MEETING NEW MEXICO’S HEALTH CARE WORKFORCE NEEDS UNIVERSITY OF NEW MEXICO HEALTH SCIENCES CENTER
MEETING NEW MEXICO’S HEALTH CARE WORKFORCE NEEDS Background Shortage of New Mexico Primary Care Workforce New Mexico has long faced challenges in training and retaining a health care workforce suffjcient to RIO ARRIBA SAN JUAN TAOS COLFAX UNION - 2 - 2 - 5 - 39 + 10 - 1 0 - 3 + 1 meet the needs of its residents. Chronic provider - 4 - 1 0 0 - 1 PCP, CNP/CNS, LOS ALAMOS + 9 shortages persist in nearly every health profession + 19 - 2 MORA and PA Shortages HARDING - 2 0 + 1 and sub-specialty despite ongoing efgorts to SANTA - 1 McKINLEY - 1 + 1 Adequate SANDOVAL FE - 9 - 22 SAN MIGUEL address the problem. 0 - 5 - 26 + 66 - 10 + 2 - 1 (No Shortage) + 12 + 5 - 1 QUAY + 21 Mild Shortage BERNALILLO 0 + 2 GUADALUPE CIBOLA + 273 + 203 - 1 - 3 0 (1 - 10 Providers) The New Mexico Health Care Workforce Committee - 3 - 7 + 146 TORRANCE 0 - 8 VALENCIA - 10 + 1 Severe Shortage CURRY has been tasked by the New Mexico Legislature - 32 - 23 - 5 DE BACA - 4 - 7 ( > 10 Providers) - 9 + 1 + 1 - 9 with assessing the extent of the provider shortage - 1 ROOSEVELT SOCORRO PC Physicians 0 - 2 CATRON LINCOLN and conducting an analysis to help guide efgorts to - 1 - 1 0 - 2 - 3 - 5 - 3 CNPs/CNSs 0 - 2 - 1 - 5 - 3 remediate these challenges. CHAVES PAs 0 + 19 - 7 SIERRA LEA - 6 + 3 - 6 - 26 OTERO GRANT + 1 - 17 In its October 1, 2015, report to the Legislature, - 9 - 20 + 11 - 3 EDDY - 11 - 9 + 9 - 8 0 the Committee estimated that 1,908 primary care DOÑA ANA - 11 LUNA - 7 + 1 physicians, 1,228 certifjed nurse practitioners and - 9 - 32 0 clinical nurse specialists, 236 obstetricians and - 4 HIDALGO gynecologists, 162 general surgeons and 289 - 2 - 3 0 psychiatrists were practicing in the state. This year, the Committee added an analysis of dentists, Signifjcant health care provider shortages of all types physician assistants and pharmacists, fjnding that persist statewide, particularly in rural areas. A particular 1,081 dentists, 694 physician assistants and 1,928 concern is the need to extend behavioral health care to pharmacists were practicing in New Mexico. all New Mexicans. The Committee’s recommendations As in previous years, the most severe provider are aimed at lowering barriers to practice, promoting shortages were found in rural New Mexico. recruitment and retention of rural providers and continued in-depth analysis of the state’s health Metropolitan areas were not exempt, however, with pharmacists in particular found to be in short workforce (see “Potential Solutions”). supply throughout the state. This bleak picture of provider scarcity underscores the need for a Update On The Committee’s focused strategy to ensure that New Mexicans have Previous Recommendations access to necessary health services. The Committee’s previous recommendations aimed at expanding the primary care workforce have Shortages already had an impact. Statewide, increased state New Mexico would need an estimated 145 primary appropriations have allowed more robust health care physicians, 197 certifjed nurse practitioners professions training. For example, an additional 16 and clinical nurse specialists, 136 physician nurse practitioner training and 18 MD residency slots assistants, 43 obstetricians and gynecologists, 18 have been added at UNM HSC. State funding has also general surgeons, 109 psychiatrists, 73 dentists supported primary care residencies at Hidalgo Medical and 293 pharmacists to enable all counties to meet Services over FY 2015 and FY 2016. national benchmarks for these providers. The Committee’s recruitment and retention Compared with data published in the Committee’s recommendations have also gained traction. In 2014 report, certifjed nurse practitioners and FY 2016, the New Mexico Legislative Finance clinical nurse specialists showed a 13 % increase, Committee recommended increased funding for with 139 more practicing in state. The supply of health professional fjnancial aid programs. In addition, other providers analyzed in both 2014 and 2015 efgorts by UNM HSC and other organizations have declined: the state had a net loss of 49 primary continued to develop programs to foster rural health care physicians (-3 %), 20 obstetricians and professionals’ career development and workload gynecologists (-8 %), 17 general surgeons (-9 %) management, and to recruit practitioners to and 32 psychiatrists (-10 %). underserved areas.
Looking Forward Extending the Rural Healthcare Practitioner ■ ■ In its 2016 report, the Health Care Workforce Tax Credit to pharmacists, social workers and Committee plans to expand its analysis to include counselors. psychologists, counselors and social workers, In 2017, reinstating U.S. Department of Health and ■ ■ emergency medical technicians and physical and Human Services matching funds for New Mexico’s occupational therapists. loan repayment program. Increasing funding levels for loan-for-service and ■ ■ The Committee also anticipates analyzing some loan repayment programs. efgects of Medicaid expansion under the Patient Analyzing the Rural Healthcare Practitioner Tax ■ ■ Protection and Afgordable Care Act on New Mexico’s Credit’s impact on retention. health professionals. Planned research also includes Permanently funding the New Mexico Health ■ ■ modeling future workforce needs based on current Care Workforce Committee so it can more health care delivery models, as well as proposed comprehensively identify the state’s provider collaborative and team-based models. needs and ofger grounded, evidence-based recommendations for the best path toward meeting them. Potential Solutions In response to the fjrst recommendation, the New The Committee recommends measures to enhance Mexico Counseling and Therapy Practice Board, the the quantity and quality of New Mexico health care Board of Psychologist Examiners and the Board providers, improve access to behavioral health care of Social Work Examiners have already agreed to and increase incentives for rural practice. These are expand or examine expanding the defjnition of described in detail in the Committee’s 2015 Annual supervised practice toward independent licensure. Report, and include: Reducing barriers to independent behavioral ■ ■ We look forward to action on the remaining health licensure and entering practice in the state. recommendations in order to close the gap between Expanding statewide access to telehealth ■ ■ rural and urban counties and allow all New Mexicans consultation. access to the care necessary for improved physical Promoting measures to allow reimbursement for ■ ■ and behavioral health. treatment by behavioral health interns, improve retention of behavioral health providers and maintain adequate licensure board pass rates for all publicly funded higher education providers. Shortage of New Mexico Obstetricians and Gynecologists, 2014 Shortage of New Mexico General Surgeons, 2014 SAN JUAN RIO ARRIBA TAOS COLFAX UNION SAN JUAN RIO ARRIBA TAOS COLFAX UNION - 4 - 1 - 1 + 1 0 0 0 + 5 + 3 + 1 Ob/Gyn General Surgeons LOS ALAMOS LOS ALAMOS MORA MORA Shortages per 100,000 People + 1 HARDING + 4 HARDING 0 0 0 0 McKINLEY McKINLEY SANTA Adequate SANTA Optimal + 2 SANDOVAL SAN MIGUEL + 4 SANDOVAL SAN MIGUEL FE FE - 8 + 1 (No Shortage) - 4 + 1 ( > 9.2 Surgeons/100k) - 5 + 6 Mild Shortage Adequate BERNALILLO BERNALILLO QUAY QUAY GUADALUPE GUADALUPE CIBOLA CIBOLA + 47 + 19 0 - 1 (1 - 5 Providers) 0 0 (6 - 9 Surgeons/100k) - 1 0 VALENCIA VALENCIA TORRANCE - 5 TORRANCE Mild Shortage - 8 Severe Shortage CURRY CURRY - 2 - 1 DE BACA - 3 DE BACA + 6 (3 - 6 Surgeons/100k) ( > 5 Providers) 0 0 SOCORRO ROOSEVELT SOCORRO ROOSEVELT Insufficient Population Severe Shortage + 2 - 1 + 2 0 CATRON LINCOLN CATRON LINCOLN to Support 1 Provider ( < 3 Surgeons/100k) 0 0 0 - 1 CHAVES CHAVES No Surgical Facility Insufficient Population 0 0 in County to Support 1 Provider SIERRA LEA SIERRA LEA - 1 - 4 - 1 - 2 OTERO OTERO No Surgical Facility Shortage or Surplus GRANT 0 GRANT + 3 - 2 0 + 3 in County EDDY EDDY + 1 + 2 DOÑA ANA DOÑA ANA 0 Shortage or Surplus - 3 - 2 LUNA LUNA + 1 0 HIDALGO HIDALGO 0 0
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