• There is a shortage of direct care providers in the U.S. Direct care providers are staff who have interpersonal contact with patients and residents to provide care and services. Direct care staff include physicians, physician assistants, nurses, and aides among others.
• There are many consequences and costs associated with a high direct care vacancy rate. High vacancy rates can negatively impact a facility's ability to provide quality care and to accept new patients, and can result in higher labor costs due to outsourced medical professional labor.
• The FY18 vacancy rate for direct care positions is as follows:
  • Quarter 1:  24.9%
  • Quarter 2:  24.3%
  • Quarter 3:  23.7%
  • Quarter 4:  27.6%
  • FY18: 25.1%

        The target of 10% was not met.

• Recruitment and retention continue to be a challenge for the facilities. On the recruitment side, NMDOH cannot quickly respond to changes in market rates for direct care positions, but we are engaging in the health care workforce rate study to inform the state personnel system about compensation and classification for these positions.
• Exit interviews with employees who have separated employment indicate that a lack of career advancement opportunities, and the challenge of providing specialized care, contribute to staff turnover.
• Facilities continue to focus on recruitment by holding rapid‐hire events, participating in career fairs, and advertising at local colleges. Retention issues continue to be monitored through the use of exit interviews to improve employee job satisfaction. This continues to be an area of focus as we work toward improving quality of care. NMDOH has partnered with the State Personnel Office to complete the largest compensation and classification study in state government to date. The study is of all health care positions in state government and will be completed by the end of 2018 or the beginning of 2019. The information gathered will help inform the State Personnel System about any necessary changes to its compensation and classification system for health care positions in state government.

• State Personnel Office
• NMDOH Human Resources Bureau
• NMDOH Public Health Division
• Colleges and universities

• Recruitment through rapid‐hire events.
• Partnering with colleges and universities to enhance training and recruitment opportunities and bridging the gap between school and work.
• Marketing the benefits of employment with the State of New Mexico as a major reason to work for NMDOH.

• Hold rapid‐hire events to recruit health care staff.
• Work with various professional schools throughout the state to enhance training and recruitment opportunities.
• Research new and innovative methods of recruiting health care staff.
• Collaborate with partners in developing opportunities to share resources in recruiting and advertising.

• Q1‐Q4: Explore efficiencies in the way services can be provided and share talent and resources within NMDOH to utilize resources in the most efficient, cost‐effective manner. Completed.
• Q1‐Q4: Continue communications by facility Administrators and Directors of Nursing with nursing schools, or other potential hiring locations for recruitment and retention of health care staff, and particularly nurses, which is the most critical shortage area. Completed.
• Q1‐Q4: Hold frequent rapid‐hire events to quickly fill direct care vacancies. Evaluate direct care position salaries. Completed.
• Q1‐Q4: Maintain regular contact with nursing schools statewide to encourage student involvement in our facilities. Completed.

• In FY18, the vacancy rate for direct care positions was 25.1%. This annual result did not meet the 10% target.
• NMDOH continues to face challenges with recruitment and retention of direct care positions, as it is also a challenge nationwide; however, the effort of exploring and taking action on new recruitment and retention strategies is ongoing.
• In late FY18, to address recruitment and retention of nurse positions, NMDOH conducted a review of those positions and hourly pay. This resulted in a 24% average salary increase for nursing staff and a more appropriate placement.
• In FY18, NMDOH, in conjunction with the State Personnel Office and Miners Colfax Medical Center, entered into a contract with a consultant to perform a health care rate study. The goal is to develop a compensation structure that is competitive with the State's market. This will enable NMDOH to attract and retain the healthcare support needed to meet its objectives.