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Study: Island Health Workforce Needs Beefing Up

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March 25, 2005 — A comprehensive study of the health workforce in the Virgin Islands concluded that medical professionals in the territory are underpaid, understaffed, and the low-income population is underserved.
According to Pamela Eckstein, Director of the V.I. Primary Health Care Office, this is the first such study of the Virgin Islands health workforce. Eckstein and her assistant, Sherri Lewis, spent about two years gathering data to form a picture of the health workforce in the territory.
"We have a dedicated workforce in the Virgin Islands, but we have shortages," said Eckstein. "It's amazing how few health care workers there are in the different settings as compared to similar settings in the U.S. We have less health care available because we have fewer people who give care."
The report concluded:
– The V.I. had substantially fewer registered nurses, licensed practical nurses, pharmacists, physical therapists and behavioral health providers per capita than the U.S. The numbers of nursing, psychiatric and home health aides were also much fewer.
– Hourly wages for nurses and pharmacists are lower than their U.S. counterparts.
– The number of physicians per capita was comparable to the U.S. However concerns remained about recruiting needed specialists, and whether there is sufficient access to low- income primary care providers.
– The territory has more dentists, chiropractors, podiatrists, and optometrists per capita than the U.S. However, low-income residents do not necessarily have access to dental health care.
– The Virgin Islands is federally designated as a behavioral health professional shortage area.
Another chronic shortage area is with registered nurses, who comprise the single largest occupational group employed by V.I. hospitals in recent years. Last year nearly half of staff nurses at the V.I. hospitals were traveling contract nurses hired to fill vacancies.
"This study gives us real qualified info that could be used for planning and grant writing," said Eckstein. "There are some efforts underway."
One of the efforts is the V.I. Healthcare workforce Training Institute, which got under way last September. The first class will certify home health aides.
"That grew out of the fact that there are no certified home health aides in the territory," said Eckstein. "Some of these allied health workers don't get paid enough to do a massive recruit effort. We have young people who need a skill and need a job. The idea of training came up."
Other strategies were identified to address both current and emerging issues, include:
– A formal process to plan for current and future health workforce needs, including forming an advisory committee to produce a periodic health workforce development plan.
– Coalitions between health care providers and health professions education programs in the Virgin Island, possibly extending to university and college programs on the mainland.
– Distance learning programs in partnership with U.S. allied health education programs to address both the educational needs of V.I. residents and also help currently employed health care workers with career advancement.
— Expansion of available funding for health professions scholarships to include service-obligated scholarships.
— Initiatives to educate V.I. youth about health care issues in general and health careers in particular, including development of a health careers Web site.
– Mentoring programs for employees at health care facilities to encourage them to pursue further nursing education.
– Competitive wages for health professionals at all levels; using funds that currently support contract workers.
The study was sponsored by the Department of Health and Human Services Health Resources and Services Administration and produced by the State University of New York School of Public Health Center for Health Workforce Studies, which has published Profiles for each state, Washington D.C. and Puerto Rico.
For information on how the V.I. profile fits in with all the others, (See "bhpr.hrsa.gov/healthworkforce/reports/").

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