RODNEY WILLET AND HARRISON HAYES
Mar 24, 2024
Virginia is facing an unprecedented health workforce crisis in attracting and retaining all types of health care providers. No part of Virginia is immune to this crisis. There are shortages of almost all types of health care workers in rural and urban areas. In fact, most of Virginia’s localities are federally designated as Health Professional Shortage Areas (HPSAs): 102 of 133 Virginia counties are primary care HPSAs and 93 counties are mental health care HIPSAs.
The General Assembly created the Virginia Health Workforce Development Authority (VHWDA) in 2010 to identify and address health workforce issues in the commonwealth. In 2022, the legislature provided the authority funding to study health workforce solutions in nursing, behavioral health and primary care. That study reflects over 4,000 hours of work and hundreds of interviews and focus groups with stakeholders across Virginia.
Most significantly, the study found that if current trends continue, workforce shortages will increase significantly across Virginia, particularly in behavioral health. Interventions focused on reducing barriers to retention, increasing recruitment and raising wages are critical for addressing these shortages.
The study also recommended a series of legislative changes to increase the powers of the VHWDA, lower regulatory barriers to entering certain health professions and expand funding for health care educational opportunities. For the 2024 legislative session, legislators recognized these imperatives from the study and introduced a wide spectrum of bills impacting health professions. The following bills were carried by Democrats and Republicans and passed both the House and Senate with strong bipartisan support: House Bill 1499 (Del. Rodney Willett, D-Henrico) and Senate Bill 155 (Sen. Head, R-Botetourt): These health workforce omnibus bills add new duties to the VHWDA including the ability to better collect health workforce data. The bills propose a regulatory framework to increase the number of nursing faculty in nursing programs (many nursing programs across Virginia could accept more students if they had more qualified nursing teachers). The bills also implement a licensing process for individuals with a master’s in psychology to practice independently, which will significantly increase the number of mental health professionals in the state.
Additionally, the bills create the Virginia Healthcare Career and Technical Training and Education Fund under the VHWDA. Although there currently is no state money allocated for this program, once funded the VHWDA wil award grants on a regional basis, similar to Virginia’s very successful GO Virginia program, to encourage innovative approaches to health care professional education and retention.
The VHWDA has several successful frameworks to leverage in creating this statewide program, including the Health Workforce Highway and Virginia Tech Talent Pipeline. VHWDA also intends to model its program after the Blue Ridge Partnership for Health Science Careers in order to attract students at all levels to careers in health care and provide career ladders for upward mobility within health professions.
House Bill 1269 (Del. Cia Price, D-Newport News): This legislation creates an exception to the barrier crime rules for employment at an adult substance abuse or mental health treatment program that permits persons convicted of certain offenses to be eligible for employment if such conviction occurred more than three years prior to the date of their application for employment. Many of these programs rely on people with the same lived experiences to help others now needing support.
Senate Bill 403 (Sen. Tara Durant, R-Fredericksburg: Durant’s bill adds new licensing types for entry-level behavioral health services providers (behavioral health technicians and behavioral health technician assistants). In addition to expanding the type and number of entry-level behavioral health providers, these technicians also have the opportunity to advance to higher levels of qualification to deliver behavioral health services.
House Bill 971 (Del. Kathy Tran, D-Fairfax): This legislation would lower from five years to three years the amount of full-time clinical experience required before an advanced practice registered nurse (APRN) may practice without a practice agreement. Most states have lowered the experience requirement so that APRNs can work autonomously sooner, thus increasing the number of providers available.
We are hopeful that Gov. Glenn Youngkin will sign all of this pending legislation in the coming weeks. Virginians can only receive effective health care if there are health professionals trained and available who can provide that health care across the commonwealth. And with more health professionals working in Virginia, health care is not only more accessible but also more affordable as there are more providers who accept health insurance plans, including Medicaid, and the Virginia free clinics and federally qualified health centers are more fully staffed.
