Hawaii continues to suffer from a serious shortage of health care workers, according to the latest findings from the Healthcare Association of Hawaii.
The 2024 Hawaii Healthcare Workforce Initiative report, published every two years by the nonprofit trade group, noted some easing of shortages for some categories, but found the state short of more than 4,600 health care workers in 94 professions.
Overall, the state experienced a job vacancy rate of 14% for health care workers, down from 17% in 2022. In 2019, when the first report came out, unfilled positions represented 10% of total health care positions in the state.
“The health care workforce initiatives are showing tangible success,” said Hilton Raethel, HAH president and CEO. “There’s still more to be done in health care, education and training efforts across the state in order for our industry to meet the growing health care needs in Hawaii, and as Hawaii’s population ages, there will continue to be a greater demand for medical services in the health care environment.”
The greatest needs still persist in nursing, entry-level positions and imaging.
Hawaii is short of more than 1,000 registered nurses, along with more than 1,000 entry-level positions such as certified nurse aides, and nursing and medical assistants.
Nursing professions combined overall show a vacancy rate that is about 11% down from 2022. For entry-level professions, however, the rate is 8% higher than two years prior.
The state is also experiencing a growing shortage of imaging technologists, in particular, CT, mammography and ultrasound techs.
“We’re using more of them, and it’s creating a growing concern among health care employers,” said Raethel, who estimated the need for imaging techs to have increased by close to 40% from 2022. “There’s a national demand, so we’re competing against the rest of the country.”
One glaring gap is a lack of training programs in Hawaii available to certify these technicians. Many aspiring technicians have to go to the U.S. mainland to undergo several years of training, and consequently, might not return to work in Hawaii.
The goal of the reports is to better match supply with demand, he said, and identifying where the greatest demand is to meet it.
The 2019 report, for instance, documented the lack of physical or occupational therapy programs available in Hawaii. Now, Hawaii Pacific University has stepped up to offer these training programs.
Raethel said he hopes this report spurs efforts, which are underway, to launch tech imaging programs in the state.
Initiatives working
Some initiatives that the state and industry have taken to recruit young health care workers appear to be working.
Among these are programs targeting Hawaii students, from high school to college, to create career paths leading to health care professions.
HAH training programs are offered at 14 public high schools across the state that help bring in certified nurse aides, medical assistants and patient service representatives. Three-fourths of these students went on successfully to secure their first health care job after graduation.
Additionally, there are bridge programs — specialized 12-month “earn and learn” programs — that allow students to work while pursuing requirements to become a licensed practical nurse.
Students enrolled in these programs continue working as certified nurse aides or medical assistants, and are able to increase their salaries significantly as LPNs. Approximately 50 candidates are enrolled in the program this year.
The 2024 report found the vacancy rate for LPNs dropped to about 23%, compared to 30% in 2022, attributing some of the decline to the bridge program.
Still, demand is expected to outpace supply, and the state faces more challenges ahead in the need to expand its health care workforce.
“The good news is that, in a direct comparison with professions and respondents surveyed in 2022, we see the positive impact of health care workforce initiatives on entry-level positions and specialty nursing professions,” said Raethel. “However, due to the increasing need for care, workforce demand remains high for these and other professions.”
Challenges ahead
Hawaii’s silver tsunami, or growing population of aging seniors from the baby boomer generation, is expected to drive even more demand for health care professionals in the years to come.
Wesley Lo, CEO of Ohana Pacific Health, said as people age, their health care needs grow more complex, with potentially more severe illnesses.
“We are seeing greater demand for nursing home beds and home health,” said Lo. “Certainly, the aging population is starting to catch up with us.”
The number of openings for certified nurse aides and nursing assistants overall has increased when compared with 2022 due, in part, to growing demand from long-term nursing facilities. There is also a demand for home health aides, with a vacancy rate of 30%.
This affects the whole “continuum of care,” as lack of available beds at long-term nursing facilities means more beds taken up at hospitals with nowhere to discharge patients.
The 2024 report is more comprehensive than past ones, and expands on the previous one by accounting for five additional professions, as well as additional data from two federal facilities, including the Tripler Army Medical Center and VA Pacific Islands Health Care System.
HAH added positions such as psychiatric aides, and environmental service and food service positions to the survey for 2024 because of their importance. The reports do not count medical doctors or surgeons.
The report also looks at shortages based on type of facility. Hospitals have the largest shortages, due to employing the most staff, followed by skilled nursing facilities and health clinics.
Hospitals have more registered nurse openings, while the nursing facilities and clinics have the most openings for licensed practical nurses and nursing assistants.
The 2024 report is HAH’s third workforce report, following ones in 2022 and 2019.
The 2022 report, which was delayed a year due to the COVID-19 pandemic, found a drastic 76% jump in health care job vacancies when compared to 2019, with more than 3,800 openings across 89 professions.
