Legislators collaborate to strengthen and diversify health care workforce
STATE HOUSE – A package of bills introduced by Sens. Sandra Cano, Joshua Miller and Pamela J. Lauria and Reps. Kathleen A. Fogarty and Teresa A. Tanzi aim to address the shortage of medical professionals while increasing the diversity of the health care workforce to match the diversity of Rhode Island’s communities.
“The continuing shortages in our health care system present us an urgent challenge but also an opportunity to open our workforce to a more diverse pool of candidates,” said Representative Tanzi (D-Dist. 34, South Kingstown, Narragansett). “We can help address the shortages in our health care system while providing pathways for more diverse candidates to expand their roles and capabilities.”
Said Senator Lauria (D-Dist. 32, Barrington, Bristol, East Providence), “Over the years in my work as a primary care nurse practitioner, I have seen firsthand the shortage of providers, nurses, specialists, counselors, and beyond across all facets of the health system. To truly ensure everyone has access to quality care, we must have enough providers to meet our needs. Along with my colleagues in the Senate and the House, I am proud to support these important bills to strengthen and diversify our health care workforce.”
The Primary Care Scholarship program (2024-H 7903, 2024-S 2717) sponsored by Senator Lauria and Representative Fogarty would fund a four-year scholarship program for primary care physicians, nurse practitioners and physician assistants. The students would either remain in Rhode Island after medical school or return to Rhode Island after residency training in family medicine, pediatrics, or general internal medicine to practice primary care for at least eight years. This legislation is part of the Rhode Island HEALTH Initiative unveiled by Senate leadership earlier this year.
“Primary care is the backbone of our health care system, keeping our state healthy while preventing costly trips to urgent care or emergency departments,” said Representative Fogarty (D-Dist. 35, South Kingstown). “This scholarship program will make it easier for a more diverse group of students to choose to forego more lucrative specialties to serve our Rhode Island communities.”
Also part of the Senate’s HEALTH legislative package and sponsored by Senator Lauria and Representative Fogarty, the Primary Care Training Sites Program (2024-H 7902, 2024-S 2716) would provide $2.7 million to primary care practices to serve as enhanced interdisciplinary clinical training sites. It would recruit 30 advanced primary care training sites with one or more preceptors, increasing training slots by 50% for nurse practitioners, physician assistant students and physician residents.
“When the primary care shortage is discussed, the shortage in primary care training in our state is often overlooked,” said Senator Lauria. “These sites are needed to train the next generation of providers, and since students often decide to work where they train, increasing training can improve access to care by encouraging primary care providers-in-training stay in Rhode Island upon licensure.”
Legislation sponsored by Representative Tanzi and Senator Cano (2024-H 8078, 2024-S 2867) would establish the Ladders to Licensure program, a grant program administered by the Executive Office of Health and Human Services to assist health care paraprofessionals to access higher education, with a focus on behavioral health and nursing.
“Our health care paraprofessionals have the workplace experience that makes them ideal candidates for higher education in medicine,” said Senator Cano (D-Dist. 8, Pawtucket). “This grant program will open a pathway for many to level up their education and training, increasing their job opportunities and standard of living while diversifying our state’s health care workforce and addressing much needed shortages.”
Said Marcela Betancur, executive director at the Latino Policy Institute, “Today, our state confronts significant challenges and shortages in the availability of health care providers, particularly for patients who are non-English speakers or from diverse backgrounds and cultures. The Ladders to Licensure Program is an innovative strategy to diversify the professional workforce by providing the help that paraprofessionals need to pursue higher education.”
Representative Tanzi is also the sponsor of a bill (2024-H 8079) that would increase annual funding to the Health Care Professional Loan Repayment Program from $100,000 to $1 million. The program provides up to $50,000 per person in loan repayment assistance for licensed health care professionals, including medical providers, dentists, nurses, dental hygienists and mental health providers, among others. In return, recipients commit to work at community health centers, mental health centers, dental clinics and other sites of high patient need for at least two years.
“The Health Care Professional Loan Repayment Program has been very successful at attracting and retaining health care workers in medically underserved areas in Rhode Island,” said Senator Miller (D-Dist. 28, Cranston, Providence), who is the chairman of the Senate Health and Human Services Committee and is spearheading this effort in the Senate. “The only problem is that the program isn’t big enough. We need to fund successful programs like this to alleviate shortages throughout our health care system.”
The bills have strong support from the Care Transformation Collaborative, the R.I. Health Center Association and The Latino Policy Institute, which are working together to promote passage of this comprehensive approach to addressing critical shortages in the health care delivery system.
“Our state’s primary care workforce crisis is impacting Rhode Islanders at every age and in every community, leaving thousands without access to care,” said Debra Hurwiz, executive director of the Care Transformation Collaborative of Rhode Island. “This targeted legislation – primary care training, scholarships, loan repayment and a pathway to licensing more health care staff – takes direct and immediate steps to bolster our workforce. Primary care is a bedrock of our state that keeps families safe, supported, and healthy – and it’s in jeopardy unless we take legislative action. We appreciate Senator Lauria’s and Representative Fogarty’s leadership on the primary care bills and Representative Tanzi’s, Senator Cano’s and Senator Miller’s promotion of the loan repayment and Ladders to Licensure program.”
Said Elena Nicolella, president and CEO, Rhode Island Health Center Association, “We need the state to recognize the magnitude of the current and future health care workforce crisis. Rhode Island is losing providers to other states that are more proactive in addressing their workforce shortages. For example, Massachusetts provides $25 million in loan repayment dollars for new providers who commit to working in underserved areas, while Rhode Island’s state investment is negligible. Diversifying our workforce through Ladders to Licensure and loan repayment, as well as focusing on strengthening primary care through scholarships and training are critical investments the state should make this year.”
