Maui has long faced hospital staffing shortages and the lack of affordable housing options has worsened the problem, according to medical representatives who spoke with Spectrum News Hawaii.
While hospitals have staffing shortages throughout the state of Hawaii and the country, the problem on Maui has become more pronounced as housing prices have skyrocketed.
“More challenging for Hawaii than other states is the high cost of living,” Maui Health Communications Director Tracy Dallarda told Spectrum News Hawaii. “Housing is expensive.”
Dallarda said this was a problem even for the highest paid positions, such as physicians.
“There is difficulty recruiting physicians, and that is mainly because the cost of living is so high in Hawaii and the availability of affordable housing is limited,” said Dallarda.
The median home price on Maui rose to a record $1,160,000 in the beginning of 2022, according to the Realtors Association of Maui.
Maui Health includes Maui Memorial Medical Center in Wailuku, which is the only acute care hospital on Maui, an outpatient clinic in Wailuku, a hospital and clinic in Kula, and the Lanai Community Hospital in Lanai City. In total, Maui Health employs 1,600 employees and has nearly 300 job openings.
Dallarda said Maui Health is currently working to fill physician and nursing positions. She said they also have non-clinical roles open in their business office and other support services.
Hana Health Executive Director Cheryl Vasconcellos told Spectrum News Hawaii in a phone interview that just like Maui Health, the largest hurdle her hospital faces in filling job openings is the lack of affordable housing.
Hana Health is a nonprofit health center that has a small staff of about 12, and Vasconcellos said they are hoping to hire an additional physician, two nurses and three medical assistants. She said they have been trying to fill the vacant physician role for several years.
“We were having serious issues around housing, and there is absolutely no housing available in Hana. When I’m recruiting for providers, or nurses, or anybody for that matter, if they are coming from outside of the area, there is no place to house them,” said Vasconcellos. “Everything is just through the roof in terms of pricing.”
In Hana, the median home price is currently at $2,800,000.
Vasconcellos said in Hana affordable housing is an issue, but finding any housing at all is also a problem as there are very few homes for sale.
To help remedy the problem, Hana Health bought a home about a year ago to house an employee and their family. She acknowledged it was an innovative idea, but said “it’s far too expensive for us. We could not continue to do that for everybody who wants to relocate here.”
Hana Health is now looking to develop affordable housing, which they could rent to employees, on land they lease from the state, according to Vasconcellos.
“We have a property to do it and we’re trying to secure some funding to at least get the initial construction documents put together,” said Vasconcellos.
Vasconcellos also said the remote geography of Hana isn’t for everybody.
“It’s a problem throughout the state, but the geography really impacts us in terms of recruitment and retention of all positions,” said Vasconcellos. “We’ve always had difficulty out here, because not everybody wants to live a rural lifestyle.”
While she highlighted the appeal of Hana’s beauty, she said Hana lacks some services and amenities. She said it is especially difficult for families who have spouses or adult children who can’t find work or go to college in the area.
Burnout in hospital staffs
Dallarda with Maui Health said the nursing shortage preceded the coronavirus pandemic, but that since it started, it has put more strain on the health care system and caused health care workers to burnout. She said some have left the hospital environment, retiring, opting for jobs where they can work from home or choosing not to work.
“Working in health care is demanding and these last two years have put a tremendous strain on all of us,” said Marian Horikawa-Barth, Chief Nurse Executive for Maui Health, in an email.
The Federal Emergency Management Agency brought nurses into the state during the pandemic to assist with COVID-19 patient care, but their help is not a long-term solution, according to Dallarda. She said the nursing shortage is expected to continue until 2030.
In August 2021 while the COVID-19 delta variant was spreading, Maui Health mandated vaccines for all employees.
“Very few have chosen to leave because of the vaccine mandate — less than ten out of over 1,600 employees,” said Dallarda.
Vasconcellos with Hana Health said the pandemic has had little to no impact on their staffing shortage, as the small rural population they assist has not dealt with large numbers of COVID-19 cases.
Still, she said the staffing shortage causes employees at Hana Health to feel stretched thin.
“It can get intense, especially when staff become ill and we're running short,” said Vasconcellos.
Since workers at Hana Health are experiencing burnout, Vasconcellos said they are running a pilot program with four-day work weeks, where employees work 32-hours but get paid as if they are working 40-hour weeks.
Vasconcellos said the pilot program is meant “to help people have a little more balance in their life and be able to have longer periods of time away from work to regroup and recover.” She said Hana Health hopes to evaluate results from the program at the end of March. If they deem the program a success, then they will expand it.
Other solutions to the staffing shortage
In order to fill roles at Maui Health, a career fair was held in February to entice new recruits. Lanai Community Hospital, which is part of Maui Health, will have a career fair on March 12.
Maui Health has also been partnering with the University of Hawaii’s Maui College since 2017, hiring over 100 new nursing graduates during that time.
“We prefer to hire people from Maui to take care of the people of Maui, which is why we partner with … Maui College and hire all of the nursing graduates,” said Maui Health CEO Michael Rembis in an email to Spectrum News Hawaii.
Vasconcellos with Hana Health said there are a limited number of nursing candidates that can enroll at Maui College every year. Spectrum News reached out to Maui College’s nursing program for information about their enrollment numbers, but did not hear back immediately.
“Even with significant interest in the profession, there's not enough educational opportunity for people to get into college and get into the nursing program,” said Vasconcellos.
To remedy the issue, Vasconcellos said Hana Health is interested in financially supporting local residents who would like to go to nursing school if they make a commitment to come back to Hana to work. She said they are also looking into being a training site.
According to Dallarda, Maui Health has training programs for entry-level positions, such as a paid-training program for nurse’s aides. They also offer tuition reimbursement for unpaid training programs.
“We are working hard to help our talented Maui residents find the right career fit within health care,” said Horikawa-Barth, the chief nurse.