Why Travel PTs Should Consider Home Health Jobs In 2019
By Stephen Stockhausen, PT, DPT, OCS, Contributing Writer, Founder of PT Adventures As 2019 rolls in we all have change on our minds. Sometimes it is something as simple as a New Year’s resolution—that chances are you have already broken—or occasionally it is something much bigger, like changing your job. For those of you considering the latter, I am here to tell you that taking a contract in home health might be one short-term change that you stick with all year. Why Travel PTs Should Consider Home Health In 2019 1. Join the Party via GIPHY With patients being discharged “sicker and quicker” from hospitals, and skilled nursing facilities incentivized to do the same come October of this year via the Patient-Driven Payment Model, a considerable uptick in home health admissions is to be expected. Early Release After Surgery (ERAS) total joint patients are popping up with increasing frequency on home health case loads. With clients foregoing the 2-5 days in a hospital bed, they are able to get up and moving much quicker under the care of a home health physical therapist. This is a growing field by all accounts. The travel physical therapist who has experience in this high demand field will find themselves sought after for jobs in locations where they previously could not find work. Building a stronger resume in more settings will only serve to boost your chances of landing a job in that dream location or at your goal pay rate. 2. Mo’ Money, Fewer Problems via GIPHY Speaking of pay rates, did I mention that home health is one of, if not the most, high paying setting in physical therapy? It is not unheard of for travel home health physical therapists to make over $2,200 per week after taxes. Add a 40 hour guaranteed contract on top of that and you have a sweet paying gig regardless of patient census. My wife and I were able to pay off around $240,000 in combined student loan debt in three years using home health jobs almost exclusively! You can read more about that story here. 3. Freedom via GIPHY Despite all of the exciting, challenging, and lucrative aspects of home health, it may be the freedom that is the most impactful for clinicians new to the setting. For most agencies, a full day in home health is 4-6 patients, and depending on visit type, sometimes only two patients are required. Making things even better, at nearly all companies you get to make your own schedule. Mani-pedis with the girls after a long lunch? Want to squeeze in a mid morning trail run? Perfect! Just call your clients and move your day around accordingly. My wife and I have our 18-month-old daughter with us on the road, and because we are both working home health jobs we can arrange it so that we only have a nanny at our home for around five hours a day. That’s hard to accomplish in most other travel job settings. Now, I do not want to mislead you. You will likely end up putting in your 40 hours for the week. The documentation and driving can eat into your working time more than you’d expect, but at least you are getting paid for mileage. Still, with most systems you can document from anywhere you can get Internet service. Nestled deep into your couch, on top of a bluff overlooking the beach, or even from the patio of a beautiful vineyard. The choices are endless, and they are all available to you. Years ago, back in PT school, it was made abundantly clear to us that home health is where therapists go to disappear. Substandard care was not the exception, but the rule, and none of us students should stoop to level occupied by the lowly home health PT. Well, I’m here to tell you that this could not be further from the truth. Things have changed in the three years between PT school and taking my first home health job. There is an abundance of superior clinicians making their way into the home health setting. OCS, GCS, and NCS clinicians, traditionally found in outpatient or acute/subacute care are migrating to home health with increasing frequency. Maybe it is the challenge, the excitement of a growing field, the money or the freedom. Whatever it is, clinicians are making a change in their lives and giving home health a try. Maybe this year is the right time for you to do the same. Stephen Stockhausen is a doctor of physical therapy, a traveler, and a founder of PT Adventures—a blog created with his wife Ellen to help travel PTs take control of their career and live their dreams. You can find Stephen and Ellen exploring the country with their daughter, Kinley, and two dogs Cayenne and Layla.
Traveler Tips: Is The PT Compact License Worth It For Travel PT?
By Stephen Stockhausen, PT, DPT, OCS, Contributing Writer, Founder of PT Adventures Having the freedom to take different jobs in various parts of the country is by far the best, and the most obvious, perk of being a travel physical therapist. But it comes at a cost of the occasionally arduous task of obtaining a new state license. There are the jurisprudence exam, state license fee, FSBPT test score verification fee, and license verification letters—with subsequent fees that need to be sent to any state you have ever held a license. Whew! That’s exhausting just to type out let alone piece together and mail off. Oh, and then you have to wait anywhere from two to six months to find out if you’re new license has been granted or not. But fear not—the Physical Therapy Compact license is designed to fix all of that! In case you haven’t heard about the Physical Therapy Compact license here is a quick summary. Enacted in 2017, the Physical Therapy Compact Commission was created to provide a vehicle for improved interstate license accessibility while maintaining the safety of the public consumer as set forth by each state’s practice act, according to their website. The PT Compact Commission has since built up an impressive list of 21 states willing to recognize the validity of physical therapist and physical therapist assistant licenses from other participating states. The first privileges were then officially granted in July of 2018. While all 21 states have passed legislation to be members, not all states are currently issuing compact license privileges at this time and are still resolving internal issues—or just dragging their feet. At the time of this writing, nine states are active participants in the compact license process, with more joining every month! Pros and Cons of the Physical Therapy Compact License for travelers Pros: Therapy privileges can be granted in minutes rather than months Once you take the jurisprudence exam for your new state—often completed online—and pay the necessary fees, you are eligible to begin working in the new state Low Fees The fees involved with the new PT Compact are very minimal compared to sending out license verification fees for each state you have ever had a license. $45 goes to the PT Compact Commission, and then each state has their own fee. Most range from $45-60, with the exception of Mississippi at $150. (Come on, Mississippi!) One set of Continuing Education Units (CEUs) to manage Since you do not have a full state license in every state that you obtain privileges for, you do not have to maintain their Continuing Education Units. The only set of CEUs that you absolutely must follow is that of your home state. Gone are the headache-inducing hours of cross-checking CEU dates with license expiration dates! Renewal This is one of the coolest aspects of the Compact system. 60 days before your home license expires they will email you a reminder. Once you renew your license at home, the Compact will automatically notify you that you are eligible to renew your Compact privileges as well, typically within a week. Responsive Admin Team When I was doing research for this article, I had a few questions that I could not find on their website. Opting to call instead of email, I was quickly connected with the lead administrator who thoroughly answered my questions and was exceedingly friendly. This was a pleasant surprise compared to the typical experience I have come to expect when dealing with licensing staff at the various states I have worked. Telehealth? While not entirely applicable to the traveler, based on the language written into the Compact it appears that Compact privileges can also be used to treat remotely via telehealth. In a burgeoning field, this is super exciting news! Especially for the therapist looking to mix in some patient care in a state where they previously worked as a traveler or will soon work as a traveler. Instead of being limited to one license per job, multiple licenses can be utilized all at once depending on the patient’s location, independent of where the PT is located. Cons: Few states fully participating Obviously, if your home state is not a participant you are fully excluded from the entire process… bummer. For those of you who are fortunate enough to have a home state proactive enough to join up, your options for states to travel to may be slim pickings. Currently, only nine states are fully active. On the positive side they are some pretty cool states. Oregon, Utah, New Hampshire and North Dakota all have some great outdoor experiences. Texas Tennessee, Missouri and Mississippi all have some killer food and Southern hospitality. As for Iowa…well, Field of Dreams is there. That’s something! There are 11 other states on the doorstep to full participation so check the site often to see if your home state or dream location is up and running. When you renew your home license you have to renew ALL of your Compact Privileges This will negatively impact folks living in a home state that requires yearly license renewal. These therapists will now have to pay all of the Compact fees again as well as fees to the state where they are working. Now, compared to paying all of the other fees typically involved in maintaining multiple licenses, this could still end up saving you money, but you will have to do the math on your specific situation to be sure. Overall the PT Compact License is—or is going to be—a huge improvement in the logistics of being a travel therapist, especially if more states get involved. If every state were to join the Compact, it would mean one license to worry about, one set of CEUs, and only paying fees to the states where you are actively working. Stephen Stockhausen is a doctor of physical therapy, a traveler, and a founder of PT Adventures—a blog created with his wife Ellen to help travel PTs take control of
Travel Healthcare As A Pair: Getting Creative When The Market is Tricky
By Alex McCoy, Contributing Writer, Owner of Fit Travel Life My husband Keaton and I are lucky enough that we both have careers that allow us to travel as a pair. I am a registered nurse and he is a physical therapist, so we are both able to work 13-week contracts throughout the country. We have been doing this for about 18 months and have managed to find contracts together about half of the time we have traveled. Even if you don’t have a spouse who can travel, many people choose to travel with a friend who is also a travel nurse. Not only does this help with loneliness on the road, but it cuts back on the cost of living and some of the work that has to be done when you move to each assignment. If you travel as a pair it can be a little trickier to find jobs that work for both of you at the same time in the same area. In the past 18 months, we have gotten a little creative, but we have managed to make it work and have some great ideas for anyone else looking to travel as a pair. Look for jobs in larger metropolitan areas. While some rural assignments offer big money based on location, the job concentration will be much lower. We have had much better luck if one person takes a job in a big city and then the second person works on finding something in that area. Plus, jobs are more likely to pop up for later start dates throughout the duration of the first person’s contract (more on that later). Be willing to have a longer commute. Many large metropolitan cities come with the price of heavier traffic. Keaton and I have each had to commute up to 1 hour each way to find contracts in a similar area. Whether it is heavy traffic or long distance, commute time could very well be an issue you have come up when trying to find jobs in the same location. Have a plan for if one person’s contract falls through. We always pick our housing based on one person’s income. Because contract cancellations are an unfortunate part of working as a traveler, we want to know we can survive even if one of us gets cut from a job. Similarly, if you travel with a friend, make sure and have a plan or a good chunk of savings in case you lose your job while on location. Look for start dates no more than 3-4 weeks out. A few times one of us has jumped on a great-paying contract early only to find the market drying up for the other person. The travel market is so hard to predict, so you may not be able to guarantee jobs for both individuals if you look too far in advance. For example, the Phoenix market was great back in the fall, but by the time we got here in the winter, physical therapy jobs for my husband had dried up and he has had to get a little creative with finding work. Which brings me to my next point… Don’t be afraid to think outside the box for jobs. Even if you can’t find a contract, that doesn’t mean there aren’t facilities in need nearby. I was able to sign up for per diem flu shot clinics in Georgia, and my husband found a per diem agency locally in Phoenix. Many hospitals choose to use local agencies first, so you may have luck reaching out to them directly once you are in town. Some places will even hire you directly knowing you’re short term because ultimately it saves them more money than hiring a traveler through a company. While traveling with a friend or spouse may take a little more leg work, it sure is nice when you get hit with a little bit of homesickness or loneliness. Knowing you have a roommate or companion to lean on is always a great source of comfort when dealing with the stress of changing jobs and adjusting to a new floor. Be sure to be open and honest with your recruiter about your goals are if you are traveling as a pair. It is even more beneficial if you share a recruiter, but for many companies that won’t be possible if you are different professions or specialties. Also, keep in mind my previous advice about working with more than one company, as it will be especially helpful if you need to try and match specific locations with your travel partner. Alex McCoy currently works as a pediatric travel nurse. She has a passion for health and fitness, which led her to start Fit Travel Life in 2016. She travels with her husband, their cat Autumn and their dog, Summer. Alex enjoys hiking, lifting weights, and trying the best local coffee and wine.
5 Things They Don’t Tell You About Travel Nursing
By Alex McCoy, Contributing Writer, Owner of Fit Travel Life Now that the new year is officially in full swing there are a lot of people evaluating their life. Where do I want to be in five years? Am I working in a career that I love? What if now is the best time to take that leap I have been considering for a while? If you have been considering working in travel nursing for any amount of time I want to preface by saying I highly recommend this career path. My experience as a whole has been positive and to anyone considering travel nursing, I would say go for it. However, as with any positive thing, there are the inevitable negative aspects that come along with it. Getting into the travel nursing world can be daunting, and being unprepared is the worst thing you can do if you want to enjoy your work as a traveler. I feel that being upfront and honest about some of the common struggles travelers face is the best way for new travelers to be prepared to manage these stressors as they come along. Here are the top five downsides to traveling that I feel all travel nursing newbies should be prepared for: 1. There is a lot of behind the scenes work to get started in travel nursing. Before you can even submit to jobs, you must have references and an updated resume ready to go. In addition, you have to have licenses on hand, locations in mind and have a baseline idea of housing costs before you actually apply. Once you have secured a position, there is usually at least a few hours of credentialing and paperwork to complete. This includes visiting a walk-in clinic for drug screens, updated labs and submitting proof of all prior vaccinations and licenses. 2. There will be upfront expenses before you get your first travel nursing paycheck. Most travel nursing contracts include a form of travel reimbursement—on the first check, that is. This means if you move in the Sunday before a Monday start day, you will not actually receive your first housing stipend or travel money until about 12 days later. Some costs to consider at the start of each assignment include first month’s rent, pet deposits, and travel expenses on the way there. I have had to pay close to $3,000 before actually starting work, so planning ahead for this is key. 3. Each state has different renewal requirements you have to monitor. To make yourself more valuable as a travel nurse you will want more than one state license. If your home is in a compact state this is great, but a lot of the destination states are not part of the compact (Hawaii and Alaska in particular). After the leg work of getting the license is complete, you then have to maintain said license. Each state has different guidelines and fees for renewals and you will have to check the individual boards to make sure you stay on top of these. 4. Loneliness is a real problem in travel nursing. A more obvious downside to travel nursing is lack of in-person connections in each area you live. You may make friends on assignment but there is always an awkward period at the beginning where you don’t necessarily have people to hang out with outside of work. While there are many ways to combat this loneliness, it is also helpful to be aware of it so you can meet it head-on. This is a normal feeling and it is okay to be lonely, but have some plans in place to deal with these emotions. Call a friend, go to a workout class, or just go for a walk if you are feeling especially down about a lack of personal interactions. 5. If you decide to switch companies, all of that hard work has to be done a second time. Working with multiple companies is almost inevitable in travel nursing, but that doesn’t mean it is easy to coordinate. Each time you decide to submit for a contract with a company you haven’t worked with, you will have to re-submit your resumes, references and paperwork. The best way to handle this is to get organized at the start. Keep a folder of all your personal identification, license copies, and vaccination records. In the event that you have a company pay for a vaccine, TB test or physical, always request copies of these records in case you work with a different company for your next contract. By keeping your files up to date you can simply send all of your paperwork over in a matter of a few clicks each time you need to establish a contract with a new company. This can all be a bit of a downer, but I would not change my choice to work in travel nursing for anything. The people I have met and the experiences that came as a result of this career are without a doubt worth all of the extra work and planning. By being prepared and knowing what to expect you can have a more positive experience as a traveler and minimize the anxiety that comes along with this career. Expect the unexpected, plan for bumps in the road, and just be thankful when you don’t have to make use of those plans when everything goes smoothly. Alex McCoy currently works as a pediatric travel nurse. She has a passion for health and fitness, which led her to start Fit Travel Life in 2016. She travels with her husband, their cat Autumn and their dog, Summer. Alex enjoys hiking, lifting weights, and trying the best local coffee and wine.
Healthcare Is Where The Jobs Are. But What Kind Of Jobs? (KHN)
By Rachel Bluth, Kaiser Health News More Americans are now employed in healthcare than in any other industry. The Bureau of Labor Statistics, which tallies job creation, says that for most of this year the health sector outpaced the retail industry. Only government, on all levels, employs more people. One of the consistent features of the BLS reports is that healthcare has reliably added thousands of jobs to the economy each month. November was no different. The healthcare industry created 32,000 jobs, adding to the 328,000 healthcare positions created since early 2017. But what kinds of jobs? Were they highly paid doctors and hospital executives or were they positions on the other end of the pay scale, such as nursing home aides and the people who enter data for billing in hospitals and clinics? It’s hard to know for sure, because the BLS monthly data measure industries not occupations and what information it does have on occupations is overly broad. For instance, it says hospitals accounted for about 13,000 jobs in November. Another 19,000 jobs were for “ambulatory” care, which is a broad term for services delivered outside of hospital systems, like in clinics and private doctors’ offices. But another set of BLS data offers additional insights. Every two years, BLS puts out a wonky set of numbers called “industry-occupation matrices,” which more finely slices job categories and predicts which will grow or shrink over the next 10 years. The most recent, from 2016, still provides a pretty accurate snapshot, according to Joanne Spetz, a professor at the University of California-San Francisco’s Institute for Health Policy Studies. Registered nurses are the fastest-growing occupation. They account for more than 25 percent of jobs in hospitals. If that share remained the same last month, 3,289 of the new hospital jobs added in November went to RNs. [protected-iframe id=”afd374bef04176b4120013d3f73733ab-7618883-99279322″ info=”//datawrapper.dwcdn.net/XoirU/5/” width=”100%” height=”500″ frameborder=”0″ scrolling=”no”] It’s likely that many of the hospital jobs went to medical assistants, who currently make up only 1.5 percent of the industry. Medical assistants are usually the people taking your vitals and helping the doctor take notes. The BLS expects about a 16 percent increase in these jobs in the next decade. “There will be a fair amount of growth in physician and surgeon employment in the next decade, but so many more medical assistants than physicians,” Spetz said. The national median pay of a registered nurse is $70,000 a year, according to more BLS data. For medical assistants, it is $32,480. Doctors’ median pay is more than $200,000. Far more of those medical assistants found work outside the hospital in the ambulatory sector: almost 1,300. There is also a good chance that in these ambulatory settings many of the newly created jobs were filled by non-medical staff. As of 2016, fewer than 30 percent of staff in ambulatory settings were workers whom Spetz calls “paper pushers.” If the trend held up, around 5,700 of the hires in November, or 30 percent of ambulatory jobs, fall into these categories. These jobs can pay as much as medical assistants. The BLS says the median income of “medical record and health information technicians” is about $39,000 a year. BLS is predicting around a 20 percent increase in “information and record clerks” and another 22 percent increase in “secretaries and administrative assistants.” But the idea that hospitals and doctors’ offices are hiring only lower-paid support staff might be overblown. The BLS figures “healthcare practitioners and technical occupations” still make up more than 37 percent of the ambulatory industry, and “health diagnosing and treating practitioners” are almost 23 percent. So nearly 70 percent of ambulatory hires last month were probably physicians or other skilled professionals like registered nurses, licensed practical nurses, social workers and personal care aides. “What we have seen over the past couple years is with the job growth in health it is not dominated by back office,” said Ani Turner, an economist who focuses on health sector labor trends with Altarum, a nonprofit health research and consulting organization. Another thing hiding in the numbers? A dissipating distinction between ambulatory and hospital care. Traditionally, hospital jobs were pretty straightforward; they referred to the doctors, nurses and support staff who worked in hospitals. But as business models shift, more care is given outside of hospital walls, something not reflected in employment numbers that split health into two distinct categories. Employees who staff the clinics, surgery centers, labs and imaging centers run by hospitals are counted as hospital staff, Turner said, though they work in outpatient settings. So those 13,000 new hospital jobs the BLS cited last month may not reflect real-world trends about where hiring happens. “Whether in physicians’ offices, free-standing clinics or hospital outpatient clinics, you’ll see it as the two separate settings, but the same trend,” Turner said. This story originally appeared on Kaiser Health News. Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.
Virginia Medicaid Expansion Enrollment Exceeds Projections
State officials had estimated 300,000 newly eligible Virginians would sign up for Medicaid coverage in the first 18 months of expansion, which takes effect on Jan. 1, but that estimate has increased based on the current pace of enrollment. As of Thursday morning, 140,643 adults now eligible for coverage under the expansion have enrolled in Medicaid, said Christina Nuckols, a media relations manager with the Virginia Department of Medical Assistance Service. State officials updated their estimate to 375,000 total enrollments by July 2020. That’s still 25,000 short of the 400,000 estimated Virginians who fall within the coverage requirements. Under the Affordable Care Act, states that expand Medicaid allow coverage for people with incomes up to 138 percent of the federal poverty level, which is $16,750 a year for a disabled person or able-bodied adult and $28,700 for a family of three. Virginia residents, find out eligibility requirements and how to enroll in Medicaid here >> A combination of automatic enrollments and streamlined enrollment processes for residents the state already knew were eligible—like those who receive Supplemental Nutrition Assistance Program benefits—are some of the reasons why the pace of signups have exceeded expectations, according to a Washington Post report. As part of the expansion, the federal government is expected to cover 90 percent of the cost of the program, to the tune of $2 billion annually. Virginia will foot its portion of the expansion costs through two new hospital taxes, which are expected to raise $590 million in two years, $248 million of which will be used to boost the reibursment rate for acute care facilities that treat Medicaid patients. The impact on travel healthcare in Virginia Even with less than one month until thousands of new potential low-income patients gain insurance coverage, Virginia hospitals are more worried about handling current needs than worrying about future patient loads, said Imran Chaudry, a senior client advisor for LiquidAgents Healthcare. “In the Richmond area, I can tell you from the feedback I’ve gotten that every hospital is still slammed,” Chaudry said. “I’ve tried talking to all of my…clients about the Medicaid expansion, but nobody is talking about that because they are so wrapped up in their day-to-day.” Job orders for travelers in the state have increased significantly since the start of November, Chaundry said, from around 100 positions to almost 200 open positions as of Dec. 5. Most of the market growth has occurred in the northeast and eastern portions of the state, around the greater Richmond region, Chaundry said. View current Virginia travel healthcare openings on StaffDNA >> Bon Secours Health System, the largest healthcare provider in the Richmond region, merged with Cincinnati-based Mercy Health in September. The merger is expected to boost services for Bon Secours in three markets including the Hampton Roads Health system near the state’s coast, according to a Modern Healthcare report. Both the Richmond region and the Hampton Roads region serve large populations of low-income residents, which could result in a wave of demand for travelers once newly covered Medicaid patients gain coverage in January. Studies have shown that low-income populations prefer using hospital emergency departments instead of primary care doctors for their around-the-clock availability and ease of use.
Missouri Travel Nurse Needs Remain High In Wake Of Slow Flu Season
Missouri travel nurse needs have remained at a significantly high number throughout November and the first week of December, according to current market data. More than 140 travel nurse needs are active in the state, most of which are newer positions located in or around the St. Louis region, said Jennifer Pomietlo, a director of client advisory for LiquidAgents Healthcare. That includes cities like St. Charles, Chesterfield and Columbia. The most-needed specialties include medical-surgical, telemetry, ICU, step-down and OR nurses, with limited openings for other non-core or surgical specialties, Pomietlo said. Allied healthcare travel positions are also fairly limited, but certified surgical tech and rad tech opportunities are available. Contact Allie Evans with LiquidAgents Healthcare for more information about Missouri travel nurse jobs >> Flu is the main driver for hiring in the state, Pomietlo said. Normally, Missouri hospitals will aggressively hire in early fall because the state is one of a handful that typically see high levels of flu activity starting in November, according to Centers for Disease Control and Prevention records. This year’s flu season is off to a slower start for the state, with “minimal” influenza-like illness activity and sporadic spread, according to CDC data. A total of one death and 1,384 laboratory-positive influenza cases have been reported as of Nov. 24 to the Missouri Department of Health and Senior Services (DHSS). More than 300 cases were reported from the eastern region of the state, where St. Louis is located. Missouri hospitals are hiring in December in anticipation of a delayed surge in flu patient census in January and February, Pomietlo said. “They get hit hard by the flu in St. Louis, and it also hangs around longer in Missouri than in other places,” Pomietlo said. In the record-breaking 2017-18 flu season, Missouri reported 133,957 laboratory-confirmed cases of flu and more than 2,000 pneumonia and influenza-associated deaths, according to a DHSS press release. Other things travelers should know about Missouri Missouri is one of the 31 states that are part of the enhanced Nursing Licensure Compact, meaning nurses who have a compact license can work in the state without paying additional licensing fees. Travelers who don’t have a compact license can get a single state license at a low cost. The state board charges $55 for a license by endorsement or $45 by examination. Missouri is also a walk-through state, so nurses can get a temporary license within a day. You can find more Missouri licensing information on the state nursing board website.
Travel Healthcare Market: Openings, Competition High For Colorado Winter Jobs
A lot of healthcare travelers like to fly south for the winter, but there are still plenty who are looking for cold temperatures, snowy climates or a quick-start position with extension potential. For those reasons, Colorado has been a highly desired winter assignment destination in previous years, and 2018 is no exception. Agencies are seeing triple-digit needs for travel nurses and surgical techs across a wide variety of specializations, according to market data provided by Tailored Healthcare Staffing and LiquidAgents Healthcare. “Most of [the hospitals] are looking for nurses to start within a couple of weeks,” senior recruiting team lead Shelbie Summers at Tailored Healthcare Staffing said. “No pre-books for January starts as of yet.” Contact Shelbie Summers at Tailored Healthcare Staffing >> Geographically, most of the jobs are located in or within a one to two-hour drive distance from Denver, the state’s capital. This includes popular tourist cities like Boulder and Pueblo close to the Rocky Mountain range The most in-demand and higher paying specialties are for surgical positions which include OR, PACU and OR certified surgical techs, said Jamison Reitinger, a client advisor for LiquidAgents Healthcare. This falls in line with typical market trends, as more elective surgeries are scheduled near the end of the year in the U.S. Openings for more common specialties like medical-surgical, telemetry, ER and ICU are available, but pay is on the lower end for these positions, ranging from $1,200-1,300 weekly gross. PACU is significantly higher with bill rates at or near $90, which can translate to more than $2,000 weekly gross depending on the agency. Contact Jamison Reitinger at LiquidAgents Healthcare >> Competition is quite high for Colorado positions currently, with at least 15 to 20 submittals for core specialties (medical-surgical, telemetry, ER, OR and ICU) and 10 to 15 for less popular specialties, Reitinger said. Part of the competition is caused by nurses looking for a great winter vacation spot during the snowy season, Summers said. “There are a lot of nurses who enjoy traveling to Colorado this time of the year, so you may not see the same opening if you wait too long to submit for a position,” Summers said. Here are a few other things for travelers to consider before applying to work in The Centennial State. Colorado is part of the Nursing Licensure Compact Colorado joined the enhanced Nursing Licensure Compact this year, so travel nurses with compact licenses can work in the state with no wait and no extra licensing fees. For non-compact license holders, you can still apply for a temporary single-state license, but be aware it can take 10-14 business days to process. For RNs—prepare for a (potential) Prophecy exam “Quite a few CO hospitals require that you take a Prophecy exam before being submitted to the position, so be prepared to pass your core Prophecy testing,” Summers said. For surgical techs—get your Department of Regulatory Agencies (DORA) certification Colorado is unique in that surgical technologists must get their DORA certification before submitting to any jobs, Reitinger said. This will involve a fingerprint background check with the Colorado Bureau of Investigation. You can apply for a DORA certification by clicking here: https://www.colorado.gov/pacific/dora/dpo Expect good snowfall this year According to weather data from the NOAA, Colorado residents should expect to see above average precipitation totals and average temperatures, especially for those in the Southeast region of the state.
Midterm Election Boosts Medicaid Expansion, But Challenges Remain
By Phil Galewitz, Kaiser Health News Medicaid — which has been a political football between Washington and state capitols during the past decade — scored big in Tuesday’s election. Following the vote, nearly 500,000 uninsured adults in five states are poised to gain Medicaid coverage under the Affordable Care Act, advocates estimate. Three deep-red states passed ballot measures expanding their programs and two other states elected governors who have said they will accept expansion bills from their legislatures. Supporters were so excited by the victories they said they will start planning for more voter referendums in 2020. Medicaid proponents also were celebrating the Democrats’ takeover of the House, which would impede any Republican efforts to repeal the ACA and make major cuts to the federal-state health insurance program for low-income people. “Tuesday was huge for the Medicaid program,” said Katherine Howitt, associate director of policy at Community Catalyst, a Boston-based advocacy group. “The overall message is that the electorate does not see this as a Democrat or GOP issue but as an issue of basic fairness, access to care and pocketbook issue. Medicaid is working and is something Americans want to protect.” But health experts caution that GOP opposition won’t fade away. David Jones, an assistant professor in the Department of Health Law, Policy and Management at Boston University, said ballot organizers now have a blueprint on how to expand Medicaid in states that have resisted. “I see this as a turning point in ACA politics,” he said. Still, he added‚ “it’s not inevitable.” Medicaid is the largest government health program, insuring at least 73 million low-income Americans. Half of them are children. To date, 32 states and the District of Columbia have expanded it under the ACA. Before that law, Medicaid was generally limited to children, sometimes their parents, pregnant women and people with disabilities. The ACA encouraged states to open the program to all Americans earning up to 138 percent of the poverty level ($16,753 for an individual in 2018). The federal government is paying the bulk of the cost: 94 percent this year, but gradually dropping to 90 percent in 2020. States pay the rest. GOP opposition has left about 4.2 million low-income Americans without coverage in various states. “It’s not over until it’s over is the story of Medicaid expansion and the Affordable Care Act as the politics never ends and the opportunity for obstruction never ends,” said Jones. “But the trend overall has been to increasing implementation and increasing coverage.” Montana Fails To Endorse Funding Two years after President Donald Trump carried Idaho, Nebraska and Utah by double-digit margins with a message that included repeal of the ACA, voters in those states approved the ballot referendums Tuesday. Together, the states have about 300,000 uninsured adults who would be eligible for the program. In addition, Democrats secured the governor’s offices in Kansas and Maine, which will increase the likelihood those states pursue expansion. Legislatures in both states have previously voted to expand, only to have GOP governors block the bills. Maine voters also passed a referendum in 2017 endorsing expansion, but Republican Gov. Paul LePage again refused to accept it. Current and incoming Republican governors in Utah and Idaho said they wouldn’t block implementation of the effort if voters approved it. Nebraska Gov. Pete Ricketts said Wednesday he would follow the will of the voters but would not support paying for it with a tax increase. It wasn’t a clean sweep, however, for Medicaid on Tuesday. In preliminary results, a ballot issue to fund Montana’s Medicaid expansion — which is already in place and slated to expire next July — was failing. Tobacco companies had mounted a campaign to stop the measure, which would have partially financed the expansion with taxes on tobacco products. The Montana legislature and the Democratic governor are expected to address the issue in the session that starts in January. No state has reversed its Medicaid expansion, even though GOP governors in Kansas and Arkansas have threatened to do so. Nearly 100,000 Montana residents have received Medicaid since its expansion, twice as many as expected. Nancy Ballance, the Republican chairwoman of the Montana House Appropriations Committee who opposed the bill that expanded Medicaid in 2015, said she is confident the state legislature will extend the program past July. But she expects the legislature to put some limits on the program, such as adding an asset test and work requirements. “There are some people in the state who may not have disabilities but need some help to access coverage,” she said. “I think we can pass something without people having a gap in coverage. … That will be a priority.” “It was never our intent to simply sunset the expansion and have it go away,” she said. Rather, the legislature put the sunset provision in to revisit the provision to make any changes. Chris Jacobs, a conservative health policy analyst in Washington, D.C., said the Montana results showed that when voters are given a choice of having to pay for Medicaid expansion through a new tax they were not willing to go along. But in Utah, voters did agree to fund their state plan by adding 0.15 percent to the state’s sales tax, just over a penny for a $10 purchase. Fernando Wilson, acting director of the Center for Health Policy at the University of Nebraska Medical Center, said the vote on the state’s ballot question indicated many people wanted to help 80,000 uninsured Nebraskans gain coverage. “I think it showed there was a clear need for it,” he said. The legislature likely won’t block the expansion, Wilson said, though it may try to add a conservative twist such as adding premiums or other steps. Sheila Burke, a lecturer in health policy at Harvard Kennedy School, said voters approved Medicaid expansion not just because it would help improve health coverage for their residents but to help stabilize their hospitals, particularly those in rural areas. Hospitals have said this step helps their bottom
Travel Jobs: Where Travelers Applied In Oct., Nov. Market Predictions
November can be a bit of an odd duck month for the travel healthcare job market. As the last month before the busiest season of the year in terms of patient census, many healthcare facilities are still trying to fill jobs needs with temporary staff. Many states still have job opportunities in the triple digits as of Nov. 13. At the same time, many travelers who were job hunting in September and October are either committed to jobs with November start dates or have pre-booked for late-December or early-January to have free time during the holidays. Travel healthcare jobs November 2018 Based on current job market data and information from staffing agency recruiters and sales representatives, we expect a slight increase in the volume of available job opportunities, but the amount of application activity should remain relatively flat. In other words, the amount travelers applying to jobs is already quite high—with dozens of submittals for competitive positions—and should stay high throughout most of the month. A good portion of the job market volume increase will come from northern and cold weather states, like Oregon, Michigan, Colorado and Wisconsin. Hospitals in these states will need to fill vacancies left by “snowbird” travelers heading south, said Jamison Reitinger, a client advisor for LiquidAgents Healthcare. “Bill rates are remaining consistently high in northern territories, except OR-RN rates, which are increasing across the board due to large OR nurse shortages in Wisconsin, Michigan and Colorado,” Reitinger said. There has also been a notable increase in travel nurse jobs available in the Southeast U.S., mostly in Kentucky, Tennessee and West Virginia. A large part of the increase is due to the recent surge in EMR conversion positions available in Kentucky and West Virginia through Appalachian Regional Healthcare. The healthcare system started advertising temporary staffing needs for their hospital in late October and will need travelers through the rest of the year and into 2019, so we expect these states to see more incoming applications from travelers in November. Depending on the severity of this year’s flu season, job market activity could also increase in Southern states like Missouri, Mississippi, Alabama and Arkansas, as those states typically see high levels of flu activity earlier than others. No major changes in the Top 10 most applied-to states The most popular states for travelers—California, Florida and Texas—retained their top spots in October, and should continue to see high application numbers for the rest of the year. South Carolina was the only new state to enter the top 10, moving up from No. 12. Georgia fell out, dropping seven ranks to No. 12. Utah makes the largest jump, Connecticut drops the farthest Utah saw the biggest surge in traveler applications by far, moving up 18 positions to No. 33 on the list. Connecticut dropped 12 spots to No. 46 October’s Top Markets California Florida Texas Michigan Tennessee North Carolina Missouri Pennsylvania Arizona South Carolina Virginia Georgia Indiana Kentucky Oklahoma Arkansas Maine Iowa Idaho Wisconsin West Virginia New Mexico Nevada Oregon Colorado Hawaii Ohio Washington Massachusetts New Jersey Illinois Louisiana Utah Alaska Minnesota Alabama Montana Kansas Maryland Mississippi New Hampshire North Dakota Nebraska Rhode Island Wyoming Connecticut Washington, D.C. Delaware New York South Dakota Vermont Editor’s note: This list is created by analyzing the number of travelers applying for jobs in these individual states and Washington D.C. Is not necessarily an indicator of traveler interest in these states and is not necessarily an indicator of job volume. Application data comes from the StaffDNA jobs database.