Introduction

UNIDOS U.S. estimates that 30% of the U.S. workforce will be Latino by 2050 (UNIDOS U.S., “Monthly Report, June 2014”). In its 2023 report to the Joint Means and Ways Subcommitte, Oregon Department of Human Services (“ODHS”) stated “community employment is a goal for everyone” (ODHS, “ODHS Presentation to the 2024 Joint Ways and Means Subcommitte on Human Service”, 2023, p.15). However, Latinos, and individuals with intellectual/developmental disabilities (IDD), are historically underrepresented in Oregon’s workforce. This report seeks to illuminate why this is the case, and provide recommendations for a solution.

Challenges Identified:

1. Latinos Are Underrepresented In ODDS Provision Of Employment Services

• Latinos account for 14% of Oregon’s population. Yet, they are underrepresented: according to ODHS’ 2023 report, 5.4% of individuals enrolled in ODDS are Latino. They also scored 2nd-lowest in ODDS’ disproportionality metric. (ODHS, “ODHS Presentation…”).

2. Cultural Barriers Provoke Decreased Engagement                                        

• 28% of individuals with IDD have never held a job and unemployment is triple that of people without IDD. Latinos with IDD experience notable hindrances to entering the workforce, including linguistic challenges, cultural barriers, and differing perceptions of IDD in the Latino community. (CBCIDD, “Adults with intellectual and developmental disabilities and employment”).

3. Rates Of Disengagment May Be Higher Than Reported

• The Kuni Foundation argues that “Research on the prevalence of IDD among adults is outdated and an inadequate foundation for assessing baseline conditions or making policy”. If using 25-year-old calculation methods, “the Larson method”, 26,600 Oregonian adults live with IDD. The report proceeds to quote a 2015 Ohio study that suggests an updated calculation method. Extrapolating it to Oregon suggests a total population of adults with IDD of 138,000. (Kuni Foundation, “Housing Needs for Individuals with Intellectual and Developmental Disabilities”, Page iii).
• Which is correct? In 2023, ODDS reported it serves 22,905 adults. Using the smaller figure, Oregon serves about 88% of adults with IDD. Extrapolating from the Ohio study, which is less established, it is 17%. This is closer to the Residential Information Systems Project’s estimate of  22% being of individuals with IDD ‘known’ by their state agency. (RISP, “People with IDD in the United States”, 2019).
• We also believe that uncertainty about eligibility due to immigration status, language barriers, cultural attitudes to retaining people within IDD within the home, a focus on care within the family, and lack of similar services in Latin countries, are responsible for higher rates of disengagement among Latinos, and probably more than reported. ODDS can increase overall engagement rates by reaching underserved Latino populations.

4. Greater Engagement Is Necessary To Meet Demographic Shifts

• Latinos are the fastest-growing ethnic group in Oregon. A continued disproportionality of Latino engagement over the following decades will lower ODDS overall engagement rates as demographics shift. In 1980, 2% of people in Oregon identified as Hispanic or Latino; today, 14% do. In Portland alone, “the Hispanic/Latino population segment is expected to add another 665,000 people by 2060, the largest increase in a race or ethnic population. Whites will grow by another 285,000 followed by another 250,000 Asians”. (Oregon Government, “2060 Growth Forecast”).  ODDS must improve culturally competent support to new Latino populations to maintain and improve population engagement metrics and Service Equity.
• According to ODHS’ “Lane and Brown Settlement Report”, in 2022, ODDS provided Employment Services to 7,000 people. (ODHS, “Lane v. Brown Settlement Agreement Report”, 2022) In the same year, 1,356 were found to be in “Competitive Integrated Employment”. This leaves significant scope for improvements in two areas. The first is raising the number of Latinos engaged with ODDS overall, and therefore, Employment Services; the second is the conversion from engagement with Employment Services, such as Vocational Rehab, and entering employment, which this project could help close.

5. Culturally Competent Services Are Required To Engage More Latinos

• Culturally competent content and resources are necessary to maximize the efficiency of ODDS Latino engagement, such as the Model Employer Program, Healthier Oregon, and Language Support in Employment Services. In 1980, 2.5% of Oregonians spoke Spanish at home. (Axios Portland, “Portland is becoming more multilingual”, 2023). Today, 8% do so. In Multnomah, Oregon’s most diverse county, 11% of residents speak Spanish at home, almost 400% more than the next largest linguistic group, Vietnamese. (State of Oregon Employment Department, “Languages spoken in Multnomah County”). We acknowledge that ODDS provides translations of posters, social media pages, websites, and more; this is greater support than many other states. That said, given low Latino engagement compared to other ethnicities, we believe cultural competency can be more easily achieved if content for this platform is first written in Spanish, and includes linguistic idiosyncrasies, cultural references, and champions from within the Latino community.
• Not all Latinos can speak Spanish and some face discrimination for being unable to do so. (Pew Research Center, Latinos’ Views and Experiences With the Spanish Language”, 2023). We will investigate if the site should also be in English to fully-serve the community. We do believe more Spanish language content is necessary to promote Service Equity and inclusion, particularly amongst a cultural group with poor dispropritionality metrics and a growing immigrant population who may speak only Spanish. For instance, the “I Work We Succeed” campaign appears to only feature case studies in English. However, we will thoroughly examine if the site should be bilingual through working with Latino cultural advisors and other stakeholders.

Recommendations

We recommend public health providers in Oregon, and beyond to produce:

• Research to:
  • Understand the impact of immigration and immigration status on Latino  engagement.
  • Analyze Latino engagement with Employment Services compared to other ethnicities.
  • Understand regional needs and capacity.
  • Make quantitative and qualitivate data analysis.
  • Engage stakeholders.
  • Benchmark capacity against other states.
  • Discover knowledge gaps to create appropriate content towards.
  • Understand how to maximize site accessibility, and cultural competency.
• A website with guides on entering the workforce, finding a job, and linked opportunities.
• An FAQ section answering uncertainties on elgibility for services per immigration status, how to access services, etc
• Success stories of individuals who have successfully entered the workforce.
• A database of friendly employers willing and ready to hire Latinos with IDD.
• A Facebook and Instagram page promoting the site’s content on social media, including paid advertising campaigns and stakeholder partnerships to drive site engagagment.

Summary

To achieve health equity, its essential for public health bodies in Oregon to consider the effects of demographic changes, particularly when it comes to individuals with IDD. Our research shows that Latinos in Oregon face systematic barriers to receiving appropriate care. We propose this is similar in many other states, and urge a reconsideration of the resources and support available to this group.

Please get in touch with feedback on this briefing, or change suggestions based on your lived experience of the issues mentioned. We are open to ideas on how to advance health equity for everyone, and in this case, particularly Latinos with IDD.

Adam Chambers

Founder of the Rural Healthcare Transformation Hub @ Nurse Recruitment X

Looking to secure Rural Health Transformation Program funds and fix your workforce shortages? Our Rural Health Transformation Hub helps rural hospitals, clinics, and home care agencies design winning proposals and build the pipelines needed to recruit and retain staff. We combine grant support with real recruitment expertise, giving you a low-risk way to compete for funds and implement workforce solutions that work.

Book a free strategy call

nurserecruitmentx.com

Introduction

The accessibility of culturally competent Peer Support Specialist (PSS) training for Latinos in Oregon is crucial to achieving health equity, particularly for the significant Latino population in several counties. This analysis examines the availability, cultural relevance, and barriers to accessing PSS training programs for Latinos in Oregon, particularly in counties with higher Latino populations, such as Morrow, Malheur, Hood River, and Umatilla.

Health Equity

Health equity is a fundamental principle aiming to reduce health disparities and ensure everyone has a fair opportunity to achieve their highest health potential. Health equity for the Latino population in Oregon involves addressing linguistic, cultural, and socioeconomic barriers that hinder access to health services, including peer support specialist training. Ensuring equitable access to such training programs is crucial for fostering a diverse workforce that can effectively address the unique needs of Latino communities, thereby promoting better health outcomes and reducing disparities.

Importance of Culturally Competent Behavioral Health Care

Culturally competent behavioral health care involves recognizing and respecting the cultural differences that influence individuals’ health behaviors and attitudes. This competency is essential in delivering effective mental health and addiction recovery services. For Latinos, culturally competent care means providing services that are linguistically accessible, culturally relevant, and sensitive to the unique experiences and challenges this community faces. Training programs incorporating cultural competence can enhance the effectiveness of peer support specialists, leading to more successful outcomes in mental health and addiction recovery.

Importance of Culturally Competent Healthcare Among Latino Populations

Latino populations often face unique healthcare challenges due to cultural, linguistic, and socioeconomic factors. Culturally competent healthcare ensures that these factors are considered in the delivery of health services. For Latino communities in Oregon, culturally competent peer support specialist training can bridge gaps in understanding, build trust, and improve engagement in mental health and addiction recovery programs. This approach not only enhances the quality of care but also contributes to a more inclusive healthcare system that respects and values the diversity of its population.

Demographic Overview

Latinos account for 14% of Oregon’s population, with notable concentrations in Morrow (37.3%), Malheur (34.4%), Hood River (32.1%), and Umatilla (27.3%) counties. Cities like Boardman and Nyssa have majority Latino populations, indicating a substantial community presence that necessitates accessible and culturally relevant PSS training programs.

Availability of Training Programs

Several PSS training programs are offered across Oregon, including in regions with significant Latino populations. Critical training programs include

• Juntos NW, Fortaleza Atravez Barreras, Libertad, and Multicultural Consulting in Portland offer Spanish Mental Health Certified Peer Support Specialist training.
• Chemeketa Community College in Salem offers Peer Support Specialist training for Adult Addiction.
• Rogue Community College in Grants Pass offers Peer Support Specialist training for Adult Mental Health.

Despite these offerings, there is a notable gap in the availability of training programs in counties like Malheur and Umatilla, where Latino populations are substantial, but training options are limited.

Cultural Relevance and Language Barriers

A critical factor in the accessibility of PSS training is the cultural relevance and language accessibility of the programs. While some programs are offered in Spanish, many do not consider the unique cultural contexts of Latino communities, such as immigration status or specific community challenges.

• NAMI Multnomah offers a culturally competent training framework, but similar models are not widely implemented across other training programs.
• Lines for Life and other organizations provide culturally specific resources and support, but there is a need for more widespread integration of these principles into PSS training.

Socioeconomic Barriers

Cost is a significant barrier for many Latinos to access PSS training. According to BLS, Latinos earn, on average, 33% less than white people in Oregon. Training programs can be expensive, and there are limited financial aid options. Implementing a pay-back system, where courses are initially free and participants pay back costs once employed, could alleviate this barrier and increase participation.

Systematic Barriers

Several systematic barriers discourage Latinos from applying to PSS training programs:

• More targeted outreach to Latino communities is needed to be done about the availability and benefits of PSS training.
• Complicated and lengthy application processes can deter potential applicants.
• Support services during training, such as childcare and transportation, could be improved.

Recommendations

To enhance the accessibility and effectiveness of PSS training programs for Latinos in Oregon, the following recommendations are proposed:

1. Expand PSS training programs to counties like Malheur and Umatilla to meet the demand in these regions.
2. Incorporate cultural competency and language accessibility into all training programs, ensuring they address the specific needs of Latino communities.
3. Implement financial support mechanisms, such as pay-back systems, to reduce the economic burden on trainees.
4. Enhance outreach efforts to Latino communities and streamline application processes to encourage higher enrollment.
5. Provide support services like childcare and transportation assistance to reduce barriers during training.

Appendices

Inventory – OHA-Approved training programs for Peer Support Specialists.

Bibliography

1. Oregon Office of Economic Analysis:
   • Source for demographic data and population statistics in Oregon.
   • Available at: Oregon Office of Economic Analysis

2. Oregon Demographics:
   • Provides detailed demographic information about Oregon’s population, including Latino population statistics.
   • Available at: Oregon Demographics

3. National Alliance on Mental Illness (NAMI):
   • Information on mental health issues and statistics related to Latino populations.
   • Available at: NAMI Latino Mental Health

4. Substance Abuse and Mental Health Services Administration (SAMHSA):
   • Guidelines and information on cultural competence in behavioral health services.
   • Available at: SAMHSA Cultural Competence

5. OHA, THW Training Programs, Oregon Health Authority : THW Training Programs: Equity and Inclusion Division: State of Oregon
   • Data on licensed training programs for traditional health workers in Oregon.

6. IndexMundi, Oregon Hispanic or Latino Origin Population Percentage By County, Oregon Hispanic or Latino Origin Population Percentage by County (indexmundi.com)
   • Data on the distribution of Latino populations and percentage composition of Oregon counties.

Adam Chambers

Founder of the Rural Healthcare Transformation Hub @ Nurse Recruitment X

Looking to secure Rural Health Transformation Program funds and fix your workforce shortages? Our Rural Health Transformation Hub helps rural hospitals, clinics, and home care agencies design winning proposals and build the pipelines needed to recruit and retain staff. We combine grant support with real recruitment expertise, giving you a low-risk way to compete for funds and implement workforce solutions that work.

Book a free strategy call

nurserecruitmentx.com

Executive Summary

The Pacific Northwest, particularly Washington State, faces a critical shortage of nurses that threatens the quality and accessibility of healthcare. This white paper explores the educational challenges contributing to this shortage, including faculty under-resourcing, outdated educational infrastructure, and barriers to career progression from CNA to RN. We propose targeted legislative support, enhanced funding, and strategic educational reforms to address these issues comprehensively.

Introduction

The nursing shortage in the Pacific Northwest has reached an alarming level, necessitating immediate and robust intervention. Washington State, in particular, requires a multifaceted approach to mitigate this crisis, focusing significantly on the educational pipeline that prepares future nursing professionals.

Current Situation and Legislative Efforts

The Washington State Hospital Association has emphasized the need for legislative measures to fill RN vacancies effectively. This initiative acknowledges the gap between the supply of qualified nursing professionals and the healthcare system’s demands.

Educational Challenges

Faculty Shortages

The American Association of Colleges of Nursing (AACN) highlights a national crisis, where nursing programs turned away over 91,000 qualified applicants in 2021 due to faculty shortages. In Washington, this issue is exacerbated by the high retirement rates among current faculty and the significant disparities in compensation between clinical roles and academic positions. The AACN predicts that one-third of the faculty may retire by 2025, intensifying the urgency for recruitment and retention strategies.

Resource Limitations

Educational institutions face critical limitations in resources, impacting their ability to expand and enhance nursing programs. These include insufficient clinical sites, outdated technological infrastructure, and limited classroom space. The HRSA stresses the importance of developing distance learning infrastructure to mitigate these issues, especially in rural areas.

Analysis of Impacts

The understaffing and underresourcing of nursing education directly limit the number of new nurses entering the workforce, thereby perpetuating the shortage. The inability to expand nursing programs to meet demand not only hinders healthcare service delivery but also affects the overall health outcomes across communities.

Recommendations

1. Legislative Support: Advocate for state and federal funding increases specifically earmarked for nursing education.
2. Infrastructure Enhancement: Invest in modernizing educational facilities and technology, particularly for distance learning, to make education more accessible and effective.
3. Faculty Development: Implement programs to attract and retain younger, diverse faculty members through competitive compensation and career development opportunities.
4. Career Pathway Promotion: Increase awareness and accessibility of career pathways in nursing, particularly from CNA to LPN to RN, to ensure a continuous and expanded workforce.

Conclusion

The nursing shortage in the Pacific Northwest is a multifactorial issue that requires a concerted effort from educational institutions, healthcare facilities, and government bodies. By addressing the educational bottlenecks, particularly faculty shortages and resource limitations, Washington can pave the way for a robust healthcare system equipped to meet the demands of its population.

References

1. AACN Nursing Faculty Shortage – American Association of Colleges of Nursing details the faculty shortage and its impact on nursing education. AACN Faculty Shortage Fact Sheet
2. Special Survey on Vacant Faculty Positions – AACN’s October 2022 survey outlining current faculty vacancies in U.S. nursing schools. AACN Vacant Faculty Positions Survey
3. HRSA’s Report on Developing Distance Learning Infrastructure – Health Resources and Services Administration emphasizes the need for improved distance learning infrastructure in nursing education. HRSA Report
4. Training Direct on Being a CNA – Offers insights into the advantages of becoming a CNA, including job stability and fast-track training. Being a CNA Could Be the Right Fit for You
5. Educator Shortage in Rural Areas of Washington – Discusses challenges faced by remote and rural school districts in Washington in creating a robust educator workforce. WA Educator Shortage Report

Adam Chambers

Founder of the Rural Healthcare Transformation Hub @ Nurse Recruitment X

Looking to secure Rural Health Transformation Program funds and fix your workforce shortages? Our Rural Health Transformation Hub helps rural hospitals, clinics, and home care agencies design winning proposals and build the pipelines needed to recruit and retain staff. We combine grant support with real recruitment expertise, giving you a low-risk way to compete for funds and implement workforce solutions that work.

Book a free strategy call

nurserecruitmentx.com