Topic:
MEDICAL CARE; LEGISLATION; DENTISTS; ELDERLY; MEDICAL PERSONNEL; PHYSICIANS; STATISTICAL INFORMATION; TRAINING PROGRAMS;
Location:
MEDICAL PERSONNEL;

OLR Research Report


September 1, 2006

 

2006-R-0546

HEALTHCARE WORKFORCE SHORTAGES IN CONNECTICUT

By: John Kasprak, Senior Attorney

You asked for information on healthcare workforce shortages in Connecticut.

SUMMARY

Well-documented healthcare workforce shortages have existed in Connecticut for a number of years according to the Department of Public Health (DPH; see “Toward Solving Connecticut's Health Care Workforce Shortages,” DPH, May 2002). While such shortages are not new to the state, DPH notes that the nature of shortages varies by discipline. In the past, nursing shortages have been cyclical. For other disciplines, current shortages have developed through a gradual process as the increase in supply does not meet the increase in demand.

Demand for health care services is steadily increasing due to an aging population and advances in medical technology. Also, the health care provider population itself is aging. Other career opportunities now compete with health care professions.

Training programs in a number of healthcare disciplines are achieving full enrollment (e.g., pharmacy, nursing), while others (respiratory therapy, radiation technology) are not. All health professional training programs are experiencing a significant rise in the student attrition rate, according to DPH. This is attributed to lack of academic preparation, competing demands of job and family responsibilities, and finances.

Connecticut is expected to have the second greatest decline nationally in the supply of nurses over the next few years and needs to expand nursing education and training programs.

CONNECTICUT AND NATIONAL DATA ON THE HEALTHCARE WORKFORCE

All of the information that follows in this section derives from statehealthfacts.org of the Kaiser Family Foundation.

Physicians

In 2004, there were over 820,000 nonfederal physicians in the United States. Of these, 12,918 were in Connecticut. The rate of physicians per 100,000 population in the state was 369 as compared to the U.S. average of 281, ranking Connecticut fifth nationally among the states and U.S. territories. Connecticut's physician population was roughly 70% male, 30% female. Of the total state physician population, 56% were white, 9% Asian, 2% black, 2% Hispanic, and 2% Native American.

In Connecticut, 38% of its total physicians were classified as primary care physicians ranking it 45th among the states. The national average was 40%. The state's primary care physicians can be further classified as (1) internal medicine-52% (37% national average), (2) family practice-12% (29%), (3) pediatrics-19% (18%), (4) obstetrics/gynecology-5% (12%), and (5) general practice-1% (5%).

The following tables provide more information on all 50 states and national averages in various physician categories.

Table 1 Number of Nonfederal Physicians, 2004

Rank

 

Total Nonfederal Physicians

United States

821,911

1

California

93,791

2

New York

77,062

3

Texas

49,170

4

Florida

44,921

5

Pennsylvania

41,223

6

Illinois

36,169

7

Ohio

33,158

8

Michigan

29,188

9

Massachusetts

28,970

10

New Jersey

28,944

11

Maryland

21,602

12

North Carolina

21,522

13

Virginia

19,726

14

Georgia

19,371

15

Washington

16,485

16

Tennessee

15,447

17

Missouri

15,350

18

Wisconsin

14,421

19

Minnesota

14,412

20

Indiana

13,825

21

Arizona

12,934

22

Connecticut

12,918

23

Colorado

12,343

24

Louisiana

11,820

25

Alabama

9,763

26

South Carolina

9,687

27

Oregon

9,665

28

Kentucky

9,660

29

Oklahoma

7,231

30

Iowa

6,445

31

Kansas

6,442

32

Arkansas

5,645

33

Mississippi

5,289

34

Utah

5,134

35

West Virginia

4,604

36

Nevada

4,570

37

New Mexico

4,538

38

Nebraska

4,237

39

District of Columbia

4,160

40

Maine

3,983

41

Rhode Island

3,902

42

Hawaii

3,809

43

New Hampshire

3,474

44

Idaho

2,445

45

Vermont

2,258

46

Delaware

2,255

47

Montana

2,074

48

South Dakota

1,671

49

North Dakota

1,547

50

Alaska

1,424

51

Wyoming

966

 

 

 

Puerto Rico

9,885

Guam

218

Virgin Islands

158

Notes: U.S. total includes territories.

Nonfederal physicians are not employed by the federal government and include medical doctors and osteopaths. They represent 98% of total physicians.

Table 2: Rate of Nonfederal Physicians

per 100,000 Population, 2004

Rank

 

Nonfederal Physicians per 100,000 Population

United States

281

1

District of Columbia

752

2

Massachusetts

451

3

New York

401

4

Maryland

389

5

Connecticut

369

6

Vermont

363

7

Rhode Island

361

8

New Jersey

333

9

Pennsylvania

332

10

Hawaii

302

10

Maine

302

12

Michigan

289

12

Ohio

289

14

Illinois

284

15

Minnesota

283

16

Delaware

272

17

Oregon

269

18

Colorado

268

19

Missouri

267

19

New Hampshire

267

21

Washington

266

22

Virginia

264

23

Louisiana

262

23

Tennessee

262

23

Wisconsin

262

26

California

261

27

Florida

258

28

West Virginia

254

29

North Carolina

252

30

North Dakota

244

31

Nebraska

243

32

New Mexico

238

33

Kansas

235

34

Kentucky

233

35

South Carolina

231

36

Arizona

225

37

Montana

224

38

Indiana

222

39

Georgia

219

39

Texas

219

41

Iowa

218

42

Alaska

217

42

South Dakota

217

44

Alabama

216

45

Utah

215

46

Arkansas

205

46

Oklahoma

205

48

Nevada

196

49

Wyoming

191

50

Mississippi

182

51

Idaho

175

 

 

 

Puerto Rico

254

Notes: U.S. total includes territories.

Nonfederal physicians are not employed by the federal government and include medical doctors and osteopaths. They represent 98% of total physicians.

Table 3: Nonfederal Primary Care Physicians as a Percent of Total Physicians, 2004

Rank

 

Nonfederal Primary Care Physicians

United States

40%

1

Alaska

49%

2

Wyoming

47%

3

North Dakota

46%

4

South Dakota

45%

5

Idaho

44%

5

Iowa

44%

5

Maine

44%

5

West Virginia

44%

9

Arkansas

43%

9

Hawaii

43%

9

Illinois

43%

9

Nebraska

43%

9

Oklahoma

43%

14

Alabama

42%

14

Georgia

42%

14

Kansas

42%

14

Minnesota

42%

14

Mississippi

42%

14

Nevada

42%

14

New Mexico

42%

14

Oregon

42%

14

Vermont

42%

14

Washington

42%

14

Wisconsin

42%

25

Colorado

41%

25

Indiana

41%

25

Michigan

41%

25

Montana

41%

25

New Hampshire

41%

25

South Carolina

41%

25

Virginia

41%

32

Arizona

40%

32

California

40%

32

Kentucky

40%

32

New Jersey

40%

32

Ohio

40%

32

Rhode Island

40%

32

Tennessee

40%

32

Texas

40%

40

Delaware

39%

40

Missouri

39%

40

New York

39%

40

North Carolina

39%

40

Utah

39%

45

Connecticut

38%

45

Florida

38%

45

Louisiana

38%

45

Pennsylvania

38%

49

Maryland

37%

50

District of Columbia

36%

51

Massachusetts

35%

 

 

 

Guam

58%

Puerto Rico

48%

Virgin Islands

43%

Notes: Nonfederal physicians are not employed by the federal government and include medical doctors and osteopaths. They represent 98% of total physicians.

Definitions: Primary care physician specialties include Internal Medicine, Family Practice, Pediatrics, Obstetrics/Gynecology, and General Practice.

Table 4: Distribution of Nonfederal Primary Care Physicians

by Field, 2004

 

Internal Medicine

Family Practice

Pediatrics

Obstetrics/ Gynecology

General Practice

Total Primary Care

United States

37%

29%

18%

12%

5%

100%

 

 

 

 

 

 

 

Alabama

35%

32%

17%

13%

4%

100%

Alaska

18%

52%

14%

10%

7%

100%

Arizona

34%

32%

17%

12%

5%

100%

Arkansas

21%

48%

15%

10%

7%

100%

California

37%

26%

19%

12%

5%

100%

Colorado

29%

39%

16%

12%

3%

100%

Connecticut

52%

12%

19%

15%

1%

100%

Delaware

30%

33%

21%

13%

4%

100%

District of Columbia

49%

12%

24%

14%

2%

100%

Florida

35%

28%

19%

12%

8%

100%

Georgia

34%

27%

19%

16%

4%

100%

Hawaii

39%

21%

20%

15%

5%

100%

Idaho

20%

54%

10%

12%

5%

100%

Illinois

41%

26%

17%

12%

3%

100%

Indiana

26%

43%

14%

12%

5%

100%

Iowa

21%

53%

13%

8%

5%

100%

Kansas

26%

45%

13%

11%

5%

100%

Kentucky

32%

34%

17%

12%

5%

100%

Louisiana

35%

26%

19%

15%

5%

100%

Maine

28%

45%

14%

10%

4%

100%

Maryland

47%

15%

23%

13%

2%

100%

Massachusetts

55%

12%

21%

10%

2%

100%

Michigan

36%

31%

15%

12%

5%

100%

Minnesota

29%

46%

14%

9%

2%

100%

Mississippi

28%

35%

16%

15%

6%

100%

Missouri

36%

28%

17%

12%

6%

100%

Montana

24%

49%

11%

11%

5%

100%

Nebraska

25%

49%

14%

10%

2%

100%

Nevada

39%

29%

14%

13%

5%

100%

New Hampshire

33%

35%

17%

13%

2%

100%

New Jersey

44%

16%

23%

13%

3%

100%

New Mexico

30%

39%

17%

10%

4%

100%

New York

50%

14%

22%

13%

2%

100%

North Carolina

33%

33%

18%

14%

2%

100%

North Dakota

28%

50%

10%

7%

5%

100%

Ohio

36%

30%

18%

12%

4%

100%

Oklahoma

25%

43%

13%

10%

7%

100%

Oregon

36%

33%

15%

12%

4%

100%

Pennsylvania

38%

31%

16%

11%

4%

100%

Rhode Island

48%

18%

21%

11%

3%

100%

South Carolina

27%

38%

17%

14%

4%

100%

South Dakota

28%

49%

8%

10%

5%

100%

Tennessee

36%

30%

17%

13%

4%

100%

Texas

29%

33%

19%

14%

5%

100%

Utah

26%

37%

20%

14%

2%

100%

Vermont

35%

33%

18%

11%

3%

100%

Virginia

34%

30%

19%

14%

4%

100%

Washington

28%

42%

15%

10%

4%

100%

West Virginia

30%

39%

12%

10%

8%

100%

Wisconsin

31%

41%

15%

10%

3%

100%

Wyoming

20%

51%

11%

11%

6%

100%

 

 

 

 

 

 

 

Guam

26%

41%

13%

12%

8%

100%

Puerto Rico

24%

18%

21%

11%

27%

100%

Virgin Islands

24%

22%

19%

29%

6%

100%

Notes: U.S. totals include territories.

Nonfederal physicians are not employed by the federal government and include medical doctors and osteopaths. They represent 98% of total physicians.

The total number of Primary Care Physicians includes Primary Care Subs and Other Specialities.

Nurses

Connecticut had 34,120 registered nurses (RNs) as of May 2005, ranking it 24th nationally. In terms of RNs per 100,000 population, Connecticut was above the national average (972 vs. 799), ranking it ninth. The following two tables provide more information.

Table 5: Total Registered Nurses, as of May 2005

Rank

 

Total Registered Nurses

United States

2,368,070

1

California

226,350

2

New York

164,370

3

Texas

149,950

4

Florida

138,760

5

Pennsylvania

123,650

6

Ohio

106,600

7

Illinois

102,510

8

Michigan

81,370

9

New Jersey

80,940

10

Massachusetts

76,870

11

North Carolina

72,130

12

Georgia

59,720

13

Virginia

53,850

14

Missouri

53,440

15

Indiana

52,330

16

Tennessee

52,090

17

Minnesota

49,390

18

Maryland

49,010

19

Washington

47,930

20

Wisconsin

47,380

21

Louisiana

39,510

22

Kentucky

37,720

23

Alabama

37,270

24

Connecticut

34,120

25

Colorado

33,050

26

South Carolina

31,160

27

Arizona

31,010

28

Iowa

29,940

29

Oregon

27,970

30

Mississippi

25,970

31

Kansas

25,330

32

Oklahoma

24,670

33

Arkansas

20,250

34

Nebraska

16,460

35

West Virginia

15,640

36

Utah

15,550

37

Nevada

13,980

38

Maine

13,330

39

New Hampshire

12,210

40

New Mexico

11,170

41

Rhode Island

10,620

42

Idaho

9,390

43

Hawaii

9,240

44

South Dakota

9,040

45

District of Columbia

8,340

46

Delaware

7,710

47

Montana

7,490

48

North Dakota

6,740

49

Vermont

5,560

50

Alaska

5,050

51

Wyoming

3,940

 

 

 

Puerto Rico

14,970

Guam

490

Virgin Islands

410

Notes: The U.S. total includes the territories. Estimates for detailed occupations do not sum to the totals due to rounding. Estimates do not include self-employed workers.

Definitions: Registered Nurses include advance practice nurses such as nurse practitioners, clinical nurse specialists, certified nurse midwives, and certified registered nurse anesthetists.

Table 6: Registered Nurses per 100,000 Population, as of May 2005

Rank

 

Registered Nurses per 100,000 Population

United States

799

1

District of Columbia

1,515

2

Massachusetts

1,201

3

South Dakota

1,165

4

North Dakota

1,059

5

Iowa

1,009

5

Maine

1,009

7

Pennsylvania

995

8

Rhode Island

987

9

Connecticut

972

10

Minnesota

962

11

Nebraska

936

12

New Hampshire

932

13

Ohio

930

14

New Jersey

928

15

Kansas

923

16

Missouri

921

17

Delaware

914

18

Kentucky

904

19

Vermont

892

20

Mississippi

889

21

Maryland

875

22

Tennessee

874

23

Louisiana

873

24

West Virginia

861

25

Wisconsin

856

26

New York

854

27

Indiana

834

28

North Carolina

831

29

Alabama

818

30

Michigan

804

31

Illinois

803

32

Montana

800

33

Florida

780

34

Wyoming

774

35

Oregon

768

36

Washington

762

37

Alaska

761

38

South Carolina

732

39

Arkansas

729

40

Hawaii

725

41

Virginia

712

42

Colorado

708

43

Oklahoma

695

44

Georgia

658

45

Idaho

657

46

Texas

656

47

Utah

630

48

California

626

49

Nevada

579

49

New Mexico

579

51

Arizona

522

 

 

 

Puerto Rico

383

Notes: The number of Registered Nurses per one hundred thousand population was calculated using the population estimates provided by the U.S. Census Bureau as of July 1, 2005.

Estimates for detailed occupations do not sum to the totals due to rounding. Estimates do not include self-employed workers.

Definitions: Registered Nurses include advance practice nurses such as nurse practitioners, clinical nurse specialists, certified nurse midwives, and certified registered nurse anesthetists.

Physician Assistants

The projected number of physician assistants in Connecticut as of January 2005 was 1,066 or 30 per 100,000 population. The national average was 19 per 100,000.

Table 7: Projected Number of Physician Assistants in Clinical Practice, as of January 2005

Rank

 

Total Physician Assistants

United States

55,063

1

New York

6,277

2

California

5,324

3

Texas

3,365

4

Florida

3,119

5

Pennsylvania

3,117

6

North Carolina

2,611

7

Michigan

2,260

8

Georgia

1,725

9

Maryland

1,488

10

Washington

1,475

11

Ohio

1,458

12

Illinois

1,356

13

Colorado

1,318

14

Massachusetts

1,186

15

Wisconsin

1,136

16

Arizona

1,106

17

Connecticut

1,066

18

Virginia

1,019

19

New Jersey

890

20

Minnesota

813

21

Oklahoma

774

22

Tennessee

681

23

Kentucky

657

24

Kansas

605

25

Iowa

599

26

Nebraska

581

27

Oregon

563

28

West Virginia

544

29

South Carolina

516

30

Utah

485

31

Missouri

464

32

Indiana

449

33

Maine

437

34

New Mexico

418

35

Louisiana

368

36

Idaho

352

37

South Dakota

316

38

Nevada

311

39

New Hampshire

289

40

Alabama

288

41

Alaska

283

42

Montana

269

43

North Dakota

212

44

District of Columbia

191

45

Rhode Island

187

46

Vermont

182

47

Delaware

156

48

Wyoming

133

49

Hawaii

128

50

Arkansas

61

51

Mississippi

59

Notes: U.S. total is the sum of data from the 50 states and the District of Columbia, and includes an additional 1,396 PAs who work or reside outside of the U.S., or whose locations are unknown.

Definitions: Physician Assistants must have graduated from an accredited educational program.

Table 8: Projected Number of Physician Assistants per 100,000 Population in Clinical Practice, as of January 2005

Rank

 

Physician Assistants per 100,000 Population

United States

19

1

Alaska

43

2

South Dakota

41

3

District of Columbia

35

4

Maine

33

4

Nebraska

33

4

New York

33

4

North Dakota

33

8

Connecticut

30

8

North Carolina

30

8

West Virginia

30

11

Montana

29

11

Vermont

29

13

Colorado

28

14

Maryland

27

15

Wyoming

26

16

Idaho

25

16

Pennsylvania

25

18

Washington

23

19

Kansas

22

19

Michigan

22

19

New Hampshire

22

19

New Mexico

22

19

Oklahoma

22

24

Wisconsin

21

25

Iowa

20

25

Utah

20

27

Arizona

19

27

Georgia

19

27

Massachusetts

19

30

Delaware

18

30

Florida

18

32

Rhode Island

17

33

Kentucky

16

33

Minnesota

16

35

California

15

35

Oregon

15

35

Texas

15

38

Nevada

13

38

Ohio

13

38

Virginia

13

41

South Carolina

12

42

Illinois

11

42

Tennessee

11

44

Hawaii

10

44

New Jersey

10

46

Louisiana

8

46

Missouri

8

48

Indiana

7

49

Alabama

6

50

Arkansas

2

50

Mississippi

2

Notes: The number of Physician Assistants per ten thousand population was calculated using the population estimates provided by the U.S. Census Bureau as of July 1, 2005.

Definitions: Physician Assistants must have graduated from an accredited educational program.

Dentists

Connecticut had a total of 2,653 dentists in 2004, ranking it 23rd among the states. Of that total, 14 were engaged in “dental public health,” defined as the science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. There were 1,990 general practice dentists and 94 pedodontics, a dental specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

Table 9: Number of Dentists, 2004

Rank

 

Total Dentists

United States

174,430

1

California

26,692

2

New York

14,498

3

Texas

10,559

4

Florida

9,072

5

Illinois

7,958

6

Pennsylvania

7,789

7

New Jersey

7,045

8

Michigan

6,039

9

Ohio

5,981

10

Massachusetts

5,143

11

Virginia

4,395

12

Washington

4,255

13

Maryland

4,169

14

Georgia

4,024

15

North Carolina

3,903

16

Minnesota

3,069

17

Wisconsin

3,055

18

Tennessee

3,027

19

Colorado

2,980

20

Arizona

2,976

21

Indiana

2,939

22

Missouri

2,722

23

Connecticut

2,653

24

Kentucky

2,325

25

Louisiana

2,040

26

Alabama

1,971

27

South Carolina

1,949

28

Oregon

1,768

29

Oklahoma

1,728

30

Utah

1,573

31

Iowa

1,546

32

Kansas

1,360

33

Mississippi

1,159

34

Nevada

1,123

35

Arkansas

1,120

36

Nebraska

1,114

37

Hawaii

997

38

West Virginia

844

39

New Mexico

832

40

Idaho

824

41

New Hampshire

795

42

Maine

629

43

District of Columbia

575

44

Rhode Island

557

45

Montana

513

46

Alaska

490

47

Delaware

377

48

Vermont

348

49

South Dakota

345

50

North Dakota

319

51

Wyoming

266

 

 

 

Puerto Rico

1,552

Guam

51

Virgin Islands

42

Notes: US total does not include the territories.

Definitions: Dentistry: The evaluation, diagnosis, prevention and/or treatment (nonsurgical, surgical or related procedures) of diseases, disorders and/or conditions of the oral cavity, maxillofacial area and/or the adjacent and associated structures and their impact on the human body.

Table 10: Number of Dentists by Specialty Field

in Connecticut, 2004

Speciality Field

Connecticut

United States

Dental Public Health

14

999

Endodontics

84

4,374

General Practice

1,990

140,112

Oral and Maxilliofacial Surgery

4

74

Oral Pathology

8

479

Oral Surgeon

129

6,220

Orthodontics

163

9,260

Pedodontics

94

4,682

Periodontics

115

4,995

Prosthodontics

52

3,235

Notes: US total does not include the territories.

Federally Qualified Health Centers (FQHCs)

Based on 2004 data, Connecticut had ten FQHCs, with 94 actual service delivery sites. These FQHCs served 182, 683 patients in 2004, with 802,642 total encounters or visits in the state. The various revenue sources for Connecticut's FQHCs in 2004 were (1) federal grants (19.7%), (2) state and local grants/contracts (12.8%), (3) foundation grants/private contracts (2.7%), (4) Medicaid (44.9%), (5) Medicare (5%), (6) other public insurance (5%), (7) private insurance (4.5%), (8) patient self-pay (3.4%), and (9) other revenue (2%). The table below indicates the number of service delivery sites operated by FQHCs in all states.

Table 11: Service Delivery Sites Operated by FQHCs,

2004

Rank

 

Total FQHCs Service Delivery Sites

United States

5,502

1

California

691

2

New York

402

3

Massachusetts

290

4

Illinois

268

5

Texas

237

6

Washington

213

7

Florida

188

8

Pennsylvania

160

9

Mississippi

144

10

Michigan

139

11

South Carolina

138

12

West Virginia

132

13

Oregon

131

14

Colorado

125

15

Alabama

114

16

Ohio

108

17

North Carolina

106

18

Georgia

101

18

Missouri

101

18

Tennessee

101

21

New Mexico

98

22

Alaska

96

23

Connecticut

94

24

Virginia

88

25

Arizona

82

26

Maryland

78

27

New Jersey

75

28

Indiana

67

28

Minnesota

67

30

Kentucky

62

31

Arkansas

56

32

Wisconsin

53

33

Hawaii

52

34

Maine

50

34

Montana

50

36

Idaho

45

37

Iowa

44

37

Louisiana

44

39

Rhode Island

42

40

New Hampshire

41

41

South Dakota

37

42

District of Columbia

36

43

Nevada

30

44

Utah

29

45

Oklahoma

28

46

North Dakota

27

47

Kansas

22

48

Vermont

21

49

Nebraska

13

50

Wyoming

9

51

Delaware

7

 

 

 

Puerto Rico

41

Notes: Data are for calendar year 2004.

The federally-funded Federally-Qualified Health Centers (FQHCs) meet federal health center grant requirements and are required to report administrative, clinical and other information to the federal Bureau of Primary Health Care. Other health centers known as "FQHC Look-Alikes" are not included here because they do not receive federal health center grants and do not report to the Bureau of Primary Health Care. The data provided here consequently underreport the services provided by FQHCs. There are approximately 100 FQHC Look-Alikes across the United States.

HEALTHCARE WORKFORCE TRENDS AND SHORTAGES

Allied Health Workforce

PA 04-220 established a Connecticut Allied Health Workforce Policy Board. Some of its responsibilities include monitoring (1) the state's current and future supply and demand for allied health professionals and (2) the current and future capacity of the state system of higher education to educate and train students in allied health professions.

The act states that “allied health workforce” and “allied health professionals” means professionals or paraprofessionals who are qualified by special training, education, skills and experience in providing health care, treatment, and diagnostic services under the supervision of or in collaboration with a licensed practitioner. It includes physician assistants, RNs, licensed practical nurses (LPNs), certified nurse assistants, home health aides, radiological technologists and technicians, medical therapists, and other qualified technologists and technicians.

According to the board's February 2006 Legislative Report (attached), data from the Connecticut Department of Labor (DOL) estimates that the total employment levels for health-related occupations, including physicians and dentists, was 141,110 for 2002. The employment level for 2012 is expected to be over 162,000, a 15.3% increase for the ten year period. The allied health occupation with the highest employment level in 2002 was RNs with over 31,000 jobs, and to a projected 15% increase (to over 36,000 jobs) for 2012. Nurse aides, orderlies, and attendants totaled almost 24,000 jobs in 2002, with a projected number of 26, 140 (8% increase) for 2012. (More detail on the nursing situation is provided in the next section.)

The fastest growing occupation in the health care field is medical assistants with 4,660 jobs in 2002 and 6,830 by 2012, a 46.4% increase over the ten years, according to the report. Radiation therapists show a 39.6% increase in need in the same ten-year span, while physician assistant openings are projected to increase by 38.1%. Other occupations show significant projected increases in openings during this ten year period: Occupational therapists (19%), physical therapy assistants (26%), cardiovascular technologists and technicians (26.6%), pharmacy technicians (20.8%), surgical technologists (18.2%), and medical records and health information technicians (31.3%).

A 2004 vacancy survey done by DOL of over 3,000 employers found that there were 1,677 vacancies in RN positions, 387 in dental hygienist positions, 305 LPNs , 114 physical therapists, and 73 occupational therapists. In the health support area, 476 vacancies were reported for nurse aides, orderlies, and attendants, and 402 among medical assistants.

A vacancy rate survey developed by the Connecticut Hospital Association also shows trends in the need for allied health workers. Although the 2005 vacancy rate of 4.7% for operating room and surgical nurses is not considered high, this nursing field has more mature nurses who are nearing retirement. Vacancy data provided by the Connecticut Association of Health Care Facilities indicate that at the end of June 2002, among the 242 health care facilities statewide, there was approximately an 18% vacancy rate for RNs, 16% for LPNs, and 6.2% for certified nurse aides (CNAs, which equates to about 742 open positions). There is also high turnover across the state with RNs at 43%, LPNs 35% and CNAs 50%.

Nursing

The U.S. Department of Labor predicts that the demand for RNs will increase by 623,000 positions nationwide, a 27% increase from 2002. Also, the demand for LPNs will increase by 142,000 positions, a 20% increase. Over a 20- year period, (2000-2020), total national demand is expected to reach over 1 million positions for RNs and 295,000 for LPNs, according to the National League for Nursing.

Connecticut is projected to have the second greatest decline in the supply of nurses nationally over the 20 year period, according to the federal Health Resources and Services Administration (HRSA). The Connecticut DOL projects the state needs to average 1,200 new RNs each year through 2012 to fill expected job openings. The following table provides more information on the demand for nurses in Connecticut.

Table 12: Connecticut Supply and Demand for Nurses, 2000-2020

Year

FTE Supply

FTE Demand

Excess or Shortage ( ) = Shortage

Percent Overage or Shortage

2000

28,000

30,200

(2,200)

-7%

2005

25,400

31,800

(6,400)

-20%

2010

22,900

34,000

(11,100)

-33%

2015

19,900

36,600

(16,700)

-46%

2020

17,200

39,600

(22,400)

-57%

Source: HRSA Registered Nurse, Demand and Shortage Projections for Connecticut, 2004, as reported in “Enhancing the Education and Supply of Nurses in Connecticut,” sponsored by the Connecticut League of Nursing (“CLN Report”) October 2005.

According to the CLN report, Connecticut nursing schools have far more qualified applicants than they can admit. This holds for both RNs and LPNs.

Table 13: Applicants and Available Slots for Connecticut RN Programs

Connecticut RN Nursing Program Applicants

2003

2004

2005*

Number of available program slots

2194

2986

1289

Number of filled slots

2095

2883

1317

Percentage of slots filled

95%

100%

102%

Number of qualified applicants denied due to lack of program slots

450

1029

1643

*As of printing of CLN Report, although only 12 of 18 schools had submitted their 2005 data, the number of qualified denied admission has eclipsed their 2004 data.

Source: CLN Report, October 2005

Table 14: Applicants and Available Slots for Connecticut LPN Programs

Connecticut LPN Nursing Program Applicants

2003

2004

Number of available program slots

400

400

Number of filled slots

400

400

Percentage of slots filled

100%

100%

Number of qualified applicants denied due to lack of program slots

800

1000

Source: CLN Report, October 2005

The CLN report finds that there is a continuing need for nursing program expansion in the state. But a lack of nursing faculty is a significant barrier affecting program expansion. CLN also reported that 90% of nurse educators believed additional training sites for students (patient care delivery sites) were needed in all practice areas.

(The full CLN report is attached.)

HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA)

HPSAs are a type of federal designation designed to focus resources (federal and otherwise) to meet identified local needs for certain health care providers. One federal program using HPSA designations is the National Health Service Corps which recruits and places physicians in needy communities.

HPSAs have shortages of primary medical care, dental, or mental health providers and may be geographic (a county or service area), demographic (low income population), or institutional (comprehensive health care center, FQHC, or other public facility). As of September 2005, Connecticut had 92 such designations representing all or part of the 36 towns in each of the state's counties (see http://www.dph.state.ct.us/PB/HISR/HPSA.htm).

LOAN REPAYMENT PROGRAMS

Connecticut has a loan repayment program for certain health care providers known as the “Connecticut State Loan Repayment Program (CSLRP). It is a state-federal partnership that assists states in addressing health professional shortages that cause disparities in access to health care (see CGS 19a-7d, as amended by PA 06-195, 84).

CSLRP is a DPH initiative to strengthen the health care workforce at the primary care level. It provides financial incentives in the form of student loan repayment to health professionals employed by health care organizations belonging to the state's healthcare safety network (community health centers and other eligible primary care sites in the state).

(See http://www.dph.state.ct.us/BCH/Family%20 Health/SLRP/slrp_home.htm for more information on the program.)

JK:ro