Addressing the Healthcare Workforce Crisis: Current and Pending Legislation and Programs
The healthcare workforce shortage in the United States has reached critical levels, prompting unprecedented legislative action at both federal and state levels. This analysis examines key legislation and policy initiatives aimed at strengthening and supporting our healthcare workforce.
Federal Initiatives Leading the Way
American Rescue Plan Act (ARPA)
The American Rescue Plan Act (ARPA) laid important groundwork by allocating $7.6 billion for public health workforce development. Building on this foundation, several promising pieces of legislation are now under consideration that could significantly impact the healthcare workforce landscape.
Bill Number: H.R.1319 – American Rescue Plan Act of 2021
Status: Enacted into law on March 11, 2021, as Public Law No: 117-2.
Related Pending Legislation: As of January 3, 2025, there is no specific pending legislation directly related to the American Rescue Plan Act (ARPA).
List of States That Utilized Funding: All U.S. states, the District of Columbia, territories, and tribal governments received and utilized funding from ARPA to address various needs arising from the COVID-19 pandemic.
Key Takeaways and Impacts:
Economic Relief: ARPA provided direct payments to individuals, extended unemployment benefits, and expanded tax credits, offering substantial economic relief to millions of Americans.
State and Local Government Support: The act allocated $350 billion to assist state, local, tribal, and territorial governments in mitigating the fiscal impacts of the pandemic.
Public Health Funding: Significant investments were made in vaccine distribution, testing, and other public health initiatives to combat COVID-19.
Education and Childcare Assistance: ARPA included funding to help schools reopen safely and support childcare providers, addressing educational disruptions caused by the pandemic.
Housing and Nutrition Aid: The act provided resources for rental assistance, homelessness prevention, and programs to combat food insecurity.
Healthcare Workforce Resilience Act
The Healthcare Workforce Resilience Act represents one of the most ambitious attempts to address immediate staffing needs. This legislation proposes recapturing unused immigrant visas for nurses and physicians, potentially bringing thousands of qualified healthcare professionals to underserved areas. The bill's emphasis on expedited processing could help healthcare facilities fill critical positions more quickly.
Bill Number: H.R.6205 – Healthcare Workforce Resilience Act
Status: Introduced in the House of Representatives on September 28, 2023; referred to the House Committee on the Judiciary.
Related Pending Legislation: A companion bill, S.1024, was introduced in the Senate on March 25, 2021.
Key Takeaways and Impacts:
Recapture of Unused Visas: The act aims to recapture unused employment-based immigrant visas for up to 25,000 nurses and 15,000 physicians to address healthcare workforce shortages.
Exemption from Country Caps: These visas would be exempt from per-country numerical limitations, expediting the immigration process for qualified healthcare professionals.
Eligibility Criteria: Eligible applicants must have approved immigrant visa petitions and meet licensing requirements, ensuring that only qualified professionals are admitted.
COVID-19 Response: The legislation is designed to enhance the U.S. healthcare workforce during the COVID-19 crisis by facilitating the immigration of essential medical personnel.
Family Members Included: Immediate family members (spouses and children) of the principal applicants are also eligible for visas under this act, promoting family unity.
Future Advancement of Academic Nursing (FAAN) Act
Another significant proposal, the Future Advancement of Academic Nursing (FAAN) Act, tackles the shortage from an educational perspective. By expanding nursing school capacity and supporting faculty development, this legislation addresses one of the key bottlenecks in healthcare workforce development: the limited capacity of training programs.
Bill Number: H.R.7266 – Future Advancement of Academic Nursing Act (FAAN Act)
Status: Introduced in the House of Representatives on July 31, 2023; referred to the House Committee on Energy and Commerce.
Related Pending Legislation: A companion bill, S.3770, was introduced in the Senate on February 12, 2024.
Key Takeaways and Impacts:
Grant Authorization: The FAAN Act authorizes the Health Resources and Services Administration (HRSA) to award grants to schools of nursing to enhance and modernize nursing education programs.
Capacity Building: Grants aim to increase the number of nursing faculty and students, addressing nursing workforce shortages and improving preparedness for public health emergencies.
Priority Consideration: In awarding grants, HRSA is directed to prioritize historically Black colleges and universities, other minority-serving institutions, and schools located in medically underserved communities or areas with health professional shortages.
Funding Allocation: The act authorizes $1 billion in appropriations to remain available until expended for these initiatives.
Legislative Progress: As the bill is currently pending, its provisions have not yet been implemented, and no funding has been disbursed.
Rural America Health Corps Act
The Rural America Health Corps Act merits special attention as it addresses one of the most pressing aspects of the healthcare workforce crisis: rural healthcare access. This proposed legislation would create a new loan repayment program specifically designed for rural healthcare providers, with expanded eligibility for mental health professionals.
Bill Number: S.924 – Rural America Health Corps Act
Status: Introduced in the Senate on March 23, 2021; referred to the Committee on Health, Education, Labor, and Pensions. As of January 3, 2025, the bill has not advanced beyond the committee stage.
Related Pending Legislation: There is no directly related pending legislation specifically addressing the creation of a Rural America Health Corps.
Key Takeaways and Impacts:
Establishment of a Demonstration Program: The act proposes the creation of a demonstration program within the National Health Service Corps (NHSC) to provide loan repayment for eligible health professionals serving in rural health professional shortage areas (HPSAs).
Loan Repayment Structure: Participants would receive loan repayment benefits over a five-year service commitment, with incremental payments covering the principal and interest of educational loans.
Funding Authorization: The bill authorizes appropriations of $50 million annually for fiscal years 2022 through 2026 to support the program.
Evaluation and Reporting: The Secretary of Health and Human Services is required to submit a report to Congress evaluating the program's impact on healthcare access in rural areas within five years of enactment.
State-Level Innovation
Several states have emerged as leaders in workforce development through innovative legislation and programs. This list is far from exhaustive and is a demonstration of a handful of interesting approaches. Contact me to discuss these or other states!
Massachusetts Healthcare Workforce Center: A Model for Workforce Development
Massachusetts's Healthcare Workforce Center has become a blueprint for other states. Their comprehensive approach includes:
Coordinated training and development programs
Targeted loan repayment initiatives
The innovative Nursing and Allied Health Workforce Development Trust Fund
The Vision for the HCWC is a health care workforce that meets the needs of all Massachusetts residents, and their mission is to improve access to health care in the Commonwealth by supporting policy making and programs which will assure optimal supply and distribution of primary care and other health professionals.
Oversight Authority: The Massachusetts Healthcare Workforce Center operates under the Massachusetts Department of Public Health (DPH).
Status: As of January 2025, the Center continues its mission to support and enhance the healthcare workforce across the state.
Influential People Involved:
Monica Bharel, MD, MPH: Former Commissioner of the Massachusetts Department of Public Health, instrumental in workforce development initiatives.
Marylou Sudders: Secretary of Health and Human Services, overseeing health-related departments, including DPH.
Key Takeaways and Impacts:
Workforce Development: The Center focuses on recruiting and retaining healthcare professionals in Massachusetts, addressing shortages in underserved areas.
Data Analysis: It conducts research to identify workforce trends, informing policy decisions to meet healthcare demands.
Educational Support: The Center collaborates with educational institutions to enhance training programs for future healthcare providers including healthcare student loan repayment plans.
Policy Advocacy: It advocates for policies that improve working conditions and incentives for healthcare workers.
California Workforce Education and Training Council
California continues to push boundaries with new legislative proposals aimed at myriad ways to streamline licensing for internationally trained healthcare workers, expanding scope of practice for nurse practitioners, and creating new pathways for workforce education and training.
Oversight Authority: The California Health Workforce Education and Training Council, established under the Department of Health Care Access and Information (HCAI), is responsible for coordinating the state's health workforce education and training efforts.
Status: As of January 2025, the Council continues to develop and implement strategies to address California's healthcare workforce needs, ensuring alignment with the state's healthcare delivery requirements.
Influential People Involved:
Dr. Mark Ghaly: Secretary of the California Health and Human Services Agency, overseeing health-related departments, including HCAI.
Elizabeth Landsberg: Director of the Department of Health Care Access and Information, leading initiatives to improve healthcare access through workforce development.
Key Takeaways and Impacts:
Strategic Coordination: The Council coordinates California’s health workforce education and training to develop a workforce that meets the state's healthcare needs.
Public Meetings: The Council holds public meetings to engage stakeholders and discuss strategies for workforce development.
Focus on Underserved Areas: Emphasis is placed on training healthcare professionals to serve in medically underserved regions, addressing disparities in healthcare access.
Data-Driven Decisions: The Council utilizes healthcare workforce data to inform policy decisions and educational program development.
Washington Health Corps: An Integrated Approach
Washington's Health Corps demonstrates how loan repayment programs can be effectively combined with apprenticeship opportunities to create comprehensive workforce development solutions.
Oversight Authority: The Washington Health Corps is administered by the Washington Student Achievement Council (WSAC) in collaboration with the Department of Health (DOH).
Status: Established by the 2019 Legislature, the Washington Health Corps is actively operating, offering loan repayment and scholarship programs to healthcare professionals serving in underserved communities across the state.
Influential People Involved:
Sarah Alkurdi, PhD: Program Manager at WSAC, overseeing the Washington Health Corps initiatives.
Luis Zepeda-Chavez: Representative of the Washington Health Corps, involved in program management and outreach.
Key Takeaways and Impacts:
Comprehensive Support: The Washington Health Corps encompasses multiple programs, including the State Health Program (SHP), Behavioral Health Program (BHP), and Federal Health Program (FHP), providing financial assistance to a wide range of healthcare professionals.
Service Commitment: Participants commit to serving in designated health professional shortage areas, improving access to care in underserved regions.
Funding Allocation: The program has received substantial state and federal funding, with allocations increasing over recent biennia to support more healthcare providers.
Diverse Eligibility: Eligible participants include a variety of healthcare professionals, such as nurses, doctors, dentists, and behavioral health specialists, broadening the impact across multiple disciplines.
Positive Outcomes: Since its inception, the program has successfully recruited and retained over 1,500 providers throughout Washington State, enhancing healthcare delivery in critical shortage areas.
Conclusion
The current legislative landscape reflects a growing recognition that solving the healthcare workforce crisis requires a multi-faceted approach. From immigration reform to educational capacity building, these initiatives represent some of the most promising solutions to date. Success will likely depend on continued coordination between federal and state efforts, along with sustained funding commitments.
*Note: As this is a rapidly evolving policy landscape, readers are encouraged to check the current status of any legislation mentioned.*
