AMHERST — As rural western Massachusetts watches its populations steadily age, reliable, accessible health care only becomes more important. But since the COVID-19 pandemic, workforce shortages in the industry have been more pronounced than before, leaving many residents without ready access to the care they need.

The vexing problem was front and center on Monday at the University of Massachusetts, where political leaders, hospital administrators and practitioners, and students in the region’s health care sphere gathered for a second annual one-day summit intended to share perspectives about the unique challenges facing the Pioneer Valley.

The Western Massachusetts Healthcare 2024 Summit, held by the university’s Elaine Marieb College of Nursing, featured conversations and speeches concerning the status, challenges and innovations in local health care, with a recurring focus on the diminished state of the nursing workforce.

“We have been struggling with a provider shortage for many years, and sadly it appears to be worsening and has resulted in a crisis in access to health care,” said state Rep. Mindy Domb, D-Amherst. She added that many constituents tell her they are unable to find needed care, and often have to wait up to a year for initial appointments.

Attendees were welcomed to the event by Allison Vorderstrasse, dean of the Elaine Marieb College of Nursing, University Chancellor Javier Reyes, and state Sen. Jo Comerford, D-Northampton, all of whom spoke to the importance of increasing the regional health care workforce, especially through academic pipelines like those at UMass that prepare new health care professionals for the working world.

Comerford noted that western Massachusetts is “disproportionately rural, disproportionately aging, and disproportionately affected” by shortages in health care staff and, like Domb, she reported cries of help from constituents whose health is deteriorating while they wait to see a provider.

“Post-COVID, it seems like most parts of the economy have recovered except for downtown real estate and health care,” said Kate Walsh, Massachusetts secretary of health and human services, during her keynote speech. “Much of our (nursing) workforce is shifting toward the end of their career, and we’ve got to find a way to replace them.”

Walsh noted that workforce shortages in health care are not a new issue, or one specific to the commonwealth, but that the pandemic made the issue particularly pronounced and exacerbated issues of inequity along regional and demographic lines. Particularly, unequal outcomes have become increasingly apparent in maternal or perinatal health and cardiometabolic health, which Walsh said have become main focuses within her department.

“When we all grew up, our parents used to tell us that health was wealth. I’m increasingly thinking that wealth is health,” said Walsh. “We need to make sure that these disparities in health outcomes are addressed.”

For Walsh and other health care leaders at the event, the key to addressing this inequity, among other challenges, is bolstering the workforce, particularly direct care workers and nurses. State Health and Human Services officials are looking to expand workforce pipelines, Walsh said, through professional-academic partnerships, grants, repayment programs and other kinds of financial support that would allow health care professionals to take the time and classes they need to advance in their careers.

From public health nursing to senior care, professionals at the summit concurred that there is a widespread feeling of lacking support. Laura Duff, a local public health nurse, explained that there was not enough guidance or mentorship when she entered the world of municipal public health, which is a keystone of public health across the state and often relies on the expertise and preparedness of just one public health nurse in each municipality.

Similarly, in senior care, a lack of qualified workers has led those working in extended care facilities to be overwhelmed with patients, even when they routinely have to stop welcoming new ones.

Ursula Elmes, a licensed practical nurse at the Center for Extended Care in Amherst, said that most of her workdays end with her staying long after the conclusion of her shift to bring dinner to her patients because there wouldn’t be enough help available if she left on time. Having spent her entire career thus far in long-term care, Elmes said that the biggest challenge she routinely faces is that of staffing.

“Twenty-seven patients to one nurse is not sustainable,” she said.

Susan Misiorski, vice president of workforce development at the Massachusetts Senior Care Association, a nonprofit representing assisted living and rehab services providers, acknowledged a persistent problem with access to long-term care in the commonwealth, and that staffing shortfalls have made such problems especially palpable in western Massachusetts. According to Misiorski, there is a 22% staffing shortage for caregivers in western Mass., as opposed to a 16% staffing shortage for the rest of the state.

Jay Prosser, executive director of the Nursing Council On Workforce Sustainability, an arm of UMass Chan Medical School, displayed the road to this shortage using graphs showing a clear plateau in registered nursing graduates from 2019 to 2022. This, he said, is due in large part to the barriers facing those who wish to enter the health care workforce or advance in it, such as the lengthy administrative processes for caregivers coming to the commonwealth from abroad or even out of state, the accessibility of professional pipelines, and violence against health care workers once they enter the field, which causes many to quit early on.

Hope for the future

But Prosser expressed hope, citing a workplace violence resolution currently being considered on Beacon Hill; funding that would allow caregivers to take the needed time off of work to continue their health care educations and earn additional qualifications; and potentially programs at the secondary school level that allow students to graduate with certain health care qualifications.

Jesse Egan-Poirer, a certified nursing assistant at Integritus Healthcare who is set to graduate as a nurse in the coming weeks, said that he wouldn’t have been able to complete his nursing program without the pipeline program he entered, offering paid training and intensive support. Egan-Poirer explained that the classmates he saw struggle the most, or even drop out, were those who did not have the benefit of a pipeline program, emphasizing the importance of funding and guidance to remove barriers for those who wish to take on more responsibility in the health care world.

Not only do such programs allow new nurses and caregivers to enter the workforce, but they may also end up saving hospitals a significant amount of money in the long run.

In a discussion among western Massachusetts hospital leadership, Kevin Whitney, interim vice president of patient care services and chief nursing officer at Cooley Dickinson Hospital, noted that traveling nurses have been vital in filling pandemic-era staffing gaps, but that they require much higher wages and come with frequent turnover.

“We have tens of thousands of positions throughout the state that are still vacant,” Whitney said. “It’s also a huge financial burden … labor costs since COVID have skyrocketed. At the same time, reimbursement is not … it’s not keeping up with inflation.”

Margaret-Ann Azzaro, vice president of patient care services and chief nursing officer at Holyoke Medical Center, seconded the need for staffing stability in hospitals for patients, workers and the hospitals themselves. Azzaro noted that many nurses quit within their first year, displaying the importance of making sure hospital staff members feel incentivized to stay in the health care industry.

“I think, financially speaking, the more we can retain the staff that we have and try to attract new staff, that’s going to help the financial burden,” Azzaro said.

What most speakers agreed on across the event’s panels was the need for increased state investment in recruitment and retention measures in health care. Speakers emphasized the need for broadened academic-professional pipelines and increased financial support for students and professionals who face monetary barriers to advancing in health care careers.

Alexa Lewis can be reached at alewis@gazettenet.com.