California has begun following up on its promise last April to spend $32 million in state and federal funds to train students for medical laboratory technician and clinical laboratory scientist jobs within the state's life-sciences industry — amid increasing concerns that the state's budget mess may slow the effort.
The state has selected 28 schools of the 110-campus California Community College System to run the first phase of training under the initiative. That's well above the 13 programs cited in a 2007 report, though the state Labor and Workforce Development Agency said most of the 28 already have CLS programs in place, with only a few launching new programs — such as the medical laboratory technician-training effort set to start at Saddleback College in Mission Viejo.
The training programs are part of the Allied Health Initiative announced April 13 by Gov. Arnold Schwarzenegger, with the goal of adding thousands of new professionals to California hospitals, health-care facilities, and laboratories — including those of life-sci companies and research institutes — over the next three years.
"Some of them have started, and the bulk of them will start in the fall," Stephanie Leach, assistant secretary for policy with the California Labor and Workforce Development Agency, told BioRegion News on Thursday.
The first phase is being funded through $8 million in federally generated Workforce Investment Act funds to be spent at Schwarzenegger's discretion, and an $8 million match from participating schools.
Saddleback, she said, had already been developing an MLT program in recent months, "and we've already started the conversation with them to see about partnering with their four-year institution to develop some kind of accelerated MLT-to-CLS [program]. But right now, with the money crunch, it's only an idea."
The allied health program's second phase will involve training courses at all three publicly-funded higher education systems — the University of California and California State University systems, in addition to the community college system. A governor's task force has met with the three systems to learn their priorities for worker training, using statistics generated by the state and recommendations from work groups studying the issue.
"They're coming back to us with these requests. That cannot be formalized or announced until after the budget is passed," Leach said.
One phase-two priority is already known: CSU wants to expand existing certificate programs designed to train students as clinical laboratory scientists via one year of one-on-one lab instruction. "We're looking forward to that for biotech and hospitals," Leach said.
"There were a number of applications that came to us through the CSU chancellor's [Charles Reed's] office, and they're summarizing the information that they've gathered, but primarily that is the expansion of existing programs," Leach said. "Those that want to open need a pretty long timeline for approval, and this money is meant to help people become active professionals as quickly as possible."
The budget, she said, will also determine how the second phase is rolled out. While another $8 million in Workforce Investment Act money will be needed, that phase of WIA money will come from the $787 billion American Recovery and Reinvestment Act, the economic stimulus measure enacted in February by President Obama.
California law requires that both houses of the Legislature must review and authorize the spending of federal stimulus funds. The legislature and Schwarzenegger, in turn, must agree to the spending as part of the fiscal year 2010 budget.
"As soon as the budget is passed, we'll know exactly where we are with the money and we can move forward," Leach said.
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Schwarzenegger and legislative leaders are scrambling to plug a budget shortfall projected at $24.3 million by the independent Legislative Analyst's Office. The governor — a Republican term-limited and unable to serve past 2010 — has proposed $16 billion in cuts, compared with $11 billion by the state Assembly and state Senate, both Democratic-controlled. Legislative leaders have expressed interest in raising some taxes and fees, such as those on cigarettes and vehicle licenses — an idea ruled out by Schwarzenegger and Republicans in both chambers.
Schwarzenegger's proposed budget calls for more than $1 billion in combined cuts to the UC, CSU, and community college systems. Matthew Gardner, president and CEO of BayBio, the life sciences industry association for the San Francisco Bay Area and northern California, told BRN the potential cuts "are going to get even further pressured to contain their programs in 2010. We're probably going to see a continuing shortage, if not yet a crisis, for these workers.
"Looks like the situation in California is going to get tougher before it gets better," Gardner cautioned. "What it has kind of forced industry groups like BayBio to look at is, how we can bring together groups of employers among our members, and in the community at large, to find alternatives."
That effort, he said, could result in corporate-sponsored programs making use of local college campuses.
"If the state system can't respond in a way that meets demand, there are only so many choices a company can have in terms of being able to meet the needs of the healthcare system," Gardner said in an interview Wednesday, adding: "They don’t have a choice of not serving that healthcare system."
Corporate-based training is more commonly practiced in highly specialized life-sci job fields, though in some cases, companies may provide the clinical end of training in life-sci programs involving schools that receive public funds, Timothy Bates, a senior analyst at the Center for the Health Professions at the University of California, San Francisco, told BRN Thursday.
"A lot of the training for the toxicologists, the chemical laboratory scientists, and the molecular geneticists, the sort of very specialized scientists that are licensed to practice a certain range of tests, a lot of that training is done by business and industry, and they do offer paid internships that function as training programs that may qualify a person to sit for the licensing exams," he added. "I think that's where programs like workforce investment money can be used to develop larger-scale training programs, and utilize the extra piece of business and industry to really generate some momentum in terms of meeting need
A new budget would not affect the rollout of the allied health initiative program, Leach said, "unless the money is reallocated. That would be unfortunate. If the budget is delayed, then yes, the programs will be delayed, and we'll lose an academic term."
Because the publicly funded colleges and universities would be required to match the stimulus money pegged for the second phase, a new state budget could potentially compel the school to cut back on the allied health initiative as a means of carrying out budget cuts.
"On that side of things, that's where potentially the budget could have an impact. But they have announced [the solicitation of] the first round of proposals, so it is definitely going forward," Bates told BRN.
Bates said the faster focus on expanding community-college medical lab technician programs reflects the fact California had not developed the MLT as a licensed occupation until 2005, despite the category existing in other states for many years.
"It's really just now starting to take shape. I see that as a really important step toward addressing workforce needs in laboratory science," Bates said in an interview. "Down the line, in subsequent rounds of funding and proposals, I would expect to see a more concerted effort to address what has been on ongoing issue in terms of recruiting and retaining clinical laboratory scientists."
According to the state labor agency's Labor Market Information Division, the number of job openings for medical lab technicians and clinical lab scientists statewide is set to rise from 10,500 in 2006 to 12,300 projected for 2016.
When the filling of existing jobs is accounted for, California is projected to need 340 additional professionals in the med lab tech and CLS fields each year between 2006 and 2016. However, California schools graduated only 125 students in both specialties in 2008, and 119 in 2007, at a time in which roughly 800 were needed to meet demand by life-sci employers and hospitals, according to a 2007 estimate by the Campaign for College Opportunity.
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"We're not meeting the market," Leach acknowledged. "On top of that, you have the incredibly fast pace of personalized medicine, so the need will be higher."
A series of reports issued over the past year by UCSF's Center for the Health Professions for the private, statewide health foundation California Endowment cited the needs of several California regions for CLSs.
The region with the largest need for CLSs is Orange County, where 1,210 such professionals were employed in 2006, and which has an average 61 job openings per year, according to Allied Health Workforce Analysis: San Diego Region, completed in June 2008.
At a median annual income for CLSs of $66,976, Orange did not command the highest salaries among California counties for the job category. That distinction went to Santa Clara County, with a median annual wage for CLS jobs at $82,326, and a total 770 jobs in the field as of 2006, and 29 annual job openings, according to Allied Health Regional Workforce Analysis: Bay Area Region, released earlier this month.
According to the studies, San Diego and its namesake county had 750 CLSs employed there in 2006, with a median annual salary of $64,813, and an average 33 job openings in the field a year. San Francisco — a combined city and county whose data was grouped with Marin and San Mateo counties — had 670 CLSs as of 2006, at median annual salaries of $72,675, and 37 annual job openings.
The California Endowment-released studies include reports for 18 central California counties, and one for the Los Angeles region that did not offer detailed info on CLS employment and projected job openings. A northern California regional report is being reviewed by the Endowment and is set to be published in the near future.
Elaine Johnson, director of the National Advanced Technological Education Center of Excellence in Biotechnology, also known as Bio-Link, told BRN this past winter that California lags behind neighboring states in producing certified lab scientist and medical lab technician graduates because it has stricter rules for state-specific CLSs and MLTs than other states [BRN, Jan. 19].
"There are not enough training facilities or licensed internship sites. And that is the problem, especially since the need for these people is increasing dramatically as companies are moving into diagnostics for personalized medicine, an area that is increasing in this region," Johnson said. "It has become a very serious issue, and something that we're definitely looking at."
A 2005 report issued by the US Department of Health and Human Services identified a nationwide shortage of CLSs, and studies over several years by HHS and others identified a similar shortage in California. In 2005, California's ratio of CLS professionals — 74 percent of the national CLS-to-population ratio — is the seventh-lowest in the United States, according to a report by the US Department of Health and Human Services called The Clinical Laboratory Workforce: The Changing Picture of Supply, Demand, Education, and Practice.
Another factor in California's shortage, Bates said, is lower salaries than many other life-sci and health specialties, which may reflect how until lately, the jobs of MLTs and CLSs have not been defined as sharply in California as in other states.
"One of the reasons that programs and laboratories have difficulty attracting students is that in recent years, the pay really hasn't been competitive, and to some extent certainly that is affected by the regulatory environment," Bates said, cautioning that he was not an expert on the regulatory issue. "I think that even though it's a few years old, there have still been some issues of differentiation from the real entry-level laboratory assistant, and where the MLT fits in between the lab assistant and the clinical laboratory scientist.
"As California gets better at really defining the scope of work in the lab, as the scope of practice issues get ironed out, I think that's going to be a really important step in addressing workforce need," Bates added.
The allied health initiative is patterned after the $90 million California Nurse Education Initiative. Since it was launched in 2005, state officials say, the nursing program has helped generate a 54 percent increase in the number of Registered Nurse (RN) graduates (9,526 graduated in 2008), an increase of more than 56 percent new faculty members (over 1,240 new faculty members), an increase of more than 68 percent new student enrollments in RN programs, and 22 new public and private RN programs.