Newsom acts to increase number of health workers in California but some say his order doesn’t go far enough

Photo: Carolyn Cole/Los Angeles Times/Polaris

Gov. Gavin Newsom speaks in front of the hospital ship USNS Mercy that arrived into the Port of Los Angeles on March 27, to provide relief for Southland hospitals overwhelmed by the coronavirus pandemic. Also attending the press conference and keeping appropriate distancing are Los Angeles Mayor Eric Garcetti, left, Dr. Mark Ghaly, Secretary of Health and Human Services,, Director Mark Ghilarducci, Cal OES, Robert Fenton, FEMA Regional Administrator for Region 9, admiral John Gumbleton, United States Navy, Captain Brian Quin, United States Navy and Captain Monica Rochester, United States Coast Guard and Captain of the Port.

Ashley A. Smith

March 31, 2020

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California Gov. Gavin Newsom on Monday encouraged thousands of medical, health and nursing students across the state to join the state’s new Health Corps initiative to help the state fight the effects of the coronavirus. Newsom launched the initiative Monday to increase the number of health care professionals needed to fight the pandemic which is expected to surge in upcoming weeks.

“If you’re a nursing school student or a medical school student, we need you,” Newsom said. “If you just retired in the last few years, we need you.” Newsom also announced that Facebook CEO Mark Zuckerberg is providing stipends to Health Corps workers through a $25 million donation to cover transportation, child care support and hotel rooms.

Newsom said the state could add about 37,000 healthcare workers, including those who are retired and students. On Tuesday, Newsom said more than 25,000 health care professionals had registered for the corps. To help them join the workforce, Newsom signed an executive order allowing state licensing boards to waive some of their requirements and decide how they would issue temporary licenses.

The California Board of Registered Nursing announced Tuesday that nursing students could provide some medical services without licenses during the pandemic without violating state laws. The board released a guideline for hospitals, clinics and health care professionals to use to determine what role a nursing student could fill when assisting with patient care based on their level of education.

But the creation of the new Corps, the nursing board’s new guidelines and Newsom’s call to action don’t completely resolve an issue that could delay up to 14,000 nursing students from graduating and getting into the workforce just when the state needs them.

Some students and instructors, who have been eager to answer the state’s call to help stop the spread of the virus wanted the governor to go a step further and order the California Board of Registered Nursing to temporarily change its policy on clinical rotations to allow them to graduate on-time or ahead of schedule.

These rotations, which are normally done in hospitals with students shadowing nurses and doctors across various specialties as they care for patients, are needed for graduation. Students, for example, rotate through an emergency room or pediatrics of a hospital as part of their training. The state requires colleges to have at least 75 percent of these clinical rotations with patients, but the COVID-19 crisis has suspended those activities.

One solution offered by nursing instructors and students across the state would be lowering the percentage of clinical rotations conducted with patients from 75 percent to 50 percent. Students would complete the other 50 percent of their clinical practice through what are called “virtual simulations,” which recreates the health care situations and incidents online, especially since many campuses have moved their in-person instruction online. Current regulations allow 25 percent of clinical rotations to be completed with simulations.

Newsom’s order allows the state Department of Consumer Affairs, which oversees the nursing board, to waive licensing requirements and change the scope of practice of healthcare professions through June 30. The department must work with each licensing board to determine exactly what will change.

Veronica Harms, a consumer affairs spokeswoman said, “We are encouraging all interested medical and health care professionals to register for the California Health Corps.  As for waivers, we are looking at all of our options to expand and grow the health care workforce during the pandemic.”

The nursing board’s actions Tuesday will allow unlicensed nursing students to help the state’s health care workforce through the pandemic.

Once specific waivers are issued, Harms said they would be published on the department’s website.

But Sharon Goldfarb, dean of health sciences at the College of Marin in Kentfield north of San Francisco and president of the northern division of the California Organization of Associate Degree Nursing, said the nursing board is not acting quickly enough.  “We appreciate Gov. Newsom’s initial response but what he’s done is put the power in the (nursing board’s) hands and they’re not doing anything,” she said referring to the waivers.

Goldfarb, who has been contacting state lawmakers and the nursing board to make changes, said the board has been slow to act.

“I don’t know what we can do but go back to writing legislators and getting students to be politically active. But we’re on a timeline. Our semester is ending.”

State Sen. John Moorlach, R-Costa Mesa, called the Health Corps a “critical first step,” but it is essential the consumer affairs department eases barriers for medical professionals wanting to help with the coronavirus response, he said.

“I sent a letter last week requesting the California Board of Registered Nursing adjusts its strict clinical hour graduation requirements for nursing students,” he said. “Until this issue is fully resolved, I will continue to monitor the situation and work to ensure the bureaucracy does not get in the way of patient care.”

Lisa Rients, a nursing student, nearing graduation in May from West Coast University in Anaheim, said she was disappointed that the clinical rotation requirements hadn’t been changed yet.  She won’t sign up for the corps until she knows what the board decides about the requirements, Rients said.

California Community Colleges Chancellor Eloy Ortiz Oakley applauded the creation of the Health Corps and said the state’s 115 community colleges would do what it could to increase the number of workers in nursing, respiratory therapy and other health fields. “The new, temporary flexibility with regard to state licensing and certification and professional scopes of work announced by Gov. Gavin Newsom today will make this easier to get qualified health students in the workforce,” Oakley said.

Corps volunteers will be reviewed based on their skills, experience, location preferences and interests, according to the site. Those who participate in the corps will be paid and given malpractice coverage.

It’s not immediately clear what effect being in the Health Corps will have on medical and health students who are nearing graduation, or when they would be able to complete licensing requirements.

Andrew Gordon, the associate director of media relations for the University of California, said there “currently no systemwide plans to accelerate graduation for our medical or health students, but we will continue to assess the feasibility and implications of this and other strategies, given the rapid developments around the pandemic and our dedicated efforts to help combat it.”

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