Sen. Murray Issues Remarks at Health Care Workforce Shortages Hearing

WASHINGTON, May 22 -- Sen. Patty Murray, D-Washington, ranking Democratic member of the Senate Health, Education, Labor and Pensions Committee, issued the following opening remarks at a hearing on addressing shortages in health care workforce:

"A robust, diverse, collaborative workforce is critical to the health of our families and communities; however, sustaining that workforce is a big challenge, and there are many smaller interconnected challenges, too...We need multifaceted approaches to build a health care workforce that is more diverse, better distributed, and trained through collaborative models to provide as many patients as possible with care that meets their needs. No single program could be adequate to these nuanced tasks, which is why the Health Resources and Services Administration, or HRSA, administers a series of interconnected programs... These programs don't just tackle the workforce shortage at large, but target specific challenges. "

"HRSA administers the Centers of Excellence Program and the Nursing Workforce Diversity Program, to address the need for better representation of racial and ethnic minorities in our health care workforce by supporting educational opportunities for young, underserved, and underrepresented students. According to the Association of American Medical Colleges, only 7 percent of medical school graduates are African American, and only about 6 percent are Hispanic."

"About one fifth of our country's population is rural--yet only about one tenth of our physicians practice in rural areas. In fact, nearly three out of five areas facing a shortage of primary care professionals are rural. Last year, loan repayment and scholarship programs through HRSA supported more than 12 thousand practitioners in underserved areas nationwide--collectively serving more than 12 million patients"

"HRSA also administers the Geriatrics Workforce Enhancement Program to support the integration of geriatrics into primary care settings, so that seniors can get care that reflects their changing needs in their own communities. The number of seniors in our country is expected to nearly double over the next few decades. As this so-called 'silver tsunami' hits, it will put us at risk of a serious workforce shortage in senior care."

"HRSA also administers the Behavioral Health Workforce Education and Training program to help address the national shortage of mental and behavioral health experts. Over half of all counties across the nation don't have a single psychiatrist. Over three-fourths have a severe shortage of psychiatrists. In fact, according to the Kaiser Family Foundation, our current mental and behavioral health workforce can't meet one third of our need in this area... So last year, our health workforce programs trained over four thousand new professionals in behavioral and mental health."

"These are great programs with a positive impact -- but we need to invest in that impact on a larger scale, because compared to the scope of the challenge, we're fighting fires with a squirt gun. We've got the right idea, but we need to do a lot more. Unfortunately, President Trump seems interested in doing a lot less. His budget proposal would all but end these efforts, cutting dozens of programs entirely and slashing funding by over 90 percent."

"Instead of drastic cuts, we worked across the aisle on substantial increases in the recent bipartisan budget deal. We increased funding for the National Health Service Corps by over a third. We increased funding for behavioral health training by half. We made substance use disorder experts eligible for workforce loan repayment programs. And I hope we can continue to build on that bipartisan work."

"I also hope we remember that strengthening our health care workforce means addressing harassment and sexual assault in the workplace too--our health practitioners need safe workplaces to do their jobs. I'm particularly concerned about how we provide that safety for home care aides who work in isolated environments. I've reached out to industry stakeholders about this and started some good conversations. I hope we can continue that conversation here too, because it's hard to encourage people to go into a field--or to stay in it--if they don't feel safe."

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Video of Senator Murray's remarks available HERE (http://xitenow.com/browse.php?u=4kl65gBkWBfhGy0bsBqV9KCLALVHJIcu&b=5).

Full text below of Sen. Murray's remarks:

"Thank you, Mr. Chairman, and thank you to all our witnesses for joining us today.

"A robust, diverse, collaborative workforce is critical to the health of our families and communities; however, sustaining that workforce is a big challenge, and there are many smaller interconnected challenges, too. We need a strong pipeline to recruit, train, and retain more health professionals, particularly in rural and underserved areas, and we need to make sure that pipeline includes professionals who have different backgrounds and specialties.

"We need multifaceted approaches to build a health care workforce that is more diverse, better distributed, and trained through collaborative models to provide as many patients as possible with care that meets their needs.

"No single program could be adequate to these nuanced tasks, which is why the Health Resources and Services Administration, or HRSA, administers a series of interconnected programs--programs authorized through Title VII to support primary care, oral health, mental health, and other providers, and programs through Title VIII that support nurses. HRSA provides scholarship and loan repayment programs; grants to support inter-professional training and residency programs in community-based settings; and research to help identity new workforce trends, problems, and solutions.

"These programs don't just tackle the workforce shortage at large, but target specific challenges. For example, HRSA administers the Centers of Excellence Program and the Nursing Workforce Diversity Program, to address the need for better representation of racial and ethnic minorities in our health care workforce by supporting educational opportunities for young, underserved, and underrepresented students. According to the Association of American Medical Colleges, only 7 percent of medical school graduates are African American, and only about 6 percent are Hispanic.

"Changing that matters because greater diversity among practitioners--as well as greater cultural and language competency--can help patients from all backgrounds get higher quality care. So it's worth noting, half of the graduates from HRSA's workforce programs last year were minorities or came from disadvantaged backgrounds, but that's not all. HRSA also administers the National Health Service Corps, and the NURSE Corps, to target the needs of underserved communities. About one fifth of our country's population is rural--yet only about one tenth of our physicians practice in rural areas. In fact, nearly three out of five areas facing a shortage of primary care professionals are rural.

"Last year, loan repayment and scholarship programs through HRSA supported more than 12 thousand practitioners in underserved areas nationwide--collectively serving more than 12 million patients. Additionally, University of Washington's School of Medicine, long recognized for its work to connect students to underserved communities, and the new medical school at Washington State University, whose students learn about technologies and techniques specifically to support care in rural areas, were both among many programs supported by HRSA grants to address this need. But that's not all.

"HRSA also administers the Geriatrics Workforce Enhancement Program to support the integration of geriatrics into primary care settings, so that seniors can get care that reflects their changing needs in their own communities. The number of seniors in our country is expected to nearly double over the next few decades. As this so-called 'silver tsunami' hits, it will put us at risk of a serious workforce shortage in senior care. U-W's geriatrics program is among the HRSA grantees addressing this. Dr. Phelan, I look forward to hearing your testimony about that important work - but that's still not all.

"HRSA also administers the Behavioral Health Workforce Education and Training program to help address the national shortage of mental and behavioral health experts. Over half of all counties across the nation don't have a single psychiatrist. Over three-fourths have a severe shortage of psychiatrists. In fact, according to the Kaiser Family Foundation, our current mental and behavioral health workforce can't meet one third of our need in this area. This is an urgent issue--especially as our communities grapple with the opioid crisis and the epidemic of substance use disorder. So last year, our health workforce programs trained over four thousand new professionals in behavioral and mental health, and even that is not all.

"These are just a few of the many programs authorized by Title VII and VIII to address our health workforce needs. One program supports children's hospitals. Another supports training providers in community-based settings. Another supports inter-professional training to help all practitioners learn to work together and with community-based organizations to provide the most patients with the best care.

"Another, the Health Careers Opportunities Program, H-COP, improves health workforce diversity by supporting programs that engage minority and disadvantaged kids in the health sciences--kids like Benjamin Danielson, who received mentorship and guidance that kindled his interest in attending U-W's School of Medicine. Today he serves as the Clinic Chief and Medical Director of the Odessa Brown Children's Clinic in Seattle, which provides specialized pediatric care to patients, regardless of their ability to pay. He also serves as a mentor thorough the same H-COP program that helped him, to support and inspire future generations of minority medical students.

"These are great programs with a positive impact -- but we need to invest in that impact on a larger scale, because compared to the scope of the challenge, we're fighting fires with a squirt gun. We've got the right idea, but we need to do a lot more.

"Unfortunately, President Trump seems interested in doing a lot less. His budget proposal would all but end these efforts, cutting dozens of programs entirely and slashing funding by over 90 percent. Thankfully, his view isn't shared by all Republicans.

"Instead of drastic cuts, we worked across the aisle on substantial increases in the recent bipartisan budget deal. We increased funding for the National Health Service Corps by over a third. We increased funding for behavioral health training by half. We made substance use disorder experts eligible for workforce loan repayment programs. And I hope we can continue to build on that bipartisan work.

"I also hope we remember that strengthening our health care workforce means addressing harassment and sexual assault in the workplace too--our health practitioners need safe workplaces to do their jobs. I'm particularly concerned about how we provide that safety for home care aides who work in isolated environments. I've reached out to industry stakeholders about this and started some good conversations. I hope we can continue that conversation here too, because it's hard to encourage people to go into a field--or to stay in it--if they don't feel safe.

"Thank you Mr. Chairman, I look forward to hearing from our witnesses about these issues and about how we build and maintain a strong health care workforce."