♪ ♪ ♪ ♪ >> Renee: COVID-19 DIDN'T CREATE A DIRTH OF HEALTHCARE WORKERS BUT EXPOSED THE SYSTEM'S VULNERABILITIES IN RETAINING MEDICAL PROVIDERS ACROSS THE CONTINUUM OF CARE FROM NURSES TO THERAPISTS AND SO FORTH.

WE'LL TALK ABOUT A COLLABORATION BETWEEN THE STATE'S COMMUNITY AND TECHNICAL COLLEGE SYSTEM, THE STATE CHAMBER OF COMMERCE AND HOSPITAL ASSOCIATION TO ADDRESS THE WORKER SHORTAGE IN THE HEALTHCARE INDUSTRY.

THAT'S NOW ON CONNECTIONS THANK YOU FOR JOINING US FOR CONNECTIONS TODAY.

I'M RENEE SHAW.

LABOR SHORTAGES ARE A CONSTANT HEADLINE THESE DAYS AS INDUSTRIES OF ALL KINDS ARE ON THE HUNT FOR QUALIFIED WORKERS, THE HEALTHCARE FIELD IS NO EXCEPTION, OUR HEALTHCARE HEROES HAVE EXPERIENCED A HEIGHTENED LEVEL OF STRESS, TRAUMA AND BURNOUT SINCE THE COVID-19 PANDEMIC BEGAN BUT THE WORKFORCE ISSUE STARTED LONG BEFORE THE ADVENT OF COVID-19.

A COLLECTIVE OF INDUSTRY, BUSINESS AND ACADEMIC GROUPS ARE JOINING FORCES TO ADDRESS THE DWINDLING WORKFORCE IN HEALTHCARE AND WE'LL HEAR FROM THREE OF THEM TODAY.

CHRIS WILLIAMS, CHANCELLOR OF THE KENTUCKY COMMUNITY AND TECHNICAL COLLEGE SYSTEM.

AND LAKISHA MILLER, EXECUTIVE DIRECTOR OF THE KENTUCKY CHAMBER OF COMMERCE WORKFORCE CENTER AND JOINING US BY SKYPE, NANCY GALVAGNI, PRESIDENT AND C.E.O.

OF THE KENTUCKY HOSPITAL ASSOCIATION.

THANK YOU ALL FOR JOINING US.

WE APPRECIATE YOUR TIME SO VERY MUCH.

I WANT TO START WITH NANCY IF THAT'S OKAY, ON THE TIME WE RECORDED THIS PARTICULAR INTERVIEW, WE HAD SPENT SOMETIME TOGETHER VIRTUALLY WITH THE KENTUCKY HOSPITAL ASSOCIATION EELS ANNUAL LEADERSHIP CONFERENCE TALKING ABOUT, AMONG OTHER ISSUES, HEALTHCARE WORKER SHORTAGE.

I WANT TO GET FROM YOU WHAT YOU KNOW ABOUT WHY THIS SHORTAGE SEEMS TO BE EXACERBATED OR ARE WE JUST PAYING ATTENTION NOW WHEN WE SHOULD HAVE BEEN PAYING ATTENTION BACK IN 2013 WHEN THERE WERE STRONG WARNING SIGNS THIS WAS COMING?

>> THANK YOU, RENEE, I APPRECIATE THE OPPORTUNITY TO BE ON THE SHOW TONIGHT AND YOU ARE ABSOLUTELY CORRECT, THE WORKER SHORTAGE IS NOT SOMETHING NEW BUT COVID CERTAINLY PUT A BRIGHT SPOTLIGHT ON THE PROBLEM AND CERTAINLY HAS EXACERBATED THE ISSUE.

SO, YOU KNOW, THERE ARE A LOT OF FACTORS AFFECTING THIS, PART OF IT IS JUST PLAIN DEMOGRAPHICS.

IT'S AFFECTING A LOT OF BUSINESSES AND THAT IS WE ARE SEEING A LOT OF OUR WORKERS REACH RETIREMENT AGE AND A LOT OF OUR WORKERS THAT ARE LEAVING ARE RETIRING.

SO UNFORTUNATELY THERE IS NOT ENOUGH NEW NURSES TO REPLACE THE ONES THAT ARE RETIRING SO THAT IS A LARGE PART OF THE PROBLEM.

BUT COVID CERTAINLY TOOK ITS TOLL ON OUR WORKERS.

I THINK, YOU KNOW, FACING WHAT THEY HAD TO FACE EVERY DAY, HAVING TO WORK LONG SHIFTS, A LOT OF NURSES DECIDED THAT WERE CLOSE TO RETIREMENT AGE THAT THEY WOULD GO AHEAD AND RETIRE AND I WAS HEARING EVEN BEFORE THE LAST SURGE HIT AT THE HOSPITALS, THAT THEY WERE JUST BARELY GETTING BY WITH STAFF AND THEY WERE VERY FEARFUL IF WE HAD ANOTHER SURGE, THEY WOULD BE IN A LOT OF TROUBLE AND OF COURSE THAT'S WHAT WE EXPERIENCED.

UNFORTUNATELY, A LOT OF THE NURSES HAD TO TAKE ON ADDITIONAL SHIFTS.

WE LOST SOME WORKERS GOING TO THE TRAVEL AGENCIES, YOU SNOW, THAT WERE PAYING MORE MONEY.

BUT AGAIN, WE WERE SHORT TO BEGIN WITH.

IT'S NOT SOMETHING THAT COVID CAUSED BUT COVID-19 CERTAINLY DIDN'T HELP THE SITUATION.

>> Renee: I WANT TO CLARIFY WHEN WE TALK ABOUT THE TRAVELING AGENCIES, WE ARE TALKING ABOUT TRAVELING NURSES.

I UNDERSTAND THAT THEY ARE PAID MUCH GREATER PERHAPS THAN THOSE WHO WORK IN STAND ALONE FACILITIES.

HOW DOES THAT WORK AND WHY IS THAT SUCH A COMPETITIVE FIELD THERE.

>> >> SO TRAVEL NURSES, YOU ARE CORRECT.

MOST HOSPITALS DON'T WANT TO EVER HAVE TRAVEL NURSES.

THEY LIKE TO HAVE EMPLOYED NURSES AND USE TRAVELERS ONLY TO FILL IN SMALL GAPS, OPEN POSITIONS.

THE PROBLEM IS COVID WAS A NATIONAL ISSUE AND THE NURSING SHORTAGE WAS NOT JUST IN KENTUCKY BUT ACROSS THE NATION AND SO WE WERE COMPETING NOT JUST FOR LABOR WITHIN OUR STATE BUT WE WERE COMPETING NATIONALLY.

HOSPITALS IN NEW YORK WERE TRYING TO GET NURSES IN OTHER STATES TO GO TO NEW YORK AND ALL ACROSS THE NATION AND SO THAT WAS DRIVING UP THE WAGES AND SO WE WERE HAVING TO PAY IN KENTUCKY A NATIONAL RATE TO TRY TO GET NURSES AND SOME OF THE-- WE WERE GETTING REPORTS EVERY WEEK ON JUST WHAT THE GOING RATE WAS AND DEPENDING ON THE TYPE OF NURSE, IT COULD BE AS HIGH AS $200 AN HOUR.

AND SO YOU CAN IMAGINE THAT WOULD ENTICE SOME PEOPLE, MAYBE TO LEAVE AND THAT JUST MADE IT WORSE FOR THE WORKERS THAT WERE REMAINING IN THE HOPS, THE LOYAL STAFF THAT WERE STAYING IN THE HOSPITALS.

>> Renee: SO $200 AN HOUR COMPARED TO WHAT WOULD BE THE AVERAGE HOURLY RATE?

>> YOU KNOW MAYBE 40.

>> Renee: OH WOW.

CHANCELLOR, MONEY IS NOT EVERYTHING BUT I BET IT SPEAKS VOLUMES WHEN IT COMES TO SOMETHING LIKE THIS.

>> IT DOES AND IT'S IMPACTING OUR ABILITY TO KEEP OUR NURSING FACULTY WHILE THEY'RE VERY DEDICATED, THEY ALSO SEE THAT DIRECT NEED AND WHEN A VACANCY OCCURS, IT MAKES IT DIFFICULT TO REPLACE THEM WITH SO MANY OPPORTUNITIES.

>> Renee: LAKISHA MILLER, IT'S GOOD TO HAVE BOTH OF YOU.

I DON'T KNOW THAT YOU HAVE FER BEEN ON THIS PROGRAM.

WE ARE GLAD TO HAVE YOU ON.

WORKFORCE ISSUES, WE'VE TALKED ABOUT WITH REPRESENTATIVES FROM THE CHAMBER FOR MANY YEARS AND SO WE ARE DISSECTING CERTAIN SECTORS OF OUR ECONOMY.

I'VE TALKED ABOUT SOCIAL WORKERS AND EDUCATORS AND SEPARATE PROGRAMS AND HEALTHCARE HEROES, 18, 19 MONTHS AGO, THEY WERE SO HERALDED AND WE COULDN'T DO AND SAY ENOUGH THINGS TO EXPRESS OUR GRATITUDE BUT THEN THINGS SEEMED TO TAKE A TURN AND THE TRAUMA AND THE BURNOUT AND STRESS AND ANXIETY I THINK IS ONE OF THE FACTORS THAT HAS LED TO SOME OF THE PEOPLE CHOOSING TO MAKE AN EXIT.

>> I COULDN'T AGREE MORE.

ONE OF THE THINGS THAT WE HEAR FROM OUR BUSINESSES CONSTANTLY IS AROUND THAT BURNOUT.

AND ALSO AROUND JUST WHAT CAN THEY DO TO HELP THE NURSES NOT BURN OUT.

WE KNOW THROUGH DEALT AND THE ORIGINAL INSURGENCE OF COVID, THEY WERE SCARED OF LOSING THEIR STAFF, SO A LOT OF PLOIRS HAVE COME TO THE CHAMBER SPECIFICALLY AROUND THE TALENT PIPELINE PROGRAM WHERE WE PARTNER WITH Dr. WILLIAMS AND HER TEAM TO SAY WHAT CAN WE DO WHAT NEEDS DO YOU HAVE?

WHAT IS YOUR DEMAND LOOKING LIKE?

AND WHAT WE DO KNOW IS EVEN BEFORE COVID THEY WERE EXPERIENCING A SHORTAGE SO AFTER COVID AND NANCY DID A GREAT JOB OF TALKING ABOUT TRAVELING NURSES AND HOW MUCH THAT HAS IMPACTED JUST THE THE LABOR POOL, THEY ARE READY TO GET ON TO WORK IN TERMS WHAT HAVE DO WE NEED TO DO IS IT WAGES?

WE CAN ONLY INCREASE THE WAGES SO MUCH UNTIL IT'S NOT AVAILABLE ANYMORE NANCY, I WANT TO COME BACK TO YOU.

IT'S NOT JUST ABOUT NURSES.

WE MENTIONED AND HEARD ABOUT THE CONTINUUM OF FAIR.

PHYSICIANS, SPECIALISTS.

THIS IS A PROBLEM THAT'S PRETTY VAST AND DEEP YES, NURSING OBVIOUSLY IS THE MOST CRITICAL SHORTAGE BUT IT IS ACROSS THE BOARD.

IT'S PHYSICIANS, RESPIRATORY THERAPISTS, NURSING ASSISTANTS, IT'S IMAGING TECHS.

IT'S THE WHOLE GAMUT OF HEALTHCARE.

>> Renee: AND IS IT REGIONAL?

ARE WE SEEING POCKETS THAT HAVE MORE OF THESE, I'LL CALL THEM HEALTHCARE WORKER DESERTS THAN OTHER AREAS OR IS THIS JUST ACROSS THE STATE?

>> IT'S REALLY ACROSS THE STATE.

I KNOW I TALKED TO CERTAIN HOSPITALS THAT MAYBE WERE ON THE BORDER OF TENNESSEE, LOSING WORKERS TO NASHVILLE, SO YOU ARE NOT JUST COMPETING WITHIN YOUR STATE.

YOU ARE COMPETING FOR REGIONAL LABOR MARKETS AND THEY WERE HAVING A VERY HARD TIME KEEPING UP WITH TRYING TO KEEP THEIR STAFF FROM GOING ELSEWHERE.

SO IT'S IN RURAL COMMUNITIES.

IN THE RURAL COMMUNITIES, THEY'RE VERY CONCERNED ABOUT LOSING ANY STAFF BECAUSE IT'S HARDER TO RECRUIT TO A RURAL HOSPITAL.

SO IT IS ALL ACROSS THE STATE.

>> Renee: AND THE IMPACT OF COVID-19 VACCINATION POLICIES IN HOSPITALS?

HOW MUCH OF AN IMPACT DO YOU KNOW IF THAT HAS HAD ON THE WORKER SHORTAGE?

>> YOU KNOW, I'M REALLY PLEASED TO SAY WE ARE HEARING IT HAS HAD PRACTICALLY ZERO IMPACT.

AS YOU PROBABLY KNOW, THE FEDERAL GOVERNMENT CAME OUT RECENTLY WITH A FEDERAL RULE REQUIRING ALL HEALTHCARE FACILITIES TO REQUIRE THEIR WORKERS TO BE VACCINATED OR TO HAVE A MEDICAL OR RELIGIOUS EXCEPTION.

AND THAT ALL HAS TO BE COMPLETED BY AROUND THE FIRST OF RIO DE JANERO 4-5 BUT BEFORE THE MANDATE CAME OUT 50% OF THE HOSPITALS CAME OUT TO AMEND THEIR EXISTING VACCINE POLICIES TO ADD THE COVID VACCINE.

HOSPITAL ALWAYS HAVE HAD REQUIREMENTS AROUND CERTAIN VACCINES FOR HEALTHCARE WORKERS.

WHEN YOU THINK ABOUT WE HAVE VERY IMMUNE OWE COMPROMISED SICK PATIENTS IN A HOSPITAL.

THAT MAKES SENSE.

WE HAVE TO PROTECT OUR PATIENTS SO THESE EMPLOYERS MOVE FORWARD TO AGAIN, ADD THAT COVID-19 VEERN AND WE JUST ACTUALLY HAD A MEETING WITH THOSE HOSPITALS, SAYING WHAT WAS THE FALLOUT OF THAT?

AND, YOU KNOW, ACROSS THE BOARD, THEY SAID AT THE END OF THE DAY, IT WAS ALMOST 99.9% OF THEIR WORKERS GOT THE VACCINE.

SO THEY LOST VERY FEW HEALTHCARE WORKERS.

>> Renee: THAT'S BOOED TO HEAR.

LET'S TALK ABOUT THE SOLUTION.

WE'VE DEFINED THE PROBLEM AND LAID OUT THE PROBLEM WHERE IT EXISTS.

I WANT TO TALK TO YOU.

WHAT ARE YOU DOING WITH THESE PARTNERS ON THE STAGE OR MAYBE ON THE VIRTUAL STAGE TO HELP MITIGATE THIS ISSUE?

>> SO OUR 16 COLLEGES ALL HAVE NURSING PROGRAMS.

WE HAVE ABOUT 20 DIFFERENT HEALTHCARE PROGRAMS WE OFFER, ALL OF THOSE AREAS YOU TALKED ABOUT FROM THE REAL NEED FOR STATE REGISTERED NURSE AIDES AND LONG-TERM CARE FACILITIES IS A HUGE NEED AND A STARTING PLACE ON THE PATHWAY TO BEING AN RN TO, YOU KNOW, PHYSICAL THERAPISTS.

THERE ARE HEALTHCARE NEEDS IN ALL THE AREAS, OUR 16 COLLEGES HAVE 23 DIFFERENT NURSING PROGRAMS SO THEY'RE LOCATED AT DIFFERENT CAMPUSES AND IN THOSE PROGRAMS, EACH PROGRAM HAS A CERTAIN NUMBER OF STUDENTS THAT THEY CAN BRING IN.

THERE ARE CAPS SET BY VARIOUS ACCREDITING AGENCIES SO WE CAN BRING IN A LITTLE OVER 1200 STUDENTS A YEAR AND OUT OF THOSE STUDENTS, WE GRADUATE OVER 900 STUDENTS A YEAR.

SOMETIMES STUDENTS HAVE TO STEP OUT OR THERE ARE CHALLENGES OR WHATEVER YOU CAN'T ALWAYS SAY 12 HIN AND 900.

THERE IS A CONTINUUM OF CARE IN THERE FOR OUR STUDENTS BILL THEY HAVE A LOT OF CHALLENGES WE HAVE A FEW WHO HAVE VACCINE HESITANCY THAT HAS IMPACTED THERE I PROGRESS, DEPENDING WHERE THE CLINICAL SIDE IS THAT THEY'RE WORKING AND THE CLINICAL SITE'S IMPACT.

MORE OF THEM ARE IMPACTED BY THEIR CHILD CARE CONCERNS THE NEED TO TAKE CARE OF FAMILY MEMBERS TRANSPORTATION ISSUES.

JUST AT THE HEIGHT OF THE PANDEMIC WHEN WE HAD TO MOVE TO COMPLETELY ONLINE EDUCATION, EVEN INTERNET ACCESS WAS A HUGE BARRIER FOR SOME OF OUR STUDENTS.

WE HAVE BEEN REALLY RAMPING UP A LOT OF STUDENT SUPPORT AND THEN WORKING WITH OUR PARTNERS WHO ARE REALLY ALSO LOOKING AT BARRIERS AND SOMETIMES THAT INCLUDES SOME REALLY EXTRAORDINARY PARTNERSHIPS WITH OUR EMPLOYERS WHERE WE ARE DOING APPRENTICESHIPS SO THAT STUDENT IS ALREADY HIRED INTO THE FACILITY AND THAT EMPLOYER IS WORKING WITH THEM AND SUPPORTING THEIR EDUCATION IN A DIFFERENT WAY AND WE ARE REALLY HAPPY TO PARTNER WITH THE KENTUCKY CHAMBER WORKFORCE CENTER ON SOME OF THESE INNOVATIVE WAYS TO GET THE EMPLOYERS AND THE STUDENTS ENGAGED TOCT IN THAT PROCESS.

>> Renee: TALK ABOUT THAT LAKISHA, FROM THE EMPLOYER SIDE, WHAT ARE THEY GETTING OUT OF IT AND HOW ARE THEY CONTRIBUTING?

>> I THINK EMPLOYERS ARE SUCH A CRITICAL PIECE OF THE PUZZLE, RIGHT?

WE HAVE FANTASTIC PARTNERS WITH OUR COMMUNITY COLLEGE AS WELL AS OTHER STATE PARTNERS BUT THE EMPLOYERS HAVE COME TOGETHER WITH OUR TALENT PIPELINE MANAGEMENT PROGRAM AND ESSENTIALLY THAT MA'AM REPS TO MOBILIZE THE INDUSTRY IN SAYING WHAT DO YOU NEED, YOU KNOW, WHAT IS YOUR DEMAND LOOK LIKE WHAT SKILLS ARE IMPORTANT TO YOU AND MOST IMPORTANTLY, HOW CAN WE HELP FEAMENT CONVERSATION WITH EDUCATION AND WORKFORCE PARTNERS SO WHAT WE HAVE SEEN THROUGH OUR TALENT PIPELINE MANAGEMENT WORK IS WE HAVE BEEN ABLE TO ESTABLISH EIGHT DIFFERENT HEALTHCARE COLLABORATIVES ACROSS THE STATE AND WHAT THAT ALLOWS US TO DO IS REALLY PINPOINT THE NEEDS OF THAT RISK REGION OR COMMUNITY SO SOME OF THE SOLUTIONS THAT WE'VE COME UP WITH EASTERN KENTUCKY, WE HAD ABOUT, I THINK ABOUT EIGHT TO 10 EMPLOYERS WITHIN THAT COLLABORATIVE.

AND THEY'RE LIKE WE NEED NURSES, WE NEED HEALTHCARE PROFESSIONALS AND WE NEED YOU TO PRODUCE MORE NURSES.

OF COURSE YOU THOUGHT THAT'S THE SOLUTION.

AS WE STARTED TO DIG INTO THAT THOUGHT, THAT WASN'T THE CASE.

WE WERE LOSING NURSES BECAUSE LIFE GOT IN THE WAY.

BUT Dr. WILLIAMS TALKED ABOUT CHILD CARE ISSUES, TRANSPORTATION, BROADBAND, SO THAT EMPLOYER COLLABORATIVE SAID OKAY, WHAT CAN WE DO.

SO WE PARTNERED WITH SOME OF OUR LOCAL PARTNERS AND THEY WENT AFTER A GRANT.

SO IT'S A DEPARTMENT OF LABOR GRANT THAT THEY GOT FOR 2.5 MILLION IN JANUARY THAT'S ALL AROUND PROVIDING SUPPORT SERVICES FOR NURSING STUDENTS.

SO THAT ARE MOVING INTO THEIR FACILITY.

>> Renee: AND REAL SOLUTIONS TO ADDRESS THE CHILD CARE TRANSPORTATION AND MAYBE ACCESS TO THE TECHNOLOGY.

>> EXACTLY.

>> SHOW THAT WAS A BIG, BIG WIN FOR THAT REGION AND OF COURSE THE EMPLOYERS ARE GOING TO KNOW THAT THESE STUDENTS ARE SUPPORTED AND THEY HAVE A GREATER CHANCE OF ACTUALLY GETTING TO OUR FACILITY.

>> AND THE CHAMBER HAS BEEN WORKING A LONG TIME WITH THE STATE, WORKING WITH THE CONTINUUM OF EDUCATION EVEN IN K-12 AS AS EARLY AS MIDDLE SCHOOL IT'S CRITICAL TO WHATEVER OPPORTUNITY LIES AHEAD.

HOW SOON ARE YOU TRYING TO GET TO FOLKS?

WE KNOW THERE IS AN IMMEDIATE SHORTAGE NOW BUT LET'S LOOK AT SHORT-TERM AND LONGER TERM I THINK IN THE SHORT-TERM IT'S ABOUT REALLY UNDERSTANDING WHAT ARE THE VAIR YERS THAT ARE CURRENTLY IN THE WAY FOR GETTING PEOPLE TO MOVE INTO THE WORKFORCE.

IF IT'S CHILD CARE, HOW CAN EMPLOYERS PARTNER WITH PARTNERS IN TERMS OF GETTING PEOPLE BACK INTO THE WORKFORCE KENTUCKY HAS, WE ARE 48th WITH OUR WORKFORCE PARTICIPATION RATE.

>> Renee: DOWN ABOUT 7 NOTCHES FROM WHERE WE WERE PRE-PANDEMIC.

>> YES.

>> EXACTLY.

SO THERE IS A LOT OF PEOPLE THAT WE NEED TO GET BACK INTO THE WORKFORCE.

SO IT'S HOW DO WE REENGAGE PEOPLE THAT ARE JUST ON THE SIDELINES.

SO IF IT'S BROADBAND, HOW DO WE PARTNER AND, YOU KNOW, GET ACCESS TO THAT.

IF IT'S CHILD CARE, HOW DO WE DO THAT.

IF IT'S TRANSPORTATION.

SO IN THE SHORT-TERM, I THINK, WHAT WE HAVE BEEN WORKING ON IS HOW DO WE SUCCESSFULLY REMOVE SOME OF THOSE BARRIERS TO GET PEOPLE IN.

IN THE LONG-TERM, HOW DO WE GET PEOPLE EXCITED.

HOW DO WE GET THE KIDS EXCITED AND INTRODUCE THEM TO SOME OF THESE THINGS AND WE HAVE A REALLY GOOD BUS TO BUSINESS PROGRAM AT THE CHAMBER WHICH WE ARE PARTNERS WITH THE COMMUNITY COLLEGE ON, WHICH IS SAYING HERE IS A VARIETY OF CAREER PATHWAYS, SPECIFICALLY NURSING OR IF YOU ARE NAM WITH NURSING-- FAMILIAR WITH NURSING, MAYBE YOU ARE NOT FAMILIAR WITH OTHER AREAS IN HEALTH SERVICES.

THAT HAS BEEN REALLY SUCCESSFUL.

>> Renee: AND TO JUMP TO THE OTHER END, FOR THOSE ALREADY ENGAGED IN THE HEALTH FIELD, HOW DO YOU GET THEM MAYBE EVEN UP IN THEIR CERTIFICATION AND IN THEIR ADVANCEMENT OF SKILLS?

>> AND THAT'S WHERE WE KEEP TALKING ABOUT EMPLOYERS BUT IT TAKES ALL OF US.

IF SOMEBODY IS EMPLOYED ON A PATHWAY, OFTEN THE EMPLOYER WILL PAY SO THAT BARRIER MAY BE A CONCERN THAT YOU CAN'T PAY FOR YOUR EDUCATION IS REMOVED.

KENTUCKY HAS EXTRAORDINARY LEGISLATIVE SUPPORT FOR OUR COMMUNITY COLLEGE AND TECHNICAL COLLEGE STUDENTS THROUGH THE WORK READY KENTUCKY SCHOLARSHIPS AND HEALTHCARE IS ACTUALLY ONE OF THE TOP SECTORS WHERE THE SCHOLARSHIPS ARE USED TO COVER LAST AID AND THE LAST AID IS WHEN, YOU KNOW THE OTHER-- HOW DO I SAY THIS WHEN THEY DON'T HAVE OTHER RESOURCES THAT COVER.

>> Renee: OR THEY HAVE BEEN EXHAUSTED THE LAST DOLLAR IN.

>> THAT HAS BEEN AN EXTRAORDINARY HELP AND THEN, TOO, WE GET A LOT OF STUDENTS WITH LATCH BACHELOR'S DEGREES AND MAYBE THEY WANT TO COME BACK AND EXPEDITE.

THEY WANT TO MOVE INTO HEALTHCARE AND THEY COME BACK TO A COMMUNITY COLLEGE AND CAN GET SORT OF GET RID OF SOME OF THE CLASS AS LONG THE WAY AND MOVE RIGHT INTO THE NURSING PIPELINE AND WE HAVE DIRECT PATHWAYS FROM THE SCHOOL YOU MENTIONED THE SCHOOL PATHWAY AROUND HEALTHCARE BUT SOME OF THE STUDENTS CAN MOVE OUT OF THE DUAL CREDIT CLASSES.

THERAPY TAKING COLLEGE CLASSES WHILE IN HIGH SCHOOL GETTING CREDIT FOR BOTH AND THEY CAN WITH A HIGH ENOUGH A.C.T.

SCORE MOVE DIRECTLY INTO A NURSING PROGRAM AND BYPASS ANY OF THE WORK ALONG THE WAY, WE HAVE AN APPRENTICESHIP PROGRAM AT OUR SCHOOL THAT PUTS STUDENTS TO WORK IN HEALTHCARE FACILITIES.

THEY CAN'T BE AT THE BED SIDE THE SAME WAY BUT THERE ARE THINGS THEY CAN DO THEIR JUNIOR AND SENIOR YEAR.

AND THEY GRADUATE WITH AN ASSOCIATE DEGREE OR CLOSE TO IT AND WITH THE WORK EXPERIENCE THAT THEY CAN TRANSLATE ON.

>> NANCY GALVAGNI, I WANT TO ASK YOU WHAT CAN BE DONE ON THE PUBLIC POLICY LEVEL OR ON THE FEDERAL LEVEL THERE THERE HAS BEEN MONIES FROM THE FEDERAL GOVERNMENT TO SHORE UP THIS EFFORT.

WHAT IS BEING DONE AND WHAT ARE YOU LOOKING AT AS POSSIBILITIES?

>> RENEE, I MENTIONED OUR HOSPITALS WHAT THEY'RE HAVING TO PAY AND OUR JOB NUMBER ONE IS TO RETAIN OUR EXISTING STAFF AND WE ARE WORRIED ABOUT THAT.

OUR HOSPITALS HAVE TO HAD BORROW A LOT OF MONEY TO GET THROUGH THE SURGE TO PAY THE 200 AN HOUR WHEN THEY HAD TO HIRE TRAVEL NURSES AND RETENTION BONUSES AND THAT SORT OF THING.

PART OF THE FEDERAL FUNDS IS THAT WERE PASSED DOWN UNDER ARPA AND I DON'T REALLY REMEMBER WHAT THAT STANDS FOR.

>> Renee: AMERICAN RESCUE PLAN ACT.

>> ARPA MONEY BUT PART OF THAT MONEY WAS INTENDED TO HELP PAY FOR ESSENTIAL HEALTHCARE WORKERS AND I CAN'T THINK OF ANY WORKER MORE DESERVING THAN OUR FRONT LINE HEALTHCARE WORKERS SO WE HAVE SEEN OTHER STATE LEGISLATORS ALLOCATE A PORTION OF THEIR STATE'S ARPA FUNDS TO HELP HOSPITALS IN LONG-TERM CARE FACILITIES PAY FOR THE HIGH EXTRAORDINARY STAFFING COSTS SO WE HAVE BEEN TALKING TO THE LEGISLATURE AND HOPEFUL THEY'LL CONSIDER DOING THAT WHEN THEY COME BACK INTO SESSION.

I THINK SOME OF THE OTHER THINGS, LOAN FORGIVENESS, THE COST OF EDUCATION HAS BEEN MENTIONED AND THAT COMES UP A LOT AND REALLY MOST OF OUR HOSPITALS HAVE PROGRAMS FOR LOAN FORGIVENESS SO THAT'S SOMETHING THAT I THINK IS ALREADY IN PLACE.

SOME OF THE OTHER THINGS THAT WE ARE TALKING ABOUT LOOKING AT IS THERE A WAY TO USE RETIRED NURSES?

I NO WE RAN A-- I KNOW WE RAN A CAMPAIGN DURING THE PANDEMIC ASKING NURSES THAT ARE NOT WORKING THAT ARE LICENSED IF THEY WOULD COME BACK IN ANY CAPACITY.

MAYBE THEY DON'T WANT TO COME BACK FULL TIME BUT WOULD THEY BE WILLING TO COME BACK PART TIME?

THINKING ABOUT NEW MODELINGS OF CARE AND YOU KNOW, HOW CAN THEY PROVIDE STAFFING PERHAPS WITH MORE SUPPORT TO THE NURSE SO THE NURSE ISN'T HAVING TO DO EVERYTHING.

I THINK WE ARE GOING TO LOOK AT THE PANDEMIC.

WE HAD TO MAKE SOME CHANGES JUST BECAUSE WE HAD TO PROVIDE PATIENT CARE AND WE HAD STAFFING CONCERNS, YOU KNOW, WHAT THINGS MIGHT WE HAVE LEARNED OUT OF THE PANDEMIC THAT WE COULD CONTINUE FORWARD LOOKING AT HOW TO DO THINGS DIFFERENTLY.

>> AND CAN YOU IMAGINE NANCY, HAD YOU NOT HAD TELEHEALTH.

OF COURSE THAT'S NOT A NEW IDEA.

WE TALK ABOUT IT LIKE IT'S NEW BUT IT HAS BEEN AROUND OVER A DECADE BUT BEING ABLE TO TAKE ADVANTAGE OF IT AT AN OPTIMAL LEVEL, HOW MUCH WORSE WOULD OUR ACCESS BE IN KENTUCKY OR EVEN AROUND THE NATION FOR THAT FACT.

>> THAT'S ABSOLUTELY RIGHT.

EVERYONE IS TAKING ADVANTAGE OF TELEHEALTH.

PATIENTS LIKE IT.

YOU KNOW, CERTAIN THINGS HAVE TO BE DONE IN PERSON BUT IT IS CERTAINLY MORE CONVENIENT FOR THE PATIENT WHEN YOU THINK ABOUT TRANSPORTATION ISSUES.

THAT'S ALREADY COME UP YOU KNOW, THAT ADDRESSES A LOT OF IT.

SO WE SEE TELEHEALTH REALLY GROWING IN THE FUTURE AND, YOU KNOW, EVEN IN THE HOSPITAL, THERE IS, YOU KNOW, YOU CAN USE TELEHEALTH IN THE HOSPITAL WITH TELEICU WHERE MAYBE A LARGER HOSPITAL CAN HELP A SMALLER HOSPITAL.

WE HAVE TO THINK INNOVATIVELY HOW WE CAN USE NEW TECHNOLOGY.

>> Renee: A CRISIS ALWAYS BRINGS ABOUT INNOVATION, DOESN'T IT, Dr. WILLIAMS?

>> IT DOES AND I WANTED TO MENTION THAT ONE OF THE THINGS OUR NURSING STUDENTS AND MANY OF OUR OTHER STUDENTS HAVE GOTTEN INVOLVED IN INCLUDING OUR FACULTY IS THE STATE'S SORT OF MEDICAL HEALTHCARE CORPS.

YOU CAN VOLUNTEER.

YOU CAN'T ALWAYS BE PATIENT CARE BUT THERE ARE MANY WAYS THAT PEOPLE CAN VOLUNTEER AND REALLY HELP OUT TO MEET SOME OF THE CHALLENGES AND IT HAS BEEN VERY INTERESTING TO SEE THE NATIONAL GUARD COME IN TO DO SOME OF THAT AROUND THE PATIENT CARE.

I HAVE JUST BEEN REALLY IMPRESSED BY JUST THE SPIRIT OF COLLABORATION AND COMING TOGETHER, YOU KNOW, IN A REAL HEALTHCARE CRISIS.

INNOVATION IS IMPORTANT AND WE NEED TO THINK ABOUT HOW TO ACCELERATE OUR CURRICULUM AND IF WE HAVE THE RIGHT PREREQUISITES.

ONE OF OUR CHALLENGES AT SOME COLLEGES, WE HAVE HUGE APPLICATION POOLS AND MANY APPLICANTS, AT OTHER COLLEGES VERY TINY POOL.

HOW CAN WE GET PEOPLE TO MOVE, YOU KNOW IT'S NOT THAT HARD TO GO AN HOUR AWAY TO GO TO SCHOOL.

FOR MANY OF OUR STUDENTS, IT IS THEY HAVE SOMETHING HOLDING THEM WHERE THEY ARE PUT BUT MAYBE OTHERS COULD THINK ABOUT GOING TO ANOTHER LOCATION OR USE THE TECHNOLOGY TO BRIDGE THE GAPS.

>> Renee: I WANTED TO ASK YOU, NANCY, DURING THE 21 SESSION OR EVEN BEFORE THERE WAS TALK OF SOME KENTUCKY HOSPITALS THAT SURVEYED CLOSURE.

JUST BECAUSE OF FINANCIAL CONCERNS.

AND I'M JUST WONDERING HOW THE HEALTHCARE WORKER SHORTAGE, HOW THAT OVERLAYS THAT DISCUSSION AND HAS IT LED TO THE CLOSURE OR NEAR CLOSURE OF SOME FACILITIES.

>> THANK YOU, RENEE.

WE ARE CONCERNED.

WE DON'T HAVE ANY HOSPITALS WE THINK ARE IN IMMINENT DANGER OF CLOSE THIS WHY YOU ARE BUT WE THINK THE LONG-TERM OUTLOOK IS CONCERNING.

A LOT OF NATIONAL STUDIES OUT BEFORE COVID HAD ANYWHERE FROM 18 TO 25 PROBABLY OF OUR HOSPITALS, WHAT THEY CALLED IN POOR FINANCIAL CONDITION THAT WOULD BE SUSCEPTIBLE TO CLOSURE AND THE MAJORITIES OF OUR HOSPITAL PATIENTS ARE ON MEDICARE AND MEDICAID PROGRAMS, GOVERNMENT PROGRAMS THAT PAY LESS THAN COST.

SO WHEN COVID HIT, OF COURSE WE HAD EXTRAORDINARY EXPENSES FOR RETROFITTING OUR FACILITIES, FOR CREATING COVID UNITS, YOU KNOW, ALL OF THAT HAPPENED.

WE SURVEYED OUR HOSPITALS AND IN JUST 2020, THE AMOUNT OF THE COST AND PLUS WE HAD, OF COURSE THE SHUTDOWN OF ELECTIVE PROCEDURES FOR SEVERAL MONTHS AND THAT'S, YOU KNOW, A LIFE BLOOD OF OUR HOSPITAL'S REVENUE.

SO WHEN YOU PUT ALL THAT TOGETHER THEY HAD 2.6 BILLION IN A B IN LOSSES.

FEDERAL FUNDS WERE HELPFUL BUT THEY STILL LEFT A BILLION OF THE COSTS UNCOVERED.

THAT'S WHEN WE ENDED 2020.

SO GOING INTO 2021, WE HAD THE DELTA SURGE.

SO WHEN THE VACCINE WAS ROLLED OUT, THE FIRST VACCINE SITES WERE ALL HOSPITALS SO HOSPITALS WERE HAVING TO BUY THE FREEZERS TO PUT THE PFIZER VACCINE IN.

THEY HAD TO SET UP REGISTRATION SYSTEMS.

THEY WERE THE ONES THAT WERE GIVING THE VACCINE INITIALLY.

REGENERON WAS THE HOSPITALS AGAIN AND THE DELTA SURGE HIT AND WE HAD EXTRAORDINARY STAFFING COSTS.

THE LOSSES HAVE CONTINUED TO MOUNT AND THAT'S WHY WE ARE ASKING THE GENERAL ASSEMBLY TO PROVIDE THE ARPA FUNDS BACK TO HOSPITALS.

THE SHOULDIES THAT WE ARE SEEING COME OUT SO THE UTILIZATION HAS NOT RETURNED TO THE PRE-PANDEMIC LEVELS.

THE HOSPITALS ARE LOWER IN THEIR INPATIENTS OUTSIDE OF COVID, WE ARE RUNNING OUT OF BEDS.

IT IS NOT BACK TO NORMAL AND WE KNOW KENTUCKIANS HAVE PUT OFF CARE.

THE OTHER THING THE THAT IS INTERESTING AND STRESSING OUR NURSES IS THAT EVERY PATIENT IN THE HOSPITAL NOW, THE ACUITY IS OFF THE CHARTS.

THAT CAN BE VERY DRAINING ON OUR NURSES AS WELL WHEN EVERY PATIENT YOU ARE TAKING CARE OF IS ULTRASICK.

WE ARE CONCERNED LONG-TERM IF REVENUES DON'T REBOUND TO WHERE THEY WERE BEFORE.

YES, WE HAD HELP FEDERALLY BUT WE ARE CONCERNED THAT IT WON'T COVER THE COSTS THAT KEEP MOUNTING.

$WE WILL BE FOLLOWING IT FOR CERTAIN AND NAN NANCY GALVAGNI WITH THE KENTUCKY HOSPITAL ASSOCIATION, THANK YOU FOR BEING WITH US.

Dr. KRIS WILLIAMS, THANK YOU FOR BEING WITH US AND LAKISHA MILLER WITH THE KENTUCKY WORKFORCE CENTER.

GOOD CONVERSATION.

WE WILL BE FOLLOWING IT.

THANK YOU FOR JOINING US TODAY FOR CONNECTIONS.

FOLLOW US ON FACEBOOK, TWITTER, LISTEN TO OUR PODCAST AT ket.org/PODCAST AND WATCH PREVIOUS SHOWS ON OUR WEBSITE.

UNTIL WE MEET AGAIN, TAKE REALLY GOOD CARE.

SEE YOU SOON.