Addressing Vermont’s Health Care Labor Force Challenge

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At this year’s VAHHS Annual Meeting, Mathew Barewicz, chief of the Vermont Department of Labor’s Economic & Labor Market Information Division and his colleague Sarah Buxton, state director of workforce development gave a break-out session addressing Vermont’s health care labor force challenge.
 
He defined labor market areas—as defined by the federal government—as where people work, live, shop. He said the Burlington/South Burlington labor area goes up to Swanton, includes five towns in Addison County and covers most of the islands.
 
“A third of the population of Vermont is contained by it and it creates about 40 percent of the jobs,’ he said.
 
He noted that Vermont has the lowest unemployment rate in the country and that the Burlington labor market is also the lowest. We also have the lowest unemployment rate in Vermont’s history.
 
While the US economy and the Burlington labor market economy have been growing since the 2007 recession, the rest of the state has not seen such growth. That could be because employers are unable to find the talent they need to fill current job openings.
 
“Whether there’s no one to fill the job or the job’s not posted, it will not show up [as a filled job] in some of this data,” he related.
 
He reported that the biggest growth in Vermont jobs is in business to business services.
 
“This is where we’re going as a society—toward more specialization,” he explained, adding that this trend bridges into the gig economy.
 
He showed through data that, amid the recessions since the turn of the millennium, education and health services remained in fairly steady growth.
 
“It never even caught a cold,” he quipped. “During the last three recessions, education and health has not shown any weakness because of economic downturn,” he stated.
 
What does this mean about health care going forward, specifically?
 
“Is there such a thing as over-supply of health care?” he asked.  “If we hired four brain surgeons and put them in a room telling them to wait for someone needing surgery, that would be an oversupply of resources.”
 
Because we are facing issues with a tight workforce, he said we need to ask ourselves, “How can we make what we have work for the people we serve?”
 
One solution, he said, is to leverage community health workers so that it makes the whole system better.
 
He said he serves on the Governor’s Task Force on Health Care Workforce, which recently hired a consultant to apply a national model to Vermont’s data.
 
“Every scenario [they created], whether it was targeting diabetes, or obesity or smoking, it changed the practitioners that we needed,” he explained. “There was never an idea that if we adopted a particular policy, we would have a major savings because ultimately, everyone will need health care services if we’re living longer. I think a lot of people don’t talk about that report because it makes people sad,” he added.
 
Health and social assistance growth in jobs is outpacing Vermont’s average job growth 2 to 1, Barewicz noted. Job growth is happening mostly in hospitals, social assistance and ambulatory, however, not nursing, which still struggles to fill vacancies.
 
He said that far from being alone in wanting for nurses, Vermont is doing better than other parts of the country.
 
“Even if we say we’re experiencing a tight labor market, even if we say we need more nurses, there are other parts of the country who are experiencing a much different thing,” he noted.
 
He summed up his discussion of Vermont’s job growth by stating, “Professional and business services, leisure and hospitality and education and health—that’s where the growth has been occurring and that’s where it’s projected to continue to grow.”
 
Despite these being growth areas, Barewicz said that when he’s talking to young people about opportunity, he also highlights construction, manufacturing and, again, health care, but for a different reason—because age in those occupations is higher.
 
“Manufacturing is experiencing declines,” he allowed, “and where you may be losing 10 people [to retirement], you need to hire eight of them back.”
 
Barewicz warned that it’s important that we be cautious about the “public narrative”—the modern myth that there are no jobs out there in Vermont, and that they don’t pay well.
 
“If we want to make young people leave, that’s a sure-fire way to do it,” he noted.
 
Due to Vermont’s low birthrate for the last 30 to 40 years, there are fewer young people out there to take the jobs, he said.
 
“How do we get young people to reframe the conversation?” he asked, positing that they have no way of knowing good jobs exist.
 
He said his office sought to develop an employer hierarchy of demand. They called many employers to ask what they were looking for and got the same answers. While jobs that pay more require more top-level skills, employers needed only a few high-level employees. They were looking for entry-level employees with basic skills:

• Show up on time
• Work well with others
• Follow instructions

He said that if employees can build these skills, employers can provide them with the training and support to rise into the higher paying jobs that require more specialization.
 
“Health care is one of those industries that has figured out how to create career pathways, he told attendees. “If you come in with basic skills, health care employers will get you the training, help you build problem-solving skills, get you the certificate, degrees, etc. you need. Employers have never been more at the table with taking people with basic skills and training for the rest.”
 
Sarah Buxton, Barewicz’s colleague and state director of workforce development, talked about how Governor Scott’s administration is working to strengthen and grow the Vermont workforce through three strategies:

• Increasing the labor participation rate
• Recruiting and relocating more workers to Vermont
• Assisting employers in accessing and retaining qualified workers

She said her department was interested in getting young people work experiences.
 
“If you would like to work with a young person, even training one in your own job, we have funds to provide wages,” she said. “It’s a minimum-wage program. We know the experience of working helps to create a habit of working,” she noted.
 
She also described a “returnship program”—an internship for people who have had experience with work. She said it helps returning moms, veterans, people in recovery and others. The department also helps those re-entering the workforce after a time in prison—sometimes with intentional trainings inside of facilities.
 
“If you are interested in hiring someone who has a record in their background, we are able to give employers free of charge bonding for that employee up to $25,000. It’s an almost risk-free way to take a chance on a new worker,” she said.
 
Her department is also working on:

• Work opportunity tax credits for hiring someone with barrier to employment
• Federal dollars to expand apprenticeships—half of those in medical assistance or LPN fields, providing college credit and a pipeline into health care field
• Special nursing programs for new Americans
• Recruiting departing military staff into Vermont jobs
• Assisting employers with recruiting with state job postings, hiring fairs and events, help with writing job descriptions and teaching interviewing skills to prospects.

For more information about these programs, contact:
Sarah Buxton
State Director of Workforce Development
Vermont Department of Labor
802.828.4343
Sarah.Buxton@vermont.gov
 
Barewicz’s contact info is:
Mathew Barewicz
Economic & Labor Market Information Division
Vermont Department of Labor
802.828.4153
Mathew.Barewicz@vermont.gov