Thousands of healthcare jobs promised by Biden are on the verge of disappearing
Billions of federal dollars to bolster public health services nationwide may not have a lasting impact when the cash pool dwindles, officials worry.
President Joe Biden has outlined a plan to create thousands of new public health jobs, a vision Democrats have sought to realize as part of the U.S. bailout (Public Law 117-2), signed into law last year. last. The administration last May pledged to spend $7.4 billion of the law to hire new public health workers. Most of that money, $4.4 billion, was intended to expand state and local health services.
But health services must compete with hospitals and other private companies for in-demand workers like epidemiologists and nurses. They often offer less money for tougher jobs — and those that may disappear in a year or two, according to public health officials.
This has raised fears that many of these departments will end up where they were before 2020: short-staffed and unprepared for a pandemic.
“The problem we face is not so much the number of dollars we see today as sustainability,” said Umair Shah, Washington state health secretary.
What the public health sphere needs is a long-term commitment from Congress to expand its workforce, officials say.
Public health services were already shrinking as the Covid-19 pandemic approached: There were 91,540 full-time positions in state health agencies in 2019, down from 101,619 in 2012, a drop of nearly 10%, according to data from the Association of State and Territorial Health Officials.
Since then, health services have been strained to track the spread of Covid-19 and distribute vaccines to protect people against the virus. This staffing shortage has made it difficult for health agencies to properly assess the number of people with the virus and has complicated response times.
An analysis by the de Beaumont Foundation, which advocates for a broader public health system, recommended the federal government fund 80,000 new public health jobs to prepare for the next pandemic.
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A source close to the government’s plan to distribute the funds said about $2 billion of the promised $7.4 billion has been distributed so far to state and local health agencies, as well as school districts. to hire school nurses.
The Centers for Disease Control and Prevention is the agency tapped to distribute much of these funds. Jude Fulce, a spokesman, said data on how many workers were hired with the money in 2021 or 2022 is not available. She said the agency expects to see preliminary numbers later in the year.
When asked how much money had been doled out so far, Fulce pointed to a notice from the White House announcing the plan to spend $7.4 billion.
The Association of State and Territory Health Officials will update its public health workforce data later this year, said Stephanie Rhodes, a spokeswoman for the group.
‘Incredibly fine stretch’
Health service chiefs say they are hiring new staff, but many cannot be promised jobs beyond 2023.
In Washington state, the health department has grown since the start of 2020. It had 1,880 workers before the Covid outbreak, and now has 2,715, according to department data. About 40% of these new hires are temporary workers.
The department has also seen an 18% turnover rate, meaning it has replaced almost a fifth of staff since 2020. Many of these new workers have less public health experience than their predecessors, said Shah.
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Health departments face burnout: their workers are entering a third year of tracking a virus that has killed at least 1,000 Americans every week since early October, and often triple that number.
“It’s cliché at this point, but it’s true: we’re incredibly thin,” said Mike DeRose, director of human resources for the Michigan Department of Health and Human Resources.
“Competing With Ourselves”
In Houston, the health department had about 1,200 regular workers before the pandemic, with all but 100 permanent employees, department director Stephen Williams said. Today, the department has about 1,600 workers, 400 of whom are in temporary positions.
Williams said the department is recruiting disease prevention specialists, microbiologists and outreach workers to bolster their Covid response. The same goes for surrounding health services and hospitals, he said.
“We compete with ourselves for some of these employees,” Williams said.
Strong demand for epidemiologists — public health workers who investigate the patterns and causes of disease and injury — and nurses is expected to continue over the next decade, according to data from the Bureau of Labor Statistics. Employment of epidemiologists is expected to increase by 30% from 2020 to 2030, compared to an average of 8% for all occupations. That’s 900 job openings for epidemiologists every year, for the next eight years.
For nurses, with a larger workforce, demand is also high: 194,500 RN openings are projected each year through 2030, a growth rate of 9%, according to BLS data. .
Competition for workers means employers pay higher wages, Rachel Greszler, a researcher at the Heritage Foundation think tank, told lawmakers on Thursday. She said the massive influx of public money into various sectors of the economy in recent years has distorted markets, driving up costs and wages.
“When it’s just employers who have to pay more to do the same thing, that translates into higher prices,” Greszler said.
Even with new hires, Williams, in Houston, said he’s pulling existing staff away from things like chronic disease prevention.
“Really, we needed close to the level of staff we have now before Covid,” Williams said. “We do a lot with what we have.
Public health advocates also say federal funds are not yet reaching many local health departments. States and counties that have received CDC funds decide how to distribute the money, and some small health departments lack the expertise to obtain grants directly from the agency.
Administrative and bureaucratic hurdles can make it nearly impossible for smaller health departments to tap into federal programs, said David Harvey, executive director of the National Coalition of STD Directors.
“There is a break in hiring everywhere; public health is no different,” Harvey said. “Administrative hurdles at the CDC don’t help.”
Extending these short-term workforce gains to a long-term expansion of the health workforce will require dedicated federal funding year over year, said Justin Mendoza, who leads advocacy for Partners in Health, a group that works to strengthen public health.
The Mendoza group wants congressional owners to increase the CDC’s annual budget by $1 billion starting in fiscal year 2023 to account for ongoing investments in public health personnel. The enacted fiscal year 2021 budget for the CDC was approximately $8 billion.
“The money we have right now is not enough, it was a down payment,” he said.
Health department heads are also advocating for regular federal investments so they don’t have to shrink again when US bailout funds dry up.
“I’m afraid we’re forgetting the lessons we’ve learned from this pandemic and just trying to move on,” Shah said in Washington. “Then the next emergency comes and we’re not ready for that.”
To contact the reporter on this story: Alex Ruoff in washington at [email protected]