federal:
Health Reinvestment Act, 110th Congress,
2007-08
 Allied
 Title


VII of the Public Health Service Act
PART G – Allied Health Professionals
AH portion of Section 799C - Not passed
Funding for Allied Health Professions in the
Stimulus Package (Amer. Recov. & Invest. Act)
HRSA Funding :
• $500M for health professions Workforce Shortage
• $200 million for health professions training programs

Allied Health may take advantage of:

DOL - $4 billion – focused on training workers for high demand professions



Workforce Investment Act (WIA) - $750M – worker training
WIA - $3B – Training & Employment, Displaced Worker Formula funding
Pell Grants – funding needy students into college - $15B
(derived from J. Colbert, Allied Health- Moving Forward, AAHP Annual Meeting, St. Petersburg, FL,
19mar09; and S. N. Collier, Where is Allied Health in Stimulus Funding?, Trends, March 2009)
Current Texas Legislation:
Allied Health Professions

SB 706 - Incentives to Recruit and Retain Allied Health
Education Program Faculty (Davis; Harris, Hinojosa, West)




Tuition exemption/reduction for children of AH Faculty
Tuition reduction for AH Clinical Preceptors
Grants for recruiting/retaining AH Faculty
SB 290 - Creation and Implementation of the Health
Professional Education Grant Program (Nelson; Zaffarini)

Grant for expanding AH education programs
Current Texas Legislation:
Allied Health Professions

SB 706 - Incentives to Recruit and Retain Allied Health
Education Program Faculty (Davis; Harris, Hinojosa, West)




Tuition exemption/reduction for children of AH Faculty
Tuition reduction for AH Clinical Preceptors
Grants for recruiting/retaining AH Faculty
SB 290 - Creation and Implementation of the Health
Professional Education Grant Program (Nelson; Zaffarini)

Grant for expanding AH education programs
Partnering in the Valley:

UTB/TSC partnering with:
 UTPA
… to expand needed AH programs to Brownsville
 OT
Program
 Speech Pathology Program
 South
Texas College... To initiate programs in Brownsville
 OTA
Program
 PTA Program
 TSTC…
to initiate new programs
 Vocational
Nursing
 Cancer Information Management
Texas Association of Public Health, 16apr09
Thank you,!...... Questions?
ALLIED HEALTH:
PROFESSIONAL SHORTAGE
Eldon L. Nelson, Ph.D.
Professor and Dean, School of Health Sciences
The University of Texas at Brownsville
and Texas Southmost College