CEO Messages

In California and Across the Country, Workforce Remains a Top Concern

Earlier this week, members from across the country gathered in Washington, D.C., for the American Hospital Association’s (AHA) Annual Meeting. It was a chance to hear from top policymakers and elected officials, catch up with colleagues from across the country, and discuss key issues impacting the field. No surprise, but workforce was one of the leading concerns of attendees and is at the top of AHA’s advocacy efforts.

It’s an issue that your hospitals are all too familiar with, and has only been exacerbated by the pandemic. California hospitals have faced the worst staffing shortage in memory with many front-line health care workers reaching their breaking point — despite significant hospital investments in retention incentives, employee mental health, and wellness programs — and are choosing to leave the profession altogether. A UC San Francisco study of the state’s nursing shortage found it will take until 2026 to close the state’s current nursing gap; in addition, California needs to add 500,000 new allied health care professionals alone — medical assistants, imaging specialists, and other non-nursing staff — by 2024.

This will require partnerships among all who recognize the need to protect the health of Californians: employers, workers, policymakers, colleges, licensing entities, and others. CHA and Hospital Council are advocating for public investments in workforce training to retain current workers and increase their expertise; to create greater equity by addressing regional health needs through public college and university programs; to welcome under-represented professionals into the workforce through community college programs; and to maximize the role of nurse practitioners, behavioral health providers, and others.

This precious resource needs immediate attention not just in California, but at all levels of government. That’s why the AHA Board has convened a Workforce Task Force (chaired by Ron Werft, President & CEO of Cottage Health in Santa Barbara), who is leading the discussion on immediate, short-term, and long-term challenges and solutions. Some of the major workforce issues being discussed include:

  • Lifting the cap on Medicare-funded physician residencies
  • Funding medical school scholarships to improve diversity in the workforce
  • Boosting support for nursing schools and faculty. American nursing schools turned away over 80,000 qualified applicants from baccalaureate and graduate programs due to an insufficient number of qualified faculty, clinical sites, classroom space, and budget challenges.
  • Protecting health care workers from workplace violence
  • Expediting visas for highly trained foreign health care workers
  • Supporting policies to attract health care workers to underserved areas 
  • Addressing the shortage of substance use disorder providers 
  • Expanding access to mental health resources

Although this is a nationwide problem, California has some additional challenges that are unique to our state. They involve employees who used to live and work in California but now reside in a different state or are working remotely out of state. This makes it very difficult for hospital record-keeping purposes and for hospitals to be in compliance with state regulations. Hospital Council is currently compiling some data and feedback on this issue from our members. We want to help, and if your organization is dealing with any of these issues related to remote workers, please share them with me directly at

Unfortunately, these workforce issues won’t solve themselves or be fixed overnight. To address current and future challenges, we must have a direct, coordinated, and sustained effort by your hospitals, educational partners, and elected officials, and California is again taking the lead in advancing these efforts.