NJ licensure during COVID-19 offers example of how to meet workforce demand
Temporary licensure of out-of-state practitioners, along with telehealth waivers, may be a valuable, short-term solution to mitigating health care workforce shortages during public health emergencies, researchers said.
A study found that temporary licensure of out-of-state practitioners and telehealth waivers, as occurred in New Jersey during the COVID-19 pandemic, may be a valuable, short-term solution to mitigate health care workforce shortages.
Researchers conducted a cross-sectional survey of the state's temporary licensees to capture their impact on workforce availability, accessibility, accommodation, affordability, and acceptability. Researchers emailed 31,805 practitioners who obtained a New Jersey temporary license between March 20, 2020, and Jan. 6, 2021. Results appeared in the August Health Affairs.
Of 10,449 survey respondents (33%), 7,552 (72%) reported using their temporary license to provide care to at least one New Jersey patient. The remaining 28% obtained but did not use a temporary license. About half (48%) were mental health providers, followed by 21% physicians, 16% nurses, 7% NPs or PAs, 2% respiratory care therapists, and 6% other. While practitioners were from all other 49 states, most were from New York (37%), Pennsylvania (25%), Florida (4%), Delaware (3%), and California (3%).
Telehealth was the main modality for care delivery. Most mental health providers (83%), physicians (64%), and NPs or PAs (51%) used telehealth all of the time. Respiratory care therapists reported that about 40% of their telehealth time was audio only.
Researchers noted that temporary licenses enabled care continuity across state lines and increased the supply of services for New Jersey patients, especially of mental and behavioral health care at a time when demand for such services was rising. The increased workforce boosted hospital staffing, with more than 1,000 respondents providing inpatient care, and also expanded care for underserved populations, with at least 670 respondents caring for Medicare or Medicaid patients. Respondents also communicated with patients in more than 36 languages.
Researchers noted that some of the findings were unexpected. Two main uses of the temporary licenses were nurses and respiratory care therapists who helped with COVID-19-related hospital care during the pandemic, and physicians and mental health providers who provided telehealth across state lines for COVID-19 and non-COVID-19 patients. Also, 29% of respondents provided non-COVID-19 care.
An editorial noted that a data credentialing platform for volunteer physicians and other health care professionals in response to natural disasters or other national emergencies could deliver health care professionals wherever they are needed most. Interstate licensure compacts offer a practical, safe, and enduring example of regulatory flexibility to deliver care whether there is a public health emergency or not, they said.
“Judging by New Jersey's example, a compelling case may be made in times of urgency for temporary licenses and licensure waivers,” the editorial stated. “There may also be ways to facilitate more rapid and widespread adoption of such programs and to extend them beyond the limits of a national emergency.”