Governor’s Task Force on the Healthcare Workforce Report
––
Governor’s Task Force
on the Healthcare
Workforce Report
2024
Governor’s Task Force on the Healthcare Workforce Report
Contents
Letter to Wisconsin Governor Tony Evers ........................................................................ 1
Executive summary ....................................................................................................... 3
Recommendations ....................................................................................................... 5
Education and training ............................................................................................... 5
Recruitment and retention .......................................................................................... 8
Regulatory policy ..................................................................................................... 10
The Task Force on the Healthcare Workforce ................................................................. 12
Members ................................................................................................................. 12
Task force process ................................................................................................... 13
Timeline .................................................................................................................. 14
Focus areas ............................................................................................................. 14
Outcomes of task force prioritization ......................................................................... 14
Current status of Wisconsin’s healthcare workforce ...................................................... 15
Shared challenges ................................................................................................... 15
Behavioral health ..................................................................................................... 17
Nursing ................................................................................................................... 20
Direct care .............................................................................................................. 22
Allied health ............................................................................................................ 25
Other healthcare professions ................................................................................... 28
Appendix A: Full List of Recommendations ................................................................... 34
Education and training ............................................................................................. 34
Recruitment and retention ........................................................................................ 51
Regulatory policy ..................................................................................................... 60
Appendix B: Acknowledgements .................................................................................. 68
Sources ...................................................................................................................... 69
Governor’s Task Force on the Healthcare Workforce Report Page 1 of 73
Letter to Wisconsin Governor Tony Evers
August 19, 2024
The Honorable Governor Tony Evers
State of Wisconsin
115 East, State Capitol
Madison, WI 53708
Dear Governor Evers:
On January 29, 2024, you signed Executive Order #220 creating the Governor’s Task Force
on the Healthcare Workforce and tasked our administration to lead the way in developing
meaningful, long-term solutions to our state’s healthcare workforce challenges—an issue
that has only worsened in the wake of the coronavirus pandemic. Today, the members of
the Governor’s Task Force on the Healthcare Workforce are pleased to present the
following report detailing the process and recommendations to address the charges in
Executive Order #220.
As you know, the future of Wisconsin’s healthcare system depends on the dedication and
compassion of those working on the frontlines in our hospitals, nursing homes, and in
emergency medical services. These workers are the frontlines of defense in helping to
ensure positive healthcare outcomes for patients throughout our state, support our
residents, and deliver quality care. Wisconsinites rely on them to be there when we need
them the most, to help not only us live healthy lives, but future generations as well. As the
task force’s work began in earnest, we identied critical issues involving healthcare
recruitment and retention, education, and regulation that must be addressed. The task
force meetings that have been held over the last six months have reinforced what needs to
be done in the next legislative session and the coming years to both strengthen and
support Wisconsin's healthcare workforce for future generations.
These recommendations are the work of healthcare providers, educators, policymakers,
and community partners providing actionable strategies to ensure our healthcare
workforce is resilient, well-supported, and equipped to meet the evolving needs of our
population. At your direction, we have worked to prepare this report, which is the
culmination of months of analysis, collaborative discussions, and dedicated eorts from a
diverse group of partners united by a common goal: to build a workforce prepared to meet
the needs of a 21st-century economy and ensure that we are doing everything in our power
to support our healthcare heroes.
These recommendations will help to move Wisconsin forward with sustainable solutions to
retain, attract, and train talented workers to address our state’s workforce challenges. On
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behalf of the entire task force, we extend our deepest gratitude for the opportunity to serve
as representatives focusing on solutions to the greatest challenges facing Wisconsin’s
healthcare workforce.
Sincerely,
Sara Rodriguez Kirsten Johnson Amy Pechacek
Lieutenant Governor Secretary Secretary
Chair Dept. of Health Services Dept. of Workforce Development
Co-vice chair Co-vice chair
Governor’s Task Force on the Healthcare Workforce Report Page 3 of 73
Executive summary
Healthcare workers make sacrices every day to keep our families, friends, loved ones, and
neighbors safe and healthy, often going above and beyond in diicult conditions and risking
their health and well-being on the frontlines of health crises. Wisconsin’s healthcare
industry continues to face signicant challenges lling jobs, with historically low
unemployment rates, high workforce participation rates, and a shrinking labor pool. The
COVID-19 pandemic amplied Wisconsin’s existing healthcare workforce challenges by
placing an unprecedented burden upon the state’s healthcare sector.
Challenges nding healthcare workers contribute to delays in care and negatively impact
patients’ health. People in Wisconsin have the right to get care when and where they need
it, but people often struggle to receive appropriate, high-quality, and timely care because of
workforce shortages.
The state must continue working to identify potential solutions that support the healthcare
industry and everyone our healthcare systems aim to serve. To address long-standing
challenges, we must also include eorts to ensure current workers remain in the
workforce, target investments to remove barriers to employment, and support initiatives to
attract, recruit, and retain talent across Wisconsin.
We must also continue to pursue solutions to ensure the state’s healthcare workforce is
prepared to meet the needs of our state. In January 2024, Governor Tony Evers established
the Governor’s Task Force on the Healthcare Workforce by issuing Executive Order #220.
He charged the task force with gathering and analyzing information and producing an
advisory action plan for the 2025-27 state budget consideration.
The task force’s work plays an important role in helping to advance the growth of
Wisconsin’s healthcare workforce. It ensures Wisconsin can continue to provide high-
quality, accessible healthcare to communities and remain a welcoming home to people
seeking sustainable employment in the eld of healthcare.
Led by the Oice of the Lieutenant Governor with the Wisconsin Department of Health
Services (DHS) and Wisconsin Department of Workforce Development (DWD), the task
force met six times over six months, bringing together private and public sector leaders to
identify policies and investments to continue advancing Wisconsin’s healthcare workforce.
The Governor’s Task Force on the Healthcare Workforce heard from healthcare experts and
leaders, analyzed labor market data, and produced an advisory action plan for the
Governor’s review and consideration. The plan:
► Presents a comprehensive analysis of current and future workforce challenges
impacting the healthcare sector, including recruitment, retention, and burnout;
► Explores educational and training pathways to create a more diverse, equitable, and
sustainable healthcare workforce;
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► Identies strategies to improve patient care and alleviate the burden on our healthcare
workforce; and
► Recommends solutions, including new policies and programs, modications to
existing programs, and necessary changes to state statutes related to workforce
development, industry innovation, education, and training.
In total, the task force adopted 10 recommendations with 26 action items representing a
variety of policy and implementation approaches aimed at addressing issues such as
education, training, recruitment, and retention of healthcare workers.
Governor’s Task Force on the Healthcare Workforce Report Page 5 of 73
Recommendations
The task force voted on a package of 10 recommendations with 26 associated action items.
Education and training
1. Support faculty who teach health professions.
Expand the faculty workforce to increase schools’ capacity to enroll students.
a. Expand incentive programs for health profession educators.
The state does not have enough educators to teach those who want to become
healthcare workers. For example, recruiting nurses into faculty roles is challenging
because nurse faculty salaries are typically lower than salaries in patient care or
other settings. Similarly, institutions of higher education report shortages for allied
health and health professions faculty. State sponsored loan repayment programs for
faculty may be helpful to incentivize qualied health professionals to serve in these
positions. This proposal would expand the Nurse Educators Program to include
other health professions and part-time faculty.
b. Increase compensation for health professions faculty
Faculty salaries are often lower than practitioner salaries, which leads to diiculty
recruiting or retaining health professions faculty. To address this, this proposal
would increase state support for higher education. Schools could use a portion of
additional funding for educator compensation to address the disparity between
educator and clinical practitioner salaries for both full- and part-time faculty.
2. Strengthen clinical training and experience.
Expand access to clinical training and other hands-on experiences to help students
complete the requirements to pursue healthcare occupations.
a. Support preparation of clinical behavioral health counselors (Qualied
Treatment Trainee Grants).
Supervised clinical experience is required for people seeking licensure as a clinical
counselor or clinical social worker. New graduates completing supervised
experience for clinical licensure must either identify a licensed clinical professional
willing to be their supervisor or nd employment that oers supervision. Providing
supervision takes time and typically has some impact on the clinical productivity of
practicing professionals and their organizations. The Qualied Treatment Trainee
Grant Program supports organizations and professionals involved in supervision by
covering costs associated with supervision and providing support to people
receiving supervision (paid clinical experiences and benets). This proposal would
provide additional state funding to continue this important program at its current
level.
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b. Support clinical partnerships and preceptors.
Clinical training is an important part of the educational process for most healthcare
occupations, yet Wisconsin has a shortage of clinical sites for students. This
proposal would direct funding to institutions of higher education to develop or
strengthen clinical training partnerships with healthcare employers and
professionals. Funds could be used to address organizational and individual losses
in productivity associated with clinical training and could include strategies such as
preceptor compensation. A preceptor is an experienced clinician who supervises
students during clinical training and facilitates the application of theory.
c. Expand experiential learning (simulation).
Institutions of higher education oer simulation labs and other experiential learning
tools as a supplement to classroom and clinical experience. This proposal would
provide additional funds to help schools expand and sustain simulation labs and
help students gain practical experience.
3. Reduce barriers to training.
Address the signicant personal and professional costs of education to help
Wisconsinites pursue and advance in healthcare careers.
a. Fund wraparound services programs for students.
Some students experience barriers, such as transportation and child care, to
completing education and training in healthcare related elds. Wraparound services
are designed to support post-secondary students experiencing these barriers. This
proposal would support wraparound services programs administered by state
higher education partners, which have been successful for Wisconsinites.
b. Train direct care professionals and nurse aides through WisCaregiver Careers.
WisCaregiver Careers provides funding to long-term care employers to cover
certied nurse aide and other direct care professional training costs and
recruitment and retention bonuses. Without a plan for continued funding, training
costs will revert to employers and workers will no longer receive state-sponsored
bonuses. This proposal would sustain and expand state funding for WisCaregiver
Careers.
c. Reduce general educational development and high school equivalency diploma
(GED/HSED) costs for students.
This proposal would encourage Wisconsinites to complete a certicate of general
educational development or high school equivalency diploma by reducing training
and/or testing costs. This could expand the pool of qualied applicants for
healthcare jobs, which often require a minimum of high school equivalency.
d. Increase training grants for allied health professionals and clinicians.
DHS administers the Allied Health Professional Education and Training Grant and
the Advanced Practice Clinician Training Grant. The programs goals are to increase
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training opportunities for allied health positions and to expand the use of physician
assistants and advanced practice registered nurses in rural areas. However, state
law restricts award amounts and requires a high match rate. Modifying the programs
to allow for exibility and increasing funds to help DHS administer additional grants
would help support these critical professions.
4. Expand apprenticeships and other learning opportunities.
Expand apprenticeships and early learning opportunities to help increase the pool of
healthcare workers.
a. Provide additional state funding for apprenticeship programs.
Apprenticeships are a work-based learning model to support workers and
employers. Wisconsin is a leader in apprenticeships, including for healthcare
occupations.
To enhance the worker and employer experience, additional funding would:
► Increase infrastructure support for apprenticeship programs to boost interest,
understanding, and navigation of healthcare apprenticeships.
► Increase staing to boost outreach to employers, build and grow pre-
apprenticeship opportunities to train people for registered apprenticeship
opportunities, and allow for more nimble policy and program changes.
► Support and enhance the development of new and existing curriculum.
► Support information technology processes to help the state respond to the
increased demand for pre-apprenticeships, registered apprenticeships, and
youth apprenticeships.
► Incentivize local groups to engage sponsors and bridge youth apprenticeships
to registered apprenticeship programs to encourage youth to continue their
career pathway as an adult.
► Support instruction-related costs for youth apprentices to ensure equitable
access to youth apprenticeship pathways.
► Support registered apprentices by covering the costs of any required licenses,
certications, and exams.
► Support the apprenticeship completion award program.
► Support on-the-job learning reimbursements to healthcare sector employers to
incentivize them to establish new registered apprenticeship programs.
b. Fund Worker Advancement Initiative Grants.
This proposal would support the continuation of the Worker Advancement Initiative,
which provides grants to local workforce development boards to help people
successfully enter and advance in Wisconsin's healthcare workforce. Examples may
include wraparound services such as transportation and child care; sector-based,
tailored training programs; and training stipends so participants can aord to attend
new skills training. This proposal would invest in training programs with
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demonstrated success within the healthcare sector that are not otherwise eligible
for federal Workforce Innovation and Opportunity Act reimbursement.
c. Increase student access to health science and dual enrollment.
Increasing awareness of healthcare careers among youth is critical to developing
the next generation of the workforce. This proposal would increase funding to boost
student access, interest, participation, and credential attainment for health careers.
For example, additional funds could support the Area Health Education Centers
program and HOSA – Future Health Professionals, which educate students about
healthcare careers. Funds could also strengthen dual enrollment programs to help
high school students complete post-secondary coursework and earn certications
and licenses. Targeted state support for youth starting as early as middle school
would ensure more students are aware of the variety of healthcare careers
available.
Recruitment and retention
5. Increase payer support for recruitment and retention.
Increase funding provided through Medicaid and other payers to help employers boost
provider compensation.
a. Expand Medicaid to support healthcare workers and fund workforce initiatives.
Medicaid expansion would save Wisconsin an estimated $1.6 billion in state funds
over two years, and the state could decide how to spend these savings. A portion
could be used to fund strategic workforce initiatives, such as Medicaid rate
increases to support hospitals and other healthcare employers. Medicaid expansion
would also encourage workforce participation among healthcare workers who
sometimes limit hours of employment to retain public benets.
b. Rate increases to strengthen the workforce for people who live in Wisconsin
who are elderly or disabled.
This proposal would support rate increases to strengthen the home and community-
based services (HCBS) workforce. Higher rates for HCBS can encourage recruitment
and retention of direct care professionals and meet the needs of our aging
population and those living with disabilities. The HCBS workforce provides services
for people who enable them to remain in their homes and communities. The cost of
providing HCBS is typically lower than the cost of providing facility-based services
(in nursing homes), but wages are typically lower. DHS has developed a minimum
fee schedule for HCBS to facilitate higher wages and help meet the growing need for
services.
c. Rate increases to strengthen the behavioral health workforce.
The state’s ability to recruit and retain behavioral health providers is inuenced by
Medicaid and commercial insurance reimbursement rates. Medicaid
reimbursement rates typically fall behind Medicare, private insurance, and self-pay
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rates. Lower reimbursement rates can translate to lower wages for behavioral health
professionals. While the state has made progress in recent years to increase rates,
this proposal would support additional Medicaid rate increases for behavioral
health services to help employers increase wages and support recruitment and
retention of professionals. Other payers, such as commercial insurers, should also
increase rates to help recruit and retain behavioral health professionals.
6. Foster recruitment and retention in areas of need.
Encourage health professionals to practice in underserved communities across the
state through state-sponsored incentive programs.
a. Expand state incentives for health professionals serving in state-dened
shortage areas.
Workforce incentives, such as loan repayments, housing supports, and provider
stipends, are a common state strategy to support recruitment and retention of the
workforce. This proposal would provide targeted funding to expand state incentive
programs for healthcare professionals in underserved communities. Incentive
strategies may include expanded student loan repayment and other innovations to
enhance recruitment and retention in state-dened areas of need.
7. Support regional innovation.
Invest in regional collaboration to help employers, schools, and other partners address
local workforce challenges.
a. Support employer-based workforce development solutions with Provider
Innovation Grants.
Funding to support workforce development innovations must be adaptable to meet
the unique needs of employers. This proposal would support funding for Provider
Innovation Grants, which oer exible funds to employers to support strategic
workforce development initiatives, such as mentorship programs, preceptor
bonuses, paid clinical sites, improved scheduling practices, professional
development, and social supports to retain their workforce. Funds could also help
employers address worker well-being concerns, such as violence prevention, that
contribute to high turnover.
b. Support regional collaboration for workforce development through Workforce
Innovation Grants.
This proposal would support the continuation of Workforce Innovation Grants to
encourage the development of evidence-based long-term solutions to regional
workforce challenges. This helps businesses nd qualied workers and assist
people in obtaining family-sustaining jobs. This would allocate specic funding to
address healthcare industry labor and workforce challenges. It would also provide
exible funding for regional planning and strategic workforce development.
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c. Support direct care professionals with health insurance benets navigation.
This proposal would support direct care professionals by funding navigation
services through Covering Wisconsin to help people understand and sign up for
publicly available health insurance and other programs that support health.
Providing resources to healthcare and connecting workers with benets that work
for them, and their families, may help with retention in these critical roles. One-in-
three direct care professionals receive public insurance coverage, such as
Medicaid. Some workers may choose to leave their direct care positions for
employment in other sectors or industries where they are oered benets.
Regulatory policy
8. Support expanded pathways to licensure.
Expand licensure pathways to keep patients safe while encouraging workforce
participation among qualied professionals.
a. Authorize Medicaid reimbursement for community-focused providers.
Doulas, community health workers, peer specialists, and other community-focused
providers help licensed practitioners operate at the top of their licenses by
supporting members of their communities, but Medicaid is not currently authorized
to reimburse directly for many of their services. This proposal would authorize
Medicaid to pay for community-focused services to increase wages, provide
stability, and help alleviate shortages among other providers.
b. Support pathways to licensure for qualied internationally educated
professionals.
Internationally educated professionals represent a potential pool of workers to grow
the healthcare workforce. Programs (education) and provisions (regulatory) may be
established or strengthened to support the recruitment of these professionals into
the state in areas of need, including in practitioner roles and in faculty roles. This
proposal would provide funding to add legal capacity at the Department of Safety
and Professional Services (DSPS) to clarify and expand pathways to practice for
qualifying internationally educated or trained health professionals.
c. Ratify and enter into multi-state licensing compacts.
This proposal would encourage the state to ratify and enter into multi-state
compacts, which allow professionals to become eligible to practice in other
participating states. Compacts can make it easier for healthcare providers to
practice across states or to relocate. Wisconsin has ratied several compacts,
including those for nursing, medicine, and psychology. Among others, the state has
not yet ratied the social work, cosmetology, or dietician compacts.
d. Revise faculty educational requirements.
Wisconsin sets minimum standards for health professions faculty, including for
nursing and allied health programs. These standards limit the number of qualied
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health professionals who can teach healthcare students. This proposal would seek
to review and potentially modify exceptions for faculty educational requirements to
help expand the pool of applicants while retaining quality.
9. Strengthen state capacity to support licensure.
Increase support for the state’s licensing agency to help health professionals gain the
necessary licenses and credentials.
a. Maintain licensing improvements and enhance licensing support for
applicants, employers, educators, and other partners.
This proposal would provide DSPS with additional sta positions to improve the
licensing process and increase workforce availability within Wisconsin
communities. In particular, the establishment of positions to support state
occupational regulatory board members’ decision making regarding educational
requirements may expedite the licensure process for qualied candidates, making
board time more eicient. These positions could perform preliminary review of
applicants’ educational requirements, prepare summary information, and provide
expert recommendations to the board.
10. Strengthen workforce monitoring and support.
Invest in workforce monitoring and support to help the state’s licensing agency work
with medical professionals to sustain workforce participation.
a. Increase healthcare workforce wellness programming to support retention.
Physical, mental, and psychological challenges faced by health professionals can
be managed with appropriate treatment. This proposal would fund programs that
support professionals facing such challenges to support overall workforce well-
being and promote continued practice. In some states, these programs are
available for licensed health professionals and supported through licensing fees. In
other cases, supports are provided by employers through employee assistance
programs or company well-being initiatives.
b. Analyze existing and gather additional data on the healthcare workforce.
Monitoring the healthcare workforce within a state is challenging. Many states use
license counts to estimate state-level capacity of health professionals.
Unfortunately, not all license holders practice or work within the state, and license
information (such as license address) may or may not reect where a professional is
practicing. The collection of supplemental workforce information (whether a
professional practices in the state, where their practice is located, their specialty,
etc.) at the time of license renewal is a best practice for states to gather the
information needed to assess the workforce, identify shortages, and target and
evaluate policy solutions. DSPS is poised to champion workforce data collection for
Wisconsin’s licensed health professionals. This proposal would direct resources to
ensure appropriate staing and expertise to collect this data and transform it into
actionable information for Wisconsin.
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The Task Force on the Healthcare Workforce
Members
Name
Affiliation
Lieutenant Governor Sara Rodriguez
Chair
Secretary Amy Pechacek
Department of Workforce Development, Co-Vice Chair
Secretary Kirsten Johnson
Department of Health Services, Co-Vice Chair
Rick Abrams
Wisconsin Health Care Association/Wisconsin Center for
Assisted Living
Tom Boelter
Forest County Potawatomi Community
Kelly Buchholtz, MSN, MBA/HCM, RN
Mayo Clinic Health System – Northwest Wisconsin
Danielle Cook, MS, CST
Wisconsin Technical College System
Sharon Cox, DNP, MSN, RN
Beloit Health System
Gina Dennik-Champion, MSN, RN, MSHA
Wisconsin Nurses Association
Dr. Amy Domeyer-Klenske
University of Wisconsin (UW)-Madison, Wisconsin
Section of American College of Obstetricians and
Gynecologists
Dylan Gould, CNA
SEIU Wisconsin
Eric Humphrey
Center for Healthcare Careers of SE Wisconsin, Froedtert
ThedaCare Health
Dakota Kaiser, PhD
Bridge Community Health Clinic
Elsbeth Kalenderian, DDS, MPH, PhD
Marquette University School of Dentistry
Thomas W. Kernozek, PhD, FACSM
University of Wisconsin -La Crosse
Shawn Lerch, FACHE
Sauk Prairie Healthcare
Joyce Mallory
Heroes for Healthcare
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Name
Affiliation
Wendy Molaska, MD, FAAFP
Wisconsin Medical Society
Barbara Nichols, RN, MS, FAAN
Wisconsin Center for Nursing
Sondra Norder, NHA, HSE, FACHE, JD
St. Paul Elder Services Inc. and LeadingAge Wisconsin
John Raymond Sr., MD, FAHA, FASN, FACP
Medical College of Wisconsin
Heather Schimmers, MBA, BSW, RW
Gundersen Health System (becoming Emplify Health)
Robyn Woolever, MSN, BSN, RN-BC
Children’s Wisconsin
Janet Zander, MPA, CSW
Greater Wisconsin Agency on Aging Resources, Inc. and
Wisconsin Aging Advocacy Network
Stacey Zellmer
Wisconsin EMS Association
Task force process
The 25-member task force met monthly in public meetings from March to August 2024. Meetings were
held in Green Bay, La Crosse, Madison, and Milwaukee and were also available to watch online. Expert
briengs and additional resource materials were provided to the task force at each meeting. A complete
schedule of the meetings and meeting minutes can be found on the task force webpage. On August 15,
2024, task force members voted to recommend a package of policy proposals to the Governor.
The task force collected comments from members of the public and distributed them to the task force
through the following means:
► A public comment opportunity was noticed on the agenda for every task force meeting.
► A submit feedback function was available on the task force webpage.
► Comments were emailed directly to the chair, co-vice chairs and sta
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Strategy Areas
Education &
Training
Recruitment &
Retention
Regulatory
Policy
Topical Areas
Behavioral
Health
Nursing Direct Care Allied Health Other/All
Timeline
Focus areas
Task force members were surveyed to dene focus areas. Members voted to advance recommendations
across all workforce strategy areas: education and training, recruitment and retention, and regulatory
policy. Of healthcare professions, behavioral health, nursing, direct care, and allied health were top
ranked. Behavioral health, long-term care, and primary care were the top ranked sectors.
Outcomes of task force prioritization
BRAINSTORM
Strategize
solutions to the
workforce
shortage
CONVENE
Identify
processes,
timelines, and
deliverables
INITIAL
SUMMARY
Provide
summary of
ndings and
proposals
PRIORITIZE
Select focus
areas and learn
from partners
about current
programs
DISCUSS
TOPICS
Review and
prioritize concept
recommendations
ACTION PLAN
Provide nal
presentation and
approve action
plan
March April May June July August
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Current status of Wisconsin’s healthcare workforce
Shared challenges
Demographics
► Wisconsin’s aging population has increased demand for healthcare services and reduced the supply
of healthcare workers as current professionals retire. The state’s population over age 65 is expected
to grow by 471,400, or 45%, between 2020 and 2040.
1
Wisconsin is among the nation’s 15 oldest
states, and nearly one-in-four Wisconsinites will be retirement age by 2030.
2
► Rural areas have critical shortages of health professionals. Out of Wisconsin’s 72 counties, 40 are
federally designated as mental health shortage areas, 37 as primary care shortage areas, and 34 as
dental care shortage areas.
3
Cost of living and education
► The high cost and limited availability of child care, housing, and transportation are a challenge for
students and health professionals.
► The cost of education (including tuition, fees, and personal living expenses) is a burden for those
wishing to pursue healthcare careers.
► Healthcare careers often come with a long and expensive runway to practice, requiring years of
education. A survey found student debt among nurses and physicians equaled more than half of
their annual salaries, a signicant debt-to-income ratio.
4
Education and training pipeline
► There are over 250 unique healthcare professions. Early awareness and education on the range of
health careers is critical to recruiting the workforce.
► High school partners note limited school resources make it diicult to oer health science programs.
Challenges include a lack of certied instructors and the high cost of paying for dual enrollment
opportunities (high school and post-secondary credit).
► Wisconsin’s colleges and universities note challenges with recruiting and retaining healthcare faculty
given non-competitive wages and high educational requirements.
Burnout and safety
► An increasing number of healthcare workers are leaving the eld or changing jobs due to concerns
about workload and safety. In 2022, 46% of healthcare workers reported feeling burned out often or
very often compared to 32% in 2018, and the percent who reported harassment more than doubled,
from 6% in 2018 to 13% in 2022.
5
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State investments in the workforce
► In 2024, Governor Evers declared the Year of the Worker and announced new eorts to build a
workforce prepared to meet the needs of a 21st-century economy, including creating the Governor’s
Task Force on the Healthcare Workforce.
► Since 2019, the Governor secured $1.2 billion in increases for the long-term care industry to support
our aging population, including signicant increases for nursing homes, personal care services,
home and community-based services, and more.
► The Governor allocated $68 million for hospital rate increases as part of the 2023-25 Medicaid
budget, starting in 2024.
6
o This payment increase will provide much-needed support to help hospitals address workforce
shortages and serve Medicaid patients.
o In total, DHS estimates Medicaid will pay $3 billion to hospitals in 2024, an average of 87% of the
costs associated with serving Medicaid members.
o DHS estimates that Medicaid payments in 2024 will average 104% of costs for critical access
hospitals, 88% of costs for psychiatric hospitals, 85% for rehabilitation hospitals, and 76% for
acute care hospitals.
► The Governor proposed a comprehensive workforce plan in 2023 to meaningfully address the state’s
workforce challenges. The plan, which has not yet been approved by the legislature, would invest
$160 million in the state’s healthcare workforce:
o $100 million to continue the successful Workforce Innovation Grant Program for regional
organizations to address healthcare workforce challenges;
o $22.5 million for Healthcare Innovation Grants, which help employers implement innovative
solutions to increase recruitment and retention;
o $17 million for Healthcare Opportunity Grants, which help those struggling with employment
outcomes since the pandemic;
o $10 million for the Nurse Educators Program, which provides incentives for nurse faculty to stay
in Wisconsin and teach the next generation of nurses;
o $6 million for WisCaregiver Careers, which addresses the shortage of certied nursing assistants
by supporting recruitment, training, and retention of people to care for nursing home residents
across Wisconsin;
o $1.5 million for the Qualied Treatment Trainee Grant Program, which facilitates the licensure of
those with graduate degrees in psychology, counseling, social work, or a closely related eld;
o $1.2 million for Graduate Medical Training Support Grants; and
o $936,600 to help develop new healthcare apprenticeship pathways.
7
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Behavioral health
Background
The behavioral health workforce includes psychiatrists,
clinical social psychologists, clinical social workers, nurses
and advanced practice registered nurses in psychiatry,
marriage and family therapists, and others who provide
behavioral health services. Approximately half of all people
in the U.S. will be diagnosed with a mental disorder or
behavioral health issue in their lifetime. However, only half
of those will get the treatment they need, due in part to the
scarcity of behavioral health professionals.
8
,
9
The majority of Wisconsin counties (40 out of 72) are
federally designated as mental health professional
shortage areas, dened as fewer than one psychiatrist per
30,000 residents.
10
The supply is particularly challenging in
rural areas and is expected to worsen. Psychiatrists are a
key component of the workforce, given their capability to
diagnose, treat, and prescribe, and are in particularly short
supply. Out of Wisconsin’s 72 counties, 20 (28%) had no
practicing psychiatrists in 2018, and 55 (76%) faced a
signicant shortage, dened as fewer than one psychiatrist for every 10,000 residents.
11
Projected Employment and Wages of Behavioral Health Occupations, Nationwide
12
Occupation
Projected
Growth
(2022-2032)
Projected Openings,
Annual Average
(2022-2032)
Median
Annual Wage
(2022)
Education
Required
Social workers
7%
63,800
$55,400
Bachelor’s degree
Social and human service
assistants
9%
47,400
$38,500
High school
diploma or
equivalent
Substance abuse,
behavioral health disorder,
and mental health
counselors
18%
42,000
$49,700
Bachelor’s degree
Educational, guidance,
and career counselors
and advisors
5%
26,600
$60,100
Master’s degree
Psychiatric technicians
and aides
9%
15,200
$37,300
Postsecondary non-
degree award
Marriage and family
therapists
15%
5,900
$56,600
Master’s degree
None of county is shortage area
Part of county is shortage area
Whole county is shortage area
Source: data.HRSA.gov, April 2024
Governor’s Task Force on the Healthcare Workforce Report Page 18 of 73
Occupation
Projected
Growth
(2022-2032)
Projected Openings,
Annual Average
(2022-2032)
Median
Annual Wage
(2022)
Education
Required
Clinical and counseling
psychologists
11%
4,100
$90,100
Doctoral or
professional degree
Psychiatrists
7%
1,000
$226,900
Doctoral or
professional degree
Challenges
Behavioral Health Professional Challenges
13
,
14
Category
Challenges
Financial
► Low wages
► Low insurance reimbursement rates
► High debt-to-income ratios due to student loan debt
Educational
► Signicant educational requirements for entry into workforce
► Top heavy workforce with limited advancement opportunities for entry- and
middle-skills roles
► Shortage of clinical sites and licensed supervisors and preceptors
► Lack of training for providers to serve diverse populations
Workplace
► Excessive workloads, which can lead to burnout
► Lack of organizational support and high administrative burdens
► Challenges with rural practice settings (isolation, resource limitations, and long
travel time)
Most occupations in the behavioral health eld require a master’s degree and a license or credential. As
an example, the State of Utah reported 73% of active licensees were in roles that required a master’s
degree or higher.
15
The average cost of an advanced degree for social workers and similar professions is
$74,840. These workers held an average of $46,798 in student loan debt.
16
Signicant up-front costs are
not reected in salaries, with median annual wages of $38,520 for social and human service assistants
and $55,400 for social workers.
17
There is also a decit in the education and training professionals receive
on how to appropriately treat specialized or underserved groups. This may contribute to rural shortages
as well as shortages in specialized elds such as child, adolescent, and geriatric psychiatrists.
18
The ability to recruit and retain behavioral health providers in Wisconsin is inuenced by insurance
coverage and reimbursement rates. Lower reimbursement rates can translate to lower wages for
providers, which can exacerbate workforce shortages and reduce patient access. In-network,
commercial insurers often pay mental health providers less than other physician specialties.
19
As a
result, patients often experience challenges nding an available in-network provider. An estimated four-
in-ten providers are accepting new patients,
20
and many have long wait times for appointments.
21
Some
insurers, including Medicaid, do not cover peer support specialists and services provided by other entry-
level behavioral health professionals, compounding the lack of treatment options. Medicaid
Governor’s Task Force on the Healthcare Workforce Report Page 19 of 73
reimbursement rates typically fall behind Medicare, private insurance, and self-pay rates, limiting the
number of providers able to support Medicaid patients.
The State of Wisconsin also employs behavioral health professionals and other health professionals
through the Departments of Corrections, Health Services, and Veterans Aairs. For example, DHS
manages seven inpatient facilities providing psychiatric treatment for people referred by county agencies
or the court system, with intellectual disabilities, with signicant behavioral health needs, and residing in
secure treatment centers. The seven DHS facilities employ psychiatric care aides, resident care
technicians, psychiatrists, psychologists, and other workers who provide essential services 24/7. Worker
vacancy rates at these facilities have risen in recent years, due in part to comparatively low wages. Other
challenges include complex clientele and work often requiring nights, weekends, overtime, or on-call
rotations. The state continues to pursue compensation increases for healthcare positions with high
vacancy and turnover rates at facilities providing essential services to high-need residents.
State investments in behavioral health
► As part of the Year of Mental Health, Governor Evers proposed over $500 million in the 2023-25 state
budget to address Wisconsin’s mental health crisis.
► While the legislature approved only a fraction of the Governor’s proposal, the budget made
signicant investments to bolster the behavioral health workforce and help Wisconsinites get the
mental healthcare they need, including:
o $30 million to increase Medicaid rates for hospital behavioral health units;
o $30 million to support collaboration between schools and mental health providers;
o $7 million for the Medical College of Wisconsin to recruit and train psychiatry and behavioral
health residents;
o $200,000 to enable farmers and farm family members to access counseling services from mental
health providers in their area at no cost; and
o A 25% increase in funding for county and Tribal veteran services oices, which help veterans
connect to mental health resources.
22
► In 2022, the Governor authorized $7.6 million in American Rescue Plan Act (ARPA) funds for the
Qualied Treatment Trainee Grant Program.
o The program supports the preparation of clinical behavioral health counselors who are working
towards licensure.
o The investment provided $5 million for 200 behavioral health employers to hire and supervise
trainees and $2 million in stipends to 200 unpaid trainees.
Governor’s Task Force on the Healthcare Workforce Report Page 20 of 73
Nursing
Background
Wisconsin has more than 7,800 licensed practical nurses (LPN) and 87,000 licensed registered nurses
(RNs). LPNs work in extended care (37%), ambulatory care (28%), and hospitals (9%). RNs are primarily
employed in hospitals (50%) and ambulatory care (24%).
23
In Wisconsin, the average annual LPN salary is
$52,700 ($4,400 per month) and the RN salary is $80,900 ($6,700 per month).
24
The salary is even lower
for RNs who work in public settings: the average annual salary for governmental public health nurses is
$68,900 ($5,700 per month). In comparison, travel nurses in Wisconsin earn an average salary of $9,925
per month.
25
DWD estimates Wisconsin will need an additional 19,000 RNs by 2040, but the state lacks the capacity to
train that many new nurses.
26
As of a March 2024 report from the Wisconsin Hospital Association,
Wisconsin hospitals report vacancy rates of 10% for RNs.
27
The nursing workforce continues to be
dominated by women, who represent 94% of LPNs and 92% of RNs.
28
LPNs are racially and ethnically
more diverse than RNs; 85% of LPNs in Wisconsin identify as white, while 93% of RNs identify as white.
Projected Employment of Nurses, Nationwide
29
Occupation
Employment,
2022
Projected
Employment, 2032
Percent
Change
Education
Required
Registered nurses
3,172,500
3,349,900
6%
Bachelor’s degree
Licensed practical and
licensed vocational nurses
655,000
689,900
5%
Postsecondary
non-degree award
Nurse practitioners
266,300
384,900
45%
Master’s degree
Challenges
Nursing Challenges
30
Category
Challenges
Financial
Better pay and benets in travel or non-bedside roles
31
Educational
► Budget constraints among higher educational institutions lead to waiting lists for
enrollment or low acceptance rates
► Lack of faculty due to educational requirements and low wages
► Lack of classroom space, clinical sites, and clinical preceptors
► High cost of education (tuition, fees, personal expenses, and cost of lost work
time and benets)
Workplace
► Scheduling challenges (nights, weekends, holidays, on-call shifts)
► Excessive workload can lead to burnout
► Workplace violence
► Limited career advancement opportunities
Governor’s Task Force on the Healthcare Workforce Report Page 21 of 73
The COVID-19 pandemic highlighted the importance of nurses and also had a signicant impact on the
nursing workforce. Nurses are decreasing hours, retiring earlier than planned, taking leaves of absence,
leaving for more lucrative or less stressful positions, or resigning.
32
A recent survey found 64% of nurses
experienced verbal abuse by a patient or family member, and 23% had experienced a physical assault or
abuse.
33
Relative to before the pandemic, 41,597 of the 87,000 registered nurses in Wisconsin (47%)
reported their mental and physical health to be worse or much worse.
34
Poor retention and high turnover
have particularly large impacts on the nurse workforce. Annual RN turnover is 18%, with an average cost
of $56,300 per RN turnover.
35
Nationwide, nursing schools are forced to limit the number of students enrolling due to faculty shortages
caused by academic budget constraints, faculty retirements, student debt among educators, and
increasing job competition from clinical positions. In 2023, U.S. nursing schools turned away an
estimated 65,800 qualied applicants due to an insuicient number of faculty, clinical sites, classroom
space, clinical preceptors, and budget constraints.
36
In 2022, 51% of RNs in Wisconsin held a bachelor's
degree in nursing, with 34% holding accreditation via a vocational certicate, diploma, or associate
degree.
37
Compensation also contributes to the faculty shortage. The median salary across advanced
practice registered nurse roles is $120,000, yet the average salary for a master’s-prepared nursing
professor is $87,325 nationally.
38
State investments in nursing
► In 2023, Wisconsin launched one of the country’s rst registered nurse registered apprenticeship
pathways to help address the demand for nurses.
39
► Governor Evers allocated more than $128 million in ARPA funds for Workforce Innovation Grants to
encourage regional solutions to workforce challenges.
o Recipients included UW-Eau Claire, which leveraged $9.4 million to help alleviate workforce
shortages and graduate more nurses. In partnership with Mayo Clinic Health System in Northwest
Wisconsin, the school created innovative curriculum and clinical experiences and added six new
programs.
o Funding was also used to establish rural healthcare hubs to bring better care and upskilled
career possibilities to rural communities.
40
o The UW System also received $376,000 to address healthcare staing shortages in Northeast
Wisconsin. UW-Green Bay partnered with local healthcare organizations to expand nursing
faculty capacity.
41
► The Governor allocated $20 million in ARPA funds for the Worker Advancement Initiative. Recipients
included the Northwest Wisconsin Workforce Investment Board, which supported adults earning an
associate degree in nursing.
► In 2019, the Governor rst proposed creating a nurse educator program to provide fellowships and
loan repayment for those who commit to teaching for three years.
The program was created in the 2021-23 state budget and allocated $5 million. In its rst year, $3.3
million was provided to support 92 nurse educators.
42
Governor’s Task Force on the Healthcare Workforce Report Page 22 of 73
Direct care
Background
Wisconsin has about 103,000 entry-level healthcare
workers, including an estimated 76,300 home health
and personal care aides and 26,700 nurse aides.
These entry-level positions are collectively referred
to as direct care professionals, an umbrella term
referring to personal care aides, home health aides,
supportive home care workers, certied nurse aides,
and other paid caregivers.
Many direct care professionals provide services in
long-term care settings, such as nursing homes and
home–and community-based settings. Worker
vacancy rates have increased from an estimated
24% in 2020 to 28% in 2022 across long-term care.
Given people’s preference to receive services in a
home-based setting, the shortage of direct care
professionals is likely to worsen as demand
increases.
43
An estimated 70% of adults over age 65 will require long-term care during their lifetime. In
2022, an estimated 18,482 people sought long-term care services but were denied or delayed services
due to a lack of sta.
44
Meanwhile, Wisconsin hospitals report one-in-three nurse aides changed jobs in
2022.
45
Projected National Demand for Direct Care Professionals
46
Occupation
2020
2025
2030
2035
% Change
Certied nursing assistants
727,520
811,120
935,480
1,074,820
48%
Personal care aides
528,780
586,680
667,320
756,900
43%
Home health aides
395,420
444,960
504,100
562,300
42%
Psychiatric aides
6,590
7,440
8,800
10,470
59%
All direct care
1,658,310
1,850,200
2,115,700
2,404,490
45%
Governor’s Task Force on the Healthcare Workforce Report Page 23 of 73
Challenges
Direct Care Professional Challenges
47
Category
Challenges
Financial
► Low wages
► Limited benets
► Low insurance reimbursement rates
► High cost of child care, transportation, and other personal needs
Educational
Lack of career pathways
Workplace
► Lack of perceived value and professional recognition
► Scheduling (inconsistent hours, unpaid travel time)
► Physically and emotionally demanding work
► Limited career advancement opportunities
Low pay and limited benets are challenges for direct care professionals in Wisconsin. On average,
Wisconsin personal care employees earn between $12.12 and $13.90 per hour, less than entry level
wages at non-healthcare employers such as Kwik Trip ($16/hour) and Target ($15/hour), despite direct
care work requiring a higher skill level.
48
Further, PHI data indicates 41% of Wisconsin’s direct care
workers in 2021 were living below 200% of the federal poverty level.
49
Direct care professionals have
highlighted that they feel underpaid, unrecognized, and underappreciated.
50
Over one-in-three direct care professionals are enrolled in public assistance, including food and
nutritional assistance, cash assistance, and/or Medicaid.
51
Full-time employment in the direct-care eld
is often unsustainable due to the low wages, limited benets, and demanding work. Direct care
professionals may limit their hours in part to retain public assistance, referred to as a benets cli. To the
extent allowable within federal guidelines, states can implement a phased approach to help workers
transition o certain public assistance programs as income increases.
The direct care sector is also challenged by low reimbursement rates. A 2021 State of the Workforce
Survey Report found an employers’ inability to increase hourly pay was a signicant barrier to recruitment
and retention. An estimated 73% of direct care professionals left their roles because of low pay.
Employers reported they need more funding to oer higher wages and benets to help them strengthen
their direct care workforce and serve more clients. Of surveyed employers, 76% had turned down clients
because they did not have enough direct care professionals to provide services.
52
Governor’s Task Force on the Healthcare Workforce Report Page 24 of 73
State investments in direct care
► In August 2024, Governor Evers directed DHS to invest $258 million in a minimum fee schedule for
home and community-based services, eectively raising wages for direct care professionals. This
investment will help make sure these caregivers receive the support and fair compensation they
deserve.
► In 2023, the Governor leveraged ARPA funds to launch a new initiative to train over 10,000 certied
direct care professionals. This initiative expands on the successful WisCaregiver Careers program
which trains certied nurse aides and creates a career ladder for caregivers.
53
► The Governor allocated $30 million in ARPA funds for Provider Innovation Grants to support 158
organizations that provide home and community-based services.
► Recipients included Capri Senior Communities in Ozaukee County, which launched a four-day work
week at two pilot locations. Capri saw a 1,500% increase in caregiver applications after launching
the program.
54
► The Governor approved nearly $500 million in increases for long-term care and direct care
professionals as part of the 2023-25 state budget, including:
o A ve percent rate increase for Medicaid home and community-based services;
o $146 million for nursing home support services;
o $43 million for nursing home incentives and other increases;
o $38 million for Family Care reimbursements; and
o $38 million for personal care reimbursements.
55
► In 2019, the Governor signed Executive Order #11, establishing the Governor’s Task Force on
Caregiving. Many of the resulting recommendations were incorporated in state budget proposals and
pandemic-era relief programs.
56
► In 2021, Governor Evers allocated $20 million in ARPA funds for the Worker Advancement Initiative.
57
Several grant projects, including those oered through the Workforce Development Board of South
Central Wisconsin and Fox Valley Workforce Development Board, helped individuals gain their
certied nursing assistant license and gain employment. Another recipient, the Southwest
Wisconsin Workforce Development Board, utilized Worker Advancement Initiative funds to oer
scholarships to phlebotomy and certied nursing assistant students.
► Governor Evers allocated more than $128 million in ARPA funds for Workforce Innovation Grants to
encourage regional solutions to workforce challenges.
Wisconsin Community Action Program Association received $4.9 million to, in collaboration with 10
partners, upskill people into entry-level healthcare roles. Program participants are immediately
employed in the nursing eld following graduation.
Governor’s Task Force on the Healthcare Workforce Report Page 25 of 73
Allied health
Background
Allied health is dened as people who have received a certicate or degree in a healthcare eld.
58
Examples include (but are not limited to) medical assistants, surgical technologists, dental assistants,
pharmacy technicians, dental hygienists, respiratory therapists, and radiology technicians. Nationwide,
an estimated ve million allied health professionals work in more than 80 occupations and represent
60% of healthcare workers.
59
Projected Employment of Allied Health Occupations, Wisconsin
60
Occupation
Employment
2020
Projected
Employment
2030
Percent
Change
2020 Annual
Median Wage
Where do they
work?
Medical
assistants
13,400
15,000
12%
$38,300
Hospitals,
physicians’ oices,
outpatient care
centers, other
Pharmacy
technicians
8,400
9,000
8%
$35,200
Pharmacies, drug
retailers, hospitals
Dental assistants
6,100
7,000
14%
$39,800
Dentists’ oices
Dental hygienists
4,800
5,400
15%
$71,100
Dentists’ oices
Radiologic
technologists
4,700
4,900
5%
$61,700
Hospitals,
physicians’ oices,
medical and
diagnostic labs,
outpatient care
centers
Surgical
technologists
2,600
2,700
4%
$56,600
Hospitals, oice of
dentists, physicians’
oices
Radiation
therapists
900
960
6%
$78,200
Hospitals,
physicians’ oices,
medical and
diagnostic labs,
outpatient care
centers
Governor’s Task Force on the Healthcare Workforce Report Page 26 of 73
Challenges
Allied Health Professional Challenges
61
Category
Challenges
Financial
► Low wages
► Limited benets
► High cost of child care, transportation, and other personal needs
Educational
► Faculty shortages
► Limited clinical sites
► High cost of education (tuition, fees, personal needs)
Workplace
► Lack of career and professional development opportunities
► Burnout and poor job satisfaction
► Lack of task diversity, schedule exibility, and recognition
Demand for allied health professionals is projected to increase given the state’s aging population,
technological advancements in healthcare, and a growing focus on preventive health measures.
Potential allied health professionals face challenges in nding educational opportunities. Many of these
workers are trained at technical colleges, which oer certicate and degree programs in a variety of
health-related elds and in every region of the state. However, technical colleges in Wisconsin report that
they struggle to recruit and retain faculty for allied health programs. Having fewer educators limits
enrollment capacity, which forces many programs to turn down qualied applicants. Technical colleges
also report the high costs of child care and transportation limit students’ ability to continue their
education.
Once employed, high turnover rates due to low wages, limited benets, and poor job quality are a
challenge for employers. One study reported an annual turnover rate for medical assistants of 59%, with
an estimated cost of $14,200 per turnover, nearly 40% of the average annual salary for the profession.
62
Governor’s Task Force on the Healthcare Workforce Report Page 27 of 73
State investments in allied health
► In 2024, Governor Evers signed 2023 Act 87, authorizing the licensure of dental therapists to help ll
gaps in care where there are shortages of dentists.
63
► The Governor approved a one-time increase of $5 million to the Allied Health Professional Education
and Training Grant Program in the 2023-25 state budget.
o Grants are provided to hospitals, health systems, and educational entities to help train allied
health professionals.
o Priority is given to applicants in rural areas.
64
► Wisconsin's record-breaking youth and registered apprenticeship programs train job seekers for
medical careers and help employers sustain a pipeline of skilled workers.
o Participation in the health sciences youth apprenticeship program area has more than tripled
over the past 10 years. Program pathways include training toward careers as dental assistants,
medical assistants, pharmacy technicians, and radiologic technicians.
o Similarly, registered apprenticeship oers an ever-expanding number of healthcare pathways
including opportunities for medical assistants, pharmacy technicians, caregivers, ophthalmic
assistants, and more currently in development.
► In 2021, the Governor allocated $20 million in ARPA funds for the Worker Advancement Initiative. One
grantee, Employ Milwaukee, utilized the funding to oer training for pharmacy technician
certication. The individuals came from high poverty and high unemployment zip codes and received
an hourly stipend while in training.
65
Governor’s Task Force on the Healthcare Workforce Report Page 28 of 73
Other healthcare professions
Other healthcare areas include oral health, emergency medical
services (EMS), doulas, community health workers, primary
care, and physicians.
Dentists and oral health
Wisconsin has an estimated 2,000 dentists, with an estimated
80 job openings per year.
66
Of particular concern are dentists
who serve low-income populations and rural areas.
► The majority (75%) of dentists are aged 40 or older, and
nearly 35% are 60 or older.
► Nearly 30% plan to leave in the next 5 years, including 34%
of Medicaid providers.
► Only 29% of dentists report serving Medicaid members.
67
► Nearly half of Wisconsin counties (34 out of 72) are
federally designated dental care shortage areas.
68
Recruiting dentists to rural and underserved communities is
challenging due to high student loan debt and low Medicaid
reimbursement rates. Dental school graduates have an average
debt of $305,000,
69
compared to an annual median wage of
$163,700.
70
While signicant progress has been made in recent budgets to increase rates, the availability
of dental services remains an issue.
None of county is shortage area
Part of county is shortage area
Whole county is shortage area
Source: data.HRSA.gov, April 2024
Governor’s Task Force on the Healthcare Workforce Report Page 29 of 73
State investments in oral health
► In 2024, Governor Evers signed a package of bills to bolster the oral health workforce:
o 2023 Act 87, to authorize licensure of dental therapists;
o 2023 Act 88, to ratify and enter Wisconsin into the Dentist and Dental Hygienist Compact,
providing the ability to become eligible to practice in compact states;
o 2023 Act 90, to establish scholarships for Marquette University School of Dentistry students who
practice in shortage areas; and
o 2023 Act 91, to allow those with dental insurance coverage to assign reimbursement for dental
services to a specic dental provider.
► The 2023-25 state budget further invested in the oral health workforce by allocating:
o $20 million for oral healthcare workforce initiatives administered by technical colleges;
o Nearly $11 million to assist with the cost of construction and equipment upgrades for the
Marquette University School of Dentistry;
o $5 million to the Marquette University School of Dentistry to establish a general dentistry
residency program and help new dentists develop skills with medically complex and special-
needs patients; and
o Nearly $5 million to help expand the Children’s Hospital Dental Center, which will improve
access to dental care for kids and reduce the burden on the state’s urgent and emergency care
departments.
71
Doulas, community health workers, and other community-focused professions
Doulas, community health workers, and other community-focused professions help licensed
practitioners operate at the top of their licenses by providing supportive services to patients.
Doulas provide childbirth education and support services, including emotional and physical support
during pregnancy, labor, birth, and postpartum. In Wisconsin, doulas may choose to be certied by
private or nonprot organizations, but there is no state certication and the legislature has repeatedly
rejected Medicaid coverage for doula services. Other states have created a certication process for
doulas to facilitate Medicaid reimbursement.
72
Doulas play an important role in reducing the burden on
other maternal health providers. Doula-assisted mothers were four times less likely to have a low-birth-
weight baby and two times less likely to experience a birth complication involving themselves or their
baby.
73
Wisconsin has an estimated 500 community health workers, dened as frontline public health workers.
In general, these workers provide nonmedical services such as housing referrals, nutritional mentoring,
stress management, and other wraparound supports. These workers earn an annual median wage of
$45,400 and are employed by community-based organizations, local public health departments, health
systems, schools, and health clinics.
74
Health systems and plans, including United Healthcare, support
these services.
75
Although the state does not have a formal certication, there are three nationally
certied training programs that provide core competency training. Medicaid is not currently authorized to
reimburse for stand-alone services provided by these workers.
Governor’s Task Force on the Healthcare Workforce Report Page 30 of 73
Public health workers also include health oicers, maternal and child health managers, health
educators, preparedness sta, public health nurses, public health physicians, and other professionals
employed by 84 local health departments and 12 Tribal health centers throughout the state.
76
According
to DHS, governmental public health workers earn signicantly less than their counterparts outside of
government. For example, a governmental public health nutritionist in Wisconsin earns an average of
$58,500 compared to an average of $68,500 for other nutritionists. About half of public health workers
report being somewhat or very dissatised with their pay. Over 40% of public health workers indicate an
intent to leave their positions in the next ve years, and 25% indicate an intent to leave the public health
eld entirely.
Certied peer specialists and certied parent peer specialists are people with lived experiences who are
trained to support the recovery of peers from mental health and/or substance use challenges. When
people with behavioral health challenges talk with someone who has rsthand recovery experience, they
are more likely to experience a positive recovery outcome. Peer support specialists are employed by
mental health and substance use providers throughout the state. Certication is awarded by DHS after
successful completion of a training course and an exam.
Community-Focused Health Profession Challenges
77
,
78
Category
Challenges
Financial
► Low wages
► Limited benets
► Lack of insurance coverage and reimbursement
Educational
No formal certications or licenses
Workplace
► Skepticism and disrespect from other healthcare professionals
► Unpredictable schedules and high administrative burdens, particularly for
doulas
Governor’s Task Force on the Healthcare Workforce Report Page 31 of 73
State investments in community-focused professions
► The Governor has proposed funding Medicaid coverage of community-focused providers through
several budget initiatives:
o Funding doula services would have beneted approximately 1,145 women at an estimated cost
of $1.3 million in 2024-25, as part of the Governor’s proposed healthy women, healthy babies
initiatives.
o Funding community health workers would have helped employ 275 workers at an estimated cost
of $19.2 million per year.
o Funding peer support services would have cost $3.7 million in 2024-25 and supported those in
recovery from mental illness or substance use disorder.
79
► The Governor invested $16 million in ARPA funds to improve maternal and child health in
collaboration with the Medical College of Wisconsin’s Advancing a Healthier Wisconsin Endowment
and the University of Wisconsin.
o The investment helped train doulas, midwives, and community health workers.
o In addition, the ARPA-funded Advancing Equity in Maternal and Child Health Grant Program
prioritized perinatal workforce development.
80
► In addition, the Governor has proposed changing eligibility requirements for public assistance
programs to address benet clis. These proposals would help workers increase workforce
participation without losing access to child care and other benets. To date, these proposals have
not been adopted by the legislature.
The Governor’s 2023-25 state budget proposal would have provided a Wisconsin Shares earnings
disregard for direct care workers.
81
► During the pandemic, the Governor proposed allocating $100 million temporary assistance for needy
families (TANF) for a temporary expansion of Wisconsin Works (W-2), Wisconsin Shares Child Care,
and other public assistance programs to support the essential workforce.
82
Governor’s Task Force on the Healthcare Workforce Report Page 32 of 73
EMS
Wisconsin has an estimated 5,800 emergency medical technicians and paramedics, with an estimated
384 job openings per year. The annual median wage for emergency medical technicians is $36,200 and
$47,300 for paramedics.
83
Turnover rates nationally range from 12% to 28%, with dissatisfaction with pay
and benets reported as a common reason for leaving.
84
Many EMS agencies are volunteer staed,
leading to insuicient resources to maintain 24/7 ambulance coverage. Wisconsin faces particular
challenges with recruiting and retaining EMS workers in rural areas:
► 41% of EMS agencies did not have adequate staing to respond to a request for an ambulance.
► 78% responded to another agency’s request for mutual aid due to a lack of staing.
► 41% operate with six or fewer sta members providing 80% of staing hours.
85
State investments in EMS
► The Governor approved a $22.8 million increase in EMS assistance in the 2023-25 state budget.
► In 2022, the Evers Administration invested more than $69 million in EMS providers.
o Investments included $32 million in ex grants to support 442 EMS providers in nearly every
Wisconsin county.
o The Administration also allocated $8 million to expand the EMS funding assistance program,
which helps train EMS personnel.
86
► DHS recently launched an EMS media campaign to recruit new EMS professionals by connecting
interested candidates with local training centers.
► DHS also created an application specic to people seeking certication based on military training.
This application pathway will help veterans and service members expand on their military education,
training, and experience to serve in EMS.
87
Governor’s Task Force on the Healthcare Workforce Report Page 33 of 73
Primary care and physicians
Wisconsin has an estimated 17,900 licensed physicians and will need an estimated 2,300 additional
physicians by 2035.
88
Rural areas of the state already have a signicant primary care shortage, and
1,088,000 residents live in federally designated shortage areas.
89
Almost 28% of the state's population is
rural, but only around 11% of Wisconsin's physicians practice in rural areas.
90
Recent data suggests
restrictions on reproductive healthcare may contribute to workforce challenges. For example,
applications for obstetrics and gynecology residency programs at Wisconsin medical schools decreased
by 10% and for all specialties by 6% during the last year.
91
Physician Challenges
92
,
93
,
94
,
95
Category
Challenges
Financial
Gap in compensation between primary care and specialists
Educational
Education and training infrastructure inadequate to meet demand
Workplace
► Burnout due to administrative burdens
► Burden of managing mid-level health professionals, such as physician
assistants and nurse practitioners
State investments in primary care and physicians
Governor Evers approved signicant supports for physicians in the 2023-25 state budget:
► $132.7 million in Medicaid rate increases for primary care providers;
► $15.4 million in Medicaid rate increases for emergency physicians; and
► $1.9 million to expand graduate medical training programs.
96
Governor’s Task Force on the Healthcare Workforce Report Page 34 of 73
Appendix A: Full List of Recommendations
Education and training
1a. Support faculty: Health professions educator incentive programs
Lead entities
Higher Educational Aids Board, Universities of Wisconsin, Wisconsin Technical College System
Background
Faculty shortages are a top challenge impacting workforce development in the health sector. A 2016
analysis of the nursing workforce projected that one third of faculty are expected to retire by 2025.
97
Recruiting healthcare professionals into faculty roles is challenging for many reasons; a top issue is the
total compensation package for educators salaries are typically lower than that which could be achieved
through clinical roles.
98
Outside of Wisconsin’s recent initiative to support nursing faculty (the Nurse
Educators Program), there are no current state scholarship or loan repayment incentives to support
faculty development among health professional programs. In fact, the remaining incentives target
practicing clinical professionals (such as the Wisconsin Health Professions Loan Assistance Program
and the Rural Provider Loan Assistance Program), which may further discourage health professionals
from seeking educator roles.
99
Challenges to recruit and retain health professional educators are most evident in Wisconsin’s nursing
and allied health programs. State sponsored loan repayment and scholarship programs for faculty may
be helpful to incentivize qualied nurses and allied health professionals to achieve the education
required to serve in these positions.
The following training programs have been prioritized for inclusion:
► Allied health
► Behavioral health
► Dental professions (dentistry, dental hygiene, dental assisting)
► Nursing
Key considerations
Wisconsin’s Nurse Educator Program has been a successful model of scholarship and loan repayment
strategies to support the health professions’ educator workforce.
100
This program includes scholarships
to encourage pursuit of the education required to serve as faculty (degree program and fellowship
program), and loan repayment for recently hired full-time nurse educators (faculty hire program).
Under the current program, master- and doctor-level nursing students are eligible to apply for a 100%
forgivable loan if they are U.S. residents of a permanent type with a Wisconsin address who are enrolled
in a participating UW school or private, non-prot, post-secondary educational institution in the state;
and who intend to practice full-time as a licensed nurse educator in Wisconsin for three consecutive
years.
101
New full-time nurse faculty are eligible for loan repayment if they are a U.S. citizen and fulll a
three-year teaching requirement.
102
Many nurse faculty teach part-time and practice part-time, so the
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current program may not be available to all interested nurse educators. Further, the current program is
restricted to nurse educators.
Other states, such as Colorado,
103
Georgia,
104
Illinois,
105
Minnesota,
106
and Washington
107
have developed
similar initiatives to support faculty directly. Relatedly, the federal government has a program that
partners with awarded schools of nursing to oer low-interest loans for nurses pursuing education to
become nurse faculty.
108
Schools of nursing should seek participation in this federal program to maximize
benets available to Wisconsin’s nurse faculty. Additionally, a federal Faculty Loan Repayment Program
is available to support faculty in nursing and allied health (among other professions) who come from
economically or environmentally disadvantaged backgrounds.
109
Coordinated marketing of this
opportunity would maximize the use of any related state investment.
Recommendation
Expand the Nurse Educators Program to a health professions educator program that will include
additional qualifying roles (allied health, behavioral health, dental professions, nursing). In addition,
expand eligibility to include both full- and part-time faculty.
1b. Support faculty: Compensation for health professions faculty
Lead entities
Universities of Wisconsin and Wisconsin Technical College System
Background
State investment in our public higher education entities is vital to Wisconsin’s economy and our ability to
recruit, retain, and train our future workforce. Faculty shortages are a top workforce challenge,
specically in the health professions education sector. Recruiting healthcare professionals into faculty
roles is challenging for many reasons; a top issue is that the total compensation package for educator
salaries are typically lower than that which could be achieved through clinical roles.
110
For example, one
study showed that an average assistant professor of nursing in Wisconsin earned $73,200 compared to
salary averages of more than $100,000 for master’s degree nurses serving in clinical settings.
111
,
112
Directly addressing faculty compensation is another strategy to support recruitment and retention of
faculty in health professions education programs. Given that salary is considered one of the top
challenges contributing to faculty shortages, initiatives to support marketable compensation for health
professions faculty are likely to address the root cause.
113
Without suicient faculty, the health professions education pipeline may be restricted, resulting in
insuicient training infrastructure and reduced capacity to train the next generation of health
professionals. Although additional compensation for faculty is a critical piece of the pipeline
infrastructure, it is important to note that this solution should be paired with other strategies to maximize
eectiveness. For example, addressing compensation will only be eective if there are enough health
professionals trained with the minimum educational requirements to serve in these roles (implying the
need for this strategy to accompany loan repayment or scholarship to incentivize program completion).
Additionally, strategies to support faculty should be implemented alongside initiatives to increase the
Governor’s Task Force on the Healthcare Workforce Report Page 36 of 73
eiciency of education (while also supporting quality), such as facility infrastructure, simulation labs,
and other education innovations.
Key considerations
Many health professions educators teach part-time and practice in clinical settings part-time, so it is
recommended that part-time faculty are included in salary adjustments. This will enable qualifying
health professionals to contribute to health services for Wisconsinites while also contributing to training
the next generation of professionals for the state.
Although this recommendation prioritizes Wisconsin’s public college systems, private institutions are
recognized as important contributors to the healthcare workforce pipeline. Private institutions should
explore strategies to support health training program faculty compensation through the development of
internal review processes, market comparisons, and strategic decision-making for appropriate initiatives
to address faculty staing and compensation packages holistically.
Recommendation
Increase state funding for higher education. Schools could use a portion of this funding for educator
compensation to address the disparity between educator and clinical practitioner salaries for both full-
and part-time faculty.
2a. Strengthen clinical training and experience: Support preparation of clinical behavioral
health counselors (Qualied Treatment Trainee Grants)
Lead entity
Department of Health Services
Background
A qualied treatment trainee is a person with a master’s degree in social work, counseling, or marriage
and family therapy who seeks to obtain a professional license and become a licensed clinical social
worker, a licensed professional counselor, or a licensed marriage and family therapist.
To meet licensure requirements, these trainees must complete 3,000 direct service hours provided under
the supervision of a licensed clinician. The grant program has three main goals: to increase the number of
trainees available, to support supervisory capacity for trainees, and to increase training on community-
based behavioral health services for underserved populations.
The Qualied Treatment Trainee Grant Program is intended to address workforce shortages impacting the
behavioral health system. Grants are awarded to DHS-certied clinics, hospitals, federally qualied
health centers, or ailiates of a hospital or healthcare system. The grants are used by recipients to
support employment experience and clinical supervision for qualied treatment trainees and can be
used to fund supervision, training, salaries, and benets.
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Key considerations
This grant program helps train Wisconsin’s behavioral health workforce and is key to expanding the
number of people trained to address the state’s behavioral health crisis. These emerging professionals
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help address the workforce shortage by providing services while working towards licensure. At the same
time, it is challenging for trainees to nd paid positions to fulll their 3,000 service hours. Employers
often cannot bill insurance for trainee-provided services or for supervisory time.
Interest in the program is high, with 274 agencies or people applying for funding last year. In 2022,
Governor Evers authorized $7.6 million in one-time ARPA funds for the program. This included $5 million
for about 200 behavioral health employers to hire and supervise at least one trainee, $2 million for
stipends of up to $5,000 per year for 200 unpaid trainees, and $620,000 to expand the network of
agencies which sponsor trainees. This one-time supplement will expire in 2024, reducing funds for the
program to $750,000 in state funds annually despite continued demand.
Without continued support for this program, emerging behavioral health professionals will experience
diiculty meeting licensure training requirements and the state could see a reduction in the number of
emerging professionals that support behavioral health services.
Recommendation
Expand ongoing state funding for the Qualied Treatment Trainee Grant Program to support the emerging
behavioral health workforce.
2b. Strengthen clinical training and experience: Support clinical partnerships and preceptors
Lead entities
Universities of Wisconsin and Wisconsin Technical College System
Background
Clinical training is an important part of the educational process for most healthcare occupations,
including allied health, nursing, and behavioral health. Most health professional education programs rely
on clinical training partnerships with healthcare employers and licensed healthcare professionals.
These partnerships support placement of students in clinical sites (clinical placement) where licensed
professionals serve as clinical preceptors, helping to supervise and train students as they learn to work
with patients. A preceptor is an experienced clinician who supervises students during clinical training
and facilitates the application of theory. Clinical preceptorship typically involves the integration of
students into a licensed professional’s routine care of patients for a specied period of time.
The level of integration and specic contribution by students varies by health professional education
program and the students’ stage of training. For example, students may observe a licensed professional’s
interaction with patients, or students may engage in some aspect of patient care under the supervision
and guidance of a license profession. Clinical training requirements, including length of training and level
of integration and/or contribution of student, vary by health professional education program, generally
based on national accreditation standards.
Key considerations
It takes time and administrative support for health professional education programs to place students in
clinical sites. Once a clinical placement has been secured, the sponsoring healthcare organization and
licensed health professionals invest time and resources into training. In some cases, productivity of
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licensed professionals may be impacted by precepting. Most healthcare organizations cannot bill
insurers for training students, and many licensed professionals do not receive additional compensation
for their time serving as preceptors. Impacts to clinical productivity and lack of incentives are likely
contributing to the shortage of health professionals willing to serve as clinical preceptors. Incentivizing
healthcare professionals to serve as preceptors can help increase capacity within Wisconsin’s post-
secondary training pipeline.
Funds would help Wisconsin’s post-secondary schools develop and sustain partnerships with healthcare
employers in the state and create a pipeline for student training opportunities. Schools would be
responsible for designing and maintaining partnerships to connect students with high-quality placement
sites and clinical experiences.
Arizona,
115
Virginia,
116
and Washington
117
have developed preceptor programs which provide awards to
previously uncompensated professionals serving as a clinical preceptor to qualifying health profession
students.
Recommendation
Provide funding to institutions of higher education to develop or strengthen clinical training partnerships
with healthcare employers and professionals. Funds may be used to address organizational and
individual losses in productivity associated with clinical training, including strategies such as preceptor
compensation.
2c. Strengthen clinical training and experience: Expand experiential learning (simulation)
Lead entities
Universities of Wisconsin and Wisconsin Technical College System
Background
Health science education has traditionally emphasized clinical experiences in healthcare settings to
oer practical training for students. However, the integration of simulation-based learning, also known as
experiential learning, has gained signicant momentum in recent years and the technology continues to
evolve quickly.
For example, all 16 technical colleges utilize various forms of simulation, including simulation manikins,
virtual reality, and standardized patients. Standardized patients are specially trained people who act as a
live patient. As an alternative, virtual reality is a newer form of simulation and is being adopted by
colleges across the country. In 2023, the Wisconsin Technical College System (WTCS) Intercollegiate
Partnership for the Alignment of Healthcare Simulation was developed to align healthcare simulation
across all 16 colleges. By incorporating current, evidence-based standards, the alignment aims to
enhance the simulation experience for both faculty and students, thus ensuring a higher level of
consistency and quality.
Key considerations
Funds are needed to expand these forms of experiential learning and to train instructors on how to use
simulations within their programs. Simulation provides a safe and controlled environment for students to
Governor’s Task Force on the Healthcare Workforce Report Page 39 of 73
practice clinical skills without putting real patients at risk. Students can learn from their mistakes and
receive constructive feedback. Through repetitive practice, students can improve their clinical decision-
making, critical thinking, and problem-solving skills. This instills a culture of patient safety from the
beginning of their educational journey and facilitates the integration of theoretical knowledge with
practical applications, bridging the gap between classroom learning and clinical practice.
Simulation can supplement limited clinical placement opportunities, which are often a bottleneck in
health science education. It provides a consistent and standardized learning experience for all students,
regardless of the availability of clinical sites. Simulation allows for the controlled introduction of specic
learning objectives, ensuring students are exposed to essential skills and scenarios.
118
Virtual reality (VR) provides immersive environments that mimic real-life clinical settings, allowing
students to practice and hone their skills in a safe and controlled environment. Through interactive
scenarios, students engage in active learning, which is more eective than passive learning. They can
make decisions, see the outcomes of their actions, and learn from their mistakes without the risk of
hurting anyone. VR allows for repeated practice of procedures and techniques, which is crucial for skill
mastery. Students can perform the same procedure multiple times until they achieve prociency. VR can
simulate complex and rare clinical scenarios that students might not encounter during regular clinical
rotations. VR can be easily scaled to accommodate many students without proportional increases in
physical resources or instructor time. This scalability makes it a cost-eective solution for institutions
with large programs. VR facilitates remote learning, making health science education accessible to
students who may not be able to attend in-person class due to geographical, nancial, or personal
constraints. It allows students to engage in learning activities at their own pace and on their schedule. VR
can be tailored to meet the needs of diverse learners, including those with disabilities. By providing
customizable learning experiences, VR ensures all students have equal opportunities to succeed.
By providing immersive, standardized, and repetitive training opportunities, simulations enhance learning
experiences and skill acquisition. Embracing VR technology in health science education is a forward-
thinking approach that can lead to better-prepared students and, ultimately, improved patient care.
Recommendation
Increase funding for institutions of higher education to expand and sustain simulation labs and other
experiential learning tools as a supplement to classroom and clinical experience.
3a. Reduce barriers to training: Wraparound services programs for students
Lead entities
Universities of Wisconsin and Wisconsin Technical College System
Background
Health workforce training programs frequently include a combination of classroom learning (delivered in
person or online) and clinical experience. This requires students to receive training on campus, through
online formats, and at a variety of clinical locations (such as hospitals and health clinics). To complete
this training successfully, students may require reliable transportation, technology (such as personal
laptops or access to internet), child care (if applicable), and other services and supports (such as
Governor’s Task Force on the Healthcare Workforce Report Page 40 of 73
tutoring, mental health, career counseling, etc.). In some instances, students may struggle with access
to the resources and services required for training. Wraparound services to support students with these
resources and services can remove barriers and help them achieve their educational goals.
Transportation: Transportation is required for students to attend classes and clinical rotations. Reliable
transportation may be a costly investment for students. Transportation costs may include vehicle
ownership and maintenance, parking, bus, or public transportation passes. A recent study estimated that
transportation costs account for nearly 20% of the cost of attending college for commuting students
(those not living on-campus) and over one quarter of students reported missing classes due to the lack of
reliable transportation.
119
Technology: Students need reliable access to technology to participate in online learning, complete their
assignments, and commute to clinical rotation sites (many times in rural areas). Inadequate technology
access is associated with lower student outcomes (challenges meeting deadlines, completing
coursework, and lesser perceptions of success).
120
Child care: More than one in ve college students are parents.
121
Only an estimated 35% of Wisconsin’s
public two-year institutions oer campus-based child care.
122
The scarcity of quality child care along with
the expense is a barrier to people seeking post-secondary education and creates logistical challenges for
students that may also be working and/or completing clinical training during non-traditional hours (such
as evening or overnight shifts). There are resources that are provided such as federal grant funding that
can oset the cost of the on campus child care center or provide vouchers to child care centers in the
community. In addition, some schools support the student parent/caregiving population by providing on
campus drop o child care options that allow a student to attend class or complete homework, providing
baby needs closets, family friendly campus study spaces, and support groups. While outside the scope
of this task force, the child care provider shortage aects the healthcare workforce and additional state
support should be provided to grow the supply of child care providers and ensure quality, aordable care.
Other supports: There are several other supports that are known to have positive eects on student
outcomes, including access to mental health services,
123
tutoring, regular academic counseling
sessions, books or materials costs, and more. To address food scarcity, some schools have a food pantry
on campus, some of which include recipes and slow cookers for the students. In addition, some schools
have career closets which carry professional clothing and access to funding to assist students in getting
uniforms or equipment necessary for their respective program area. These supports can be organized on
a student-by-student basis, to certain programs, or made available to all students.
Key considerations
Access to wraparound services is known to increase the full-time enrollment of students (thereby helping
them achieve their degree and enter the workforce faster) and increase their likelihood to complete their
degree program.
124
Wisconsin’s schools may already provide some of these services. While these school-
sponsored supports are essential, the needs among students are signicant and they do not have the
capacity or resources to serve as direct providers of all the services and resources students may need. To
complement these services, some schools may also invest in partnerships with organizations within the
Governor’s Task Force on the Healthcare Workforce Report Page 41 of 73
community that are better positioned to provide the wide range of supports that students need, which
may include, but is not limited to, the following examples:
► Collaborations with local food pantries and community supported agriculture (CSA) providers to
expand access to aordable, healthy food options for students experiencing food scarcity.
► Referrals to community mental healthcare providers through memorandums of understanding and
access to virtual mental health providers to supplement the in-person services available.
► Partnerships with local child care providers.
► Sharing on-campus spaces with community service providers to improve accessibility for students.
Recommendation
Fund wraparound services programs, administered by state institutions of higher education, to address
barriers to education such as transportation, technology, and child care.
3b. Reduce barriers to training: Train direct care professionals and nurse aides through
WisCaregiver Careers
Lead entity
Department of Health Services
Background
In 2018, DHS launched WisCaregiver Careers to help bolster the certied nurse aide workforce in skilled
nursing facilities. In 2023, Governor Evers expanded WisCaregiver Careers using one-time federal funds
to increase the number of certied direct care professionals in home and community-based settings.
125
The program has primarily been supported through limited-term federal funds. However, in 2023, the
legislature allocated $2 million in one-time state funds for the CNA component of the program. Both the
nurse aide and direct care certication components are scheduled to end in June 2025 unless additional
funds are provided.
Certied direct care professionals
Direct care professionals provide personal care and supportive home care to older adults and people
with disabilities. It is often the rst step on the caregiving career ladder from direct care professional to
certied nurse aide, licensed practical nurse, and registered nurse.
To be certied as a direct care professional, candidates must complete a 30-hour online training program
currently oered in English and Spanish. WisCaregiver Careers participants receive free online training
and certication testing, join a one-stop workforce platform and provider registry,
126
and earn up to a
$500 bonus upon successful course completion and employment with an eligible employer.
Since DHS began to certify direct care professionals in July 2023, 521 people have completed the training
and 380 are employed in the eld. An additional 202 people have completed the training and are waiting
to take the test. DHS maintains a map showing the location of registrants and certied direct care
professionals.
127
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Certied nurse aides
Certied nurse aides in Wisconsin must complete a minimum 75-hour state-approved training program
and pass a competency evaluation. There is no minimum age requirement, although employment rules
for minors apply, such as work permit requirements and restrictions relating to mechanical lifts.
WisCaregiver Careers follows an employment-rst model, in which trainees work while enrolled in the
training and certication process. Participants apply directly to a chosen employer, with application
assistance from the program, and can begin work while completing the training and certication process.
WisCaregiver Careers is a public-private partnership administered by DHS in partnership with UW-Green
Bay, the Wisconsin Health Care Association, and LeadingAge Wisconsin.
128
New nurse aide hires must
pass a nurse aide competency exam within 120 days of the start of full-time employment as a nurse
aide.
129
Skilled nursing facilities that participate in WisCaregiver Careers are then reimbursed for training
and testing costs (about $700 per certied nurse aide) and retention bonuses ($500 per certied nurse
aide). Since July 2022, over 3,100 participants have been trained and certied as certied nurse aides
through WisCaregiver Careers.
Key considerations
The goal of WisCaregiver Careers is to provide training and education for paid caregivers, including direct
care professionals and certied nurse aides, and a pathway for career advancement. Without a plan for
continued state funds, training costs will revert to employers in mid-2025 and workers will no longer
receive state-sponsored recruitment or retention bonuses. Wisconsin needs more caregivers. In January
2019, Wisconsin had 56,900 certied nurse aides. By December 2020, that number had plummeted to
48,400. While the profession has recovered slightly, Wisconsin only had 51,900 certied nurse aides as of
March 2024.
130
A survey of 805 long-term care providers reported a 28% vacancy rate for nurse aides and
direct care professionals.
131
Further, the need for nurse aides is expected to increase as the state’s
population ages.
WisCaregiver Careers is cited nationally as a best practice for supporting healthcare workers. Idaho, New
Hampshire, and North Carolina have launched programs modeled after the program. The National
Governors Association recommends states implement similar programs to “encourage entry into the
direct care workforce and identify and support pathways that will remove barriers and facilitate transition
to higher skilled jobs with better wages.”
132
A cost-benet analysis by the UW calculated that the certied
nurse aide component produced a net benet to the state of $5.8 million over two years (with estimated
costs of $1.3 million and benets of $7.1 million). Benets included increased participant productivity,
avoided costs of turnover, and avoided costs of low-quality care.
133
DHS is currently working with the UW
to evaluate the direct care certication component.
Recommendation
Sustain and expand state funding for WisCaregiver Careers to support training, recruitment, and
retention costs for direct care professionals and certied nurse aides.
Governor’s Task Force on the Healthcare Workforce Report Page 43 of 73
3c. Reduce barriers to training: Reduce GED/HSED costs for students
Lead entity
Department of Public Instruction
Background
The general education development (GED) tests measure competency in math, science, social studies,
and language arts. Each of the four sections costs $39.75 ($159 for all four required tests). Wisconsin’s
version has four additional subject areas called the high school equivalency diploma (HSED). HSEDs
include additional requirements of health, civic literacy, employability skills, and career awareness. The
GED and HSED are accepted by most employers, technical colleges, universities, and the military. In
2023, 2,905 Wisconsinites earned a HSED and 1,840 earned a GED.
Key considerations
► Funding for alternative education is an important aspect of economic development as it results in
increased access for learners from underserved communities to earn a high school diploma.
► There are 266,497 adults in Wisconsin without a high school credential.
134
In 2022-23, 5,268 students
(1.4%) dropped out of high school.
135
► Wisconsin has 2,762 high school students ages 17-18 in a GED alternative pathway, resulting in
districts covering the costs of GED testing.
Recommendation
Increase funding for the GED/HSED and alternative education pathways oerings for school-aged and
adult students and subsidize testing costs. This would benet school districts and increase student
access to this high school credential and post-secondary healthcare career opportunities.
Consider re-establishing an alternative education grant program. The program was appropriated $5
million annually beginning in 2001 and was eliminated in 2017. Grants were available to school districts
and consortia of school districts to develop programs for students at-risk of academic failure. This would
provide much needed resources to districts to ensure that students earn their high school diploma and
are prepared for post-secondary education, including healthcare career opportunities.
3d. Reduce barriers to training: Increase training grants for allied health professionals and
clinicians
Lead entity
Department of Health Services
Background
The primary care program under DHS administers two grant programs to support education and training:
the Allied Health Professional Education and Training Grant
136
and the Advanced Practice Clinician
Training Grant.
137
Governor’s Task Force on the Healthcare Workforce Report Page 44 of 73
Allied Health Professional Education and Training Grant Program
The goal of this grant is to increase the availability of quality education and training opportunities for
critical allied health positions. These grants may support education and training for a wide variety of
health professions that provide diagnostic, technical, therapeutic, or direct patient care and support
services to a patient.
Eligible applicants include:
► Hospitals, health systems, and educational entities that form healthcare education and training
consortia for allied health professionals.
► Priority is given to rural hospitals, health systems with at least one rural hospital or clinic, and rural
educational entities.
► Based on high need, priority is given to applications targeting behavioral health specialists and
technicians, mental health counselors and assistants, psychiatric aides and technicians, and
substance use counselors and counselors-in-training.
► Recipients must match the amount received (100% match) either in cash or through in-kind funding.
The maximum award amount is $125,000 per year.
Advanced Practice Clinician Training Grant Program
The goal of the grant is to expand the use of physician assistants and advanced practice registered
nurses to increase access to healthcare in rural areas. Grants may be used to expand existing training
programs or to develop new training programs.
Eligible applicants include:
► Hospitals, clinics, or an entity partnering with a hospital or clinic as a training site.
► Priority is given to hospitals or clinics in a city, town, or village with a population less than 20,000
people, or to clinical training programs that include rural hospitals and clinics as training locations.
Priority is given to hospitals or clinics developing new clinical training opportunities for advanced
practice clinicians.
► Recipients must match the amount received (100% match) either in cash or through in-kind funding.
The maximum award amount is $50,000 per year.
Key considerations
For the 2023-25 state budget, DHS expects to train 585 allied health professionals and 400 advanced
practice clinicians through the two grant programs.
The last state budget provided a one-time increase of $2.5 million per year for the allied health
professional program and expanded eligibility to include registered nurses. Unless additional state funds
are provided, this program will have a total budget of $500,000 per year starting in July 2025. The
advanced practice clinician program is currently allocated $500,000 per year.
Note: DHS has not been able to award the full amounts allocated for either program. Legal restrictions,
including the low limit per recipient, the high match rate, and parameters for applicant types have limited
the agency’s ability to spend funds.
Governor’s Task Force on the Healthcare Workforce Report Page 45 of 73
Recommendation
Modify the Allied Health Professional Education and Training Grant and the Advanced Practice Clinician
Training Grant Programs to allow for additional exibility. Increase funds to help DHS administer and
allocate additional grants.
4a. Expand apprenticeships and other learning opportunities: Additional state funding for
apprenticeship
Lead entity
Department of Workforce Development
Background
The Department of Workforce Development (DWD) administers the state's nationally recognized
apprenticeship programs, including youth apprenticeship for high school juniors and seniors and
registered apprenticeship for adults. Both are earn-while-you-learn models that oer participants a
competitive wage while they complete their education, which results in an industry-recognized
credential. Both programs have experienced record high apprentice and employer participation in recent
years. During the 2022-23 school year, 8,357 youth apprentices enrolled and 5,719 employer sponsors
participated. In 2023, 16,384 registered apprentices and more than 2,900 employers participated.
Wisconsin currently oers eight healthcare registered apprenticeships: medical assistant, registered
nurse, caregiver, sterilization technician, interventional cardiovascular technologist, paramedic,
pharmacy technician, and ophthalmic assistant. Youth apprenticeship oers the health science program
area, where students may be hired as a medical assistant, nursing assistant, pharmacy technician, or
dental assistant, or work in a medical oice or ambulatory or support services.
While apprenticeship is recognized as one of Wisconsin's strongest options for growing the healthcare
workforce, DWD is not able to fully take advantage of the growing interest and opportunities in its health
sciences apprenticeship programs due to limited sta capacity and barriers to participation. Registered
apprenticeships in healthcare are currently only available through seven employers, located in ve
counties.
The apprenticeship model requires experienced sta to mentor apprentices as they receive their training
on-the-job. While recognized to demonstrate a return on investment over time, the initial investment may
be cost-prohibitive for some healthcare employers to participate. Apprentices are paid while they receive
their instruction; however, instructional costs (i.e., tuition, fees, and books) and related license or exam
fees may still prevent some apprentices from being able to participate or successfully complete their
apprenticeships.
DWD currently oers on-the-job learning grants, funded by the U.S. Department of Labor, to help
subsidize the cost of training and wages that some employers, including those in the healthcare industry,
invest in their apprentices. DWD also administers the Apprenticeship Completion Award Program (ACAP)
to partially reimburse eligible apprentices or sponsors for the costs associated with an registered
apprenticeship. The apprentice or sponsor may be reimbursed a maximum of $1,000 or 25%, whichever
is less, for the tuition costs charged for an apprentice to participate in related instruction. As
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participation in the apprenticeship program has increased, so has the demand for completion award
program reimbursements.
Youth apprenticeship opportunities include uniform statewide curriculum guidelines, but the programs
are oered and administered locally by regional consortia. While youth apprenticeships have been a
successful youth employment training program in many schools throughout the state, approximately
25% of Wisconsin's school districts do not oer them. In addition, several of the state's largest school
districts oer them, but historically have had very low participation.
Although both Wisconsin's youth and registered apprenticeship programs have served as national
models, until recently, they have lacked a clear framework for students to transition from a youth to a
registered apprenticeship. Providing such a connection guides students toward meaningful careers and
helps employers ll their long-term workforce with skilled employees. The number and percentage of
new registered apprentices who previously participated in a youth apprenticeship program have steadily
increased each year since 2018; however, there are currently no opportunities to do so in the health
sciences eld.
Key considerations
► Increase the number of sta to run apprenticeship programs to facilitate greater outreach and attract
more aspiring healthcare workers into apprentice positions. Sta and related resources should be
distributed across the state to improve equity of access, prioritize geographic and industry need, and
expand eorts to target underserved youth.
► Provide funding for a healthcare-specic on-the-job reimbursement grant program to allow DWD to
establish criteria that provides nancial incentives to employers to participate in sponsoring
registered apprenticeship programs designed to meet their workforce needs.
► Support local groups and sponsors who share responsibility in expanding opportunities to bridge
youth apprenticeships to registered apprenticeships, as they are key in building relationship bridges
between schools, students, job seekers, and employers.
► Invest in staing and information technology infrastructure to allow for more strategic analysis and
improvement of program outcomes and customer service across apprenticeship programs. This
allows for monitoring enrollment and completion rates, including across the training and educational
programs, and expediting the processing of documents.
Recommendation
Increase state funding for additional sta, information technology updates, and curriculum
improvements to support greater healthcare workforce apprenticeship development, quality, and
outreach across the state. Bolster funding supports to healthcare employers and apprentices that reduce
barriers to develop, enter, and complete apprenticeship programs, including through the following
activities:
► Cover costs of youth apprenticeship instruction to ensure equitable access across diverse student
populations and backgrounds;
► local groups to streamline individual apprentice pathways, including the bridge from youth
apprenticeship to registered apprenticeship programs;
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► Provide funding and support for high schools to increase participation in healthcare youth
apprenticeship programs;
► Cover registered apprenticeship fees for licenses, certications, and exams;
► Increase funds for ACAP; and
► Dedicate state funds and review eligibility for on-the-job reimbursements to encourage the
development of additional registered apprenticeship programs in healthcare and the hiring of more
apprentices.
4b. Expand apprenticeships and other learning opportunities: Worker Advancement Initiative
Grant
Lead entity
Department of Workforce Development
Background
Some job seekers experience complex barriers in obtaining and maintaining employment. In these
instances, human-centered approaches are eective in connecting job seekers with job leads, training
opportunities, and careers they nd engaging by providing individualized support and resources that best
address their specic employment barriers. However, human-centered approaches are time consuming
and require specialized placement skills and resources that either cannot be sustainably met or are not
covered at all by DWD's current ongoing federal funding streams.
The Workforce Innovation and Opportunity Act (WIOA), Titles I through IV, are the primary federal funding
streams available to state and local employment and training programs for youths, age 14 and older, and
adults. Title I of WIOA requires each state to align workforce development activities and resources with
larger regional economic development areas. In Wisconsin, DWD satises this requirement by
contracting with the local workforce development boards (WDBs) because daily they are on the frontlines
striving to address their designated regions' workforce challenges, including worker quantity challenges.
WDBs are comprised of businesses, worker representatives, educators, and other partners who
cooperate to develop economic and workforce development strategies for their regions, including ways
to support driver industries such as healthcare. While WDBs have identied that wraparound services are
eective in addressing barriers to employment for people disconnected from the workforce, WIOA
reimbursement requirements do not necessarily allow coverage of costs for wraparound services. As a
result, WDBs must consider other grant opportunities to ll this gap in services in order to best assist the
workforce.
Governor Evers provided DWD a $20 million Worker Advancement Initiative Grant using one-time federal
ARPA funding in state scal year 2022. DWD disbursed this grant to Wisconsin's 11 WDBs, with the goal
of serving 2,000 people whose previous employment had yet to return post-pandemic or people who
were not attached to or had been unsuccessful in the labor market prior to the pandemic.
While WDBs target outreach to participants based on their communities' needs, some examples of target
populations include people involved in the justice system, veterans, people experiencing homelessness,
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non-custodial parents, people with limited English language prociency, people with disabilities, human
traicking survivors, and people in alcohol and substance use treatment.
The Worker Advancement Initiative is implementing innovative methods to provide subsidized
employment and skills training opportunities with local in-demand industries, including healthcare, to
help their residents successfully nd and maintain employment. Using these funds, WDBs have oered
occupational skills training, on-the-job training, paid work experience, and job readiness training. They
have also provided a variety of supportive services to encourage completion of these trainings, including
oering worker stipends and completion awards, osetting their costs of child care, transportation
(including auto repairs), exam fees, out-of-pocket medical expenses, work-related equipment, and
providing access to digital technology and internet connectivity.
Some examples include the Northwest Wisconsin Workforce Investment Board supporting adults earn an
associate degree in nursing and in-school youth earn their nursing assistant certication by covering the
costs of training. Employ Milwaukee oered a variety of healthcare skills training programs, including for
community health workers, and oered participants hourly stipends, as well as completion and job
retention incentives. The Workforce Development Board of South Central Wisconsin partnered with
Centro Hispano to support people whose second language is English become certied nursing assistants
by covering their costs of training and oering participation incentives. North Central Wisconsin
Workforce Development Board supported training in dental assistance and medical oice coding, also
oering participants mileage reimbursement, attendance incentives, and housing assistance.
The Worker Advancement Initiative period of performance will end December 31, 2024. As of May 2,
2024, the initiative has provided 21,129 unique services to 4,283 unduplicated participants across the
state. WDBs have identied a need for further funding for non-WIOA covered expenses that promote
successful employment outcomes in their regions, which were covered through the initiative, but will or
have ended upon the completion of their grant projects.
Key considerations
► Local WDBs have the experience, relationships, and data and scal infrastructure to support the
successful implementation and delivery of supportive services to unemployed and underemployed
constituents in their communities.
► Local WDBs cannot use their WIOA funds for wraparound services that are essential components of
their human-centered service approach, despite those services leading to improved employment
outcomes.
► Ongoing state funding for wraparound services will leverage current federal investments and
programs.
Recommendation
Provide sustained funding and administrative support for the continuation of the Worker Advancement
Initiative. This provides grants to the local workforce development boards, in alignment with their regions'
workforce needs, to support a person’s successful entry into and advancement within Wisconsin's
healthcare sector leading to family-sustaining careers.
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4c. Expand apprenticeships and other learning opportunities: Increase student access to
health science and dual enrollment
Lead entity
Department of Public Instruction
Background
Wisconsin Career Pathways - Direct Patient Care is oered in all regions of the state, each with its own
advisory group of local employers, educational organizations, and economic and workforce development
interests. According to 2022-2023 school district data, 225 out of 383 (59%) school districts oer the
Direct Patient Care career pathway. There are 158 (41%) school districts where students do not have
access to a quality career pathway in health science. This data also reects fewer programs in rural and
under-resourced areas of the state due to teacher retention and funding to run a program.
School districts and students face barriers to expand dual enrollment opportunities in the Direct Patient
Care career pathway. Students taking dual enrollment courses can earn healthcare credentials such as
nursing assistant, phlebotomist, emergency medical technician, dental assistant, medical laboratory
technician, licensed practical nurse, and more. A lack of qualied and credentialed educators, capacity,
and staing for school districts to coordinate and support students, and students having to leave their
high school campus to participate in dual enrollment all inhibit more students from earning dual credit
leading to industry credential obtainment.
Wisconsin HOSA-Future Health Professionals (HOSA) serves as a key healthcare pipeline, supporting
high school students to enter the career pathway while helping to address industry workforce needs.
HOSA consists of around 4,000 members across 127 middle and high schools. Through HOSA, students
directly connect with industry professionals while showcasing their workforce skills and knowledge.
Some examples include leadership roles, certications, micro-credentials, job interviewing, internships,
professionalism, and access to mentors and like-minded peers. Membership dues cost $17.00 per
student. Conference and special training fees range from $15.00 to $135.00 depending on the event in
addition to associated travel costs.
Additionally, Wisconsin Area Health Education Centers (AHEC) oer a variety of education and training
programs for high school and post-secondary students to increase the diversity and distribution of the
healthcare workforce and enhance healthcare quality and delivery in rural and medically underserved
communities. Through seven regional centers, a statewide program oice, and partnerships with
academic institutions and community-based organizations, AHEC serves over 6,000 learners annually.
AHEC is currently supported by the federal government and the UW.
Key considerations
Demand is growing but school districts struggle to support career and technical education health
science programming without additional resources.
► Inequities exist for Wisconsin students in schools with limited or no access to a health science
career pathway. Increased funding would help school districts establish programs to help students
understand their interests, explore career-based learning experiences, and earn healthcare
credentials.
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► Due to industry need and student interest, awareness is spreading fast for schools identifying a need
to develop or grow their health science oerings. However, starting new programs or expanding
existing ones is diicult when there is no funding for start-up or current resources are spread among
all career and technical education areas to maintain what is already in place.
► It’s diicult for school districts to recruit and retain teachers for a health science career pathway.
Industry professionals make more money in the eld than teaching, and current qualied and
licensed teachers are either leaving education or moving districts. This shifts programming or leaves
a program vulnerable to reductions or cuts if schools cannot hire replacements.
More support is needed for dual enrollment to help students complete post-secondary coursework and
earn certications and licenses
► Many high school teachers do not have the support or nancial incentive to obtain advanced
degrees, training, or credentials to expand oerings for dual credit and industry recognized
credentials. Additional funding can provide incentives for teachers and school districts to support
credentialing for teachers.
► School districts are responsible for coordinating dual enrollment. As more students participate in
health science dual enrollment, more school district staing is needed to support course oerings
and student success. Additional funding to school districts can support growth in this area and
student completion of dual enrollment courses.
► High school students skip taking dual enrollment courses due to diiculties accessing post-
secondary or college campuses. Students who can take dual credit courses without leaving their
high school have a higher success rate for enrollment and completion.
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Additional funding can
support school districts to contract with colleges for instructors and create health science labs
required to deliver courses in high schools.
To address workforce shortages now and for years to come, more eorts and resources are needed to
engage young people through HOSA and AHEC. The following challenges prevent more students from
participating in HOSA and AHEC:
► There are student and school district costs to participate in HOSA.
o Not all students can aord membership dues, professional attire, and fees associated with
training and conference events. Many schools do not have the funding to cover these fees for
students.
o Chapters are required to have a school advisor. School districts are challenged to nd extra funds
to support extended contracts, dues, and travel for teachers to serve in the HOSA advisor role.
Schools are wary to start a HOSA chapter when funds are not available to support the advisor or
establish the chapter with start-up funds.
► There is awareness and interest for school districts to provide early learner exposure to health
careers but very few middle school programs exist for health science in Wisconsin.
Having a HOSA chapter at the middle school level is one way for school districts to engage young
students in this career pathway. However, funding to support middle school career exploration is
limited. The earlier the exposure to a career, the more likely a student will pursue that pathway.
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► AHEC has a regional infrastructure with extensive partnerships and relationship with higher
education, K-12 academic settings, and health-focused organizations, but current AHEC funding is
restricted in how it can be used.
Recommendation
Increase funding to support health science education and career pathways for secondary and post-
secondary students, including middle schools. Funding could support secondary student pathways
through health science courses, dual enrollment opportunities, work-based learning, industry-
recognized credentials, and HOSA. In addition, funds could support AHEC programming to expand
student access, interest, participation, and credential attainment for health careers.
Recruitment and retention
5a. Increase payer support: Expand Medicaid to support healthcare workers and fund
workforce initiatives
Lead entity
Department of Health Services
Background
Under federal law, states can choose to expand Medicaid eligibility for adults with incomes up to 138% of
the federal poverty level ($43,100 for a family of four). Wisconsin Medicaid partially expanded in 2014,
using state funds, and the program is currently available for adults with incomes below 100% of the
federal poverty level ($31,200 for a family of four). Many adults on Medicaid work at least part-time and
do not have aordable or available health insurance benets through their employers.
Full expansion would extend Medicaid coverage to around 90,000 Wisconsinites, an estimated 30,000 of
whom are currently uninsured. The federal government would reimburse the state for a higher share of
Medicaid costs, meaning that expansion would save taxpayers a signicant amount money while
expanding access to care.
Under current projections, expansion would save Wisconsin an estimated $1.6 billion in state funds over
two years, and the state can decide how to spend these savings. Of the $1.6 billion, $1.1 billion is a
signing bonus: a one-time, no-strings-attached incentive through ARPA. After the rst two years, the state
would save an estimated $300 million annually to spend on any purpose.
In addition to state savings, DHS estimates the state would increase hospital access payments by $266
million each year because of the higher federal match rate, helping to oset the cost to hospitals of
serving more Medicaid members.
Key considerations
The signicant state savings of $1.6 billion from expanding Medicaid could help ensure the state has the
resources to fund healthcare workforce initiatives, encourage workforce participation, or fund other task
force recommendations. These exible savings to the state’s general fund could be used for any purpose
authorized by state law, such as these important investments to support the healthcare workforce.
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Expansion would help entry-level healthcare workers, who often limit work to part-time to retain public
benets and avoid exceeding the income limit of $31,200 for a family of four (referred to as the benets
cli). In Wisconsin, 45% of direct care professionals work part-time, with median annual earnings of
$21,100.
140
A recent report estimated that expansion would allow a direct care professional to work up to
457 more hours annually without going over the income limit, equal to an extra shift per week.
141
Given
high vacancy rates for these positions, expanding Medicaid could encourage current workers to increase
their hours.
Wisconsin is one of only 10 states that have not fully expanded Medicaid. This lack of action has
signicant scal impacts on the state. While Wisconsin does provide Medicaid access to Wisconsinites
earning up to 100% of the federal poverty level, this partial expansion was not enough to qualify
Wisconsin for increased federal funds, putting the additional burden on Wisconsin taxpayers. If
Wisconsin had fully expanded Medicaid starting in 2015-16, the state would have saved a total of $2.4
billion in state tax dollars and gained an additional $5.8 billion in federal revenue by now. Instead, the
money that Wisconsinites pay in federal taxes is given to states that fully expanded. Wisconsin tax dollars
are being directly invested in other states to reduce uninsured rates, improve access to and aordability
of care, and grow their economies.
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DHS estimates expansion could reduce hospital revenues by $133 million each year because some
people would shift from commercial insurance to Medicaid, which pays lower rates. Because of the
higher federal match rate, the state would increase hospital access payments by an estimated $266
million each year.
In addition, to support hospitals, associated Medicaid rates could be increased using a portion of the
state savings generated through expansion. Such increases would be especially impactful for hospitals
that provide a greater share of services for Medicaid members and hospitals in rural areas. Increased
rates would allow hospitals to invest in their employees, alleviate costs associated with the workforce
shortage, and sustain healthcare services.
Recommendation
Fully expand Medicaid to encourage workforce participation and save the state money. Ensure savings
are used to strategically strengthen Wisconsin’s healthcare workforce and support hospitals and other
healthcare employers.
5b. Increase payer support: Rate increases to strengthen the workforce for people who live in
Wisconsin who are elderly or disabled
Lead entity
Department of Health Services
Background
Home and community-based services (HCBS) are essential to meet the daily needs of people who live in
Wisconsin who are elderly or living with a disability. Examples include personal care, home healthcare,
supportive home care, respiratory care, in-home nursing care, physical therapy, occupational therapy,
Governor’s Task Force on the Healthcare Workforce Report Page 53 of 73
and care received at an assisted living facility. These services are a cost-eective alternative to higher-
cost institutional services, such as nursing home placements or hospital services.
Wisconsin Medicaid can help HCBS providers recruit sta and maintain this important long-term care
system through reimbursement rates. To set a oor for allowable rates, federal regulations require states
to have some type of minimum fee schedule. A minimum fee schedule is a list of the lowest prices
managed care organizations are allowed to pay for Medicaid-funded services.
DHS has developed a minimum fee schedule for adult HCBS services.
143
The fee schedule denes
services and sets minimum rates across adult HCBS programs. This fee schedule is an important step
forward in making sure providers are paid consistently and fairly. It also encourages career advancement,
and helps agencies recruit dedicated and qualied workers, reduce turnover, and be competitive in the
market.
Key considerations
The state’s population over age 65 is expected to grow by 471,400, or 45%, between 2020 and 2040.
144
Providers expect labor costs to rise as the demand for long-term care outpaces workforce growth. Most
people prefer to stay in their homes as long as possible. HCBS also provides support to people living with
disabilities. A sustainable reimbursement system that supports HCBS providers is essential to maintain
this preferred care system.
The cost of providing HCBS is typically lower than the cost of providing facility-based services (in nursing
homes), but wages are typically lower. Medicaid is a primary payor for long-term care services, and low
Medicaid rates likely put upward pressure on private pay families. Medicaid rates need to be suicient so
there are enough workers and providers to meet the growing need.
Increasing Medicaid rates represents a critical investment in our long-term care system and in the people
who provide care to some of our most vulnerable citizens.
Recommendation
Support higher rates for home and community-based services to encourage recruitment and retention of
direct care professionals, help workers earn family-sustaining wages, and meet the needs of our
population.
5c. Increase payer support: Rate increases to strengthen the behavioral health workforce
Lead entity
Department of Health Services
Background
Governor Evers declared 2023 the Year of Mental Health, calling mental and behavioral health a
burgeoning crisis aecting Wisconsin’s kids, families, and workforce. The demand for mental healthcare
is high with one-in-four adults in Wisconsin reporting symptoms of anxiety or depressive disorder, and
one-in-three reporting they needed counseling but did not receive it.
145
Provider shortages and low
insurance rates from both private and public payers can contribute to challenges in nding aordable,
accessible mental and behavioral healthcare.
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Medicaid covers mental and behavioral health services for members. For example, outpatient mental
health services provide diagnostic evaluations, psychotherapy services, mental health clinical
consultations, and other psychiatric services in homes, provider oices, outpatient clinics, and other
community-based settings. Child and adolescent day treatment provides intensive mental healthcare in
a nonresidential setting. Services include case management, medical care, psychotherapy or other
therapies, skill development, substance use counseling, and follow-up to alleviate problems related to
mental illness or emotional disturbances.
Key considerations
The ability to recruit and retain behavioral health providers in Wisconsin is inuenced by Medicaid and
commercial insurance reimbursement rates. Although Wisconsin has made progress in increasing
reimbursement rates for behavioral health in recent years, Medicaid reimbursement rates typically fall
behind Medicare, private insurance, and self-pay rates.
146
Low reimbursement rates can translate to
lower wages for providers.
Higher rates could encourage workforce participation and expand access to services. Out of Wisconsin’s
72 counties, 40 are federally designated mental health professional shortage areas, meaning that we lack
suicient providers to meet the demand for services.
147
Investing in our behavioral health workforce
through rate increases would ensure Wisconsinites in all stages of life can access behavioral health
services and receive care closer to home.
Recommendation
Increase Medicaid reimbursement rates for behavioral health services. Other payers, such as
commercial insurers, should also increase rates to help the state recruit and retain behavioral health
professionals.
6a. Foster recruitment and retention in areas of need: Expand state incentives for health
professionals serving in state-dened shortage areas
Lead entity
Higher Educational Aids Board, Department of Health Services
Background
Health occupations require a signicant amount of post-secondary training, with approximately 76% of
healthcare occupations requiring a bachelor’s degree or higher, and 38% requiring a master’s degree or
higher.
148
This requires many students to incur substantial costs to pay for their education in high-
demand healthcare careers.
The average student loan debt for bachelor’s degree healthcare professionals is around $30,000, while
the average student loan debt for doctoral-trained professionals (such as physicians and dentists) is
greater than $200,000.
149
Depending on the profession type, the debt-to-income ratio can vary
substantially. Student loan debt and low salary expectations may disincentivize students from pursuing
high-demand healthcare careers that are the backbone of the healthcare infrastructure in Wisconsin
communities.
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For current practitioners, student loan debt, lower salaries, and cost of living are known to cause
substantial nancial stress and impact their employment decisions, driving practitioners to seek jobs in
aluent communities and serve patients of private payers.
150
Wisconsin’s rural areas face severe physician shortages in elds such as obstetrics and gynecology,
primary care, behavioral health, and oral health. For example, the U.S. faces a shortage of 9,000
obstetrician-gynecologists, which is expected to grow to 22,000 by 2050. One in three Wisconsin
counties does not have a practicing ob-gyn.
151
Less than half of rural Wisconsin women live within a 30-
minute drive of the nearest hospital.
152
Key considerations
Workforce incentives, such as loan repayments, housing supports, and provider stipends, are common
state strategies to support recruitment and retention of the workforce.
153
The cost of higher education is a
burden for Wisconsin students, including those wishing to pursue healthcare careers. State investment
in public higher education is vital to Wisconsin’s economy and our ability to recruit, retain, and train our
future workforce.
Loan repayment is a common and eective state strategy to support the healthcare workforce and target
workforce development in high-need communities. All 50 states oer some type of loan forgiveness for
healthcare professionals, either through federal pass-through programs (administered by the Health
Resources and Services Administration as State Loan Repayment Programs), or though the development
of supplemental state-funded state programs.
154
Wisconsin has received federal funding through ARPA to support a federal pass-through loan repayment
program, called the Health Professions Loan Assistance Program, which is administered through the
Wisconsin Oice of Rural Health.
155
This program currently supports primary care and psychiatrist
physicians, dentists, dental hygienists, certied nurse midwives, nurse practitioners, and primary care
physician assistants. Wisconsin also has a supplemental program, the Rural Provider Loan Assistance
Program, that is accessible by primary care physicians and psychiatrists serving in rural communities.
156
In 2022-2023, these programs awarded over $1 million to 99 healthcare providers throughout the state,
primarily in family medicine specialties.
157
Recommendation
Provide targeted funding to expand state incentive programs for healthcare professionals to include
those serving in underserved communities. Incentive strategies may include expanded student loan
repayment and other innovations to enhance recruitment and retention in state-dened shortage areas.
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7a. Support regional innovation: Support employer-based workforce development solutions
with Provider Innovation Grants
Lead entity
Department of Health Services
Background
Workforce development innovations must be adaptable to meet the unique needs of employers and
communities. A Provider Innovation Grant Program would provide exible funds to employers to support
strategic workforce development initiatives, such as mentorship programs, preceptor bonuses, paid
clinical sites, improved scheduling practices, professional development, and social supports.
This recommendation would leverage insights gained through the ARPA Medicaid Home and Community-
Based Services Innovation Grants. Grants funded new programs to support paid caregivers, such as
direct care workers and nurses, in home and community-based settings. Qualifying projects had to
demonstrate creative ways to recruit and retain sta and expand access to services. DHS awarded nearly
$30 million in grants to 158 projects with awards ranging from $25,000 to $2 million and were distributed
geographically across the state in both urban and rural areas.
Funded projects included:
► A $907,000 innovation grant for Capri Senior Communities in Ozaukee County to launch a four-day
work week at two pilot locations. Sta worked 32 hours but were paid for 40 hours. The program
improved recruitment, increased retention, and reduced burnout. For example, Capri saw a 1,500%
increase in caregiver applications and lled 70% of open positions in two weeks after launching the
program. Capri is considering expanding the program to 18 senior living campuses in southern
Wisconsin, which serve 2,200 seniors daily.
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► A $88,400 innovation grant for Stay at HomeCare, LLC in Oconto County to use mapping software to
target recruitment to home care workers who live near clients. In the most rural parts of Northeastern
Wisconsin, Stay at HomeCare has diiculty convincing sta to drive more than 20 minutes to work
with clients in their homes. Their experience has shown that the most long-lasting employee-client
pairings are those who are local to each other. The grant funds supported mapping tools to increase
the potential for successful recruitments in rural areas.
Key considerations
Provider Innovation Grants can support the workforce through activities that are outside the scope of a
providers’ central responsibilities and are generally not reimbursable. Innovative solutions include
creating mentorship programs, providing preceptor bonuses, sponsoring paid clinical sites, fostering
professional development, improving scheduling practices, and providing social supports. These best
practices strengthen the pipeline from the classroom to the workplace and provide a high-level of
support for new hires to ease their transition to work. These practices recognize workers need to be
compensated for their time, including for duties related to internships and mentorships. These
innovations could help create healthy, high-quality, and sustainable workplaces. In addition, exible
grant funds could help employers address workforce concerns that contribute to retention issues, such
as workplace violence.
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To maximize public investment, grantees should report on outcomes, include a plan for sustaining
programs once grants expire, and model initiatives that could be replicated or scaled. To achieve this,
grant recipients had to submit quarterly reports analyzing milestones and outcomes to demonstrate
impact. In late 2024, grantees will convene at an in-person summit to share project outcomes and learn
from each other about innovative workforce strategies.
DHS received over 717 applications from providers requesting $200 million. This is signicantly more
than the $30 million available, demonstrating strong provider demand for innovation funds. Further, the
program was only available to Medicaid home and community-based services providers. Expanding
innovation grants to other healthcare providers and to public health agencies through a sustained
investment would help build a more resilient workforce.
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Recommendation
Provide sustained funding and administrative support for a Provider Innovation Grant Program to help
healthcare providers implement best practices and innovative solutions to support the workforce. These
grant funds could be leveraged by employers to develop and share innovative strategies to retain their
existing healthcare workforce.
7b. Support regional innovation: Support regional collaboration for workforce development
through Workforce Innovation Grants
Lead entity
Department of Workforce Development
Background
To help the state recover from the COVID-19 pandemic and the economic crisis it caused, Governor Evers
developed the Workforce Innovation Grants Program using one-time federal ARPA funding and led by
DWD and the Wisconsin Economic Development Corporation. In this program, more than $128 million
was allocated to encourage regions and communities to develop leading-edge, long-term solutions to
address the greatest workforce challenges facing the state. The Workforce Innovation Grants Program
expressly rejected a one-size-ts-all approach and set to work unleashing local expertise and creativity to
tackle long-standing employment barriers.
These projects develop and implement long-term solutions to a range of workforce challenges, with four
projects directly addressing challenges related to healthcare. One project, led by the Wisconsin
Community Action Program Association, is working to help underserved people enroll in study and
training programs by covering tuition and other expenses, and providing ongoing coaching for careers in
the healthcare industry. Another project serving 16 northwestern counties, led by UW-Eau Claire and the
Mayo Clinic Health System, is working to address worker shortages in healthcare, education, and social
services in addition to improving rural health.
Governor’s Task Force on the Healthcare Workforce Report Page 58 of 73
Within the healthcare sector, Workforce Innovation Grants funds are being used for the following:
► Placing education and social work students in rural communities.
► Oering new curriculum and clinical experiences with the goal of increasing the number of
graduating nurses.
► Developing new degree programs in public health, healthcare management, and psychiatry.
The projects are monitored to ensure they meet their required deliverables and, as the projects are
completed, the lessons learned will be shared so other communities and healthcare organizations may
apply and replicate the successes across the state.
Key considerations
Investing in Workforce Innovation Grants results in specialization across a wider variety of potential
expenditures, allowing for exibility to innovate and tackle diverse needs across the state. Child care,
transportation, apprenticeships, and even broadband internet investment in rural areas are all real-life
examples of grants at work. Areas with the highest need for these programs should be prioritized to
ensure equitable access.
► The state should leverage the systems and processes developed through the Workforce Innovation
Grants to ensure investments in innovation still safeguard tax dollars. For example, grant applicants
were required to include data and evidence-based practices in developing their project proposals.
Training provided to participants using grant funds included a focus on up-skilling or re-skilling for in-
demand jobs. Applicants were also required to demonstrate proper planning and quality assurance
metrics.
► Methods of sharing and implementing successful practices into other regional plans should be
established to extract maximally eicient benet from funds. Integrating impactful measures while
allowing for regional specication is one of the grant program's core strengths.
Recommendation
Provide sustained funding to continue the Workforce Innovation Grants Program statewide, including
information technology and administrative infrastructure needed to support the program. This program
will encourage the development of long-term solutions to help businesses nd qualied workers as well
as assisting people in obtaining family-sustaining jobs. Within this program's investment, allocate
specic funding to address the healthcare sector's workforce challenges.
7c. Support regional innovation: Support direct care professionals with health insurance
benets navigation
Lead entity
Department of Health Services
Background
An estimated 31% of direct care professionals in Wisconsin receive public health insurance coverage.
This ratio is highest for those working in home care settings and lowest for those working in nursing
homes. In Wisconsin, an estimated 14% of direct care professionals live below the federal poverty line,
with median earnings of $21,100 per year. In Wisconsin, 22% of direct care professionals also receive
Governor’s Task Force on the Healthcare Workforce Report Page 59 of 73
food and nutrition assistance.
160
Many health professionals also struggle to nd other services to support
health and workforce participation.
Health Insurance Status for Direct Care Professionals in Wisconsin
Health Insurance Status
Home Care
Residential
Care Homes
Nursing Homes
All
Any health insurance
87%
88%
93%
90%
Through employer/union
40%
52%
65%
55%
Medicaid, Medicare, or
public coverage
41%
33%
25%
31%
Purchased directly
15%
12%
10%
12%
These workers often need assistance to secure health insurance coverage, seek timely care, and navigate
the healthcare system. Wisconsin’s Regional Enrollment Networks were rst formed by DHS in 2013 to
optimize local enrollment assister capacity and maximize Medicaid and Marketplace coverage for eligible
people living in Wisconsin. Developed with the launch of the Patient Protection and Aordable Care Act
health insurance Marketplace (HealthCare.gov), the networks coordinated and aligned with county
income maintenance agencies (these agencies determine eligibility for Medicaid programs). Enrollment
networks were phased out after 13 months, with DHS resources scaled back.
With the onset of the public health emergency, the networks were reestablished by Covering Wisconsin,
a federally certied and state-licensed healthcare navigator agency based out of the UW. Covering
Wisconsin has leveraged the networks to support consumer coverage education, outreach, and
enrollment needs. Current membership includes over 2,300 people across 10 enrollment networks (eight
regional, one statewide Hmong enrollment network, and one statewide Latinx enrollment network).
Key considerations
Studies show a lack of benets are a main reason why workers leave employment. The Wisconsin
Personal Services Association found 93% of personal care providers have had diiculties in lling
positions, 70% have been unable to sta all hours, and the annual turnover rate has been up to 67%.
161
A recent report by LeadingAge Wisconsin, the Disability Service Provider Network, the Wisconsin
Assisted Living Association, and the Wisconsin Healthcare Association attributes high industry vacancy
rates to the fact that employees in the long-term care sector can receive better benets elsewhere. In
Wisconsin, 69% of surveyed long-term care providers oer health insurance to full-time employees and
about 13% oer it to part-time employees. Even when oered, benets are commonly too expensive for
direct care workers to accept due to the high employee-paid share of costs.
162
Funding for benets navigation services and to maintain enrollment networks would support increased
access to healthcare by:
► Building enrollment assister support and capacity.
► Organizing and streamlining local and statewide outreach eorts.
Governor’s Task Force on the Healthcare Workforce Report Page 60 of 73
► Keeping partners informed about policy changes and enrollment trends.
► Creating regionally and culturally-relevant messaging.
► Facilitating metrics reporting, such as Medicaid and Marketplace application assistance.
Recommendation
Support direct care professionals by funding navigation services to help them understand and sign up for
publicly available health insurance and other programs to support their health. This funding will help
ensure entry-level healthcare workers continue to have a well-integrated, no-wrong-door experience in
seeking enrollment in and across Medicaid and Marketplace options and accessing other supports.
Regulatory policy
8a. Support expanded pathways to licensure: Authorize Medicaid reimbursement for
community-focused providers
Lead entity
Department of Health Services
Background
Doulas, community health workers, peer specialists, mental health navigators, and other community-
focused providers help licensed practitioners operate at the top of their licenses by supporting members
of their communities. Wisconsin Medicaid is not currently authorized to reimburse for stand-alone
services provided by these professionals.
Doulas provide childbirth education and support services, including emotional and physical support
during pregnancy, labor, birth, and postpartum. In Wisconsin, doulas may choose to be certied by
private or nonprot organizations, but there is no state certication. Other states have created a
certication process for doulas to facilitate Medicaid reimbursement.
163
Doulas can help alleviate the
burden on maternal health providers by contributing to better birth outcomes.
Community health workers are the bridge between community members and clinical and social services.
They often have lived experiences in overcoming barriers, navigating systems, and using community
resources. These workers provide nonmedical services, such as housing referrals, nutritional mentoring,
stress management, and other wraparound supports. They can help alleviate the burden on healthcare
providers by helping members to connect to the care and resources they need to stay healthy. Although
the state does not have a formal certication, community organizations, technical colleges, and other
partners are developing curricula and implementing apprenticeship models.
164
There are also three
nationally certied training programs that provide core competency training.
Certied peer specialists and certied parent peer specialists are people with lived experiences who are
trained to support the recovery of peers from mental health and/or substance use challenges. Peer
specialists can help alleviate the burden on licensed behavioral health providers by supporting those in
recovery between appointments. DHS certies peer specialists after successful completion of a training
course and passing an exam. They are employed by a variety of behavioral health providers throughout
the state. For example, peer specialists are employed by 11 peer recovery centers to facilitate activities
Governor’s Task Force on the Healthcare Workforce Report Page 61 of 73
focused on education, information, skill-building, and socialization. Currently, these services are only
Medicaid allowable under the comprehensive community services program.
Key considerations
Community-focused providers are challenged by a lack of insurance coverage and reimbursement, low
wages, limited benets, and unpredictable schedules. The populations they serve are often Medicaid-
eligible; for example, over one-in-three births in Wisconsin are nanced by Medicaid.
165
Authorizing
Medicaid to pay for their services can increase compensation, provide stability, and help alleviate other
shortages among licensed healthcare professionals.
Doula involvement is a cost-eective method to improve patient outcomes. A national study found
doula-assisted mothers were four times less likely to have a low-birth-weight baby and two times less
likely to experience a birth complication.
166
Reducing incidences of low birth weight saves money and
improves lifelong outcomes. One study found inpatient hospital charges for low-birth-weight babies were
$10,000 to $100,000 higher than for healthy-weight babies.
167
Weighing less than 5.5 pounds at birth was
found to increase the probability of dropping out of high school by one-third and reduce yearly earnings in
adulthood by about 15% percent.
168
Other states, such as Arizona, Colorado, Massachusetts, Minnesota, New Mexico, and Texas have
allowed community health workers to enroll as Medicaid providers and to receive reimbursement. These
services have resulted in better health outcomes and lower healthcare costs. For example,
Massachusetts Medicaid saw a 46% decrease in emergency department visits among children with
asthma after implementing a community health worker home visiting program. In Connecticut, a
community health worker cancer prevention program resulted in a return on investment of $3.16 for every
$1 spent. Such programs have been shown to signicantly improve patients’ use of prevention services
among low-income and immigrant women, in addition to improving health behaviors such as healthy
food choices and physical activity among patients with diabetes.
Certied peer specialist services are also linked to better patient outcomes. Peer support is an
evidenced-based practice and has shown to reduce the number and rates of hospitalization days. When
people use peer support in peer-run respites, the reported need for crisis services decreased. Engaging
with a peer specialist has also been shown to increase engagement with providers and decrease missed
appointments. Studies have also shown a decrease in the cost of overall services when certied peer
specialists are integrated into behavioral healthcare. When people with behavioral health challenges
work with a certied peer specialist, they are more likely to experience an increase in empowerment,
self-determination, and hope, creating a positive recovery outcome.
Recommendation
Authorize Medicaid to pay for services provided by doulas, community health workers, peer specialists,
and other community-focused providers.
Governor’s Task Force on the Healthcare Workforce Report Page 62 of 73
8b. Support expanded pathways to licensure: Support pathways to licensure for qualied
internationally educated professionals
Lead entity
Department of Safety and Professional Services
Background
Wisconsin currently has pathways to licensure for some health professions but not all. For example,
there is a specic process for internationally educated nursing applicants. Also, physicians who do not
meet all stated credentialing requirements, including the completion of approved post-graduate training,
can document their experience and submit it to the Medical Examining Board, which would then evaluate
the information to determine whether the applicant’s education and training are substantially similar to
that required by Wisconsin law. If the education and training is determined to be substantially similar, the
board can waive requirements and issue a full license, with or without restrictions. Also, Governor Evers
recently signed 2023 Wisconsin Act 214 into law, which outlines a process for gaining a provisional
license for people who have substantially similar but not substantially equivalent education and training.
This legislation does not apply broadly to other health professions, each of which is regulated by its own
statutes and rules. It is possible that there are potential pathways to licensure for other professions but
also barriers that limit the opportunity. Work to identify new or expand existing pathways would require
case-by-case analysis and engagement with the appropriate regulatory authority (the board or the
department).
Key considerations
While there is signicant interest in nding pathways for internationally trained clinicians to qualify for
licensure in Wisconsin, there are many professions for which there is no neutral entity that exists to
determine licensure equivalency. Without a reputable third-party entity to compare education, training,
and experience, it is diicult for a volunteer board to competently and condently make determinations
about licensure equivalents. It requires sta support to provide case-by-case international legal analysis.
It is diicult with the current staing levels and model at DSPS.
Recommendation
Provide funding to add legal capacity at DSPS to clarify and expand pathways to practice for qualifying
internationally educated or trained health professionals.
8c. Support expanded pathways to licensure: Ratify and enter into multi-state licensing
compacts
Lead entity
Department of Safety and Professional Services
Background
Multi-state compacts allow professionals to become eligible to practice in other participating states
while maintaining quality care. Compacts can make it easier for health providers to practice across state
Governor’s Task Force on the Healthcare Workforce Report Page 63 of 73
lines either physically or via telehealth. Compacts can also make it easier for health professionals to
relocate from one participating state to another.
Wisconsin has ratied several multi-state licensing compacts, including those for nursing, medicine, and
psychology. Among others, the state has not yet ratied the social work, cosmetology, or dietician
compacts.
Key considerations
Occupational licensing compacts oer states a clear pathway for expanding licensure portability. These
agreements are developed with extensive, diverse partner involvement.
According to the National Center for Interstate Compacts, a division of the Council of State
Governments, occupational licensing compacts enable states to establish uniform standards for multi-
state practice while preserving a state’s practice act and initial licensure process.
169
Compacts also facilitate the communication of licensure data, including disciplinary orders and other
actions, among compact states. This positions states to more eectively and eiciently fulll their public
protection responsibilities.
Recommendation
Ratify available multi-state licensing compacts and support implementation at DSPS, while ensuring
quality care in Wisconsin.
8d. Support expanded pathways to licensure: Revise faculty educational requirements
Lead entity
Department of Safety and Professional Services
Background
Nurse faculty are the academic sta at school of nursing that support the education of nursing students.
The legislature has given authority to the Board of Nursing (Board) to establish standards for nursing
schools (including both professional nurses and licensed practical nurses).
170
From this, the Board has
developed associated rules as to the process for nursing schools to qualify for Board approval.
171
This
includes rule guidance for nurse faculty standards. Nursing is a unique sector, as there are multiple paths
to entry into professional nursing: both the bachelor’s degree and the associate degrees qualify a person
for a registered nurse license. The Board has authority over faculty standards for all professional nursing
programs. Currently, faculty at any nursing school that prepares professional nurses (including both
bachelor’s and associate degree programs) are required to hold an active Wisconsin registered nurse
license (or privilege to practice, such as through the Nurse Licensure Compact) and a graduate degree in
nursing.
Some exceptions may be made to these faculty requirements through request to the Board, such as for a
faculty member who is actively enrolled in a degree program that satises the faculty education
requirements (instead of already holding that degree), permitting a bachelor’s degree professional nurse
faculty to serve for one semester in an emergency situation, or enabling a faculty member with a
Governor’s Task Force on the Healthcare Workforce Report Page 64 of 73
bachelor’s degree in nursing to serve as faculty in a specic content area if they also have a graduate
degree that is relevant to the teaching assignment.
The challenge of this current structure lies with the associate degree professional nursing schools. Under
current requirements, these associate-level programs are required to sta faculty that hold graduate
degrees in nursing (or two degrees higher than the students they are teaching). This results in a limited
pool of potential nurse faculty (in the context of nurse faculty shortages) and competition between
bachelor’s and associate degree programs for the same qualifying or interested prospective faculty
members.
Key considerations
In light of the nurse faculty shortage, some states have pursued modications to nurse faculty education
requirements to expand the potential pool of faculty members in some limited scenarios. For example,
Indiana
172
recently permitted people with a bachelor of science in nursing to serve as faculty in eligible
associate degree programs if 1) the nursing program has demonstrated quality in student outcomes
(evidenced by an annual successful completion rate of 80% or higher from graduates completing their
nursing entrance examination), and 2) the bachelor-trained faculty member completes a qualied nurse
educator certicate program (which includes at least 15 credit hours of relevant content). This provides a
pathway for additional nurses to serve as faculty in associate-level nursing programs while ensuring
quality is not sacriced. Ensuring maintenance of quality faculty should be an important consideration
for any similar initiative.
Nursing education accreditation is an important factor to consider with any state change impacting
education standards. Associate degree nursing education programs are generally accredited by two
entities: the Accreditation Commission for Education in Nursing (ACEN) or the National League of
Nursing’s Commission for Nursing Education Accreditation (CNEA). Flexibility is provided on
interpretation of qualications for nurse
173
faculty in both accreditation models. ACEN’s standards dene
faculty as those nurses who hold the educational requirements as required by the governing organization
and regulatory agencies, thereby deferring to the academic institution and state board of nursing for
establishment of appropriate standards.
174
CNEA standards similarly provide exibility to allow for
bachelor’s degree nurses to serve as faculty and recognize the standards put forth by state regulatory
agencies, but their standards do emphasize the importance of programs to continually strive to employ
full and part-time faculty who hold a graduate degree in nursing.
175
Recommendation
Evaluate the eectiveness of exceptions to the current faculty education requirements and consider
whether any modications are necessary, while ensuring quality.
Governor’s Task Force on the Healthcare Workforce Report Page 65 of 73
9a. Strengthen state capacity to support licensure: Maintain licensing improvements and
enhance licensing support for applicants, employers, educators, and other partners
Lead entity
Department of Safety and Professional Services
Background
Over the past several years, DSPS has undertaken a comprehensive modernization project to implement
cutting-edge cloud-based licensing technology, update processes, and reorganize sta. This has
dramatically reduced licensing timelines for applicants. Actions that once took months and then weeks
are now happening in days.
Sustaining this progress is critical for the stability of healthcare employers and for the well-being of
applicants themselves. Further, this work was facilitated by a signicant expansion of division sta made
possible by ARPA funding, allocated by Governor Evers, that added temporary credentialing sta
positions and a contract call center that quadrupled capacity and improved answer rates from 33% to
over 90%. Additional temporary sta were included in the 2023-2025 state budget.
When the ARPA funding expires, it will dramatically reduce the capacity of the call center and available
license processing sta. Some of the temporary positions allocated by the last budget will expire on June
30, 2025. Together these staing losses will reduce DSPS’ capacity by a third at a time when licensing
demand continues to grow. Further, partners routinely ask for dedicated consulting sta to provide higher
level decision making and handling of complex cases, to answer practice questions, to oer training and
education to sta and students, and to provide additional support during the application and renewal
process. DSPS is not currently staed to provide partner support services and will not be if temporary
staing is not made permanent and additional resources are allocated.
Key considerations
An eicient and eective regulator enables qualied applicants to become licensed as easily and quickly
as possible. This requires good systems, modern technology, and adequate sta to handle all work
related to issuing and renewing licenses. Further, an eicient and eective regulator also helps raise the
competence of licensed professions to ensure they have the information they need to practice safely and
condently. Employers have come to rely on current service levels at DSPS. These must be maintained by
making temporary sta permanent and by ensuring available resources for technology maintenance and
improvement. Further, additional sta and resources should be allocated to increase access to sta by
license holders, employers, and educators who need additional support in the licensing and renewal
process and additional information to ensure safe practice.
Recommendation
Maintain DSPS licensing service levels by making temporary positions permanent, by adding dedicated
sta to support employers, educators, and other key partner groups who regularly engage in the
credentialing process for employees and students, and by adding sta who can answer complex practice
questions and generate educational and information tools that increase practice competence and
condence among regulated professionals.
Governor’s Task Force on the Healthcare Workforce Report Page 66 of 73
10a. Strengthen workforce monitoring and support: Increase healthcare workforce wellness
programming to support retention
Lead entity
Department of Safety and Professional Services
Background
More clinicians are leaving health professions than are entering. Wisconsin conducts workforce surveys
for licensed practical nurses and registered nurses at renewal. These surveys have clearly pointed to
retention, not recruitment, as the bigger challenge for the professions. Burnout and other factors are
driving nurses and other clinicians from healthcare faster than the state can license replacements.
Further, experienced clinicians take with them invaluable experience that benets facilities and the
patients they serve.
Wisconsin does not have a comprehensive wellness program designed to support clinicians and keep
them in practice at whatever the highest level of safe practice is for them. A comprehensive state
program designed to support clinicians with retention as the primary goal would benet not only
employers but—more importantly—the public who relies on clinicians for their physical and mental well-
being.
Wisconsin cannot meet healthcare demand by focusing on recruitment alone. Wisconsin must retain
more of its workforce, and to do so it must address the myriad factors driving clinicians from practice.
This is an opportunity to creatively and completely reimagine how the state approaches clinician well-
being and patient outcomes.
Key considerations
A comprehensive clinician retention program could improve factors driving clinicians away from practice.
This kind of comprehensive program would also oer supportive rehabilitation services to clinicians
experiencing any kind of impairment due to physical and mental health challenges.
Wisconsin is one of the few states that does not oer a comprehensive wellness program to physicians.
Wisconsin has an opportunity to better support its entire healthcare workforce by adopting a
comprehensive retention program designed to keep all clinicians practicing at the highest level of safe
care.
Recommendation
Establish a comprehensive clinician well-being and retention program designed to support the
healthcare workforce and keep them practicing at the highest level of safe practice.
Governor’s Task Force on the Healthcare Workforce Report Page 67 of 73
10b. Strengthen workforce monitoring and support: Analyze existing and gather additional data
on the healthcare workforce
Lead entity
Department of Safety and Professional Services
Background
Wisconsin currently conducts a mandatory workforce survey and related data analysis when registered
nurses and licensed practical nurses renew their license. This eort has enabled the state to better
understand challenges facing the state healthcare system and the nursing profession as well as related
impacts on public and population health.
Wisconsin has also conducted optional workforce data collection for physicians, dentists, and dental
hygienists during the last two renewal cycles. This information has simplied the work the state must do
to qualify for federal Health Resources Service Administration grants for demonstrated health provider
shortage areas.
Key considerations
Monitoring the healthcare workforce within a state is challenging. Many states use license counts to
estimate state-level capacity of healthcare professionals. Unfortunately, not all license holders practice
within the state, and license information (such as license address) may or may not reect where a
professional is practicing. Being able to identify who is practicing in Wisconsin and where they are
practicing would provide the state with a more accurate estimate of its capacity to provide care.
The collection of supplemental workforce information (for example, whether a professional practices in
the state, where their practice is located, any specialties or sub-specialties, etc.) at the time of license
renewal is a best practice for states to gather information needed to assess the workforce, identify
shortages, and target and evaluate policy solutions.
DSPS has already established processes for data collection and partnerships for data analysis.
Additional resources are necessary to enable them to expand this work across most health professions
and transform the data into actionable information for Wisconsin.
Recommendation
Implement workforce surveys for health professions and allocate resources necessary for the data
collection, analysis, and dissemination.
Governor’s Task Force on the Healthcare Workforce Report Page 68 of 73
Appendix B: Acknowledgements
The task force wishes to thank the following contributors, who provided subject matter expertise and
administrative support to the task force.
► Angela Miller, Department of Health Services
► Karen Odegaard, Department of Health Services
► Lauren Rieves, Department of Health Services
► Leeann Duwe, Department of Health Services
► Sara Knueve, Department of Public Instruction
► Christina Patrin, Department of Public Instruction
► Sharon Wendt, Department of Public Instruction
► Rachel Harvey, Department of Revenue
► Patricia Mayers, Department of Revenue
► Jennifer Garrett, Department of Safety and Professional Services
► Secretary-designee Dan Hereth, Department of Safety and Professional Services
► Patrick Lonergan, Department of Workforce Development
► Heather Thompson, Department of Workforce Development
► David Polk, Department of Workforce Development
► Danielle Williams, Department of Workforce Development
► Dennis Winters, Department of Workforce Development
► Justin Koestler, Oice of the Lieutenant Governor
► Eric LaGesse, Oice of the Lieutenant Governor
► Rachel Roberson, Oice of the Lieutenant Governor
► Jill Baures, Pauquette Center for Psychological Services
► Kathy Devine, Universities of Wisconsin
► Johannes Britz, Universities of Wisconsin
► Jessica Smith, UW-Whitewater
► Dr. Melissa Weege, UW-La Crosse
► Bridgett Willey, UW Health
► Courtney Medlock, Veritas Health Solutions
► Dr. Hannah Maxey, Veritas Health Solutions
► Rebecca Larson, Wisconsin Association of Independent Colleges and Universities
► Ann Zenk, Wisconsin Hospital Association
► Brandon Trujillo, Wisconsin Technical College System
Governor’s Task Force on the Healthcare Workforce Report Page 69 of 73
Sources
1
https://www.dhs.wisconsin.gov/aging/demographics.htm
2
https://www.wha.org/WHA-Workforce-Report-2024
3
https://www.ruralhealthinfo.org/data-explorer?id=208&state=WI
4
https://www.laurelroad.com/resources/nancial-survey-healthcare-professionals-student-loan-debt/
5
https://www.cdc.gov/vitalsigns/health-worker-mental-health/index.html
6
https://content.govdelivery.com/accounts/WIGOV/bulletins/34fd6b9
7
https://content.govdelivery.com/accounts/WIGOV/bulletins/3698bbb
8
https://health.gov/healthypeople/objectives-and-data/browse-objectives/mental-health-and-mental-disorders
9
https://www.commonwealthfund.org/publications/explainer/2023/may/understanding-us-behavioral-health-workforce-
shortage
10
https://www.ruralhealthinfo.org/charts/7?state=WI
11
https://wispolicyforum.org/research/rural-counties-face-psychiatrist-shortage/
12
https://www.bls.gov/careeroutlook/2023/article/careers-in-mental-health-services.htm
13
https://www.gao.gov/assets/gao-23-105250.pdf
14
https://www.ncsl.org/labor-and-employment/behavioral-health-workforce-shortages-and-state-resource-systems
15
https://oplr.utah.gov/wp-content/uploads/2024/01/OPLR-2023-Periodic-Review-Behavioral-Health-1.pdf
16
https://educationdata.org/average-cost-of-a-masters-degree
17
https://www.bls.gov/careeroutlook/2023/article/careers-in-mental-health-services.htm
18
https://content.govdelivery.com/attachments/topic_les/WIDHS/WIDHS_437/2020/11/09/le_attachments/1595461/2019%
20Wisconsin%20Behavioral%20Health%20System%20Gaps%20Report__1595461.pdf
19
https://www.healthaairs.org/doi/epdf/10.1377/hltha.2018.05226
20
https://nihcm.org/publications/the-behavioral-health-care-workforce-shortages-solutions
21
https://www.gao.gov/products/gao-22-104597
22
https://content.govdelivery.com/accounts/WIGOV/bulletins/3868c05
23
https://www.jobcenterofwisconsin.com/wisconomy/wits_info/downloads/nurse-survey-
reports/legislative/2023%20DWD%20Report%20to%20Legislators%20-%20WI%20Nursing%20Surveys.pdf
24
https://skillexplorer.wisconsin.gov/Summary.aspx?curocc=292061&selocc=292061
25
https://www.ziprecruiter.com/Salaries/Rn-Travel-Nurse-Salary--in-Wisconsin
26
https://jobcenterofwisconsin.com/wisconomy/wits_info/downloads/nurse-survey-reports/supply-nurse-
reports/2020_WI%20RN%20Nurse%20Supply%20Demand%20Forecast%202020-2040.pdf
27
https://www.wha.org/WHA-Workforce-Report-2024
28
https://jobcenterofwisconsin.com/wisconomy/pub/nursetabv23.htm
29
https://data.bls.gov/projections/occupationProj
30
https://www.nsinursingsolutions.com/Documents/Library/NSI_National_Health_Care_Retention_Report.pdf
31
https://www.nursingworld.org/content-hub/resources/nursing-leadership/why-nurses-quit/
32
https://onl.memberclicks.net/assets/docs/ONLWorkforceReportJan2022/ONL_Workforce_Report_Jan2022.pdf
33
https://storage.googleapis.com/craft-production-static-content/prod/Nurse.com-2024-Nurse-Salary-and-Work-Life-
Report.pdf
34
https://jobcenterofwisconsin.com/wisconomy/pub/nursetabv23
35
https://www.nsinursingsolutions.com/Documents/Library/NSI_National_Health_Care_Retention_Report.pdf
36
https://www.aacnnursing.org/Portals/0/PDFs/Fact-Sheets/Faculty-Shortage-Factsheet.pdf
Governor’s Task Force on the Healthcare Workforce Report Page 70 of 73
37
https://jobcenterofwisconsin.com/wisconomy/pub/nursetabv23
38
https://www.aacnnursing.org/Portals/0/PDFs/Fact-Sheets/Faculty-Shortage-Factsheet.pdf
39
https://content.govdelivery.com/accounts/WIGOV/bulletins/3abfd95
40
https://content.govdelivery.com/accounts/WIGOV/bulletins/353b805
41
https://content.govdelivery.com/accounts/WIGOV/bulletins/353b805
42
https://docs.legis.wisconsin.gov/misc/lfb/budget/2023_25_biennial_budget/302_budget_papers/480_higher_educational_aid
s_board_nurse_educators.pdf
43
https://www.wha.org/2023-DHS-BakerTillyLTCReport.pdf
44
https://www.leadingagewi.org/media/113792/2022-workforce-report-7-13a.pdf
45
https://www.wha.org/WHA-Workforce-Report-2024
46
https://bhw.hrsa.gov/sites/default/les/bureau-health-workforce/LTSS-Projections-Factsheet.pdf
47
https://www.phinational.org/wp-content/uploads/2017/09/wisconsin_home_care_landscape_phi_2017_0.pdf
48
https://www.commonwealthfund.org/blog/2024/direct-care-workers-play-vital-role-providing-care
49
https://www.phinational.org/policy-research/workforce-data-center/
50
https://www.commonwealthfund.org/blog/2024/direct-care-workers-play-vital-role-providing-care
51
https://www.phinational.org/policy-research/workforce-data-center/
52
https://www.dhs.wisconsin.gov/non-dhs/dms/2021-nci-idd-workforce-report.pdf
53
https://www.dhs.wisconsin.gov/news/releases/080823.htm
54
https://www.dhs.wisconsin.gov/arpa/hcbs-grantsopportunities.htm
55
https://content.govdelivery.com/accounts/WIGOV/bulletins/3abfd95
56
https://www.dhs.wisconsin.gov/gtfc/index.htm
57
https://dwd.wisconsin.gov/workforce-solutions/wai/
58
https://uscode.house.gov/view.xhtml?path=/prelim@title42/chapter6A/subchapter5&edition=prelim
59
https://explorehealthcareers.org/eld/allied-health-professions/
60
https://www.jobcenterofwisconsin.com/wisconomy/pub/projections
61
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10757398/
62
https://pubmed.ncbi.nlm.nih.gov/32430374/
63
https://content.govdelivery.com/accounts/WIGOV/bulletins/387c83b
64
https://www.dhs.wisconsin.gov/primarycare/ahp-grant.htm
65
https://dwd.wisconsin.gov/workforce-solutions/wai/
66
https://jobcenterofwisconsin.com/wisconomy/pub/occupation.htm#Viz
67
https://www.dhs.wisconsin.gov/publications/p03204.pdf
68
https://www.ruralhealthinfo.org/data-explorer?id=208&state=WI
69
https://www.ada.org/-/media/project/ada-organization/ada/ada-org/les/resources/research/hpi/hpigraphic_1021_1.pdf
70
https://jobcenterofwisconsin.com/wisconomy/pub/occupation.htm#Viz
71
https://content.govdelivery.com/accounts/WIGOV/bulletins/387c83b
72
https://www.dol.gov/sites/dolgov/les/WB/WB_issuebrief-doulas-v3.pdf
73
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3647727/
74
https://jobcenterofwisconsin.com/wisconomy/pub/occupation.htm#Viz
75
https://www.uhccommunityandstate.com/content/blog-post/andy-mcmahon-posts/the-essential-role-of-community-
health-workers-
76
https://www.dhs.wisconsin.gov/lh-depts/counties/index.htm
77
https://jamanetwork.com/journals/jama-health-forum/fullarticle/2816057
Governor’s Task Force on the Healthcare Workforce Report Page 71 of 73
78
https://www.dol.gov/sites/dolgov/les/WB/WB_issuebrief-doulas-v3.pdf
79
https://docs.legis.wisconsin.gov/misc/lfb/budget/2023_25_biennial_budget/200_comparative_summary_of_provisions_2023_
act_19_august_2023_by_agency/health_services.pdf
80
https://www.dhs.wisconsin.gov/news/releases/101222.htm
81
https://docs.legis.wisconsin.gov/misc/lfb/budget/2023_25_biennial_budget/200_comparative_summary_of_provisions_2023_
act_19_august_2023_by_agency/children_and_families.pdf
82
https://dcf.wisconsin.gov/press/covid-proposal
83
https://jobcenterofwisconsin.com/wisconomy/pub/occupation.htm#Viz
84
https://ambulance.org/wp-content/uploads/2021/07/2021-AAA-EMS-Turnover-Study.pdf
85
https://worh.org/wp-content/uploads/2023/03/EMS-Reliability-Report_March2023.pdf
86
https://content.govdelivery.com/accounts/WIGOV/bulletins/364ac00
87
https://www.dhs.wisconsin.gov/dph/memos/ems/23-11-ems.pdf
88
https://static1.squarespace.com/static/5a3ac16af14aa15aede6d0ed/t/61cca4825825487bd2b83324/1640801412799/WCM
EW+2021+Workforce+Report.pdf
89
https://www.k.org/other/state-indicator/primary-care-health-professional-shortage-areas-hpsas
90
https://www.med.wisc.edu/news/training-addresses-rural-physician-shortage/
91
https://www.aamcresearchinstitute.org/our-work/data-snapshot/post-dobbs-2024
92
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7388019/
93
https://docs.legis.wisconsin.gov/misc/lrb/wisconsin_policy_project/primary_care_shortage_3_5.pdf
94
https://www.gao.gov/products/gao-17-411
95
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7388019/
96
https://docs.legis.wisconsin.gov/misc/lfb/budget/2023_25_biennial_budget/200_comparative_summary_of_provisions_2023_
act_19_august_2023_by_agency/health_services.pdf
97
https://www.nursingoutlook.org/article/S0029-6554(16)30314-1/abstract
98
https://www.hrsa.gov/sites/default/les/hrsa/advisory-committees/nursing/reports/nacnep-17report-2021.pdf
99
https://worh.org/resources/for-the-workforce/loan-repayment/
100
https://heab.state.wi.us/features/nep.html
101
https://heab.state.wi.us/les/forms/nep-eligibility-degree.pdf
102
https://heab.state.wi.us/les/forms/nep-facultyhirefaq.pdf
103
https://cdphe.colorado.gov/nurse-faculty-loan-repayment-program
104
https://healthcareworkforce.georgia.gov/loan-repayment-scholarship-programs/loan-repayment-programs
105
https://www.isac.org/faas/other-programs/loan-repaymentforgiveness-programs/nurse-educator-loan-repayment-progam/
106
https://www.health.state.mn.us/facilities/ruralhealth/funding/loans/nursfac.html
107
https://wsac.wa.gov/nelr
108
https://www.hrsa.gov/grants/nd-funding/HRSA-24-015
109
https://bhw.hrsa.gov/funding/apply-loan-repayment/faculty-
lrp#:~:text=Get%20help%20with%20your%20application&text=Eligible%20faculty%20members%20can%20apply,an%20eligi
ble%20health%20professions%20school
110
https://www.hrsa.gov/sites/default/les/hrsa/advisory-committees/nursing/reports/nacnep-17report-2021.pdf
111
https://wicenterfornursing.org/wp-content/uploads/2023/12/2021-2022-Wisconsin-Nursing-Education-Facility-Report.pdf
Governor’s Task Force on the Healthcare Workforce Report Page 72 of 73
112
https://www.hrsa.gov/sites/default/les/hrsa/advisory-committees/nursing/reports/nacnep-17report-2021.pdf
113
https://www.aacnnursing.org/Portals/0/PDFs/Fact-Sheets/Faculty-Shortage-Factsheet.pdf
114
https://www.uww.edu/orsp/research-centers-and-initiatives/citee/qtt
115
https://www.azleg.gov/viewdocument/?docName=https://www.azleg.gov/ars/36/01806.htm
116
https://www.vdh.virginia.gov/content/uploads/sites/76/2024/02/Nurse-Preceptor-Guidelines-Updated-2024.pdf
117
https://app.leg.wa.gov/rcw/default.aspx?cite=18.79.430
118
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7056349/
119
https://www.trelliscompany.org/wp-content/uploads/2023/07/Research-Brief_Jul23_Transportation.pdf
120
https://www.mhec.org/sites/default/les/resources/2021The_Digital_Divide_among_College_Students_1.pdf
121
https://iwpr.org/wp-content/uploads/2021/10/Evaluating-the-Role-of-Campus-Child-Care_FINAL.pdf
122
https://iwpr.org/wp-content/uploads/2020/12/C445.pdf
123
https://edworkingpapers.com/sites/default/les/ai24-925.pdf
124
https://urbanlabs.uchicago.edu/attachments/89ba899bbb8d94545822ecb39ae94f2c736345/store/466e7cde4a3f66a7c388
d8f39c0ca80efc914f34b85caacb63509f4a4de2/Final_OMD+Working+paper_updated+June+2022.pdf
125
https://www.wiscaregivercdcp.com/
126
https://www.uwgb.edu/certied-direct-care-professional/nd-a-job/
127
https://www.google.com/maps/d/u/1/viewer?mid=1r5Hq9Is7132dplfPi0P6De7ZXXOHGCo&ll=44.67828188026806%2C-
89.68447222376497&z=8
128
https://wiscaregivercna.com/
129
https://www.dhs.wisconsin.gov/caregiver/nurse-aide/nar-test-faq.htm
130
https://www.dhs.wisconsin.gov/caregiver/nurse-aide/statistics.htm
131
https://www.leadingagewi.org/media/113792/2022-workforce-report-7-13a.pdf
132
https://www.nga.org/wp-content/uploads/2021/10/NGA_SectorGrowth-DirectCare_report.pdf
133
https://lafollette.wisc.edu/research/a-cost-benet-analysis-of-the-wiscaregiver-careers-program/
134
https://data.census.gov/table/ACSST1Y2022.S1501?q=wisconsin%20education%20attainment
135
https://wisedash.dpi.wi.gov/Dashboard/dashboard/16657
136
https://www.dhs.wisconsin.gov/primarycare/ahp-grant.htm
137
https://www.dhs.wisconsin.gov/primarycare/apc-grant.htm
138
https://dpi.wi.gov/sites/default/les/imce/acp/pdf/2020_03_09_ACP_FAQs.pdf
139
https://dpi.wi.gov/sites/default/les/imce/dual-enrollment/2021_01_21_2020_09_Dual_Enrollment_Intro_1.pdf
140
https://www.phinational.org/policy-research/workforce-data-center
141
http://www.survivalcoalitionwi.org/wp-content/uploads/2019/04/Medicaid-BadgerCare-expansion_0419.pdf
142
https://www.k.org/medicaid/report/the-eects-of-medicaid-expansion-under-the-aca-updated-ndings-from-a-
literature-review/
143
https://www.dhs.wisconsin.gov/arpa/hcbs-ratereform.htm
144
https://www.dhs.wisconsin.gov/aging/demographics.htm
145
https://www.k.org/statedata/mental-health-and-substance-use-state-fact-sheets/wisconsin/
146
https://docs.legis.wisconsin.gov/misc/lfb/budget/2023_25_biennial_budget/302_budget_papers/
407_health_services_medical_assistance_eligibility_and_benets_medical_assistance_provider_reimbursement_rates.pdf
147
https://www.ruralhealthinfo.org/charts/7?state=WI
148
https://www.bls.gov/ooh/eld-of-degree/healthcare-and-related/healthcare-and-related-eld-of-degree.htm
149
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10503048/
150
https://www.consumernance.gov/about-us/blog/student-debt-and-health-care/
Governor’s Task Force on the Healthcare Workforce Report Page 73 of 73
151
https://www.obgyn.wisc.edu/ob-gyn-department-news/uw-smph-department-of-ob-gyn-thanks-rural-training-partners-
on-national-rural-health-day-2023
152
https://pbswisconsin.org/news-item/dr-amy-domeyer-on-the-lack-of-ob-gyns-in-wisconsin/
153
https://www.nga.org/state-health-workforce-toolkit/training-recruitment-retention/#workforceRetention
154
https://nhsc.hrsa.gov/loan-repayment/state-loan-repayment-program/awards
155
https://worh.org/resources/for-the-workforce/loan-repayment/#1663163095569-3186b10b-fd7e
156
https://worh.org/resources/for-the-workforce/loan-repayment/#assessment-tools1f91-8d71a69b-a0e3
157
https://worh.org/wp-content/uploads/2023/12/LAP-Annual-Report-22-23.pdf
158
https://www.dhs.wisconsin.gov/arpa/hcbs-grants-112823.pdf
159
https://www.dhs.wisconsin.gov/arpa/hcbs-grantsopportunities.htm
160
https://www.phinational.org/policy-research/workforce-data-center/
161
https://www.dhs.wisconsin.gov/gtfc/gtfc-report.pdf
162
https://www.leadingagewi.org/media/113792/2022-workforce-report-7-13a.pdf
163
https://www.dol.gov/sites/dolgov/les/WB/WB_issuebrief-doulas-v3.pdf
164
https://www.dhs.wisconsin.gov/dph/community-health-workers.htm
165
https://www.dhs.wisconsin.gov/stats/births/birth-char.htm
166
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3647727/
167
https://www.princeton.edu/~davidlee/wp/birthweight.pdf
168
https://news.umich.edu/born-to-lose-how-birth-weight-aects-adult-health-and-success/
169
https://compacts.csg.org/compacts/
170
https://docs.legis.wisconsin.gov/document/statutes/441.01
171
https://docs.legis.wisconsin.gov/code/admin_code/n/1.pdf
172
https://iga.in.gov/laws/2023/ic/titles/25#25-23-1-7.3
173
https://resources.acenursing.org/space/SAC/1825603701/STANDARD+2+-+Faculty
174
https://resources.acenursing.org/space/SAC/1825603701/STANDARD+2+-+Faculty
175
https://irp.cdn-website.com/cc12ee87/les/uploaded/CNEA%20Standards%20October%202021-4b271cb2.pdf
